Magic 8 Ball

About a week ahead of time, the CT scan makes itself felt on my horizon. It’s a small white noise in the back of my brain, Val’s too I think, more buzzy the closer it gets.

Nowadays, in between doctor moments, sometimes we can just have a day. Sometimes several.  Tickle the dog, try to think of something besides kale to eat, do some volunteer work, call those guys back about the marmoleum. Relationship stuff, some of it huge. Job stuff. The stuff of people who get to live their lives.

But the damn CT scan, every 6 weeks or so now, gathers up all the fragmented rays of normal and focuses me back into cancerland. Reminds me of our altered premise. The period of time that involves going in for the scan, and awaiting its results – usually a few days’ wait; once an awful week and a half – distills all the tiresome ambiguity into an urgent, unsatisfying Magic 8 Ball kind of Q & A:

What will happen?

Cannot predict now.

How does our luck hold?

Concentrate and ask again.

So on scan day Val drinks her morning barium shake. We reunite from our freshly, weirdly, separate residences and take ourselves back to the Kaiser parking garage. We follow our regular path through the cement forest of columns and enter the little elevator lobby, whose faint, distinctive smell greets me with a familiar little shove in the chest. Ghosts of trauma past and present.

We ride upstairs, telling each other jokes, silently noting people with hair, people without, trying not to breathe in any sick air. Moving fluidly through known territory. Stationing ourselves on our regular, blocky lobby sofa. Val checks in for the CT scan, confusing the receptionist with whimsical answers. She disappears for her scan, 20 minutes later she’s back. We descend to the garage, drive out into daylight, go out for lunch. It’s a routine. Cynthia meets us for Thai food and then we go rescue the dog from boredom. Two more days of white noise before we know the results.

This is the Schrödinger’s Cat part of the experience. Schrödinger’s Cat Scan. If you haven’t come across it, Schrödinger’s Cat is a thought experiment in quantum physics, basically trying to express how paradoxically weird quantum mechanics becomes if you apply it, metaphorically, to something alive and big enough to see: for example a cat. In quantum physics there is a concept (I see from Wikipedia it’s called quantum superpositions) that proposes that all states of a system (say, a subatomic particle) exist at once. So. In Schrödinger’s metaphor, you put a cat in a box. You close the box so you can’t see the cat. Then you set up some kind of killing device that would be triggered by one possible state of a subatomic particle. You don’t know which way the subatomic particle is going to go. It might kill the cat, it might not. But the memorably brain-stretching part is this: until you open the box, the cat is both alive and dead. All states existing at once.

Schrödinger’s Cat Scan: until we hear the results of the scan, they are both good and bad. Doom and grace. Conclusive and inconclusive. For the duration of the wait, we live with one foot on each path. I go to work, I try to think, I try not to miss appointments, and meanwhile my neurons are oscillating compulsively back and forth, straining for grace but unable to rest there.

Wednesday morning comes and we are in the oncology department early. Same parking garage, different floor, different receptionist, different familiar routine. I play with the industrial scale (how much does my coat weigh? how about my hat and gloves? Val’s coffee mug?) while they get Val’s temp and blood pressure, making morning conversation. Then we wait in an exam room until the doctor arrives, not too many minutes later. She is our age, personable, with a direct glance and a quick laugh.

How was Montana?, she asks sociably, remember our last meeting in December.

We blink. Val says, It was okay, it was fine.

We wait.

Feeling pretty good today? asks the doctor.

Val mentions the symptoms of her cold, says otherwise she’s feeling pretty well.  The doctor follows up with this for a bit. We discuss various attributes of phlegm.

After a minute she looks at us again and suddenly her eyes widen. Oh! You haven’t heard your results yet, have you! Oh man, I’m sorry. Your results are good. They’re good results.

You’d think I’d relax at this, and at some level I must, but my neurons keep ricocheting around in the ambiguity.

And this is the other funny part. As Val said, afterwards she kept checking with me – and I with her – to see if we remembered the same words. In fact it’s always like that. The doctors say something, a brief handful of things, choosing their words rather casually it seems, and then they leave. And then we spend a few days sitting in the gypsy tent with the Magic 8 Ball, rolling those words around and around, trying to extract our future from their faint purple glow. And we are never even certain we remember the right words. And even if we did, who’s to say civilians like us are gleaning the same connotations the doctor intended?

But really, this time it was like a dream, where you are sure you know exactly what happened and then you try to describe to someone else and it all turns into sticky webs full of holes.

I remember she said: Basically the tumor is about the same size as last time. Even a little bit smaller, bearing in mind that different people measure slightly differently. Either way, it’s great, it’s good.

I think she said: Actually, one thing that could mean is that the tumor is actually dead, that it’s necrotic tissue we’re seeing. That would make sense the way it’s gotten pretty small and then stopped, except for a little tiny bit going away each time.

But did she say it was “likely”? Or “could well mean”? Or “it’s possible”? Or “I think it’s”? These are the things we ask ourselves in the afternoon, walking the dog. Which was it?

We asked questions: So it could actually be dead? What would happen then? Would it go away?

And I think I remember she said: Yeah, if it’s dead, your body’s immune system is all back now, and it would take care of it.

Take care of it?

Yeah, pretty much eat it up. The macrophages would break it down, take it to the spleen, get rid of it. It could take a long time. Which is fine. Or another possibility is that it could just scar over, and just stay there, as scar tissue. That’d be fine too. The main thing, the thing we know for sure, is that it’s not growing. I would even say it still seems to be getting smaller.

That’s what I remember Dr. T saying. And then she kept thinking about it, and that’s when she said, You know, I hadn’t thought about this, but let me think about ordering you a PET scan.

So we talked about this a few minutes, the gist (as my crazy brain remembers it) being: She doesn’t usually order things that are medically unnecessary. And the results of a PET scan wouldn’t affect the treatment plan. But if we could find out that the tumor was really just a wad of necrotic tissue, “that could give you a boost.” (Val and I both remember that line.) On the other hand, it’s possible the PET scan (which shows areas of heightened metabolic activity) could show surprising little hot spots in other areas. Which, she explained, would most likely be non-cancerous little random bits, for example “a lesion on your liver or something like that.” But there they’d be, and they might create unease for us, and then we’d have to decide (she’d have to decide) if they bore investigation, which could mean invasive biopsies or something. All for hot spots we probably all live healthily with all the time.

So it’s a bit of a psychological risk. Also an extra expense. But the potential for “a boost” is persuasive. What if we find out the tumor is really, actually, totally dead?

What if that damn recalcitrant Magic 8 Ball can be forced to cough up a sweet little “Signs point to yes”?

“You may rely on it”…?

“It is decidedly so”…?

So I think Val will have another test. And we will sit in the box with Schrödinger’s PET. And then we’ll tell you what happens.

Thanks for all your love and kind thoughts. These are crazy times, but beautiful.  I saw fresh beaver tracks at the river on Tuesday.  That’s the sort of thing this world has in it.  All the little webbed toes of a beaver.  

Deborah