A Zebra is Born

7 Oct

“In medicine, when you hear hoofbeats behind you, don’t expect to see zebras.”

It’s a lesson in diagnostics taught in medical school; when your patient presents with a certain set of symptoms, don’t reach for the exotic diagnosis, the zebra.  A zebra can be a rare disease or a disease that is rare in certain people or places.  The rash your patient has is poison ivy, not flesh eating bacteria.  The patient with blood in their urine probably has a UTI, not paroxysmal nocturnal hemoglobinuria. The 24 year old with cramps, urine frequency and bloating probably has a cyst, not ovarian cancer.  But, just because zebras are rare, doesn’t mean they don’t exist. 

I’m a zebra.  I’m 24 and last week I was diagnosed with ovarian cancer.  In retrospect, I probably had all the symptoms.  I had more cramps than normal – but I’d stopped hormonal birth control and my periods were more intense than before.  I sometimes felt bloated – but who doesn’t?  Maybe I had to urinate more frequently – but not outstandingly so.  I had a routine annual exam and my doctor thought that I felt “a little uneven” in my pelvic region. She ordered an ultrasound and reassured me that is was nothing to fret about, probably just a fibroid cyst.  I had an ultrasound that week and the lump didn’t look like a fibroid.  I was on vacation, at the beach, and it was probably just some other type of cyst.  My doctor ordered a CAT scan to confirm.  I think I even said to my mom “It’s not like it’s cancer or something.”

A month later, I had begun medical school and didn’t get around to having a CAT scan until the end of September.    The next day I had my first day of Gross Anatomy lab.  I spent hours meeting my cadaver and beginning my dissection.  When I got out of lab, I’d missed a ton of calls and even a text message from my doctor.  I called her back at the bus stop.  She started telling my about my CAT scan results.  Ovarian mass…blah blah blah…size of a softball….blah blah…lymph nodes in there…blah blah… bright spot on your liver…blah blah blah.  I stopped her there.

 “You said lymph nodes and liver.  Are we talking about cancer?”

“I hate to do this over the phone, but yes, that is what we are talking about.”

I couldn’t breathe.  Waiting for the bus.  In the rain.  I couldn’t breathe.

My Doctor gave me Dr. Great’s number, his personal cell, so that I could talk to him about what the next move was. 

My bus arrived.  I got on it.  And because I was about to lose it and couldn’t blab on the bus about my ovarian cancer, I texted Chris.  Who, even in text, is the only reason I didn’t lose my shit completely on the bus.  The people around probably thought I’d just been through a bad break-up or something.  I had that oh-woe-is-me-on-the-public-bus look.  I’ll never judge mopey, oblivious, texting people on the bus again.  They probably just found out they have cancer.

I called Dr. Great, who I liked immediately. He told me about himself, let me cry, comforted me and told me to come in to his office the next morning anytime after nine.  He offered to call my mom for me.  He told me to call him anytime, he loves midnight conversations.

So, I packed crazy, useless stuff into a small bag and got in my car and drove to Chris.  I listened to a Michael Chabon audiobook Chris had bought me and tried not to think about how I was going to die next week and never have kids and be fat for the rest of my life because there’d be no time to lose weight now!  

I made it to Chris.  We didn’t sleep very well.  The next morning, I met my Dr. Great.  We did all kinds of exams, bloodwork, counseling and planning.  They said it could be cancer or it might be something else weird.  I was scheduled for surgery on Thursday morning to take out this mass and figure out exactly what was going on.  I met with the Reproductive Endocrinologists that day to talk about freezing my ovaries and eggs and maybe even making little baby-sicles with Chris’s sperm for later. 

Wednesday, I met with the anesthesiologists and did bowel prep for surgery, one of the most disgusting and weird experiences of my life.  I took an ungodly amount of laxatives mixed with blue Gatorade and spent the afternoon in a Residence Inn, watching NCIS, and eventually experiencing what they call “clear stool”.  Yes, clear, like peeing out your butt.

We, my mom, stepdad, sister and Chris, were at the hospital at 6 the next morning.  I checked in, met my surgical team, signed some papers and got some sedative.  The last thing I remember was being moved onto the surgical table.  I thought “Wow, they really have those big lights like on TV.”  They put my arms straight out on either side of me.  I must have look dubious about this arrangement because my anesthesiologist said “Don’t worry, nobody is getting crucified today.”  And then I went to sleep.

