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The CAT Scan Diaries

I went back to the doctor's today. This was my first experience with the American medical system. I found it odd I had been given a chest x-ray. I've never had a chest x-ray in my life at a Canadian doctor's. And he gave me a blood test right in his office. Usually in Ontario, they send you to a lab in a part of town full of crack dealers. He called me back today to go over the results of the blood test and x-ray. Again, that was different. You never have follow up visits.

The good news was I tested negative for syphilis! It's a bit disappointing in that all the great writers, composers, artists, and generals have died of syphilis. Abnormally high cholesterol is considered 200, mine came in at 174, which is good despite a mother with high cholesterol and a diet that consists of mostly cheese and bacon. McDonald's here I come.

I got my car emissions test a couple weeks before my blood test. I was worried, since my car is five years old. But like my cholesterol, my emissions test came in way way below allowable maximums. Like for example, the maximum hydrocarbon emissions is 220 parts per million. Mine sputtered out 38 parts per million. In retrospect, I'm not sure why I was worried. The sucker is a 1 liter 3 cylinder Firefly. Hell, I could burn a rich mixture of PCBs and used truck stop cooking oil and probably come in well under the maximums.

So my blood test was all good. That was the good news. The bad news came in the form of my chest x-ray.

In short:

I'M A DEAD MAN

This is what radiologist's report says (emphasis add by me) "a 1.4 cm nodule seen overlying the right mid-lung zone. This, I believe is in the right lower lobe. It is fairly low-density and a significant nodule including

carcinoma (!!!!!!!!!!!!!)

cannot be excluded here. I cannot entirely exclude the possibility of a second nodule overlying the left lung laterally also at approximately the mid-level. This measures only about 6 mm in greatest dimension."

The "fairly low-density" part comforts me in the same way hearing "non-Hodgkins" would comfort me if I was told I had non-Hodgkins lymphoma. Like, my thinking would go "Thank god I don't have that Hodgkins stuff. That lymphoma sounds bad enough. Don't need that Hodgkins stuff mucking everything up". One less thing to worry about.

I now need to book a CAT scan to determine if the x-ray is really showing a "nodule" (which is probably a nice way of saying a freakin' lump). Luckily I'm in the USA and I don't have to wait for 14 months for a CAT scan while this so-called nodule finds a nice lymph node to settle down in and GROW OUT OF CONTROL. I called CAT Scans R Us and they told me it's about a week wait. Unfortunately, my doctor (a 4' 11" tall Japanese man with two lovely nurses -- I wore my Versace tie today for my second visit) didn't transmit the work order or whatever it's called. So I have to wait until Monday to book my CAT scan.

I'M A DEAD MAN

I emailed my dad (a professor of medicine at McGill) for some further information.

He wrote back

My dad loves me eh? I talked to a medical student friend (she looks a bit like Dark Angel and no none of you guys can't meet her) and she said there are all sorts of reasons why you could have a 1.4 cm something in your lung. (You know, 1.4 cm sounds HUGE to me...) She said it could be something like a bit of asbestos in your lung that's got all calcified. Come to think of it I grew up in Quebec in the '70s. Quebec was like the largest producer of asbestos back then (before they found out the stuff was plain deadly). It was everywhere. Heck they used to put it in our cereal. I suspect it's not the asbestos. It's more likely all those mercury vapors I used to inhale as a teenager. Kicks. You know?

I'M A DEAD MAN

After a lot of phone calls back and forth between my doctor (with the wonderful assistants) and the hospital (with the CAT scanner), I've finally managed to book an appointment. I kept asking the hospital if the doctor had given them my "work order". Finally, the woman told me it is called a "referral". How am I supposed to know? The closest I've been to requiring hospital-type services is a garage to get my car fixed.

The hospital with the CAT scanner looks nothing like a hospital in Canada. When I was there last, I was walking through the lobby thinking "odd I have to walk through a Hilton hotel lobby to get to the hospital". I kept seeing signs saying "hospital", "admitting", "information", "gift shop" but I didn't see anything like green cracked tile or gurneys with white shriveled old people left in the hall to die ... stuff my mental map says "you're now in a hospital".

I asked at a reception desk, "where do I find diagnostic radiology?"

"Go past the marble fountain and take a right at the pasta bar. Keep walking down the hall until you get to the Florida room with the string quartet -- if you hurry they're doing Bach's Third Brandenburg concerto -- and then go through the gold doors next to the espresso counter. Just don't go through the bronze doors. That leads to the quantum medical physics lab... they don't like to be disturbed since they all won their Nobel prizes. If you're unsure ask Serge the barrista."

So I go for my CAT scan Saturday at 2 pm. I thinking of wearing blue faded CK jeans, a white Club Monaco tshirt, and a pink button down A&F shirt.

I had my CAT scan today. It was at 1:45 pm but I got there 15 minutes early. I'm always early. I will be early to my funeral. I wore Gap khakis, a baby blue DKNY tee, and a blue/white striped button down Ralph Lauren shirt. For reasons I don't understand the doctor made me remove my shirt but I could leave everything else on including my DKNY tee. However, I had to put a hospital gown over my T-shirt and pants. I didn't even have to take off my shoes. I don't get it.

The CAT scanner was not as big as I thought it would be. I thought it would be this huge machine with a long tunnel. It was like not much bigger than a downtown condo's fireplace.

The doctor looked at my work order. He made some comment about the nodule (the bloody lump) not being very big (1.4cm). I could only interpret that as a positive comment in the same way a lonely man who's had a decade long unrequited love for his neighbor could interpret her comment "sorry, I got some of your mail" as pledge of love.

I got on the gurney and the doctor began to swab my right arm with disinfectant. He let me know he was going to put in an IV. This would be my first actual IV. I've given blood but I've never had anything that actually injects chemicals into my blood stream.

During pre-IV insertion convo, he wanted to know where my "accent" was from. I told him I was from Canada. Some people think I have an accent. I don't know. I did my "out and about" ("oot and aboot") for him. He himself had an accent. So I took the opportunity to ask him where he was from. I guessed Taiwan. He said he was from Cambodia. Holy. I asked if he lived there during the whole Khmer Rouge thing. He said yes. I asked him what happened. He said he was put into a camp when he was 16. I've never met anyone who resided in a death camp. It was weird he seemed lost for words to describe living through the horror. I mean someone steps on my foot, I'll write 4 pages about the injustice of it all.

It occurred to me to ask him why an IV (why a big suit? why a movie?). He said he would inject a dye that lets him see the veins. See, if it appears the nodule (the damn lump!) is being fed by blood, then, well, you're in big trouble. Big big trouble. I sort of chuckled in a way that implied "pity the fool with one of them nodules". The laughter gave me the illusion that I had control over what was growing inside of me.

