If We Break It, We'll Fix It
/Incidental Findings
"You need a biopsy, Tara," the pulmonologist advised as he fiddled with his mouse to bring up the CT scan on his computer.
"Yes, a biopsy" he repeated, focusing on the flat screen. "The nodule in your lung has gotten bigger in the last three months." Clicking on the mouse, he enlarged one area of the black and white image. "See," he pointed to the offending nodule, "the ground glass aspect has a solid component in it now, measuring 5 by 7 millimeters."
An abdominal CT scan that itself was normal, turned up an incidental finding of pulmonary nodules. Incidental findings. Things you weren't looking for, but found nonetheless, and now required that you follow up.
They both stared at the follow-up scan that showed "significant interval growth" in just three short months. Localized to the right middle lobe of the lung.
Just A Biopsy
A lung biopsy.
A long needle pushed through your chest wall to gather tissue from deep inside. Not a simple venous puncture.
The overshadowing and unspoken fear? Lung cancer.
The frustrating part? She was a lifetime non-smoker.
Risks of the procedure?
"Well, the usual," he intoned. "Infection, but that's unlikely." Right. Any time something punctures your skin and digs into your body, you have a risk of infection.
"And a collapsed lung," then he quickly added, "but that really is unlikely. You're strong and healthy, Tara. It's not like you have COPD."
Tara wasn't feeling terribly strong or healthy at the moment. Her gaze fell on the lump of her black purse sitting on the floor beside her. She really needed to replace that. She had promised herself she would buy one that wasn't black, now that she was free to have any color that tickled her fancy.
With retirement finally reached a month ago, she dreamed of a new purse that wasn't "regulation." She hadn't gotten around to that yet.
We'll Fix The Complications
And in the unlikely chance it happened? A collapsed lung? What then? She pictured herself positioned on the CT scan machine, lying on her side in the midst of the biopsy, suddenly unable to breathe.
"Don't worry, we'll fix that," he stated as a matter of fact. "We'll insert a chest tube and admit you to the ICU to give your lung time to reinflate."
Tara had to smile to herself. Medicine is so linear and mechanical. If we break it, we'll fix it and if we break it again, we'll fix that too. Because that's what we do in medicine. We fix things.
For all the frustrations with reductionism in medicine, there are wonderful aspects. Broken bones that could handicap us for life are carefully mended with the use of ultrasounds. High blood pressures that could slam our hearts to a crashing halt are coaxed down to reasonable levels with pills.
Medicine puts us back together, extends our lives, makes us prettier.
Medicine also finds incidental things, especially with the myriad scans, x-rays and ultrasounds that we order.
Sometimes, that's a blessing. We find something, we take care of it right away.
Other times, it's nothing and off we run on a wild goose chase.
It was possible it was only inflammation. That's what her radiology report said, "inflammation versus malignancy."
It's Your Move
She would need to hold space in her meditations for this one.
Tara was clear that her meditation didn't guarantee a rosy outcome. Still, the inner support comforted her. It was hard to explain. Unlike medicine, the richness of the support accessed was not linear or mechanical.
She supposed she could choose to do nothing and let nature take its course, whatever that may be. Cancer or not. Maybe this was the end of the ride. How do you know when it's time to say goodbye?
Taking a deep breath, she looked down and placed one hand in her heart for clarity with her choice. When she looked up, their eyes locked, and she nodded consent to the biopsy.
For some reason, not any particular one she could identify, today was not the day to do nothing.
"We'll find out what those cells are up to," he nodded back for emphasis.
"Alright," Tara whispered when she added a final pen stroke to her signature on the consent form, "Let's do this."
