​The doc’s abnormal mammogram. Or: my right breast hates me

 Caveat: I might be a good doctor, but I’m not a great patient. And having knowledge about medical things doesn’t make anything easier when tests are abnormal. Maybe the opposite.
 
So here’s what happened. Last week, I got the standard mammogram, complete with uncomfortable chit-chat with the mammo tech who has chilly hands. You know the drill. Stand in an awkward position, let the tech scoot “the girls” between the plates, and hold perfectly still as the tech cranks down the vice to hold what little breast tissue I have in place. (Like I could go anywhere?) Repeat on the other side.
 
Please understand I’m not dissing mammograms. No way. Not even close. I believe strongly in mammography as an excellent way to pick up breast cancer in its earliest stages so patients receive the best treatment.
 
I just don’t appreciate being the one with the abnormal result. I’m the freakin’ doctor. Irony, much? Damn it.
 
The first result was “BIRADS 0” which means inconclusive or needs more views and an ultrasound. I’m told my breasts are “dense” which is hilarious if you consider #1) there’s not much there and #2) the damned things are drifting sideways and south – there ain’t much density to them from where I stand. But some guy in a dark room looking at my films says they’re dense and he can’t make a definite conclusion as to whether the nodule is something worrisome or not? Who am I to argue?
 
Anyway, next step in standard operating procedure is to request prior films from where I had my mammogram last year and compare them. If the “area of interest” is the same last year compared with now, then it’s probably no big deal. So yay, right?
 
Nope. Not my girls. Miss Right Breast has something funky going on in it, and now we go to more mammogram views and an ultrasound.
 
Let’s pause for a moment. Although the doctors and techs say the extra views are the next step, I know exactly how this process rolls, because I talk with patients about abnormal mammograms at least every other week. I know how to explain in a gentle way that the radiologist needs to look at the breast tissue ‘in a different way to see it better’, and how that’s normal protocol.
 
But I also know that in this type of scenario with the way the findings are described, it will be unlikely to stop at the ultrasound and additional mammo views. If they can’t call it 100% clear, then the next step is getting a tissue sample. Biopsy.
 
I do biopsies several times per day on suspected skin cancers and endometrial cancers and cervical cancers. I understand folks’ anxiety and try to allay their fears. It’s my goal to make patients comfortable and get their results to them the minute we know them. But damn it, it sucks to be the patient.
 

​​Let me digress into a completely irrational, unprofessional tirade that is fueled by honest-to-shit fear that many of my patients think as they’re waiting for more test results. Because over this last weekend, my brain just freakin’ WENT THERE on every single level imaginable. Just like a regular patient does. Shit.
 
Do you even understand how pissed off I’m going to be if this bullshit goes to biopsy and beyond? Because somehow I always assumed that being the one delivering the news somehow shields me from ever being the recipient of the bad news. Wrong.
 
I’ve made good life choices. Damn it, I don’t even eat meat or drink alcohol or smoke or do drugs. I exercise 5x weekly as recommended and maintain an almost-normal BMI. My only vices are diet Dr. Pepper and chocolate.
 
Now you’re telling me I have an abnormal mammogram? Then why the hell did I clean my house last week or pay bills? Should I have been out enjoying myself? And goddamn it, I have shit to do. What if I have to have surgery? Or chemo or radiation? Can I get chemo in the morning then go back to work that afternoon? Shit. There are patients that need to be cared for who don’t deserve to have their appointments cancelled. Their time is important, too. And I have to take call every 3-4 weeks and remain functional.
 
I have vacations to take, a half marathon to train for, and books to write. Can I write or edit while sitting in the goddamned chemo chair for 4 hours per treatment? Can I take care of my patients and take calls and sign orders while getting treatments? Will patients leave the practice because I am out of commission? Will patient satisfaction ratings decrease if I’m not feeling 100% when I see patients, or if I have to cancel a day because I’m throwing up? Will patients freak out if I’m bald or should I have a wig made? Will my cats attack and eat the wig? I can’t even take care of my own hair. Wonder what color my hair really is? How much gray is in there? If it grows back in, will it look awful?
 
What stage is the spot in my breast? Is it receptor positive or negative? Will it respond to standard chemo? Should I start researching latest cancer treatments? Will any of this mess shorten my life? Should I reprioritize what I should be doing with my life? Take more vacations? Work more on writing? Move up into medical leadership? Retire early? Cut hours? Stop delivering babies?
 
What will my husband think if I have only one boob? Or none? Will people look at me differently? Will I get less professional respect if they see that I have a weakness? At work, no one gets to see anything other than strong and tough and competent. Because if I’m not strong personally, then how can patients be confident that I can be strong for them when they need me?
 
Yeah. So that was me over the entire weekend -- brain spinning, worst case scenarios, irrational, vacillating between pissed-off and hopeful. Just like any other patient.
 
So tomorrow we’ll do more testing and see where it takes me. Sucks to be the patient.
 
And damn my stupid, dense right breast.