I woke up in sheet clutching agony 2.5 hours later.  They gave me morphine and asked me stupid questions.  I asked them if it was cancer, no one could tell me.  They wheeled me up to my room, moved me into my bed and handed me my morphine pump.  No one could tell me if it was cancer, they didn’t know.  My family came in, I asked if it was cancer, my mom said that yes, it was cancer.  I said “Ok.”

The only other thing I really remember well from that day is asking the nurse for a mirror so that I could look at my incision.  It’s a nine-inch incision from my bellybutton down.  There was no gauze or dressing because these days they just sew you up on the inside and then put this super-glue/nail-polish type stuff on the outside.  I call it Franken-belly because it is my bloated, misshapen sewn up little buddy.

I’m home now, after an eventful hospital stay, full of Law & Order, morphine, gas pain and shower struggles, a blood transfusion, a fever scare, a chest X-ray and a visit from friends who made me laugh so hard I literally thought I was going to bust my gut open.  Some doctors were great, some made me cry.  I loved all the flowers and good wishes I got – even if I didn’t respond, it meant so much to me to hear from everyone, to know they were thinking about me.  And I can’t say enough about my family, my amazing, loving, funny, drop everything when you need us family.  And that includes Chris.  Dr. Great came to see me, even on a Saturday, and always had wonderful things to say, reminding me that we’re measuring my life in 50, 60 70 years and not to panic.  My reproductive endocrinologist, Dr. Cool, came to see me too.  My ovaries now exist as 15 test tubes of primordial eggs, one actual egg that they found during the surgery and these little estrogen patches that I’ll wear on my abdomen forever, so that my boobs don’t sag and my vagina doesn’t fall out and my bones don’t crumble.  I start chemo next Thursday. 

My posts won’t normally be this long, I just thought bringing everyone up to speed was a good idea.  This blog is our coping strategy, out outlet, our fuck off to cancer.  We’ll be funny, we’ll keep you updated, we’ll post pictures of the puppy I’m going to get and the outrageous wig collection I’m going to accumulate.  We won’t always talk about cancer.  Talk back, write a guest post, tell me about books I should read on my tumor vacation.  I lost the script to my life, as Joan Didion might say, the story I was telling myself in order to live has changed, it’s undergoing a massive re-write.

Love,

Zebra

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24 Responses to “A Zebra is Born”

  1. Jonathan October 7, 2010 at 2:15 pm #

    Love you babe. A great first post…refreshing to see you in good spirits and with sense of humor in tact. Miss you very much and wish I could give you a big hug and kiss.

    Talk soon,
    -Jonathan

  2. Jen October 7, 2010 at 2:40 pm #

    Colleen,
    I’m so sorry to hear all of this. I hope you and Chris are doing the best you can right now. Thought of some good reading, though this is probably going to sound like an academic nightmare where you wake up naked in a lecture hall: Ovid’s Metamorphoses (trans. Mandelbaum– nice balance of arty and straightforward). Honestly, though, it’s all about people going through huge changes and how they adapt. And it’s beautiful. Failing that, there’s always cakewrecks.blogspot.com. Greg and I are going to be up (briefly) at Thanksgiving and again at Christmas, and I hope we’ll get to see you guys– I think Greg’s planning to have people over per usual on Thanksgiving Eve (which is a holiday now). Meantime, stay well, acquire outrageous wigs, and post puppy pictures when a puppy materializes!
    Love,
    Jen

  3. Amy October 7, 2010 at 3:47 pm #

    Colleen,
    I’ve never had tears in my eyes of sadness, and chuckled at the same time finding humor in writing as I found myself having read your first post. What a great way to vent, share feelings and your journey. My thoughts and prayers will always be with you and I look forward to the collections of wigs and puppy photos. 🙂
    Amy

  4. Sara Blanchard October 7, 2010 at 4:07 pm #

    All I can say is that you are amazing! We are sending all of our love from Atlanta.

    Recently read “The Help” and enjoyed it. Sounds like you are a Law and Order girl – I recently read several by Karin Slaughter. Entertaining crime fiction. Try to go in order ’cause the cops, detectives, and coroners have their own stories.

    Sara

  5. EReid October 7, 2010 at 4:48 pm #

    DK, this first entry practically made my heart pop with love for you. Thank you thank you thank you for creating it; I so appreciate hearing your side of all of this, and I honestly think that having all of this stuff down and your attention to detail here will be some of the stuff that will make you an even better doctor down the line. For serious! Also, I was totally just thinking of JDid yesterday, so it’s creepy/ cosmic that you bust out that killer quote at the end. I love it!

