A Bizarre Morning in Radiology
It's a cold, dark Canberra morning, and I am to have surgery to remove a breast lump. The alarm goes off at 5.30, but I'm already dressed, I've been awake for half the night. We creep around the house, the grandchildren are still asleep. A cup of tea would be comforting, but I can't have one - nil by mouth.
I drive myself - controlling small things seems more than usually important. D. is quiet, probably still in a state of shock; this has all happened very quickly.
When we get to the hospital, there is the admissions procedure to go through - paying the excess on my insurance, reciting my name and date of birth several times, and signing away my right to privacy. But then before I can go through to the waiting room, I am to have another procedure, a medical one. The surgeon has told me about this. It's called a 'hook-wire insertion', and involves inserting a thin wire into the breast with a needle under local anaesthetic to mark the exact spot which needs to be excised - a spot already marked by a metal clip which was inserted when I had the biopsy several days ago, ('Don't worry, it doesn't set the airport XRay machines off!') I am not looking forward to it.
The procedure is done while the breast is clamped in the mammogram machine. The radiologist, a nice man with very clear diction, crouches in front of me while he explains exactly what he is going to do. His description is detailed and factual. The wire has to hit the exact spot, the breast must be positioned just right, it is a fiddly procedure with 'a certain amount of discomfort.' Am I ready?
Ready? This is a philosophical question that requires much more time to answer than I have. What would constitute NOT being ready? What preparations could I do that I haven't done yet? It is a rehearsal. I know I will never be ready for the final moment, even if I were to go through a thousand procedures. Time pulls you inexorably forwards, that's all.
The nurses begin hauling my breast about, clamping and unclamping, changing the position, taking pictures, dozens of them. At last they seem satisfied. The radiologist gives me the local anaesthetic, which is so surprisingly painful despite my most lurid expectations of pain, that a little cry escapes me.
'That's the worst part over,' one of the nurses says. None of us know how wrong she is.
I stare out of the window, and think about people who have had far far worse things done to them, and suffered infinitely more than me. I think about the 'discomfort' as I feel the radiologist getting on with it - and I have a few interesting moments of detachment, as if I seem to experience it as if it's happening to someone else. After an unknown time, but perhaps fifteen minutes, someone says , 'that's it!' cheerfully, and unclamps me. I'm left on a low stool by the machine in my shapeless white gown. I feel very cold. I turn and look at them, the two nurses and the radiologist, standing behind the screen. Their faces are anything but cheerful.
The radiologist comes back, and once more crouches before me. I know this is because he doesn't want to be talking down to me. I like him. If I was his mother, I'd be proud of him.
'I'm afraid it's not good news,' he says. I already knew that. 'This hardly ever happens, but the wire has gone past the mark, it's gone too far!'
'Oh no!' I say, but sympathetically. 'It's important for it to be accurate, I suppose.'
'Absolutely!' he says. 'We've got a couple of alternatives. I can either try to pull it back into the right position, or I can take it out altogether and start again.'
I am silent, gazing at him, nodding, empathic. I seem to have entered counsellor mode.
'I'll have a go at pulling it back into position' he says, after some reflection over the pictures. 'There's a chance it might work.'
I want to say, 'yes, but not today. Today it will not work. You will save yourself time, and me more 'discomfort', if you just start over again.' But I don't. Neither of the nurses has contributed to the discussion. One of them comes and stands by me and holds my hand. She asks me about life in Brindabella, and the snow on the mountain, and my grandchildren. I talk, while the others wrestle with my breast, and whatever else. It's absurd, I am absurd, but talking is as good as a slug of whiskey. I feel emotional about the nurse and don't want her to leave me.
They stand behind the screen studying the result, and briefly they are pleased.
'It's perfect!' says the radiologist.
'You're an artist!' I tell him, indulgent with relief, and he glows and says that's a lovely compliment.
But when they unclamp me and look at the pictures again, their faces fall and I know it's still not over. The radiologist is crouched back before me again; he sighs deeply, he is very uncomfortable. I think he doesn't want to look at me anymore.
'...when we unclamped the breast,' he is explaining, 'the wire jumped back. This is pretty unprecedented. It's only happened to me a couple of times before.'
There is nothing for me to say.
'We'll start over again, from the beginning.'
'Will I have to have another local anaesthetic?'
'No, it lasts four hours,' he says, glad to give some good news.
This time they don't clamp me quite as hard. The nurse stands close again, and we talk like old friends. She has grandchildren too, and they love to go up to the snow.
I am sorry for my breast; I want to protect it, but I can't. Suddenly, I am assailed by a guerrilla army of wild anxieties. Supposing it is too late to have the surgery now, and I have to go home? Supposing they can't do this procedure at all, and there is another, much worse one that I have to endure. Supposing this radiologist hasn't actually done this before at all, and the nurses are just covering for him?
'That's done!' he says, triumphantly. He goes behind the screen and looks; they are a;; smiling, relieved.
'Just one last picture,' the nurse says, 'to send over to theater.'
And they take one more. Then I am trying to cover myself, starting to shiver, and I look over and see their astonished faces. It seems they can't speak. They are leaning in to the machine, staring. They are shaking their heads. They appear deeply puzzled. Shocked even.
'What's the matter?' I say eventually. Someone has to speak.
'It's gone!' they say, coming out from behind the screen as if they are sleepwalking. 'It isn't there anymore!'
'What do you mean, gone?' I say. I have a strange sensation of needing to take charge here, but being half naked still puts me at a disadvantage.
'It's just not there anymore! It's not in the picture! It's not anywhere! It must have come out!'
'How could it have come out?' My tone is that of Mum dealing with bullshit.
The radiologist stands before me, stricken. 'It must have jumped out,' he says. It's designed not to come out, it's got a hook to stop it from coming out. I have never, ever had this happen before.'
I want to send him home. I put my hand on his arm. 'It's alright', I tell him.
But he is deeply rattled. 'We have to find it,' he says, rather wildly. 'It must be accounted for.'
I rise to the occasion, I'm good at this. All four of us commence a search. It's not a large room, but it's full of equipment, and the floor is a mottled grey which would camouflage a small piece of rebellious wire very easily. We move and shake equipment, scan the floor over and over, upend the chairs, check my hair, my gown is removed, examined and passed back to me. The nurses shake out their cardigans, take off their shoes. We start laughing incredulously, but immediately a wave of hysteria enters the room and nearly does for all of us, and we fall silent again.
One of the nurses fetches a brush and pan. She is going to be systematic and starts at the farthest wall where it is inconceivable that the piece of wire could be. Immediately, she finds it, and holds it up triumphantly. Everyone is terribly relieved.
The pathologist has left the room, and now returns. He is sorry, he says plainly, and repeats that this has never happened to him before and he can't explain it He says he is sending me over to his colleague in ultrasound who will do the procedure using the ultrasound machine.
'In view of the bizarreness happening here,' he says, spreading his hands helplessly, 'I think a different pair of...' Hands? Eyes? Nurse assistants? I don't know, because he trails off, and leaves.
Over in ultrasound, the new radiologist is brisk and does not want to engage with the story about what happened, although I am dying to tell it. I lie back quite comfortably. One nurse silently assists, staring intently at the screen, while I stare intently at her pretty face and wonder if she gets used to such gazes. It is over so quickly I don't remember it beginning. In fact, strangely, I can't remember it at all. I am on my way back to the admissions center, for the main event. Ready?
9/1/2018 01:02:59 am
Kafkesque day to learn you were short listed for the Steele Rudd Short Story Prize.
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