Marcia Trahan

Bloodletting

I suck down my last breath of cold April air and plunge through the clinic’s main entrance, clutching my leather bag against my side as if it were made of my own skin. At the end of the brown buffed-linoleum hallway, the lab waiting room sits empty. It’s four-fifteen on a Wednesday afternoon; I’ve never been here at this hour. I am used to weary throngs, clinicians in scrubs pushing their way through.

There is no one at the lab desk to check me in, but I know what they’ll want when they come for me. I dig into my bag’s secret zippered compartment and pull out a requisition order for a blood test. One page that delivers the lean poetry of facts: My name, date of birth, sex, medical record number, insurance plan. Test facility, collect date, doctor’s name and fax number. Below these facts is the encrypted narrative of abbreviations, diagnosis codes. This is me, today; I am TRAHAN, MARCIA L, a thirty-six-year-old female, a doctor’s patient. Diagnosis PAPILL CARC, tests ordered T4 and TSH.

The narrative presented here in code is impressively succinct. I had a complete thyroidectomy when papillary carcinomas were discovered in both lobes of my thyroid. My blood must tell its secrets in numbers which the endocrinologist will use to determine the correct dosage of levothyroxine, a synthetic version of the hormone my body can no longer produce. These tests are routine. The crisis has passed. The cancer is gone.

All of this is technically true. It leaves out details that are important only to me. It omits my first visit to the surgeon, how he traced his finger along the base of my throat: “We’ll make the cut here, where there’s already a crease. As you age, the skin will sag over the scar. Eventually, it’ll be less visible.” I answered, “Well, that’s something to look forward to.” We laughed. I was still whole then. I had a thyroid nodule, a lump visible to me now that it had been pointed out. There was a ninety-percent chance it would turn out to be benign. I was the good patient, smiling, nodding my understanding. I had not yet been reduced.

The blood work order does not say that there were two surgeries, that the surgeon in his caution clipped just the half where the nodule grew, that the pathologist found malignant tumors only after I was sewn up. It is silent about the second operation to retrieve the other half, the four-inch scar pinkly obvious six months later. It makes no mention of the green-and-gold capsule of radioactive iodine I swallowed, 120 mCi of I-131 according to another single-sheet report stashed at home; a small missile sent to destroy any remaining thyroid tissue. It says the cancer is gone but it cannot claim I feel it is gone.

Everything happened so fast, with such merciless efficiency. Like most people who take a sharp turn from health to illness, I was wholly unprepared to deal with Medicine, the sharp points, the great whirring machines, the teams in white coats, the irrevocable losses. I’ve been told I am lucky. I know I ought to feel gratitude more often than I do. But I have not yet found a way to forget about having a piece of my body cut out and thrown away, to undo the dread I now feel toward my flesh.

I stand at the lab desk, page in hand, staring at a sign that thanks me for my patience. Five, ten minutes pass. No one comes. I feel stiff, foolish, ridiculously abandoned. Efficiency, and yet it all comes down to waiting, to being made to wait. Line or no line. I want only to return to the world. I want to hand over this sheet of half-truths and race back to the gray day. I want to resume my impersonation of an inviolate self.

At last, a nurse glides out from the back room. “Can I help you?” Her large red-rimmed glasses match the color of her hair, which is held back in a sanitary ponytail. She is not at all perturbed by my arrival in her previously silent waiting room. This is her territory. I am in her house. She’s in charge of the needles I fear; she has stacked the out-of-date magazines that fail to keep patients’ minds off needles.

I hand her my paper. “Thank you. If you’ll please have a seat.”

“Thank you,” I mutter, and do as I am told. She disappears again.

Anger twists me into a giant knot. I sit with my arms folded, my legs crossed, my coat still buttoned, refusing to pick up a magazine, scowling into the face of a large clock—it’s four-forty, now it’s forty-five, I’ll miss the next bus home. I wonder if I’ll ever forgive Medicine. I haven’t forgiven the many cryptic messages left on my voice mail, asking that I call for my “test results” (could you give me a clue? Good, bad, neutral? Am I great, OK, or dying?). I haven’t forgiven all the times I was told, “Don’t worry,” when I simply asked for clarification—when a little more information delivered with a little less jargon might have quelled my fears. I haven’t forgiven the pathologist for not seeing and then seeing my cancer, or the surgeon for cutting, or the radiologist for sticking needle after needle into my neck during the two-hour biopsy that yielded inconclusive findings, or my nurse practitioner for discovering the nodule during a routine physical. I haven’t forgiven my body, solidly healthy for thirty-five years, for becoming my enemy. I haven’t forgiven myself for being frightened, weary, furious, bereft; for being sick.

“Marcia?”

“Yes,” I answer, as if I could be confused with anyone else, and stand. I follow the calm, red-haired nurse into a familiar room. The shelves are stacked with boxes of sterile gauze and alcohol wipes. A brown leather chair waits.

“Would you like to hang up your coat?” The nurse gestures toward a brass hook on the wall. “This floor sure can get dusty.”

I unbutton my coat and realize that my body’s tight coil has come undone. What has softened me? It’s the humbling prospect of yet another needle piercing my skin, the cumulative effect of a thousand such small violations. It’s the desire to slip free of anger, if only for a moment. I am not ready to forgive Medicine; I am not even close. But I think I can be the good patient again, today, for the next five minutes. I can return the nurse’s cool smile. I can do whatever she tells me. I can believe that taking the needle is worth it.

I sit in the brown leather chair and roll up my sleeve without being asked. And what about gratitude? It won’t come to me here. Maybe when I’m back outside, the chilled air throbbing in my lungs as I race to catch the bus.

The nurse is all business now, the politeness gone. She ties a rubber strap around my arm. “Make a fist,” she says, and I do.

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