14 August 2009

Anniversary the Fifth

It is here. It is today. I feel remarkably ambivalent, although a bit short-tempered, but that might have more to do with not getting enough sleep this week than with the charged nature of the day.

My mom and stepdad are keeping Maddie and Riley tonight, which gives me a nice break. I think I'll go for a run, take a long, hot bath (probably with Diego bubbles since I don't think I have any grown-up ones), and then eat yummy snackies and drink wine and maybe watch a movie or something. I guess it all sounds a bit melancholy, but as my wise dad pointed out to me last weekend, I don't get a whole lot of time to be truly alone and to just spend time with my thoughts. I know I'm not alone in that; I think we could all use the gift of time to just be. And so I shall take this gift on this day that is such a strange combination of sublime and wretched, and it will be what it will be.

*******************
I've had a question on my mind for the last five years, and I'm going to see if any of you readers can answer it. The question is this: Did he know?

The he in question is John's primary care doctor. A few weeks before our wedding, John went to see said doctor because of increasing trouble with fatigue and intestinal distress. John had not been feeling 100% for a long time—not surprising given that by the time his cancer was diagnosed he fell into a classification known as "nearly dead." But by the same token, John hadn't felt awful, either. When he went to see his primary care doctor, his two chief complaints were that he felt more tired than seemed reasonable and that he had transient, nonspecific episodies of gastrointestinal discomfort and distress. Given that John also had a horrifically stressful job, was in the throes of planning a wedding, and was interviewing for a new job to get him out of the horror that was his old job, it's frankly not surprising that the felt tired and nauseuous some of the time.

But off John went to see Dr. C. And, thankfully, Dr. C did not simply say, "Take some Prilosec and shut up." Instead, what he said was, "I want to run some tests. In the interim, take some Prilosec, which will hopefully take the edge off." I'm not sure exactly what tests Dr. C ran, but one of them was a routine blood workup. That may have been the only test.

The results of that workup came back while we were in Portland for the wedding. In fact, I think it was the day of our rehearsal dinner. The result was that John's liver function was high, really high. Somewhat alarmingly high. Dr. C told John that it was not hepatitis and that further tests would need to be done to determine what was going on. His advice was to take it easy on the booze at the wedding and get in touch when we got back to Massachusetts.

John and I were too busy at that point to do any Internet research, for which I am thankful. Because when we did find the time to do research, what we found was that there aren't that many reasons for liver function tests to come back so abnormally high. It takes a lot of damage for one's liver function to be seriously impaired. Hepatitis can do it, but we knew it wasn't that. There a handful of other diseases—for which John had no other symptom—and some drugs that can cause exceptionally poor liver function. And, of course, so can the presence of tumors in the liver, tumors that are likely metastases from an original cancer located elsewhere in the body.

I'm obviously not a doctor. But when I think back on that time, I feel like Dr. C must have known—by which I mean strongly suspected to the point of near-certainty—that John had cancer, and that it was likely a cancer that had metastasized, and thus was almost certainly terminal. That it was pancreatic cancer it seems less likely that he knew. But again, I'm not a doctor. In the end, none of it matters. When we got back from our wedding, John got an abdominal ultrasound, our lives spiraled out of control, and Dr. C transferred John's primary care to an oncologist whose compassion and skill was unparalleled.

I think about Dr. C every day, though. Soon after John started treatment, Dr. C moved away from Boston, and we never tracked him down. I have always wondered, though, how much he knew, how much he suspected. I'm grateful to so many people for the kindness they showed us during John's illness, probably no one more so than Dr. C. I'm grateful that he took John's nonspecific complaints so seriously. And, assuming that he had an inkling of what was to come for us, I'm especially grateful that he kept those worries to himself, that he managed to not lie, or even give us false hope, but state the facts in a way that protected us without compromising his integrity.

John and I shared virtually no married time together that was not tainted by terminal illness. But on the day of our wedding, for all we knew, we had years stretched out in front of us. I'm so thankful for that. Today, more than usual, I will think fondly of Dr. C and what he did for me, for John, for our marriage.

For any doctor-readers, do you think he knew? How much do you think he knew? What would you have done if you and found yourselves in his shoes?

47 comments:

Amy in Mississippi said...