Eventually he got around to inserting the IV. All I can say is OUCH. Now I've had needles. I've given blood and had those big milking pipes stuck in my arm. But this IV needle really hurt. It was like he was trying to jack hammer a sharpened coat hanger 3 inches up my vein. Every little movement of my arm hurt. Anyway, he retreated to the control room and the technician began flipping switches and sliding me through the CAT scan machine's ring. Basically you're slid back and forth through the ring and you're told at times to hold your breath. If you ever do this, definitely take a DEEP breath when told to breath and hold your breath. You need to hold your breath for a good 30 seconds. Not being a snorkler, this isn't as easy as it sounds.

After a couple passes through the ring, the doctor came back in the room and told me he was going to inject the dye. This, he told me, would make me feel warm "from the pelvis up". He was right. It produced a slightly euphoric warm feeling. I giggled a bit while being slid back and forth through the ring.

Now the only time I've ever seen a CAT scan in operation was in the movie Exorcist. The movie makes the device look like an instrument of torture. Other than the coat hanger they try to jam up your arm, the actual CAT scan is painless. It's even not that loud.

After the scan, the doctor I think mentioned there was indeed a nodule (i.e., it wasn't an aberration of the x-ray machine). He didn't seem to tell me if it was being fed by blood vessels. He said my doctor would tell me the results Monday. I took that as a bad sign. I mean granted, they're not really supposed to tell you the results or something and they're supposed to leave it up to your actual doctor to lay the results on you but huh. I wonder. I tried to read their eyes. Were they looking at me like one might look at a condemned man? I couldn't tell.

Oh well, another visit to my doctor's (the one with the wonderful assistants) and another outfit to plan...

The doctor called me this morning. He wanted to talk to me about my nodule (the freakin' lump) and the results of the CAT scan. I was going to call him in the afternoon so I was a bit disturbed he called me first thing in the morning. This can't be good. Not good at all.

I zipped over to his office. As always I like to get there 15 minutes early to smile at his lovely nurses and then plunk myself down in his waiting room and read (A Confederacy of Dunces).

First he wanted to do a TB test on me. I guess he wants to eliminate the possibility of TB before they do a biopsy (which sounds like they jam a long needle into your lung). I don't know too much about tuberculosis other than it was known as "the white plague" and it's a pretty horrible disease but probably not as horrible as lung cancer (which has about a 10% five year survival rate). So, for those of you out there pulling for me, gimme a "Go TB!"

He's put in a work order for the biopsy. I asked him if the nodule (the evil lump, heretofore known as "Ray Hnatyshyn" for reasons only my friend Terry Brown would understand) was being fed by a blood supply and he indicated it wasn't. I guess that's good.

The preliminary report reads "Solitary right lower lobe 11-12 mm noncalcified nodule with no adenopathy or additional nodule. Recommend (unreadable... looks like percutaneous) biopsy (stab!) to confirm benign nodule."

I like that "confirm benign nodule". Benign. Confirm. Confirm benign. It's got a nice ring to it. It would be a nicer ring if "confirm" was phrased in the past tense. "Confirmed benign". Revisiting my lonely man analogy from the previous CAT scan diary, it's akin to the unrequited love saying something like "your lawn looks green". SHE NOTICED I HAVE A LAWN AND ITS COLOR! Swoon.

I have no idea what "adenopathy" means. That it's preceded by "no" I suppose that's more good news.

Tomorrow I go back and get the results of my TB test.

I said domo arigato (not followed by "Mr. Roboto") to his assistants as I wrote them another check for $10. This literally costs me $10 every time I set foot in his office. I better get a girlfriend out of this.

I wore Gap jeans, a gray tshirt, and a pink button down A&F shirt (untucked).

So that's the official CT report. I think it's fairly good.

I went back to the doctor's today (another cheque for $10 ... I keep adding up these $10 copays and what I've saved on my taxes compared to Canada is rapidly narrowing) to get the results of my tuberculosis test. I was negative. That's bad. But it came with a frogurt. That's good. The frogurt is cursed. That's bad.

The doctor gave me a work order (referral) now for my biopsy. He kept babbling something about it's better to over check than to under check and miss something. While he talks to me, he writes random, cryptic things on various forms in my file and in my possession. Sometimes he writes things in my file in hiragana. This may limit me in finding a new doctor if something happens to this guy.

My doctor started telling me a bit about the doctor who would perform the biopsy. He thought the doctor was quite good. He applied to 25 medical school and got accepted to 24 (Harvard rejected him ... if I was a perfectionist this would unsettle me). The fellow is from some French colony in the Caribbean. My doctor thought a bit then hazard a guess at Jamaica but I think that was a British colony. If he is Jamaican I sure hope he knows where I can get a Jamaican patty in Seattle. I really miss those. I pray he's not from Haiti and learned his biopsy needle sticking techniques at the Baby Doc School of Applied Tonton Macoutes Information Retrieval.

My doctor showed me a fax of the biopsy doc's planned trip to Japan (it was covered with grease stains but seemed to have some critical information about my case written on the back). I guess I would have preferred to see some information about what the actual biopsy procedure involves but this was 2:30 pm during the day and anything was better than going back to work.

The biopsy doc thought my Japanese doctor had some line on better fares to Japan. I wanted to shout "I'm a doctor, not Priceline.com!" but this is Seattle and he has a number of Microsofties as patients so I'm sure he's heard all the McCoy jokes. The ticket price was $1,000. I think the biopsy doc was being a bit over charged. I paid $800 to Seoul and all my Korean friends claimed I was over charged.

My dad got back to me on what this "no adenopathy" is. Basically, in my dad's words:

Yep, that is good news. McDonalds here I come. Again.

For my TB test efforts, I got a little Washington State "Official Life Time Immunization Record" card which comes in a little clear plastic sleeve like you used to get for bankbooks. It looks like I can also use it to keep track of the stats of my favorite Mariners' ball players (Go Ichiro!) I don't know if I'll need to get a TB test for my green card. I'm from Canada not the Congo but sometimes here in the states they don't make any kind of differentiation. Either you're born here or you're from some freaky place and you probably bring strange diseases and poor driving habits.

I booked my biopsy for May 29. It's at 7:30 am. Actually, it's at 8:30 am but I guess they want you to get there early so they can give you a run down about the procedure (stab!). I hope they make me sit in one of those cool high-backed chairs like fighter pilots get to sit in when their being briefed on the day's bombing mission and they show me a cool vector-generated graphic of my lung and the needle (stab!).

"The nodule is ray shielded so they'll have to use proton torpedoes."

"No one can hit a nodule only 1.2 cm wide!

"That's impossible, even for a CT-guided biopsy!"

"It's not impossible. I used to bull's-eye womp nodules in my T-sixteen back home. They're not much bigger than 1.2 cm."

