On Friday I had to have my monthly injection of Triptorelin. Well, it was due next Tuesday, when I will be in Perth at this conference, and so I timed the shot for what I knew would be my doctor's last day of practice before her retirement.
I have been going to see Barbara, I saw from my rather thick file, since 1988, and count myself lucky to have been under her care these nineteen years. I'm not sure how long she's been practising in the little surgery in the heart of Carlton, but I know she was already famous then around Melbourne as a GP who also specialised in obstetrics. There were several years there when you'd have an appointment but you'd have to wait, or they'd phone you up to re-schedule because some baby had come along that day. Still, I've never felt rushed under her care, and always found her humane, intelligent and sensible. Until his sudden death around six or seven years ago, her husband Evan Burge was Warden of Trinity College at the University, and so she was always clued in to the currents of university life, with a sympathetic ear whenever I would trot along with the sinusitis and bronchitis that were always exacerbated by teaching, especially in Joel's early years when we all picked up whatever bug was circulating around the creche or kindergarten. If she sometimes attributed me with greater medical understanding than I had, she could always follow up with a clear explanation; and her counsel always seemed sensible.
Barbara saw me through various ailments, picked me up and put me back together when I crashed my bike and cracked a bone in my finger (and then later my wrist: separate accident); dug out varoukas from my feet; told me to give a proper burial to the poor blighted ovum that preceded my pregnancy with Joel; and saw me through his joyful birth. She refused to try and turn the baby when his little head was still nestling resolutely up under my ribs in the last weeks, and wouldn't countenance my going into labour. "That's real tiger country," she said, and sent me off to see a specialist surgeon. All the people she's referred me too over the years have been fantastic: the physiotherapist, the psychiatrist, the gynecologist, the obstetrician, and of course the wonderful Team Suzanne at the breast clinic.
When it became clear from the mammogram and the ultrasound last September that there was something that had all the appearance of a carcinoma, I think I was pretty much ready for the news (blind Freddie could have seen the big black mass the radiologist froze on the ultrasound screen), but Barbara still made sure that the moment when the word "cancer" was uttered was a calm one, and we sat and talked for quite a while before she'd let me get back on the bike.
I'm going to miss that lovely sense of her familiarity with my medical history when I find my new doctor (must start researching soon, with the list of names she has given me). I'll miss her network of medical practitioners of all kinds around Melbourne. I'll even miss the little wooden framed pictures of ducks that have sat above the examining table for years - a curious point of focus during pap smear tests.
Last Friday's appointment was a long one. I had the shot; Barbara checked the sore muscle on the side of the breast surgery and confirmed that yes, indeed, I had strained it doing too much serving at tennis, and that no, it wasn't secondary bone cancer (too much reassurance is never enough, I am beginning to realise); she also gave me a tetanus shot; and we talked about other doctors in the area I might like. She reminded me not to strain the arm too much, and as she did so, laid her hand on my forearm in a gesture of affection, with her quick and ready smile. Other signs, too, in this immensely admirable woman, of how her customary restraint was gradually loosening up, as the day, and as her professional life came to an end. Never before had I seen her take a call about another patient, but there she was, giving her home phone number to a psychologist she wanted to call her back about a young woman in distress. We talked about others of her patients I knew, which we would never normally do. And when it was time to go, it was good to embrace her in goodbye.
But the first thing she said when I came through the door was "I'm so sorry to hear about Paul." Turns out she had seen my dear friend Robyn the previous day, and so she heard the news about his melanoma in Robyn's last appointment. Paul hasn't featured much in this blog, but he was intrigued to think I could write about his cancer too. He goes into hospital tomorrow for the day to have a melanoma removed from his chest, and further surgery on another little patch on his nose. The surgeon thinks this is all the treatment that will be necessary since the melanoma is nowhere near the magical 7.6 mm thick that triggers the next stage of alarm, but there were several days last week when we were thinking about radiotherapy and chemotherapy and lung and rib damage, and it was all just a bit too scary and odd. He will be in the same hospital, and he is also pleased that his surgery will be on the same side as mine. It will be an anaesthetic that sounds as if it is somewhere between a local and general, and with any luck he'll be back home in the early afternoon, ready to take it quietly for a few days, until he is well enough to go out and buy a HAT. We're so confident he'll be ok that I'm still hoping to head off to Perth as planned on Tuesday morning. If I have time I'll log on tomorrow night to update with news, but otherwise will be missing in conference action till Sunday.
[Update: Paul sailed through surgery this morning and was home and tucked up in bed by 1.00. He can't remember much of the procedure, and slept through most of the day. How lucky we are to live in a city that offers such efficient and prompt medical care. It's a mere week since he received the pathology reports on the first biopsy and his treatment is complete. All the same, we are now advocates for early detection in this family. Any doubts about lumps or moles? off to the doctor with you, NOW!!!]