No Woman’s Land

I’m going to spare you the details of my visit to the Cancer Centre earlier this week. Suffice it to say that my cancer is not the issue right now. Despite the kindness, concern, and breadth of knowledge of my favourite nurse practitioner, I left my appointment more muddled than when I arrived. I realized I needed to find a new way to think of my doctors’ visits, so I came up with my ping-pong analogy.

Dr. Family

One triangle with four embedded triangles

(I’m in the middle.)

 Dr. Cancer                                              Dr. Liver

Imagine a triangular ping-pong table, but if you have more doctors involved in your care, your table might be a hexagon or even an octagon. (N.B.: If I were smarter than a fifth grader, this graphic would be much better; I’m counting on your imagination here.) My specialists (Dr. Liver and Dr. Cancer) and my family physician (Dr. Family) each occupy one corner. Each doctor has a net, and each can direct the ball at any other doctor. There’s a No Woman’s Land in centre court. In case you haven’t figured it out, I am the ball.

I’m not suggesting my doctors whack me around because this is not the case. The game is not competitive. The docs have a gentle volley with soft paddles–recall my propensity for bruising. But my concerns may have multiple causes, and often one doctor’s intervention may compromise that of another.

As you can see, the problem with this model is that I often end up in No Woman’s Land in the middle of the table. The doctors are trying to lob me over the net but sometimes they just don’t know where to direct me. Occasionally, other factors leave me there (e.g., lost paperwork, vacationing doctors, or differing opinions).

I have to get my head around the fact that I spend a lot of time spinning in the middle of that table for reasons that no one can control. That’s why I often leave a doctor’s office with more questions than answers and a need to follow up with a different physician or two. I am a perpetual, ever-changing puzzle.

Consider my anemia: Cancer and cancer treatment can make people anemic. (Dr. Cancer has first serve.) But anemia has many potential causes, including a malfunctioning thyroid (Dr. Cancer serves to Dr. Family) or some kind of gastrointestinal bleed (Dr. Cancer to Dr. Liver). Dr. Liver finds ulcers that may explain anemia, so Dr. Liver increases medication that can interfere with chemotherapy absorption (Dr. Liver returns ball to Dr. Cancer). Also, Dr. Cancer prescribes iron supplements to address anemia, thereby aggravating the ulcers (Dr. Cancer returns to Dr. Liver). But wait, thyroid is off again (Dr. Cancer lobs back to Dr. Family). Dr. Cancer suggests IV iron to address iron-supplement side effects, but IV iron is hard on the liver. (I’ve lost track of who has the ball, but no matter; the game won’t end until I do.)

I’m not trying to suggest I feel tossed around. Sometimes I end up in someone’s court because of a spin or curve I initiate. I’m an active participant in my game, and I am full of surprises. Luckily, my ball has a lot of bounce left in her yet.

What have I learned from my time in No Woman’s Land? That I can live with uncertainty. That there’s no point panicking when the answers aren’t immediately apparent. That I’ll take my cues from my doctors: if they’re not overly concerned, why should I be?



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