I called yesterday to book my biopsy but much like trying to book my initial CAT scan, my doctor hadn't sent them my workor... my referral. Anyway, I called today. A guy picked up. He sounded a lot like a travel agent. I said "Hi, Dr Zenri wants me to--" He cut me off. "Oh you're Karl. Good." I heard him flipping through some papers while he was trying to determine a day. I indicated that I was flexible, although I had my Seattle Film Fest schedule in hand in case he tried to schedule this potentially life saving procedure during a film I have tickets for. I'm not walking away from 8 bucks.

He first suggested Monday May 28 at 8:30 am. I glanced at my film fest schedule and noticed I was seeing the film "Barking Dogs Never Bite" (South Korea, Director Bong Joon-Hu) at 11:30 am that day. That might not be good. I was about to suggest to him another day when it struck me as odd I was seeing an 11:30 am movie on a Monday. Then I realized that Monday was Memorial Day. We both chortled simultaneously that that was one of the few public holidays in existence here in the USA and that might not be a good day for anyone. Doctors like to BBQ like anyone else. Although I'm sure they BBQ a more expensive cut of meat. Or lobsters.

I braced myself for the next available date being July 4 or September 3. But he then said "what about Tuesday May 29... same time?" I looked at my film fest schedule. I'm seeing "Teeth" (Italy, Director Gabriele Salvatores) that day at 7:15 pm. I figured it would be fine. (On a coincidental note, the movie Teeth is about painful dental surgery ... a comedy.)

He was silent a bit. Then he asked "now what are we booking you for exactly?"

I looked at my CAT scan report. I told him a biopsy for a 1.2 cm nodule (Ray Hnatyshyn) in my right lung.

"Oh yeah," he said. He then commented "that's pretty small". Huh! That's the second person that has told me that. Emboldened I also noted it was not only small but "well marginated".

"That's good too right?" I asked in a casual, knowing, relieved manner.

"Sure." He sounded non committal.

"I mean, it's not spiculated or lobulated," I pressed

"I don't really know all the terms."

Maybe he was a travel agent.

He told me I shouldn't eat or drink 3 hours before the procedure. No coffee! Cringe. He said if I had to take any medication I should only take it with water. My mind raced. 'Hey if I can drink some water, well, coffee is just like water only better...'

"What about coffee? Can I still have coffee?"

"A coffee should be okay. Really, we just don't want a lot in your stomach incase you have an adverse reaction and throw up."

"Yeah I guess I don't want to choke to death on my own vomit."

"Well just make sure you drink it first thing."

I thanked him profusely.

I woke up at 6 am and immediately made coffee. My hospital check in time was 7:30 am. I estimated it would take about 30 minutes to get to the hospital. I always estimate it will take me 30 minutes to get anywhere, even if I have to drive just down the street. This is the secret to always being 15 minutes early: always assume it will take you 30 minutes to get some place. If it will really takes you 30 minutes then assume it will take you an hour. The advantage of arriving early is you can always find a place to sit down and read a book. I read a lot of books. I finish 2-3 novels a month plus sundry nonfiction works.

I was made aware this out-patient biopsy thing involves the CAT scan with the needle (stab!) and then a few hours of lounging around in recovery. So I thought I'd better pack a couple books. I packed two books for my trip to hospital. "Ishmael" by Daniel Quinn and a nonfiction book called "Armies of Pestilence: The Effects of Pandemics on History" by R. S. Bray. The latter I figured was good light reading (and not actually planned for a stay in hospital).

I pondered for a few days what to wear for an out-patient procedure. My friend the ArtBabe warned me off talking about clothes in these diaries ("Telling us all what you were wearing each time is questionably gay") but I must make such an aside. I must tell the whole story. When I had my original CAT scan I determined big clompy Doc Martens didn't work so well on the gurney they make you jump up on. So I decided to wear runners and loose baggy clothes (Gap khaki cargo pants and a white crew neck long-sleeved ribbed top from Old Navy). I considered the possibility that since they were going to drill into my chest, I might have to wear the traditional hospital gown. I assumed I'd be able to leave on my undies. I dug out my bestest, newest pair of black CK cycling shorts style underwear.

I got to the hospital early and parked in the parking garage. My doctor (Dr. Zenri) warned me parking at the hospital was outrageously expensive. Lord knows I have a frugal side but at some point you have to ask yourself "what price health?" It turned out parking was $5 for the entire day. Cripes, that's half the copay fee I pay to sit in his office for 15 minutes.

I was told to check in at the admitting desk. For my original CAT scan I had to check in at the diagnostic radiology desk. Wow. Admitting this time. I had to be admitted to an actual hospital. I've never been admitted to a hospital. I've spent a lot of time in hospitals -- what with relatives who are sick and dying, friends who are sick, suicidal, or unskilled at negotiating out-of-control trucks on the highway, and my friend Rosanne who has a liver that tries to off her once ever other year.

I like visiting friends in hospital. I like bringing them magazines and sitting at the end of their bed and reading to them. I like playing with their cool hospital TVs. I like expounding on my latest theory. I like that they can't go anywhere. I like to look around their room and ponder what's worth stealing. But most of all, I like inspecting their hospital food. Everyone complains about hospital and airplane food, but nothing excites me like food served to you on trays with neat little compartments!

After checking in, a woman led me to the outpatient care area and then into a private hospital room. This was going to be my room. I didn't consider I'd actually be spending any time in a hospital room. I thought they wanted me to get there one hour early so they could show me a video about the procedure ("Hi I'm Troy McClure, you may remember me from such patient care videos as 'Cancer Survivor III: The Islets of Langerhans' and 'Three Men and a Cesarean'") but no. I was given a hospital gown, told to undress down to my undies, and hop in the bed. The woman left and told me a nurse would be along soon.

I looked around my room. I could do worse than a private room. This was great, in fact. Maybe I was upgraded because I had so many Frequent CAT Scan Miles.

I put on my gown. They also give you these cool socks. They were gray and matched my black underwear. The neat thing about them is they have little rubber foot pads on the bottom so you have traction (I suppose they would also aid you in climbing out your hospital window). I don't recall any friends in Canadian hospitals ever being given those. I first noticed these socks in use when my friend the Korean Koffee Woman was hit by a truck on a Seattle highway. I'd go visit her in the hospital and she was always wearing a blue variety.

I sort of hopped halfway onto the bed. I had this feeling like I wasn't really sick in the traditional sense so I didn't think I really need to be completely in a hospital bed. I sort of bounced on the edge of the bed and dangled my legs until a nurse appeared. She had a clipboard and confirmed my patient information (name, date of birth etc.). She asked who drove me here today. I said I drove myself.

"Oh dear... they didn't tell you not to drive?"

"No."

