Stage IV diagnosis

Mama had a thyroid ultrasound this morning. They rescheduled the needle aspiration for Friday. Right afterward we wandered the hospital corridors until we found the radiation treatment wing (prominently labeled, "Cancer Center"). That's where her appointment with the radiologist was located.

The Queen's Hospital was built in 1867 by King Kamehameha IV and Queen Emma to bring modern medical help to all Hawaiians. It's a beautiful hospital. Over the years it's been added onto wing by wing. Now it's an incredible maze of wings, elevators, and corridors that require a map to navigate. The best course of action is to ask one of the hospital staff, who initially begin to give instructions but always end up simply leading the way to the destination. I'm sure the maze keeps staff cognitively alert. The twisting navigation has got to increase IQ points in all patients. It felt like a local version of "Where in the World is Carmen Sandiego".

We finally found ourselves in the hospital basement. The radiation warning tapes and signs on doors were ominous reminders of the materials that are used to kill out of control cells. I wondered if the place glowed when the lights were out.

After check-in, we sat in the waiting room listening to live ukulele music by hospital staff that apparently strolled through just to cheer us up. We needed the cheering; the other patients were grim reminders of what was in store ahead. Scarves, canes, hobbling, and gaunt faces filled the room and I wondered exactly what each of us was waiting for.

Eventually it was Mama's turn to be ushered into an exam room.

The nurse was cheerful, kind and patient. She asked Mama question after question and ended with taking vital signs and having Mama change into an examination gown. Thankfully, she brought a warm blanket to cover Mama. All that expensive equipment has to stay cool; people get to leave the building to warm up again. Nurse left saying that the doctor would soon be in and that he was wonderful.

Dr. Yamashiro was indeed a warm and caring doctor with a marvelous bedside manner. He examined Mama and then had her dress. We met him in the consultation room where he sat studying her stack of test results.

He took out a set of papers titled "Lung Staging Form" and carefully explained how the test results mapped to the form. He wrote the pertinent info from the tests on the form as he circled letters and numbers. He ended up with Stage IV M1b diagnosis. He told Mama that it meant the cancer wasn't curable but that they would use radiation and chemotherapy to control the growth and spread of what was there. He likened that approach to diabetes -- it's controlled, not cured.

I watched Mama out of the corner of my eye as the doctor outlined the diagnosis. I watched her shoulders slump as the full realization of what he was saying sunk in. She finally interrupted him to ask how long she had to live. He said that only God knew that. She said that she wanted to know so she could attend to her dogs.

As I listened to her explain that she loved her dogs more than her children I was grateful to not feel any bitterness. Those dogs have kept her alive and happy for over 30 years. She has lavished attention on them that she was never able to provide for her human children. Funny how that works: the high maintenance, tiny show dogs are so much easier for her to understand and love than the children that she bore (or adopted in my case) and raised. I'm trying to love this difficult woman just the way she is and on her terms. Maybe, sometimes, just trying is good enough.

Mama goes back for a preliminary scan tomorrow. They'll place markers on her chest for where the radiation will be aimed. We've been given a card with a name and number to call to arrange for transportation to and from the hospital while Mama has her daily treatment over a two week period. I'm grateful because I can work during this time and Mama can feel independent. I'll still go to her weekly consultation with Dr. Yamashiro, but Mama will manage the daily treatments by herself.

We're looking at chemo after the radiation. I'm grateful that Mama has the two weeks of independence. We're not sure how much longer she'll get to stay independent. Every day of normal routine is a triumph.