Mayo (the clinic not the spread)

Yesterday, my husband Jordan and I made the hour and a half drive down to the Mayo Clinic. We wanted to get another set of eyes and ears on my case, and when one of the best hospitals in the world is practically in your backyard… why not recruit them to your cancer army?

It was a gray and gloomy day—never ideal but particularly unwelcome these days. My mood matched the day. I sat in the passenger seat with my newly buzzed head in my hand, staring out the window like an angsty teenager. I kept catching a glimpse of myself in the side mirror and almost had to laugh at how reminiscent the reflection was of twelve-year-old Sam. I might as well have been wearing a pair of Dickies and clutching a compact disc player with Blink-182’s “The Mark, Tom, and Travis Show” snapped inside. All I needed was a pair of cheap foamy headphones to complete the look.

I’ve been in a mood ever since chemo started a week ago. Not because I’m depressed about having to go through treatment or losing my hair or anything like that. Not at all. In fact, I was super happy upon arriving for treatment. Ready and eager to start the battle. I just didn’t know that they were going to load me up with steroids for a day and a half after treatment, and ever since those started to wear off three days ago, I’ve felt like I’m coming down from cocaine.

For some, steroids are apparently the worst part of chemotherapy. So far, that seems to be the case for me. I really haven’t had any of the other side effects that I expected—namely nausea and diarrhea. And I won’t lie, I’m a little miffed about that. I was banking on the chemotherapy weight loss plan to help me lose all the baby weight! Unfortunately, I have a full appetite, and nothing is gushing out from either end, so I’ll be left to my own devices after all. (Although, the chemo-induced mouth sores do make eating a bit more challenging, so that might help a little).

Mayo is just as swanky as everyone says it is. The Gonda Building is a thirty-or-so-story glass edifice that could easily blend into the Manhattan skyline. Inside were three separate elevator banks that each go to a different section of floors (just like a Manhattan skyscraper in fact, if you’ve ever been in one). It’s a good thing Jordan was there because twelve-year-old me was too busy huffing and puffing to figure it out. (Ironically, I’m the one who lived in New York for half a decade.) When we made it to the correct floor, we had to find the right wing, and then the right check-in area, all of which had digital check-in stations—just like how you check your bags at an airport. Fortunately, that didn’t make me feel like luggage. And the setting was far less chaotic than any airport I’ve ever been to.

Soon after checking in, I got a text message telling me to meet my “care team member” at Door C. It really is like the Disneyland of hospitals. My team member was extremely nice (everyone we interacted with was nice, but I was in such a foul mood that it just made me feel guilty for not being able to match their level of kindness). She took my vitals using various fancier-than-usual contraptions and then took me to my “care room” down the hall. She made the usual quick small talk: “How are you? You just had a baby! Your first? Oh, two boys, wow, you must be busy! Sorry for what you’re going through. Like you didn’t have enough on your plate! Now for your medical history…” I’m not trying to criticize. Those are the natural talking points. I would use the same script. I’ve just had to have the same conversation dozens of times in the last month, so I’m a little numb to it all.

My doctor (Dr. Idossa) came in shortly after the nurse left and she, too, was exceptionally nice. She was wearing a face mask, maybe to signal that Mayo doctors haven’t actually turned into cancer-curing robots… yet. We went over my medical history and talked about all that’s happened in the last month, from finding the lump all the way to my first round of chemo on Tuesday (what a month!). We discussed my diagnosis: triple positive invasive ductal carcinoma in my left breast that has metastasized (a fancy word for spread) to my liver, lymph nodes, and bone. Stage IV. Incurable. Yada yada. And finally, we discussed my current treatment plan: 6-8 rounds of chemotherapy and targeted hormone therapy, followed by continued hormone therapy that will hopefully keep the cancer at bay.

Fortunately, Dr. Idossa told me that she whole-heartedly agrees with this course of action, as did the rest of her team. (Mayo works in teams. Mine is the “Orange Team.” The nurse assured me that the color orange had nothing to do with the severity of my illness, which I thought was kind of funny. People on the red team must get really uncomfortable and are probably the ones who asked about the color significance. Team green probably feels okay about it).

So the hope is that this treatment plan, while not curative but palliative in nature, should allow me to live for… some number of years. It’s clear that doctors can’t or won’t tell me how many years they think I might live. Partly because the number of years must vary quite a bit. But partly because no number of years gives a patient the perfect amount of hope. Too few (three years?) and you’ll live in fear for those years. Too many (twenty?) and you’ll sue them if you’re on your death bed in five. So I understand that providing any number of years is a difficult task for a doctor. Then again, not knowing how long you might live is also a tough ordeal for a patient.

Mind you, this is all under the assumption that this first line of treatment works. All the doctors and nurses I’ve spoken to are very hopeful that it will. But if not, there are second lines of attack. Namely clinical trials. And third lines of attack as well. But I’m not going to dwell on these much. I’m just going to hope for the best and most likely scenario.

So, no, the Mayo didn’t have some brand-new invention to implant inside me or any groundbreaking research to add to the mix. But they did leave me with two very valuable takeaways:

The first is their assurance that I am getting the gold standard of treatment and that they wouldn’t be doing anything differently.

The second is that none of this is my fault. And that is equally as valuable as the first.

Two years ago, during my first pregnancy with Winston, I found a lump on my left breast—exactly where the cancer is now. I told two different OB’s about it during routine exams, and both told me it was likely nothing to worry about. Breasts go through lots of changes during pregnancy, and getting a mammogram isn’t recommended during pregnancy anyway. I certainly wasn’t going to risk getting any unsafe imaging done, especially not after having had a miscarriage just a few months before. So, I did what the doctors told me. I didn’t worry about it.

Fast-forward to last month and I discover that I have this aggressive tumor that will likely kill me (timeline unknown) and instantly, my first thought was, this is all my fault. If I had just gotten this checked out, none of this would be happening. I’m going to die because I was too lazy to go to the doctor. Or too frightened to ask more questions. Or too busy raising a child. Or too tired during my second pregnancy. Or too tired because I don’t eat well enough. Or too tired because I don’t exercise enough. If it wasn’t for my own shortcomings, none of this would be happening.

But the Mayo doc took all that away. She noted that this kind of cancer grows so quickly that there is no way it was present two years ago. She looked me straight in the eyes and told me it wasn’t my fault. And I actually believed her.

So even though I have cancer, and even though it might kill me… at least it won’t be my fault. And I can live with that. (Well, sort of).