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?