"Because you'll be under sedation so legally you can't drive for 24 hours after you're released."

"Oh, well, parking for the day is only $5 and my work is just a few blocks away. I can walk back to work and catch a lift home."

"You're going to go back to work after this?"

She looked at her clipboard with my data. "Oh you work at Infospace. How is that company doing? I bought stock in Infospace."

She said that in the tone of voice one might say "My dad used to go to art school with Hitler in the 1920s and one day saved his life by pushing him out of the way of a street car." All around an ill-fated decision. (Thank you Kurt Vonnegut for that analogy.)

I consoled her by telling her the company had no debt, $350 million in the bank, and it was run by this miserly, bottom-line guy and we would achieve profitability at all costs. I pointed out that my desire to return to work immediately after surgery was an indication of the level of commitment found in Infospace employees. To further assure her, I noted I make it a regular habit of walking around my floor and turning off lights in boardrooms and photocopy rooms to save money. I then noted anything I said was a forward-looking statement and not a guarantee of future share-price performance.

The woman snapped her pen and cast her gaze to a checklist of questions for me. "Do you take --"

"No." I cut her off. I've been through these lists before. It seems they ask you these questions every time they so much as want to press a stethoscope to your chest.

She smiled and continued with her questions. Everything I answered in the negative. I particularly like the questions about if I've been hospitalized for mental illness and if I take recreational drugs (that was their phrasing... not illegal drugs... "recreational drugs"... I can only imagine the hand wringing this phrasing must have caused in committee..."if we use recreational drugs, that might jeopardize our financing from the Bush administration...")

She's like "wow, most people we get in here I have to put a lot of checks in the yes column."

Have no doubt there are sick people in hospitals.

The woman excused herself and then told me my actual nurse would be along to put in my IV. If you'll recall from a previous CAT scan diary, those IVs hurt like hell.

"Oh I need an IV?"

"Yes, for the sedation."

"I thought it was a local anesthetic."

"They give you that but they also put some La La Juice in the IV."

La La Juice. A medical term.

My actual nurse showed up shortly after the first nurse left. She had all sorts of medical devices wrapped in sterile plastic bags. First she placed these strange self-adhesive patches on my chest and back. They were slightly bigger than American silver dollars and had little metal studs on them. Oddly enough she didn't attach anything to the metal studs. She started preparing the IV and told me to lie down in the hospital bed. So it began.

I started telling her about how painful the last IV was, how it was like someone trying to jam the sharpened end of a wire coat hanger a couple inches up my vein.

She said a lot of people find it painful but she uses a numbing solution and you hardly feel anything. She said even the biopsy isn't so bad.

"People find the dentist more painful," she noted.

"Oh, that's great because I love going to the dentist."

I do. It's fun to sit back in a chair surrounded by neat equipment and rest and have a medical professional look in your mouth and say "you have really good teeth... you're lucky." I'm sure if I ever had to have a filling I might not enjoy dental visits so much.

Now a lot of people, many of them engineers, when you say "nurse" or "nurses" their eyebrows do a dance and they say "nurses, eh" in the same way they might say "six women dressed as school girls, eh?" But this is reality, not some direct-to-video movie penned by the single free hand of Joe Eszterhas. My nurse sort of looked like a truck driver. She could have easily passed for one of my sister's friends. Despite her hardened appearance, she was very soft spoken and particularly caring. She was from Ohio. I told her I was from Canada. She said she was of French Canadian descent. "Oh, I'm half French Canadian on my mother's side. Clouthier."

"I'm Hibert."

While I repeated her name out loud several times -- practicing rolling the R and not pronouncing the final consonant in the proper French fashion -- she swabbed on some iodine and numbing stuff and inserted the IV.

Whew. It didn't hurt so much. Not like the one administered by that Khmer Rouge death camp survivor. Nurse Hibert slapped on some tape to hold the IV in place. She told me the needle doesn't actually stay in ... just the catheter.

I looked at the tube that was gurgling a clear liquid into my blood stream. I looked at what appeared to be a large air bubble traveling down the tube and approaching my arm. I looked at her. I looked back at the air bubble. I looked back up at her to see if she noticed the air bubble rushing towards my circulatory system, which as anyone named William Harvey will tell you leads right to chambers of my heart and delicate parts of my brain expecting actual blood.

Unable to contain myself I asked "say, is that an air bubble in the tube?"

"Oh, don't worry. It takes a lot of air to do any damage. It would take a whole tube of air."

Well, that blows away the plots of half of the world's murder mysteries.

Nurse Hibert told me my biopsy would be a little late. She kept referring to it as "tissue recovery". She felt biopsy was too severe sounding to patients already unnerved by the specter of cancer. I preferred biopsy as her phrasing was a bit too close to a term used by the meat packing industry called "advanced meat recovery", which is a euphemism for the processing of tendons, ligaments, spinal cord tissue and such into tasty "all beef" hot dogs.

It turned out they bumped me from my 8:30 am slot because of an ICU emergency. She told me after my biopsy I'd be given a chest x-ray, brought back to my room and monitored for a while. Then I'd get a final chest x-ray and let me go. In some rare cases, a biopsy can result in a collapsed lung. So they don't want to let you go until they're sure your lung is okay. If that happens, they have to put a tube in your lung and reinflate it or something. They then have to keep you in the hospital for a day or two. I had done some research on the procedure and I knew this was a possible complication. I told my boss at work if I didn't make contact with him by 5 pm that at best my lung had collapsed and I gave him some next of kin information.

One of the problems with living alone, you're never sure how long before someone would come looking for you if you died in your sleep or slipped in the tub. There was a tragic story a number of years ago about this lonely man in Germany who died before Christmas. No one missed him. They found him dead in his apartment months later. He was sitting in his easy chair, his TV was still on, and the Christmas lights were still blinking in his living room. This is an often told tale amongst lonely people. Sort of a cautionary tale, really. THIS IS A FATE WORSE THAN BEING BURIED ALIVE. I think the story is often told because the blinking Christmas lights element heightens the pathos of the story. Not only is it sad no one missed him for months, but he's so practiced in his solitary lifestyle he celebrates Christmas alone.

Nurse Hibert and I chatted for a while. Since we're both mid-westerners (Canadians call Ontario "Eastern Canada", Americans call states underneath mighty Ontario "the mid-west" ... I try not to fight them on this point) we talked about the difference in climate. We both agreed the total lack of winter made up for the 200 days of rain. She wanted to know how I came to Seattle. I told her my company was bought out by a Seattle dot.com.

"Oh which company do you work for?"

"Infospace."

"Oh dear. I own shares in Infospace. They're not doing so well."

I gave her the song and dance about the lack of debt and the money in the bank. Two Infospace shareholders, both nurses, seemed an improbably coincidence. I commented "you know the nurse previous to you had shares in Infospace as well."