Snick,
I think he knew. My husband went to the doctor-ER actually-because we were in the middle of a move to another city and all the doctors offices had closed for the night. He had pretty much the same symptoms as John but had a little jaundice. At first glance they thought he had hepatitis but after blood work, urine test, and a blood sugar test, they told him that it was not hepatitis and they suspected pancreatic cancer or a gall stone lodged somewhere. It was a teaching hospital so he went straight for a CAT scan that same night and we had the diagnosis within a couple of hours. It was a out-of-body experince to say the least. At 7:00 PM we were excited about starting a new life in a new city and by midnight we knew he had a terminal illness. The doctors were very kind and compassionate and I know it was very hard for them to tell us the truth because my husband was only 39. So, I think he probably had a very strong suspicion but wanted you both to enjoy your wedding day and honeymoon.
Thinking about you tonight and hoping the evening brings sweet memories of the life you shared together.

Cheryl Lage said...

Not a doctor, but think he may have "known" or his suspicion was incredibly high.

Peace to you on this day...and onward, Snick.

Snickollet said...

Oh, Amy. I'm so sorry. I've seen your comments before, and it seems like we share so unfortunate much.

E-mail me directly if you want. I'd love to be in touch. But if you don't want to, or can't right now, that's fine. I understand.

Amanda in Atlanta said...

I vote for:
Knew and let you have your wedding as a celebration. Only a true ass would have told you what he truly suspected to be very bad news of some kind on the eve of you wedding day. As my GP tells me often - I treat the whole family or household as a family practice.
Part of that is knowing what is going on in your patient's life and honoring that knowledge. I can't go in for a hangnail without him asking about my job, marriage, and family.

Enjoy your time to yourself. When else can you drink a glass of wine or read uninterupted?

10 lbs of awesome in a 5 lb bag said...

He probably knew.

I have a similar story, not as severe, and with a better outcome. Two weeks before our wedding, I had to get a blood test; the state required everyone to get a test for an STD before they would issue a marriage license.

For some reason, the doctor decided to listen to my chest during the exam, rather than just drawing blood, giving me the mandatory notation about AIDS that the law also required, and sending me on my way. I was annoyed because I was working out like crazy then.

She listened and asked me if I had a heart murmur. I said that I did not. They quickly brought in an EKG and hooked me up. After it ran, they told me to go to a cardiologist. I was moving out of town, and said that I would find one when I got there, thinking that this doctor was a little off.

A couple of days before the wedding, I saw a cardiologist where we got married. A physician family member pulled strings to get me squeezed in, after he had listened to my chest and did not like what he heard.

The cardiologist ran a bunch of tests, and even I could see on one of them that the valve looked pretty floppy and was not sealing. I'm not a doctor, but that seemed odd for a valve that is supposed to close. The doctor, however, told me to go get married, go on my honeymoon, not scuba dive, and see a cardiologist when I got back to what would be my new city. He said that maybe I'd need surgery when I was in my 70s, maybe I wouldn't.

I had open heart surgery less than two months later. I can't imagine he didn't know that I would need to have it fixed.

Anne said...

Hi Snick,
The doctors were careful not to alarm us too early, but were certainly straightforward with us when necessary.

My husband was scheduled for an eight hour Whipple operation to remove a blockage or so all of us (including doctors of course) thought at the time. I went to the cafeteria about hour four or so. I saw the attending physician there! I spoke to him and asked him how it was going. Well, unbeknownst to me at the time, they saw metastasized pancreatic cancer and could not continue with the full operation.
The doctor very compassionately explained to me that my husband was doing well and the primary surgeon would give me an update when he was finished.

Of course this doctor already knew, but he compassionately concealed this fact from me until I could get all the information in context from the primary doctor.
It must be heartbreaking to see a hopeful family member asking for a glimpse of good news, when you already know the serious truth.

It's been ten years for me this year, and ten years sometimes seems like a long long time, and sometimes it seems like yesterday.

My best to you ,
Anne

Christine said...

I don't think I've commented here before, but I read often and wanted to let you know I'm thinking of you today.

Boston Blogger Girl said...

Snick, I hope got the time and peace you needed this evening.

And I think your gut instinct is right about Dr. C. I think he very likely knew.

My opthamologist told me less than four months before my wedding that a retinal specialist would be the best person to address my concerns about what was then a minimal decrease in vision, but she assured me it could wait until after the wedding (and after I was covered under my husband's much better health insurance). She didn't let on what I'm nearly certain she knew from her own tests, which is that my retinas were failing and I was going blind from retinitis pigmentosa, a genetic disorder for which there is no cure.

