Well - Tara Parker-Pope on Health
March 1, 2011, 8:24 am
The Doctor Who Knew Too Much
By DR. PETER B. BACH

“You know more than you should.”

It was Saturday, three days after the surgeon’s gentle but unmistakable pronouncement that my wife, Ruth, had breast cancer. I was on the phone with a longtime colleague who was trying to talk me out of my gloomy mood. He reminded me that as a physician at Memorial Sloan-Kettering Cancer Center in New York who only takes care of patients admitted to the hospital, I often see only those who are critically ill.
Peter B. Bach

“You don’t see the other side,” he told me, predicting that my wife would be like the thousands of men and women with cancer every year who sail through treatment and go back to their lives.

The day before, Ruth had lain on the table in Sloan-Kettering’s nuclear medicine department. A huge white detector arm moved over her as they ran a bone scan, which searches for metastatic cancer that is out of reach of the surgeon.
Patient Journal The Doctor’s Wife

Dr. Peter B. Bach writes about his wife’s breast cancer diagnosis and treatment.

    * When the Doctor’s Wife Has Cancer

The bone scan takes about 45 minutes. The results appear as little black and white skeletons a few inches tall. In another context they’d be decorations for a 5-year-old’s Halloween party.

“These are mostly good stories,” my friend continued. “Early-stage cancers found and cured.”

As Ruth lay there on the bone scan table, a microscopic radiotracer they had injected into her veins coursed around her circulatory system. It scoured her bones, looking for the smallest little hideout of cancerous cells to latch onto and ring the alarm.

After the test, they put on a bandage to cover the site where the radiotracer was injected, and we went home for the weekend. It was a Friday, and we would have to wait until Monday for the results.

If the cancer had moved beyond the reach of the surgeon — if it was metastatic — then the road ahead would be much harder.

My friend was right: I knew too much. More than 40,000 women die each year in the United States of breast cancer. Most of them have metastatic disease.

Throughout the weekend, I just prayed that Ruth did not fully understand what the bone scan was looking for and what it would mean if her scan lit up. Later I realized that of course she understood, and she was just bravely and silently moving forward.

Had she been my patient, not my wife, I would have been able to discuss the bone scan with her. But not when our lives were tied to where the radiotracer chose to land.

They say doctors make notoriously bad patients. They don’t take the medications they are supposed to and don’t go for their checkups. Some of them even smoke. Maybe doctors make bad spouses of patients, too. Of course I should have been open with Ruth about my fears, but I also knew the weight those fears, coming from a doctor, could carry.

I loathed being stuck on the high wire that stretched between being doctor and husband, one who knew too much about the test and the other too petrified to contemplate it. It was just a long fall to either side. So all weekend long I stood there and said nothing about the bone scan.

When Ruth was handed the diagnosis, she had decided, “Tell everyone.” Her argument was that our friends would want to know, and that we needed them, and that frankly we’d never keep the story straight if we endeavored to somehow filter what was happening.

Meanwhile, I was trying to figure out how to keep the whole thing a secret. Maybe it would all just go away. Maybe I’d wake up tomorrow and we would be back at the surgeon’s office on that sunny morning, and this time he would say, “It’s nothing, don’t worry about it.”

On Monday, we found out Ruth’s bone scan didn’t light up. One hard reality avoided. Her cancer could be cured. But I felt no sense of relief whatsoever. There was plenty ahead to fear, many tests that could come out one way or another.

I’ve always assumed that you can’t be a functioning doctor if you worry every day that you or someone you love may become a patient. After all, we are called upon daily to be battlefield surgeons who tell the truth, hand over the whiskey and do what needs to be done.

So as we walk through a waiting room to our offices, we don’t acknowledge that some other day we may be sitting in that same waiting room. And we don’t contemplate that someday we’ll have to wait over a weekend to learn the results of a single test that could make all the difference. If we did, we might be too afraid to order it.

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