"Oh see most people on this floor own Infospace. A while ago a doctor on this floor started telling people that Paul Allen was going to invest so a lot of us bought a bunch of shares."

I got the impression this doctor was no longer on staff.

Nurse Hibert pulled out a clipboard and began asking me more questions. She wanted to know if I had anything to eat.

"Just a cup of coffee at 6 am."

"But no food for the last 4 hours?"

"No just a bowl of granola at 6 pm Monday."

"You're probably really hungry but don't worry. We'll feed you after."

My nostrils flared. My heart rate increased. After all these years! After all these visits to friends and relatives in hospital! My own tray of hospital food!

I could not be more excited if she told me they would have six naked women parade through my room.

Nurse Hibert was about to leave. She asked if there was anything I needed. I asked her if she could pass me my backpack. I had been reading Ishmael but I figured with the coming excitement I should switch to my lighter reading. I struggled to get my book out of my bag with my left arm. I left my right arm, with the IV, rigid and unmoving.

"It's okay to move your right arm," Nurse Hibert noted, watching my struggle.

"Oh. Do these things ever fall out?"

"No. I've seen them pulled out, though."

I didn't pursue this comment. Sometimes I actually limit my own morbid curiosity.

The nurse took one last look at my IV. "The skin is pretty red. Do you know if you're allergic to the iodine?"

"I don't think so."

"Are you allergic to shell fish?"

"Shellfish?" I asked back. I have this habit of answering a woman's question with a question. It's a reflexive stalling technique that gives me time to figure out what the woman is really asking for. Women so rarely ask simple, direct questions.

"The disinfectant is made from a substance found in shellfish." She paused and tried to rephrase the question, removing all the tricky "allergy" bits.

"Do you eat shellfish?"

I thought a moment and realized this question, to be answered accurately, required a two-part answer. "If by shellfish you mean lobsters, shrimp, and crab, I eat those. If you mean clams and oysters, I don't eat those as I avoid eating anything with their digestive systems still intact. I'm horrified by the notion of putting something in my mouth that might have been in mid-poop before being sautéed."

I could see this was clearly too much information and I might have just ruined her future enjoyment of clams and oysters.

"I've never had any kind of allergic reaction," I hastily added.

Nurse Hibert removed the tape holding my IV in place and washed off the residual iodine. She applied some new tape and left.

Around 10:15 am she returned with an orderly (a member of the "transport" staff) and a wheelchair. They moved me and my IV bag over to the wheelchair. Again another first. I've pushed a lot of people around in wheelchairs but this is the first time I've enjoyed this form of translocation. Let me tell you, it's not a bad way to travel. I grabbed my copy of Armies of Pestilence and we rolled on out of there.

The thing about being in a wheelchair is people get out of your way. That's pretty cool. But they also look at you. I tried to communicate to people using only my eyes that I wasn't really sick but gave up. I might have been giving them a look like "please help me, I'm being wheeled away for use in a diabolical medical experiment." I flipped through my book to avoid their gaze.

The orderly parked me in the hallway for a bit while they got the CAT scan room ready. At that moment I had a sensation like I was in a Canadian hospital... being left in a hallway to die. I read my book. It was a chapter about the Black Plague. Three interesting things happened as a result of the Black Plague. One, the Renaissance. Between 30 and 50% of Europeans were left dead. The survivors inherited a lot of stuff. People now had excess money that could be spent on the arts or support guys like Da Vinci and their hair-brained ideas like tanks and parachutes. Two, the Church really took it in the can. If a whole college of Cardinals praying their hearts out couldn't stop the plague, what the hell good were they then? Three, Lords and Princes lost a lot of serfs, in essence a lot of free labor. To make up, they had to hire people. This created wealthier peasants, craft guilds, etc. With more money in the hands of the lower classes, political power shifted a bit.

After 10 or so minutes in the hallway I was wheeled into the CAT scan lab. I got back on the table. No Cambodian guy this time. The CAT scan operator took some initial shots with the CAT scan. This time, however, they have to be really accurate in locating the nodule (Ray Hnatyshyn) since they have to stick a needle (stab!) into you. You have to make sure you take identical breaths each time you're run through the scanner. I decided I would count to three each time I breathed and hold it. After holding my breath I also counted to 30, knowing they never made you hold your breath for longer then a 25 or 30 count. CAT scan operators should tell you to do this, as it helps alleviate the anxiety of wondering when you can take in vital air again.

The CAT scan tech came back and made some marks on the right side of my body, several inches under my arm pit.

"Just giving you a tattoo here," he quipped.

"Could you make it look like a flying skull with wings and surrounded by flames?"

After the CAT scan tech got the bearings the "team" came in. The nurse swabbed me up where the needle would be inserted. She told me she would soon add the "La La Juice" to the IV. She looked at my chart.

"Oh you work for Infospace? I have shares in that company. How's it doing?"

Oh no. I realized I was here not just as a patient but also as a healer. Again I told this nurse about the company's optimistic prospects. I added this time "I just want you to know I'm critical to that company's operation. If something were to happen to me here, the stock price would plummet."

She smiled and juiced me.

The doctor came in. Dr Zenri, as you'll recall diary reader, thought he was from a French colony in the Caribbean. My head was on the other side of the CAT scan ring for a while and I couldn't get a look at him. He had no accent, French or otherwise. When they pulled me out (I guess so the doctor could insert the needle), I took a quick glimpse of him. He didn't look like he was from the Caribbean at all. He looked like he was from Ghana or some other part of French Equatorial Africa.

The sedation at that point really started kicking in. Which is good because that's when he inserted the needle. It's an interesting level of sedation. It's just enough to disassociate you from the specifics of reality (like a needle is being thrust into your lung) but not enough to put you out entirely. You drift off but you can still follow the CAT scan operator's breathing instructions. When I closed my eyes, the sedation produced an interesting light show. They should really play "In-A-Gadda-Da-Vida". I wanted to shout out, "My god! It's full of stars!" but I didn't want to wake up as an old man in a white room with a black monolith at the foot of my bed.

Who would?

Now the needle biopsy doesn't hurt per se. But it's certainly uncomfortable. It's like someone taking a long piece of Lego and slowing pressing it into the side of your body. Because of Ray Hnatyshyn's small size, the doctor had a hard time getting a piece of it. I became aware of his efforts as the sedation wore off. I began thinking of hospital food. I caught the nurse's eye and asked her for more sedation. It wasn't that I was feeling any actual pain. I just wanted the light show back and the pleasant drifting sensation. The actual tissue removal (which I think the doctor tried 3 or 4 times before I heard him say "yeah that's it... got it") makes a strange sound, faintly reminiscent of pulling a Pez dispenser's magazine all the way back and then letting it go. There's a somewhat unpleasant sound of snapping springs and plastic.