Things have changed dramatically since then for me and my husband..both in good ways and the not-as-good. Looking back to that time, also five years ago, I feel like I'm seeing a different person's life...and I'm beyond grateful that I had that time to enjoy that wedding and live that life free from the diagnosis as long as I did.

mamie said...

i do think he knew. i work with doctors daily and the good ones know how to do their jobs, but also remember how to be people. and that they are people too. i am glad you had your wedding day....that it stayed with you as a day of celebration without having to be one of uncertainty. my thoughts are with you.

Anonymous said...

I think wise doctors often behave as yours did. Until there is certainty about a diagnosis, especially a grave diagnosis, telling patients about a suspicion can't lead to anything good. And there's always the possibility, however remote, that the bad test result is something much more benign.

I'm glad your doctor acted so compassionately, truly I am.

Shelley

sappho said...

Hi Snick,
I'm thinking of you today and hoping you have a very relaxing time to yourself, even though it is a difficult day to get through.
Take care
xox
Sappho

Just Me said...

I know that pancreatic cancer is something that often absolutely shocks doctors. I'm an occupational therapist and so I have patients from time to time who have just been diagnosed. Reading a lot of MD reports for a zillion problems you start to be able to see when they express surprise, even when something was in their differential list.

I also know that I've seen at least one case where the woman had all kinds of symptoms of pancreatic cancer and not one health professional figured it out. We all attributed the symptoms for to one thing, then another, then another, and she was hospitalized for something as far removed from cancer as it gets. Then they thought she had pneumonia and the xray found the tumors. Which had invaded her spinal column before they were found. Yet we'd all ignored her complaints of back pain because they were no more adament that her general aches and pains. In fact I had been using heat treatments on her, which is contraindicated with cancer and which had there been any sign I wouldn't have done.

On the other hand, I think John's doctor knew something very serious was wrong. Bloodwork is standard with the symptoms John had, because it can be an ulcer and so they test for H.Pylori. A liver test would also be fairly routine, although if his liver function was that high the dr. may have seen early jaundice (like the skin inside the eyelids) that is hidden unless you look. He may also have felt enlargement of the liver or even palpated some amount of tumor. I've seen those things happen in reports.

So anyway, I'd guess he had a suspicion it was something serious, but given the rareness of that cancer at that age he may not have had the full picture. I've seen several times they've been looking for liver cancer or idiopathic cirrhosis and found pancreatic cancer.

It's an evil illness (just sent someone home to die of it yesterday) and I'm so, so sorry for what both of you went through.

Kim said...

I think they knew. My friend's husband, who died of brain cancer, was told the day they did the CT scan by the hospital radiologist on staff. (They still had to biopsy the tumor once removed, but still.) I think because of the nature of his tumor and the gravity of the situation (he was virtually symptomless, save for headaches, and yet they didn't expect him to live another week or two without surgery) they told him, otherwise they'd have waited until the Monday appointment.

I feel like with you and John, they must have wanted to give you those last few days of normalcy before it all hit the fan. What a gift from Dr. C.

Mama Mama Quite Contrary said...

Beautiful post. My thoughts are with you.

Bert Bell said...

Snick,

Does it really matter to know whether this doctor knew or didn't? The reason I ask is this...if you don't let go of the past and the what ifs you will never fully enjoy the fullness of your future. The past is the past, it can't be changed or explained. It is what it is. All you can do is see what God has brought you through, look to the lessons you learned on this part of the journey of life. See the blessings in what was the chaos of it all and just enjoy the 2 beautiful children you and John were able to make to carry on John's name. Praying you will allow God into those dark secret parts of your heart that is clinging onto the past and all the pain of it and that you find the healing you need for not only your life, but for your children as well. God's most abundant blessings upon you and your wonderful family.

Lals said...

Snick,

I think Dr. C knew. I'm not MD, but rather Ph.D with focus in oncology. I can't say for sure, but given John's (lack of major) symptoms and the elevated liver levels, the most likely culprit would be have been pancreatic cancer. Five years ago, pancreatic cancer wasn't nearly as well publicized, so the symptoms weren't as well-known, but as an MD, it was very likely on his radar screen.

You and John were blessed to have a compassionate doctor who allowed you to at least enjoy your wedding and honeymoon in peace. When my father wad diagnosed (with metastatic melanoma) we had a brilliant doctor (who incidentally had no bedside manner) callously tell us his suspicions long before the biopsy results came in. Nothing can change the reality, but having a compassionate doctor can make a huge difference...

