Georgetown and Radiation Bombs
So I finally got into Georgetown.
When I was, well, younger, and working on Capitol Hill, my former graduate adviser came to D.C. to give a presentation on American foreign policy. We got some dinner, and he asked if I was ready to quit fooling around with politics and get back to real work. Those were his actual words, if I remember correctly. And by real work he meant research and writing about politics. American history, anyway. And he was perfectly serious. I admired him quite a bit, and when he suggested I could live in DC, keep a hand in politics and still get my doctorate at Georgetown (of course, he knew some people), I nearly took him up on it. At the time, though, I was too caught up in seeing history unfold in real time. It’s one of those points in your life where you look back and wonder how a different decision would have changed the direction of your life. I guess there are many of those. I’m glad I made the right decision. I don’t know what I’d do without Dena and the kids to help me get through this fight with cancer. And besides, I eventually got into Georgetown anyway.
About a week or so ago I officially applied and was accepted to the Georgetown Department of Radiation Medicine. Admittedly, the circumstances of my enrollment at Georgetown are somewhat different than those I’d considered when I was younger. For one thing, American foreign policy and radiation oncology don’t have as much in common as you might think. For another thing, I’m going to be on the pointy end of the radiation stick.
Dena and I arrived at GU today for our consult and simulation session. Heath care providers may or may not be aware to what extent the environment of a hospital affects a patient’s confidence. Considering that we were pulling onto the campus of one of the nation’s elite colleges, with a architectural history dating back nearly to the founding of the United States, I was expecting some grand surroundings. Pastel flower arrangements. Towering oaks. Statues of inspiring men on horseback. What we drove into was as a extended carport with shattered concrete and construction barriers everywhere. Even inside, the mood lightened little. The radiation oncology department is located in the basement of GU’s Lombardi Cancer Center, and there is little light or fresh paint in those tight, underground corridors. The waiting rooms were akin to those you’d find at the CarMart, except CarMart has television.
And then we met Dr. Sean Collins and our moods changed. For one thing, Dr. Collins had actually reviewed my CT scans and medical history prior to arriving at the consult. (No, this happens less than you might think.) And clearly, he’d given it quite a bit of thought, as his treatment plan was different from what we expected — more aggressive, which we liked. Most importantly, though, he was funny. Just damn funny — and not in a weird Patch Adams kind of way. In my opinion the most important qualities you want in a doctor are skill and competency, but how much nicer is it when you find such a doctor who also has a good beside manner? We’ve been lucky in this regard; most of our doctors have been skilled and compassionate. Dr. Collins is this, and goes a step further. He seems like the kind of guy who might blast your lungs with radiation and then offer to buy you a beer afterwards — either as a kind of apology for burning through your skin or as an opportunity to relive the glory of it. In fact, I’m going to ask him if I can bring in a sixpack to split tomorrow during our first radiation session. Even if he says no (and Dena and I have to down a quart of bourbon hiding by ourselves in the bathroom as we usually do), my confidence level remains high anyway. And confidence is critical when you find yourself registering with a new medical facility, especially one decorated by the medical examiner.
Now, Dr. Collins did emphasize on more than one occasion that he could hurt me. I am going to assume that this was not meant as a boast but an explanation of why he wants to proceed with his treatment plan more slowly than expected: four weeks rather than two. This gets back to his aggressive treatment plan. Like Dr. Song at Johns Hopkins, Dr. Collins observed that the mets in my subclavicular area threatened my brachial plexus, which is a network of nerves passing from my neck through my armpit and down my arm. Should the mets continue to get larger it could cause some real damage, besides the nerve pain I’m currently experiencing — such as the loss of the use of my right arm. However, he also noted some alarm about mets pressing against my trachea and bronchial tubes. These could create some obvious respiratory challenges should they expand. The term collapsed lung came up once or twice.
So Dr. Collins proposed that we move forward with a higher dose of radiation than we originally discussed with Dr. Song and that we also go after the lymph nodes in the chest that are threatening my airways. This, he said, would require at least four weeks of treatment, every day. So we’re looking at a solid month of daily radiation treatment (and, who knows, maybe a lot of beer), starting tomorrow at 4:40 p.m.
After our consult with Dr. Collins, I went under the CT machine and simulated a treatment session — meaning that they measured my chest and neck from every angle and marked my body with tattoos (no, really) indicating where the radiation beams will be directed tomorrow. I also got to make a facemask. How cool is that? More on the simulation tomorrow morning. Time to force some kind of foodstuff down my throat.