After that they put me back in the wheelchair and took me for a chest x-ray. I was pretty groggy and had to be helped up. No lung collapse. So back to my hospital room. I slept until 1:30 pm.

Nurse Hibert reappeared and I woke up as she entered my room.

"Do you want something to drink? We've got juice... apple juice, orange juice, grape juice."

"Grape please."

"Would you like something to eat? We have muffins or a turkey sandwich."

A muffin sounded really good but I could use some meat.

"I'll have the turkey sandwich, please."

The nurse returned with not just a turkey sandwich but a huge turkey sandwich, some grapes, some baby carrots, and an individually wrapped Fig Newton. This was far in a way better than anything you get on American Airlines.

The nurse apologized for the quality of the food.

"NO THIS LOOKS GREAT!" I shouted.

She left me while I ate. She returned 15 minutes later to see how I was doing. I was popping the last bit of Fig Newton into my mouth. There was nothing but crumbs left on my tray.

"I was going to ask you how the food is but I can see you probably liked it."

"Oh yeah. This is far better than what I'd eat at home. I mean, wow, grapes and everything!"

We discussed how hard it is to prepare decent food when you live alone.

"Would you like some more juice?" she asked.

I seized this opportunity for further sustenance. I ventured cautiously, "there was a mention, previous, about muffins... could I have a muffin?"

"Certainly."

Nurse Hibert returned with a big warm fluffy poppy seed muffin and some more grapes. I didn't even ask for grapes. Clearly she picked up on the all-consuming joy grapes had induced in me.

She left but returned later with a medical dictionary. "We won't know your biopsy results until Thursday but the doctor thinks it's probably something called hamartoma."

She showed me the medical definition. Basically, it's a benign lump. There's no known cause but it doesn't appear to be life or health threatening. My regular diet of coffee and McDonalds would be unaffected if I were diagnosed with hamartoma. In that regard, it's not a death sentence.

Elated, I reached into my backpack and pulled out my 35 mm automatic camera. "Could you do me a favor? Could you take some photos of me in my hospital bed? Is this permissible?"

"Sure."

"Thanks. I keep writing emails to my friends and relatives about the differences between Canadian and American healthcare and I want to document this."

"You know this is a first. Not many people want to fondly remember their stay in a hospital."

"Please make sure you get that expensive looking machinery behind me in the photo," I directed. "Thanks!"

At 4 pm they took me back down to the x-ray department and gave me the all clear. No evidence of lung collapse. I could go home.

Back in my hospital room, Nurse Hibert removed my IV and let me get dressed. I looked at myself in the mirror. There was a bandage on the right side of my body. The black pen marks from the CAT scan tech made it look like the bandage was covering a dark hole bored into the side of my chest. It looked worse than it was.

I also noticed I still had those strange patches with the metallic studs on them. When Nurse Hibert came back in I commented "oh I still have those Frankenstein patches on me." She pulled the ones off my back. I removed the ones from my front.

"What were they for?" No one seemed to wire anything to them. The studs looked like they were for electrical clips.

"They're for a heart monitor used during the biopsy."

They didn't seem to have any sort of IC in them, so I had no idea how they transmitted heart data to a machine. I didn't ask. At this point I was anxious to leave and check my email at work.

Before leaving I asked what they did with the socks. They threw them out. I asked if I could keep them. "Certainly". The nurse also gave me my plastic Overlake Hospital water bottle.

Nurse Hibert walked me to the hospital exit and bid me goodbye. She asked if she could inquire about the results of my biopsy so she'll know how it all turns out.

Part of being a writer is exposing a lot of your private life for public consumption.

"Sure thing!" I said and left.

In sum: I'M GOING TO LIVE.

I called the hospital Thursday as instructed. Again they told me little and said I had to talk to my doctor. Arg. Wouldn't you let it slip "you need to call your doctor but just so you know it's benign"? I mean, it was right before the weekend! I would have liked to go into the weekend knowing I was not a dead man. Despite all the circumstantial evidence to the contrary, I had a paranoid fear that maybe the news would be bad.

I spent part of the weekend trying to psych myself up for possible bad news. I also tried to imagine what I'd say to the doctor if he said "it's cancer." I resolved to say "oh crap."

If the biopsy was negative, I decided I'd come up with a slogan. This is what I came up with:

No cancer of the lung for 2001

I got to the doctor's fifteen minutes early and nearly finished "Ishmael" in his waiting room before being called into Dr. Zenri's office.

He had my file open. I avoided trying to read what was on the file.

I forget now his exact words, other than it was hamartoma. He pulled out a huge medical text and began showing me pictures of grapefruit-sized hamartoma nodules taken from the lungs of dead people.

Yeah. When he got bored of that, he started showing me pictures of other tumors, both benign and cancerous. He mumbled something about not being sure why he gave me a chest xray in the first place. I'm glad he did. What if my doctor in Canada had gotten around to giving me a chest xray when I was 50 and they found the nodule? It's hard to imagine waiting for months for a CAT scan and then a biopsy. Wading through just half of May with all this was bad enough.

So basically, you need to keep an eye on the hamartoma and make sure it doesn't get so big that it affects your respiration. But pieces can't break off and travel to your brain or liver and devour those rather critical organs.

As my friend Terry indicated, he won't have to be writing the CAT Scan Eulogy any time soon.

The report of the French colonial doctor prepared was interesting. He wrote "The nodule in the superior segment of the right lower lobe was biopsied with a 20 gauge Cook core biopsy device coaxially via a 19 gauge needle. Multiple cores were obtained and submitted to the attending pathologist. Following confirmation that adequate pathologic material had been obtained, the procedure was terminated. Patient tolerated the procedure well."

It sounds a bit odd that something listed as "20 gauge" can be contained in something that's 19 gauge. But I learned something from my friend the ArtBabe (who's studying to be a doctor 'n' all). The larger the number, the smaller the needle. A 20-gauge Lung-Core-O-Matic is actually smaller than a 19-gauge Shur-Stab needle. So the Lung-Core-O-Matic can reside in the Shur-Stab needle.

I like the part about me tolerating the procedure well. Does it mean I was a generally pleasant patient? If there's one thing I value about myself, it's that I can remain pleasant and cheerful while someone is trying to tear my insides apart (figuratively or literally). I generally take breakups with girlfriends well.

