Well - Tara Parker-Pope on Health
February 21, 2011, 3:39 pm
When the Doctor’s Wife Has Cancer
By PETER B. BACH, M.D.
Christopher Silas Neal
Peter B. Bach

As a medical student 20 years ago, I learned all about anatomy, physiology and pharmacology. My professors also taught me, implicitly, how to put on the white doctor coat as a shield against human vulnerability. With the coat on, you could get right up close to frailty, even touch it, and it wouldn’t be able to reach out and pull you in.

Residency training, with its harsh hours and unrelenting pace, added several more layers of protective shellac. But in all those years I didn’t have one class on how to be a patient, never mind how to be the spouse of one.

It was 8 a.m. on a sunny and crisp Wednesday in October when I became one. My wife, Ruth, and I arrived in the clinic of my colleague Dr. Hiram (Chip) Cody, a breast cancer surgeon and my fellow physician for more than a decade at Memorial Sloan-Kettering Cancer Center in New York. When I told him Ruth had felt a lump, he had made room to see us right away.

I was hyperaware of my surroundings, as if I were a first-time visitor in my own hospital. Things that were around me every day of the week were suddenly new: the type and volume of forms Ruth was asked to complete; the conduct of the first secretary we met; whether the staff members introduced themselves by name.

Then we were in the room. Usually these lumps are a matter of anxiety and tests, leading to nothing. I leaned in the corner, stripped of my stethoscope and white coat of authority, as Chip stood examining Ruth. I waited as he felt her breast. More than 200,000 women each year in the United States walk out of these appointments with life-altering news. But many more are reassured, either during the visit or after a biopsy comes back negative.

This time: “Oh, Ruth, I think this is a cancer.”

That was it. Shock. And then the walls closing in and the floor giving way beneath. Down into the tunnel Ruth and I tumbled, into the strange, dehumanizing, aching, opaque and misunderstood world of cancer doctors and cancer care.

My colleagues of 10 years at Sloan-Kettering, whom I saw on the hospital ward, watched get married, drank with at holiday parties and sat next to at meetings, were about to be Ruth’s doctors. The places I had passed through year after year — the exam rooms in the clinic, the waiting rooms outside the operating room, the hospital floors where patients amble with IV poles — were transformed to places where we would soon sit in terror. Half an hour earlier my biggest concern had been finding a parking place.

Chip took out his notepad and made a simple drawing of my wife’s breasts, nipples and all, then superimposed an outline of the tumor he thought he felt. On a new sheet of paper he drew an enlarged version of the tumor growing, explaining how it had probably started inside her milk ducts. A few more pencil strokes animated the cancer, invading through the ducts into the breast tissue and forming the mass. Then he showed how it could travel along channels and spread to lymph nodes.

Ten years earlier Ruth and I had stolen away to Paris for a Thanksgiving break. We were still newlyweds, walking the city in a constant freezing rain. We made it to one museum. In it, high up in a remote corner of a dimly lighted room in what used to be a train station, was an exhibit of crayon drawings by Degas.

We moved clockwise in the darkness, stopping at each drawing. I lost Ruth in the crowd a few times, even though we were separated by just two or three drawings. Some consisted of only a few curved lines that still managed to evoke both character and story. The effect of these simple depictions, in the darkness, was ethereal and emotive. So much, so sparingly.

I thought of Degas again when I came across Dr. Cody’s penciled sketches a year or so after Ruth’s diagnosis — pictures of our lives imploding around us on his notepad. The late nights along the Seine were as dark and dreary as the sunshine was bright that Wednesday morning on the Upper East Side of Manhattan. The simple, perfect drawings in the museum that conveyed the burdens shouldered by a woman bathing or a young girl dancing were as universal as the particular pattern of my wife’s breast cancer was specific — her mass, her possibly involved lymph nodes. Our ambling on cobblestone streets was as aimless as the rapid-fire schedule of tests and biopsies and meetings with other doctors and nurses that would follow the meeting with Dr. Cody was purposeful.

Dr. Cody finished his drawing and looked at us, his arms on his desk with his lab coat sleeves hiked up, the overhead lights reflecting off his glasses. I sat with Ruth, bracing myself for the next step.

This is the first in a series by Dr. Peter B. Bach, an attending physician at Memorial Sloan-Kettering Cancer Center in New York City. His essays, about his wife’s breast cancer, will appear Tuesdays on the Well blog.

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