((Hugs!))

Emmie (Better Make It A Double) said...

You know, it may give you some peace just to write the doctor a note saying you're not sure if he knew, but that regardless, you appreciate how he let you know. I think that when we get stuck on a detail from a difficult (OK, horrible)time, some kind of ritual and/or resolution is often helpful, and can also be helpful to the doctors and nurses who see so much grief first-hand. Wishing you a peaceful break today.

Katherine said...

Snick, hugs to you today. Your post was beautiful. I'm not doctor, so this is just a guess, but I think Dr. C at least suspected. And had the grace to allow you to enjoy your wedding day. I am saddened that your entire married life was clouded by cancer.

I am struck here by the abundance of those of us who have lost a spouse to pancreatic cancer. When my now-deceased husband was diagnosed seven years ago, I had barely heard of it. Now, I hear of new cases each week it seems. My husband had some intestinal issues, went for a colonoscopy, colon cancer was suspected, and surgery scheduled for the following day. Right before the surgery, the doctor came out and told me that the tests had come back and the biopsied tissue showed no colon cancer. Naively, I thought that was GOOD news. The surgeon went in to remove damage they'd found in my husband's colon--and saw the cancer in the pancreas. At the time, they closed him up and then called me in to tell me what they'd found. I didn't know then how pancreatic cancer is one of the worst kinds. But I was struck by how shaken the surgeon was. He had met me, and our two young children, the day before, and when he gave me the diagnosis, came over to me, hugged me and said, "We're going to have to be really strong because he is going to really need us now."

We were lucky, in a sense, because Don's tumor was operable and, 10 days later, a pancreatic specialist removed part of his pancreas and all the tumor he could see. Unfortunately, it was in Don's lymph nodes, so though radiation and chemo followed, it ultimately wasn't a cure. But he did live, and live with a decent quality of life, for FOUR more years. So I am thankful for that. My youngest was 3 when he was diagnosed, and 7 when he died, so at least now she has some memories of her dad.

To the reader who instructed you not to "live in the past," I would say until you have walked in our shoes, don't judge us. Remembering our loved ones' illnesses is a part of remembering them--it is something we lived through with them and was a huge part of our relationship. Thinking about it, wondering about certain parts of it, does not mean we are LIVING in the past. Someone living in the past wouldn't have moved across the country with two young children for a great new job. Snick, I wish you peace with your memories, and great success and happiness in the new life you are making for Maddie and Riley.

June said...

I read with great interest how these 'other' people responded to your post. I agree with the last comment about you 'living in the past'. It's alright that you REFLECT on occurrences that impress you on a daily basis. You have so many treasured memories of those days, & now you have those two beautiful children that will forever remind you of your lost love. I don't fault you for remembering - sometimes that's good. My brother that passed away June 24th had a very long (6 mos) stay in the hospital. I sat by his side many, many hours & watched his progress go up/down. He had always been a strong, healthy man & watching his health decline on a daily basis was quite heart wrenching. It GIVES ME STRENGTH to recall moments with him when I could encourage & share TIME. Reflecting back to those stressful days also helps me to realize I need to be thankful for TODAY. Now & then, I have to take time to remember the happy moments with my brother, & that helps me to cope with losing him. I commend your honesty & talent in being able to verbalize what you are feeling. I felt from the get-go that my brother's doctors knew his lifespan wasn't going to be long. They addressed important issues of what we might expect, yet was compassionate enough not to give us false hope either. I wish you comfort in this time, and times yet to come, & I ask God to be near you & your children. I'm happy you are near your family now. I never had the privilege of meeting John, but I KNOW he was a fine young man who truly loved you & would want you to find peace. God Bless You, My Friend!!!

Amelie said...

I think he was suspicious at least, but wanted you to enjoy your wedding. Actually I had been wondering about this, whether John had had any symptoms before the wedding, since you said that he was diagnosed the month after. I'm glad you had this day together without the health worries.

I hope your evening was what you needed it to be ("good" seems like the wrong word in this context...).

Steph said...

Though not a physician myself, I've lived and worked with one or another for more than 16 years (with the added bonus of having had close friends die of liver cancer, and a mom die of lung cancer - all too young).

