Pathology

I think we all periodically go through things that change our lives. Graduation, wedding, birth of a child - those are all major events that we expect will alter the course of our lives. However, some of the most profound life-changers are unexpected - an accident, sudden illness, winning the lottery. I suspect that events like these probably affect us even more, because we don't have time to prepare for them. Also, while the "milestone" events outwardly change us, it's the unplanned events that will probably cause us to re-think our lives, and therefore result in changes in how we view the world, what our accomplishments have been, and what we want our future to be like.

I definitely have changed. I'm not sure it's a positive change, but I am a different person. The old Jami is aloof. Don't bore me with details about your personal life, don't invade my personal space, and don't expect any sympathy or a hug because I don't know how to do that. The new Jami has discovered empathy. And I am even figuring out how to show it! I practice on my clients. Just yesterday, a middle-aged blue collar gentleman and his 20 year old daughter came in with their 17 year old lab whom they decided to put to sleep. When I asked if they wanted to be present, the man burst into tears and said, Don't ask me that! We can't go through that! My daughter just died two months ago! The old Jami would have said, I'm sorry... and found an excuse to leave the room. This time I thought I'd try something new. I said, Was it sudden? Was it an illness? So he told me the whole story, about how she had a toxic reaction to methadone and her arm swelled and this is a common side effect that kills a lot of people. Then he even told me he just had a colonoscopy! Wow! If you allow people to open up, they will. I think that people really want to share their lives, even if it is with their veterinarian. I also feel sort of like an autistic person would, trying to figure out how to act in these social situations, since I'm not sure I intuitively know it. My techs at a previous job would joke with me about how to tell if someone needed a hug, because I never felt confident  in my ability to tell if one was needed. But you know what? I think everyone would appreciate a hug if they're dealing with a sick or dying pet. Maybe that will be my default from now on. Hugs for all.

I think I may be giving the wrong impression here. It's not that I don't care about my clients and patients and want to give them my best. It's just that sometimes it is all about bedside manner; the medicine is secondary. I believe that my clinic does provide top-notch care, but clients may not know it because they don't know what that means. All they know is the personalities of the staff, including me. If I can open up to them, and allow them to open up to me, there is more trust between both parties. Plus, it actually feels good.

It's not just at work that this is happening. I feel more empathy towards my friends as well. I think that it is because I have received so much unconditional support through this all. I am grateful for all that has been done for me, and I now realize that I should do the same for my friends when they are in need. Duh! Because I get it now. It took 40 years, but I get it.

I had another surreal medical experience today. The short story is that one of the pathologists that signed off on the original DCIS path report actually called me today from a conference she was at in another part of the country. She left a message with her cell phone number! She knew that the Vanderbilt third opinion report was due back today and she wanted to explain the thought processes that were involved with my original report. It turns out that she and the lead pathologist on the case were not in agreement with the original biopsy, but she acquiesced and allowed the other pathologist to make the DCIS diagnosis. When the surgery sample came in, she knew the original biopsy report was wrong. Basically, she said, we overcalled it. Oh, and she can't recall this ever happening before. She did say, however, that my case was borderline and that some pathologists would still call it DCIS, but the majority (including the experts at Mayo and Vanderbilt) would call it ADH. I am glad that she called, and cared enough to talk to me for almost 30 minutes. AND she is coming home from her vacation a day early in order to meet with us a week from Monday. Really. Although now I feel guilty about that so I'm going to reschedule the meeting.

Does that happen often? That the pathologist calls the patient to explain why they made the diagnosis they did?

Also, she did say that it did not change the fact that I needed the surgery I had and I will need careful monitoring and possibly Tamoxifen. But she is sorry for all of the emotional trauma I must have been through. You don't even know the half of it, I thought to myself. I do have an appointment with an oncologist in the middle of June.

So, I officially don't have cancer any more. And I am officially starting to leave the dark recesses of my mind. I really think that the conversation with the pathologist helped. I know that even though each pathology report only had like 5 words in them, many people thought and argued and pondered about those 5 words. See! People care! Even pathologists care about the patients they have never even met. Maybe I'll give her a hug when we meet.