Well, a whole year has gone by since I began the CAT Scan Diaries.  I notice via my web log people actually read (or glance) at my diary. They search on terms like "hamartoma" and "noncalcified nodule with no adenopathy" via Google (all praise google). When I first found out I had a lump (Ray Hnatyshyn) in my lung that wasn't supposed to be there, I could only consider the possibility that it might be cancer and I was going to die a painful death. My skin might even turn a pasty white! I'd look just like the Smoking Man in The X-Files finale. What I found most saddening about the idea of dying at a young age wasn't so much dying but thinking about all the crying women at my funeral. When I look back at it now and think I got all worried about a lump of gristle in my lung, all the worrying I did seems a touch foolish. I'm sort of glad if people stumble on my diary, actually read it, and discover that "noncalcified nodule with no adenopathy" probably means you're not a DEAD MAN and you don't have to be running around all in a panic and commissioning a requiem for yourself. Like I did. If you're really lucky, you won't only not die, but you might also get to hang around with a couple wonderful nurses like I do. Like I say, if you're lucky.

Last week I had a chest X-ray to see if Ray Hnatyshyn (the lump) was getting any bigger. The good news is the X-ray still reports him as being 1.4 cm in size. Although the lump is benign they can grow. You don't want them to get so big they diminish your lung capacity.

Last week went I went for my actual chest x-ray, I brought Dr. Zenri and his nurses some peanut butter cookies I made the night before. Here's the recipe:

1 cup of peanut butter

1/2 cup of sugar

1 egg

Yes. That's all. No flour needed. Just mix it all in a bowl. Use a table spoon to glop out balls of peanut butter about three times the size of Ray Hnatyshyn (say half the size of a golf ball) onto a greased cookie sheet. With a fork squoosh each down flat. Remember if you have children, make sure you get the fork marks correct. Children do not enjoy peanut butter cookies unless they have pronounced fork ridges. Bake at 325 f for 15 minutes. Do not over bake. These suckers can burn easily. Let cool. And I mean it. They're still quite mooshy until they've cooled.

I brought them in a big brown lunch sack full of the cookies. Kayako said Dr Zenri liked them. He kept going back to the kitchen to eat the cookies between patients.

Yesterday I prepared dough for naan (that yummy Indian flat bread). This morning I cooked it up, wrapped it in tin foil, put it in a thermosack, and brought them warm, fresh, doughy, sweet naan. Here's the recipe:

4 cups flour

1 packet of yeast

1/2 cup of sugar

2 cups of yogurt (I like to use vanilla-flavored yogurt)

1 cup of warm water

2 tablespoons of oil

Mix it all up in a bowl, kneed, and add flour as needed. Let rise. Then roll out pancake sized dough bits. All what you do then is cook them on a Teflon skillet like you'd cook pancakes. Don't put any oil on the skillet. Just cook them on a hot, dry Teflon pan surface. You only need to cook each side about 2 minutes. Check the cooking side until it looks naan like then flip over and cook that side until it looks naan like.

Right. Where was I? Oh yeah, Doctor Zenri decided since there's a chance these hamartoma nodules (freakin' lumps) can grow he thought he'd send me to a (get this wickedly named specialty) "cariodiothoracic" specialist and let him determine if it's worth actually removing Ray Hnatyshyn.

Lung surgery! Cool.

I got my work order (referral) for a Dr. Andrews at Overlake hospital. Dr. Zenri, who seems to have all the dope on Overlake doctors, said he was a Canadian and went to McMaster University in Hamilton to get his M.D. I looked at Dr. Zenri. "That's a terrible school, doctor!"

Dr Zenri looked horrified. "Really?"

"No. I don't know. It's okay I guess. It's not Harvard, however."

"You're making a joke. You're a funny guy because you're blood type A!"

He went on to explain how blood type determines personality.

 I walked over to Dr. Andrews office at Overlake and booked an appointment with his secretary. I usually like first-thing-in-the-morning appointments but apparently he's in surgery during the mornings. I find I do my best work in the morning too so that made sense. Still, I'm not sure I'd want to go under the knife and gas on a Monday morning. It's like we used to say in my hometown of Windsor (Canada's car capital). "Never buy a car made on a Monday!"

Those looking for a thesis topic for your PhD in Industrial Psychology or MBA might want to investigate that bit of conventional wisdom. I give this idea to you. It's yours. Run with it.

I booked my appointment for next Tuesday (right after Memorial Day). This wasn't for surgery, mind you. Just a "consultation". So no worries.

Later in the afternoon Dr Andrew's office called. The receptionist made a mistake. Dr Andrews doesn't see patients with lung problems. He's the cardio portion of his cariodiothoracic practice. A Dr Hong does the lung work. Hearts and lungs, what an offally good team they make! Christ, I slay me. I should look into some recipes employing sweetbreads.

I called Dr Zenri's office and let them know I changed time and doctors. Kayako called me back a bit later asking me if I knew Dr Hong's first name so they could re-do the work order. I said it was "Vu". "V as in Victor" and "U as in ... errr umbilical cord". What's a good U word? "U as in Urethra?" "U as in Unnecessary Surgery?" I decided to stick with "umbilical cord" and let the chips fall where they may. Kayako is a mother. She'll understand.

I had to stop by Dr Zenri's office on my way to the thoracic specialist. They needed to give me a new work order with Dr Hong's name on it. Kayako was at the desk and had the work order ready. As I was folding it and putting it into my pocket, she pulled from her pocket three foil-wrapped snacks and gave them to me. The packets were covered in Japanese characters.

"Do you like these?" she asked.

"More yummy rice crackers?" I asked back. I'm practiced at the art of answering a woman's question with another question.

She took them out of my hands and showed me how each foil package had a different colored stripe in the corner. One was a vanilla color. One was a strawberry color. One was a chocolate color. I quickly realized these weren't any seaweed-wrapped rice crackers. These were chocolate, strawberry, and vanilla flavored seaweed-wrapped rice crackers!

Just then Dr Zenri came in. He said something about if I don't like this doctor he knows another one. I wondered if Dr Zenri did consulting for the legal profession. "If this one won't give you the testimony you desire, I know a couple others who will."

Dr Zenri thanked me for the naan I made last time and strongly hinted he liked the peanut butter cookies better. He saw Kayako giving me back the biscuits.

"Hide those from Dr Hong," he cautioned.

I walked over to the cariodiothoracic office at Overlake Hospital. After checking in at the desk, I was introduced to a woman who introduced herself as Judy, Dr Hong's "Nurse Practitioner". Nurse Practitioner? This might be what Registered Nursing Assistants (RNAs) call themselves these days. Apparently they don't like the "assistant" part in their title. It gives those smarmy RNs liege to boss them around.

Nurse Practitioner Judy took me into an examination room and asked me all the standard questions: Do I smoke? Do I drink to forget? Am I allergic to anything? Do I have diabetes? Do I have trouble sleeping? Do I have night sweats? Do I frequently wake up in the middle of the night screaming? Have I ever been hospitalized for anything? If you cut me, do I not bleed? Much like my biopsy I answered no to everything. Much like my biopsy, this nurse again commented she's accustomed to putting more checks in the "yes" column. Where do all these sick people come from?