I think Dr. C 'knew', even if it was an unconfirmed type of knowledge. I also believe it was likely deliberate that he mercifully did not raise your collective suspicions and apprehensions in that time before your wedding day.

In my experience, it's unusual for a physician to show his or her hand unless there is concrete evidence of a clear diagnosis, before all the appropriate tests have been done.
At that time before your wedding, there was suspicion, not certainty. So whether it was in fact mercy or just a doctor doing what he had been taught to do is up for interpretation.

Maybe there was an element of both. In any case, I'm sorry for what ensued, but glad that your wedding day was spared that shadow.

Anonymous said...

I hope you had a good night with yourself, Diego bubbles, snackies, wine, good movie (which one?) and your thoughts. I hope it was healing and relaxing. Cynthia

Supa Dupa Fresh said...

Snick, darling,

I hope you had a decent evening to yourself. What a blessing! I'm jealous of you, your parents sound so lovely and I'm glad you're "home!"

Dr. C was so -- elegant and considerate! with what and how he told you. I'm not sure if he knew (PanCan sneaks up on some pretty smart peeps), but I'm grateful you had someone like him.

I agree that a note to Dr. C. (this post serves well!) or a ritual might be satisfying for youo.

In our case, the dx came in the clunkiest, worst form, made for a great story ("whoo-hoo") but definitely made a bad situation worse.

{{hugs}}

Supa

mlg said...

Hi Snick.. I love the way you are spending your evening. It seems like the best way to honor yourself and your memories with John. It is also a great way for the twins to enjoy today.

I love your question. I hadn't thought about it before just now, but man does this make me wonder...

When I KNEW something was wrong with the kid I took her to the doc, only to be told that I had high expectations as a parent and that I should be patient with her hitting her milestones. He didn't even send her for tests.

For the last 12 years I have told folks that I knew when she was 10 mos, but the docs didn't catch on until she was 15 mos. ha. thanks for the lighbulb that has gone off just above my thick head.

See, I started that appointment by telling the doc that I was worried cause she used to walk and didn't walk anymore. I also told him I was expecting #2, I had given notice at work, put my (Dallas, TX) house on the market and accepted a new job in California. I wanted to just know for sure before we moved... Now, with my newfound wisdom, I see that my life would have been in shambles had I gotten that diagnoses on that day.

Instead I moved, started my new job, and my new insurance, and then, after 8 days on the job, got the diagnosis. Life was so difficult then, but now I see it would have been worse had the doc sent us for tests or told us that day what he must had had an idea about.

I will have fond thoughts of him today and from now on tell people a much nicer version of my life 13 years ago.

Thank you, once again, for fresh new insight.

Liz said...

Hi, Snick. I just wanted to send you some support and maybe some doctor insight. I'm a primary care physician and I doubt that John's doctor knew the exact diagnosis. I'm sure he probably knew something was very wrong with liver function tests, but I think pancreatic cancer would still have been pretty low on the list of possibilities for a number of reasons. It sounds like he very wisely let you both enjoy your wedding while still informing you of the abnormal tests at the same time. Your post really teaches me a lesson about how to broach bad news with my patients so thank you for posting it. I hope you and the twins have a quiet weekend.
Liz

Finch said...

He knew.
My husband's grandmother came to visit us so she could see the Rose Parade in person. She was 80 and this was a lifelong dream.
While visiting, she fell ill. I drew some labs and... I knew.
She rallied enough to attend the Rose Parade. As we drove them to the airport, I told her daughter (my mother-in-law).
She was dead within a month. But she got to see the Rose Parade.

Melissia said...

I have to disagree with the majority of readers. I have no doubt that Dr. C knew that something was wrong but elevated LFTs can indicate a host of problems with the liver from Wilson's disease to alcoholic cirrhosis to liver cancer. No doubt he knew that John needed follow up in a timely manner, but his lack of jaundice was most likely reassuring and I am sure that he was compassionate and did not want to ruin your wedding with alarm. (I am a retired nurse and have seen many elevated liver function tests that were thankfully not liver cancer but were actually other conditions).
So hoping that you have a peaceful and restful evening.

Anonymous said...

The reason why I'd bet money he knew is because he didn't insist John get immediate medical attention, no matter where in the world he happened to be or what he was doing. If Dr. C suspected the inflated liver values were due to something infectious or viral in nature, something that required immediate medical attention to save the liver of a young man, he'd have done it.

