Waiting for Doctor #1

Doctor #1 or Dr. M as I Refer to Him.

12 years ago my PCP (Primary Care Physician) noticed a slight increase in my PSA (Prostate Specific Antigen).  Based on a hunch he sent me to a urologist for a follow up.  With referral slip in hand I headed off to meet my new comrade in the cause we shall call “Keeping Rufus Alive”.

Dr. M was a shorter man.  He was of Arabic descent and had a perma-tan.  As our years together would reveal to me, he liked the ocean and he liked beaches.  Dr. M was confident but not cocky.  When he looked at my PSA change he gave me about even odds that I was dealing with something that was just aggravating my prostate.  Still, we had to check given that I was so young and all, a mere 50.  Men don’t get prostate cancer at 50. Testing would happen quickly.

Testing required I be sodomized by a staple gun in the shape of a dildo.  The results came back ambiguous.  According to the lab they might be inflammation but then again they might be symptomatic of prostate cancer.  Dr. M stated that the appropriate course of action was that I wait a short while to see if the inflammation resolved.  In a very knowing voice he told me that we would again do the anal probe in a few months.  To quote a script by John Sayles, “I did not ask for the anal probe.”  Say that six times with different inflections, emphatic, timid matter of fact, fearful, sorrowful and perhaps shocked.

In three months time there I was again on the examination table listening to the pop, pop, pop of the prongs taking flesh from my jizz generator.  Again confident but not cocky Dr. M told me we would have the results in a few days.  He told me he would call as soon as he knew.  This time he didn’t tell me he was sending the samples to Johns Hopkins for review.

True to his word he called 5 days later on a Monday morning at about 8:45 a.m.  He was calm but very direct, “You have prostate cancer and from my perspective given your age the best possible course of action is to remove the prostate.”  I was shell shocked.  I was looking for other answers.  I went to a noted local oncologist who looked at the results.  He too was Arab.  He did not hesitate to tell me that with these results at age fifty I had to have my prostate out.

For twelve years now I have followed up with Dr. M.  My PSA has remained nil.  After a decade you get told it isn’t coming back. For each visit I would wait for him by sitting on the exam table in the lotus position.  I find it more comfortable that the chairs they wedge in those rooms.  Each visit we would talk about Arab food.  Kibbie rules.  Each visit he would be supportive and understanding.

Taking the prostate out changes the places of pieces and parts of you innards.  Things shift.  Your penis shrinks a tad.  Damn miserable stuff.  Over time you lose a little muscle control front and back.  Yeah, I know too much info, but it is what it is.

One of the things I noticed in the past two to three years was that my bladder region has gotten tender.  Twice now Dr. M has run the camera up my penis, yes it is not very pleasant.  Twice the samples taken by this device from inside my bladder came back negative for cancer.

At Dr. M’s behest I was sent for therapy.  This involved sphincter squeezing exercises.  It involved a giant rubber band and a small rubber ball.  Finally it involved both exterior and interior massages.  Yeah, you got that right.  I had a fifty something woman using one of her gloved digits to massage the interior of my posterior.  Thing was it helped.  I mean I am still not gay but that digit thing made my bladder feel better for a couple of weeks.

Despite doing all the rubber band stretches and the rubber ball between my knees compressions, I still have an agitated bladder.  Dr. M decided to look a bit further to see if there was any structural reason for this, i.e., a tumor or something.  I was shuffled off for a CAT scan and well if you have been reading along you know the results.

What was different this time was that the personal touch of Doc M had changed a little.  After the CAT scan I got a call within two or three hours telling me I needed a biopsy.  This call came from a nurse, not from Doc M.

I got the biopsy and good old Dr. S who drilled in my kidney, the inerventional radiologist told me the results would come in 7-10 days.  Nyah.  The biopsy was on a Tuesday, two days later I got a call from Dr. M’s assistant asking me if I could make a 4:45 pm appointment with the doctor on Friday.

What freakin’ self respecting doctor is setting appointments on Friday afternoon in the height of summer?  I am going to attach a clip below, it is the ending to the movie A Serious Man.  The movie is very Jewish but watch it even if that particular experiential set is different from your own.  Crucial to understanding my reaction to the call for a quick appointment  is the part where the doctor in the movie calls the aspiring college professor. You need to see this to have an understanding of how terrorized I was. https://youtu.be/2Qk4H7yfwPg

To be called in on a Friday I was sure I had to be toast. (I still may very well be but that we will find out as time progresses now won’t we reader?) For 24 hours my guts churned, my mind raced and my toes sweated.  I was emotionally and physically drained by the time I reached Doc M’s office.

Sitting with my wife in the examination room the door opened.  The good doctor came in smiled a gentle smile and in a very matter of fact tone told me I have renal cancer.  He showed me the film and he told things like it was stage 1 and it was slow moving.  His advice is to remove some of the kidney but not all of it.  We will again use the DaVinci machine.

Why did he call me in on a Friday at 4:45 p.m., well because he knew me and he knew how worried I would be.  He wanted to sort out the good news from the bad and calm me down a bit.  Doctor M is a good man, the field of Urology will lose a good practitioner when he retires in December.  I asked him if he had ever seen a Serious Man.  He hadn’t. Kind of wish he had.