One day I'll move some place where the medical establishment asks questions like "Do you drink more than 6 cups of coffee a day?" "Do you sit too close to the TV?" "Do you make it easy for strangers on the Internet to find your apartment?" "Do you eat more than 12 hot dogs a month?" "Do you melt cheese on everything?" Then I'll be in trouble.

Nurse Practitioner Judy then gave me this oddly thorough physical examination. She felt my thyroid for lumps. She took my blood pressure from both arms and got different readings. This is apparently not uncommon. She thumped around my tummy and pronounced my liver to be exactly where it should be. Despite what some of my friend's mothers thought when I was in high school, I'm not a space alien! She even checked to see if I had hair on the top of my feet.

"That's a good sign," she said. "It means you've got good circulation." I always thought it meant I was freakish.

Then she asked to see my hands. I showed her my palms first and the reluctantly revealed the tops of my hands. I quickly confessed to being an incessant nail bitter. She made a little cross face.

"This is my way of dealing with stress," I protested. "I feel it's healthy. I mean I don't drink or smoke or kill people." My voice trailed off on the "kill people" part.

I pointed out a couple weird grayish black spots that appeared on my hands a couple years ago. They look a bit like someone drew them on with an HB pencil.

"Do you know what these spots are? They're not dirt. They don't wash off." Believe me I've tried. Soap, hydrogen peroxide, isopropanol, lye and a wire brush. They don't come off. She seemed so experienced I figured she could clue me in.

"I've never seen those before."

After that she asked me why I was there to visit Dr Hong. I explained about the hamartoma and how they normally don't grow but in rare cases they can. I told her about the horror book Dr Zenri showed me of chihuahua-sized hamartoma lumps they've taken out of dead bodies. Dr Zenri, I suggested, really just wanted me to get a second opinion whether or not it would be better to remove the sucker now. I figured too if they can grow, is it better now to get it done when I'm young and in the States versus waiting until I'm 60 and in Canada.

"What's hamartoma?" she asked.

I explained how it's a benign coin lesion. They're more frequent in women than men. They're usually not discovered until people are in their late 50s or 60s. And it's basically a small ball of gristle in your lung that doesn't affect your health or well being unless it grows. If they do grow they have a doubling time similar to a cancerous pulmonary tumor.

"Oh you seem to know a lot about this," she said.

"Yeah, well thank goodness for the Internet, eh."

She went on to talk a bit about lung surgery and how she would not wish it on her worst enemy.

She left and I sat there for about half an hour. Luckily I always have a book with me. This time around I'm reading Memoirs of a Geisha. It's not my first choice in literature but my friend Minn gave it to me and my friend Leiah has been urging me to read it (or more like cajoling me "Karl, you have to read it. You know, you'd never make it as a geisha. Never!").

Kayako was telling me she studied tea ceremony in Japan and she's a qualified Tea Ceremony Practitioner or something. Anyway, she gets a newsletter from some tea society in Japan so surely she's a professional. Kayako once noted that the doctor's wife (who Kayako and Mie refer to as "the Missus") is, in fact, qualified to teach Tea Ceremony. Kayako says sometimes when they're bored at work, they conduct a mini tea ceremony. Anyway, I have no idea what this tea ceremony involves but it sounds like there's some damn tasty tea at the end of it. I mean, there better be. (Wait, hold that thought, transubstantiation never really added anything perceptible to the wafer's taste.)

 A few days ago, the book's geisha-in-training reveals she'll learn the tea ceremony as part of her geisha training. Okay that sparked my interest. I can finally find out what this tea ceremony is all about.

However, reading in Dr Hong's examination office I came across this passage:

"My last lesson of the morning was in tea ceremony [oh good!]. This is a subject many books are written about, so I won't try to go into much detail."

Well, Christ! What a way to fob the issue. Thanks Arthur S. Golden!

Dr Hong eventually showed up and led me to his office. Dr Hong was wearing a nice grey pinstriped three-button single-breasted suit. It looked a lot like one I owned. And just like the one I owned, it looked about a size too big for him as well.

He started to tell me he's read my medical reports and reviewed my chest x-rays with that tone of voice you might use with your friend when confirming that you "read" the 14-page log she sent you of a chat between her and her boyfriend and your opinion on the state of her relationship is most assuredly informed opinion.

Dr Hong suggested another CAT scan (here we go again) to confirm Ray Hnatyshyn shows no signs of cancer.

Cancer? I thought we had eliminated that possibility.

I mentioned the needle biopsy (stab!) and asked wasn't that proof the lump was hamartoma and not a cancerous lump?

"A needle biopsy only takes and analyzes a small sample. The only way to be 100% sure is remove the entire nodule."

He drew a circle on a piece of paper and then dotted the inside of the circle with squiggles to indicate cancerous cells. He then drew a few lines through the circle to show how a needle could miss the squiggles.

He then pulled out a brochure called "Lung Surgery" and opened it to a page with an illustration of a lung. He drew a circle about where Ray Hnatyshyn lives and then enclosed it in a wedge.

"To remove it what we'd do is deflate your lung, so you're only breathing with one lung, and then cut a wedge out of your lung like this."

Oh dear.

"So any questions? How do you feel about the CAT scan idea?"

"Sounds good to me."

He wrote me a work order for a CAT scan and gave me the Lung Surgery brochure.

Later that day, after work, I went to Starbucks to review the brochure. The brochure uses art work in those muted pastel colors which are universally employed in brochures or back-of-the-airplane-seat cards which deliver information of a terrifying nature. Oddly enough, the brochure's art work also remind me of Hari Krishna recruitment brochures that used to litter my university student center's coffee lounge -- images of people with shaved heads, wearing robes, and seeming overjoyed their daily existence involves chanting and harvesting gourds.

The brochure basically explained that even the simplest of lung surgeries involves about 2-4 days in hospital. That doesn't seem so bad. First, a few days in a nice hospital with nothing to do but read, watch TV, sleep, play with the bed controls, eat food you don't have to cook for yourself, and talk to nurses is a relatively attractive prospect. Second, you get pain killers.

However, what dissuaded me from pioneering the field of "surgical tourism" (a plan, nay a calling, I mapped out when I was in my early 20s... I had a plan to get registered on bone marrow donor lists all over the world, if my number came up, that could mean a free trip to Europe or Australia to donate bone marrow) is the brochure's section on recovery period. It speaks of not days, but weeks. I get fitful if I'm away from my gym for more than two days. The brochure's "Easing into Activity" section gives a 4-6 week time frame. Next to it is a picture of an old coot overjoyed as hell he's now allowed to collect his mail at the end of his driveway.

Okay, pass.

* * *

Copyright 2002 Karl Mamer

Direct comments and questions to kamamer@yahoo.com