I think he strongly suspected cancer. As someone else pointed out, there can be other causes, but cancer would have been right up there especially since John didn't have other symptoms. Either as a primary hepatic tumor or as mets, and either way, the diagnosis/prognosis wasn't going to be good.

But, at the same time, if it was hepatic cancer/mets, a couple of weeks either way wasn't really going to make much of a difference. So why not let him enjoy his wedding?

I'd have done the same thing.

Betty M said...

WNether he knew ewhat was wrong or not I am glad he gave you both to have your wedding without the cloud of terminal illness. Wishing you well .

OTRgirl said...

He sounds like a really good doctor. I'm so glad you were able to enjoy those days without a diagnosis cloud over your heads.

Speaking about the issue of you being accused of 'living in the past'...I see you as someone who stays very busy in the present and who (like me), often doesn't want to 'choose' to visit the sad areas. Every time you do choose to do some of the work around grieving, I commend you. It's hard work and necessary. Reflection, missing someone, realizing what was meaningful, crying -- none of those actions mean you're trapped in the past or ungrateful for the present.

And, speaking as a Christian, I'm a little frustrated to have any of that dressed in 'blessings' and 'cheer up'. (It also hits me emotionally because of the faith vs dying stuff we're going through right now.)

You're where you need to be right now. I'm glad you were able to have time and space to reflect.

Linda said...

Hi Snick,

Internist here - no, he didn't know. He was almost certainly worried about the possibility, and he might have suspected, but most of us who have been in this business for very long, know much better than to guess about a fatal diagnosis on the basis of elevated LFT's. Not knowing what the exact labs were, it's hard for me to be more definitive - I suspect it was an elevated alkaline phosphatase which is how he knew that it wasn't hepatitis. There are a number of things that can raise that, not all of them cancer and not all of them fatal. Most likely he was making the decision for emergent vs. urgent follow-up on the basis of symptoms, which sound like they were nonspecific and not indicative of the need for an emergency referral for additional tests. I'm very glad for you that he made the recommendations that he did and that you had a bit more time "before".

All the best wishes for you and the twins.

L. said...

Snick, this was one of the most heart-wrenching posts of yours for me--not to mention all the comments that followed. I guess because you and your readers depicted so clearly that moment when you don't know the sword is above you, hanging by a thread, just about to fall... I am so sorry all over again for your loss; and for all those of your readers as well. I hope you had a peaceful day.

Anonymous said...

Snick, the more I think about this (and you've been in my mind and heart since I read it), the more I think writing that doc might be a wonderful thing to do, both for you and for him. You, because you can thank him and tell him what his compassion meant to you (because regardless of how strongly he suspected serious illness, he handled it exactly right), and for him too -- when in life you're unexpectedly told that your actions helped, that you made a difference, it's an enormous gift.

Peace to you!

Shelley

Debbie B said...

Hi - I'm STILL procrastinating about going to bed - Facebook and blog reading are two of the very best ways I know.

I'm a physician, and I think your doctor did not know. Autoimmune, idiopathic, , infectious, tylenol or alcohol related causes would still have been higher on the list given John's young age. But yes, cancer would've been on that list. but not necessarily # 1. And I don't blame him for not giving you the entire list.
All my best,
Debbie in Vancouver.

denise said...

I hope your day and evening was easy on your soul.

I wish you and the kiddos peace and warm memories of John...

denise
Surviving breast cancer...
http://TeamDenise.org

merry jennifer said...

I would guess he knew something bad was going on - whether it was cancer or something else as potentially devastating. I would also guess that he wanted you to have the celebration you deserved and that he felt the bad news could wait.

I'm an oncologist, by the way, and I love your blog.

Nina said...

I haven't commented in a long time and I have no real insight as regards your question except to say that Dr. C sounds like an excellent, compassionate doctor. Your post was so moving though and I think an apt way of remembering John on this difficult day.

Like OTRgirl, however, I find myself totally put off by the commenters accusing you of "living in the past" while pouring their "blessings" upon you. I'm a Christian as well and the duplicity of this response makes my insides crawl. I firmly believe that God wants us to process and grieve and remember and WHATEVER however it is we need to. So, just want to say, you are doing beautifully, remembering, questioning, taking baths in Diego bubbles.

cooler*doula said...

I would think that he probably suspected, but as others have said, I'm glad he withheld the list of possibles.

