I had my annual mammogram today, a pleasant enough experience that did not even extend past the 30-minute free-parking period at Group Health. The technician said, “you’ll hear by letter if everything is OK, or someone will call you if something shows up.” Does she say the part about if something shows up to everyone? I put off the annual exam for about 6 months, not being sure of what my insurance status would be. A friend of mine died in the 90s of advanced breast cancer, having delayed follow-up care because she didn’t have health insurance. I’m sure it happens all the time in the US.
Back in 2003, when a routine mammogram showed the inevitable something, I was called back for another view of my left breast, which led to an ultrasound, and weeks of waiting for a biopsy, which turned out to be a cyst. They knew it was a cyst, I knew it was a cyst, but I still had to go through the whole drama. The pay-off was being able to see the radiologist collapse the cyst with a needle while I was watching on the ultrasound screen. Cool.
I know a good deal about breast cancer diagnosis and treatment, there is a history of it in my own family and I’ve seen quite a few patients die of advanced breast cancer, several cases where there had been no treatment whatever, leading to volcanic break-through tumors. We each have our own way of reacting to medical issues. Here is how I reacted to the (admittedly minuscule) possibility of having breast cancer. I made the following chart:
I performed this logistical paradigm in the same manner that another person might worry, or rally support from family or friends, or go online to arm herself with information, or panic, or whatever we do when there is any degree of uncertainty that we find hard to deal with.
One of my major complaints about the healthcare system is the degree to which it conspires to hide from the person who is facing important medical decisions as much information as possible about what’s in store for her. A map that shows where the forks in the road will be encountered, and what each fork’s paths lead to after that. Most people don’t have the map that I was able to make for myself.
I’m not sure why we do it this way, stuffing uncertainty into a box called silence.