The Sky is Falling

My husband sat opposite me sipping on a delicious double Starbuck’s cappuccino. We sat on those small fanciful wrought-iron chairs at a round table in the middle of the Chevy Chase Pavilion, a few miles from the National Institutes of Health. We were completely surrounded by the wonderful shops: Pottery Barn, Hold Everything, the Limited, Express, a sun glass shop, and a party shop to name a few. On the upper levels were the rooms of the Embassy Suites Hotel.

Immediately overhead was a giant, light teal green ornamental truss system in the shape of a gazebo that seemed to be holding up the sky. Through the clear skylight and truss system the irregular shape of the clouds were clearly visible: racing past on this sunny, blustery day. A short distance away, the cherry tree blossoms around the Tidal Basin were a day away from their glorious peak.

I gingerly tasted a few sips of my husband’s aromatic coffee, afraid that too much might aggravate the diarrhea I experienced as a side effect of the gastroview I had drunk the day before for my CT scan. I peered up at the sky and was reminded of the folk tale, Chicken Little, and the repeated phrase, "the sky is falling." Supportive armature, like the trusses, would be necessary to keep my own will power from collapsing.

Two hours earlier, Dr. Phillips entered the consulting room cheerfully enough and began our consultation with the words, "only a slight change," This is what my husband and I heard and remembered. I, however, wanted more details – specifics, numbers, how much was this slight change? On which of the two small malignant tumors, one in each kidney, was the change?

I was told that according to the CT scans the tumor in the left kidney had gone from 0.7 centimeters to 1.5 centimeters. A malignant tumor of 1.5 centimeters in the kidneys is not in itself something to be too concerned about for VHL patients. Experienced urologic oncologists have decided through research that there is little risk of metastasis before tumors reach the threatening size of 3 centimeters. Because of the frequency of tumors over a patient’s lifetime they are comfortable postponing surgery until that time. Then surgeons do nephron sparing surgery, when they take out the smallest amount possible of the kidney, thus preserving a patient’s own kidney function as long as possible. What seemed worrisome about the increase in growth rate of my tumor in the left kidney was that it had doubled in size in one year. I mentally calculated that if it doubled again in the next 12 months, I’d need renal sparing surgery this time next year or shortly thereafter. Not a happy thought.

I felt angry. Not violently angry; just in a bad mood. I had hoped to beat the averages and get a 100% "no changes" report. I had tried to live healthily by eating lots of fruits and vegetables and drinking green tea and eating soy foods! My surroundings in the impersonal mall with all the people shopping looked surreal. I felt as if they were of another species – the cancer-free. I tried to feel part of that world, but this afternoon I did not. I felt like an alien surrounded by lovely, attractively displayed things to buy that all seemed superfluous. What I wanted was not for sale. I wanted a new pair of genes (VHL genes, not blue jeans). I wanted a magic pill to kill my tumors. Among all the reproductions for sale immediately before me I couldn’t find an artificial kidney. None of the world’s most prestigious shops that adjoin the Pavilion had any of these items. Not even Saks, Neiman Marcus, Tiffanys, Jaeger, Gianni Versace nor Cartier.

I was keenly aware, as I was brooding on my latest diagnosis, that I’d have to get out of my surreal way of looking at things and get back into the swing of life promptly. For with or without me, life would go on. People would go to the Pavilion shops and purchase what they wanted and derive pleasure just from being there. They would share a coffee or a beverage with a loved one and enjoy idle chit-chat. I needed to feel I could, and would want to, do the same. From past experiences with other tumors I took comfort in knowing that my anger and surreal lenses were temporary. I knew that I’d find more strength. Someday, I hoped, I would find the silver lining in those clouds above, which for now was completely hidden.