When tests were being run and scans being taken of my dad, my brother, a doctor, would not voice the possibles to any of us, although he later admitted, that he had feared that it would be the cancer it turned out to be.

Much love to you.

Anonymous said...

Hmm I'm not sure if he knew. If he did know and, in fact, didn't say so because of your wedding, that's pretty amazing and great. A lot of doctors I know wouldn't remember or care about the patient's life outside of the disease.
I'm also struck by your mention of gastrointestinal symptoms and the number of your commenters who have lost someone at a young age to this disease. When they found the precancerous mass in my pancreas everyone was pretty amazed because I'm in my twenties and
every doctor seemed convinced that the gastrointestinal symptoms I had were not connected. The gastrointestinal symptoms I had caused them to do a catscan where they found the mass but all the doctors said that was just coincidence and the symptoms weren't related. Clearly based on yours and other experience this cancer is possible at a young age and gastrointestinal distress is a symptom. There really needs to be more research on this disease to confirm that! I was very lucky in that it was found before it went from precancerous to cancerous, but you and so many others aren't so lucky.
I've been reading you for a while, though this is my first comment. When the docs first told me that they suspected I might have pancreatic cancer, you and John were the first people I thought of. So thank you for your blog-it helped me interpret what the docs were saying.

Kathryn said...

I agree with Liz and Linda. I too, have worked in Primary Care offices and I don't think his doctor knew. He couldn't have known without doing further tests.
My husband has had high and abnormal liver tests for years, but does not have hepatitis or cancer. Nor does he drink alcohol or do drugs. It's not an automatic given.

django's mommy said...

just wanted to let you know you helped me get through my Anniversary the 9th (Aug 6th). As always, you say so eloquently what I am feeling.

I am grateful you had your wedding day.

winecat said...

Snick, a little behind in my reading but this post was wonderful. When I had my breast cancer biopsy I'm reasonably certain the doc knew it was cancer but as a friend he didn't want to worry until the confirmed results came back. I will always bless Dennis for that night of peace I got before the world went to hell in a handbasket.

I think Dr. C did the same for you and John. He knew something was wrong, possibly terribly wrong but didn't want to destroy your most precious day together.

MD's like Dr. Mcdonald (Dennis) and Dr. C are the gems of the medical world who remember we are people not just test results.

Hope you had a peace filled night.

Mel said...

What a special man. I am sure he knew and wanted you to have vows that spoke of forever with forever being a very long time. So sorry your time with John was just way too short.

~ Jolene said...

Catching up...I think he knew. *sigh* This is why I always keep coming back to your blog...you write in ways that make me think so profoundly. You have such a way with words. I hope you're well Snick.

Michele (Moosh) said...

Oh my gosh, Stacey.
After no internet for so long and being backlogged, I am just reading this.

A huge lump is in my throat and I don't have words. Just...sympathy? Fear? I don't even know the words. I'm unsettled to say the least. And for me it's virtual--for you, it was real. Sometimes there is nothing more I want then to reach through this PC and give you a hug.

I think with all of his experience he strongly suspected, to say the least.

Michele (Moosh) said...

...and I meant to say "than", not "then". *giggle*

cluelesscarolinagirl said...

I am not a doctor, but a lawyer who grew up surrounded by doctors and research scientists and have done a fair amount of research on my own due to my own illnesses.

My "bonus dad" died of pancreatic cancer, so I have researched it extensively at medical school libraries.

Just a layman's opinion so take it for what it is worth but I think he suspected it was something very bad but did not know for sure.

Every doctor will tell you about cases when they were "sure" it was x and turned out to be wrong.

I myself was a "not x". I had a nasty, nasty ovarian cyst with a ghastly history of pelvic problems. I had done fertility treatments and when they did the wand, I knew the protocol. When the "wander" left to get the doctor with some inane excuse I knew. My doc, who isn't a personal friend but a "friend" (you know what I mean) looked at the cyst and turned white. I mean you could see her skin change color. She knew I knew a lot about oc and I said, it's oc, isn't it. She looked at me and said quietly, I can't rule it out.

But she knew. I knew. And she knew I knew. And I knew she knew that I knew. You get the point. She was already asking me which oncology surgeon I preferred "if" it was cancer. She said she would open me up and if it was cancer she'd call in the oncology surgeon.

I teach at a college and she had me called out of class for an emergency to tell me my CA-125 was an 8, which meant it probably wasn't cancer.

Clean as a whistle. It was endometriosis.