    In the meantime, if you’re interested in passing some time with additional gut-busting laughs/ perhaps a few cringes at how melodramatic our baby Hampshire hearts were back in the day, have Chris show you our old LiveJournal blogs [which still exists in the internet ether, I’m a little horrified to say I know!]. Did you ever see those? Throwback!

    Last, just in case you thought I was fucking with you:
    http://articles.baltimoresun.com/2009-09-16/news/0909150076_1_samurai-sword-samurai-weapon-pontolillo

    Love you, buddy!

    • sara October 7, 2010 at 5:48 pm #

      ahhhh our livejournals are so embarrassing and yet still guffaw-worthy! Coll you are so amazing and I am sending tons of love your way.

  6. Kristin October 7, 2010 at 5:14 pm #

    Colleen,
    You are such an amazing individual. I could spit out a hundred cliche’s, or I could simply tell you this. In the few brief times we have spent together, I have had one of the most positive impressions of you possible. Any time your names comes up I always say, “Colleen? I love her.” J laughs because I am so fond of you despite our having spent relatively little time together. I believe you can handle this with a grace that a precious few could match.

  7. Rick Blanchard October 7, 2010 at 9:20 pm #

    You’re an incredible, beautiful, funny lady. Thanks for sharing your journey with us. God bless and!know that we’re thinking of you everyday.
    Love,
    Rick

  8. Greg October 7, 2010 at 9:29 pm #

    Jen and I are thinking of you down here in Arkansas. If there’s anything I can do to cheer you up, especially if it is find old embarrassing pictures of Chris, let me know. It sounds like you’re getting great care from Dr. Great and Dr. Cool. You could have got stuck with Dr. Asshole, and that wouldn’t be good. I mean, he’s a nice guy, just not the best oncologist.

  9. lisa October 7, 2010 at 11:57 pm #

    Zebra,
    I wish it weren’t so cliche to say that I laughed and cried at your blog, but I laughed and cried at your blog. I’m sad that you are sick, but I’m so happy that you’re getting great care and have an optimistic prognosis and are still the most insightful, brilliant, compassionate lady around. So proud of you and how are you facing this.
    I just read a great book, _The White Tiger_. If you haven’t read it, I will send it to you.
    xoxo
    Lisa

  10. kathy bryson October 8, 2010 at 7:49 am #

    😦 🙂 😦 🙂 You are the coolest chick I have ever met. Hang tough sweetpea. Can’t wait to see your stiches. xoxoxo KB

  11. Irene October 8, 2010 at 2:05 pm #

    Z~
    You are amazing and an inspiration.
    It’s that simple.
    Sending you love and hugs and anything/everything else that is good energy.
    XO
    Irene

  12. Vanessa October 8, 2010 at 5:48 pm #

    Although I didn’t get a chance to know you well in our initital few months together at school, this news still comes as a total shock and I’m sitting her speachless and not really knowing what to write. You are in my thoughts and I’m sure all of our thoughts in the first year class. This first post was truly inspiring, and I am so impressed by your courage and strength. Keep on fighting and we are all here for you.

  13. Stas Lazarev October 8, 2010 at 5:55 pm #

    Colleen! I just found out, and I’m very sad to hear this news. We’ve been in the same ICDM small group, and although we haven’t talked much, I always found your comments in the class very insightful and invaluable!

    You are a fantastic person and I will pray that all your dreams and goals will come true despite the illness. They will! Just try to never lose your faith and hope, Colleen!

    You are a very enthusiastic and resilient lady.

    Stas

    P.S. Btw, I love “Law and Order”!

  14. Liz Robison October 8, 2010 at 6:05 pm #

    Zebra,
    I missed your smiling face in the halls and I wondered where you had gone. I know we don’t know each other that well (yet) but I will be thinking of you everyday. Your blog is great, you are awesome, and it is seriously our loss to not have you around the rest of this year. Keep up your great attitude and know that everyone is on your side!
    Liz (med school classmate)

  15. Alison Alpert October 8, 2010 at 11:08 pm #

    Dear Zebra,

    You are an amazing writer. I’ve always had the feeling that I’d love to get to know you, and I only feel that more after reading your blog. You must be very busy with correspondences, but if you have time, I’d love to be your correspondent. I would like to apply to be your correspondent. You can find me at aalpert@uvm.edu. I’m really sorry that you’ve had to deal with all of this. Maybe it is useless to say that I have dealt with major medical issues and empathize with what you are going through and wish you didn’t have to.

    Maybe this is more helpful: Kellie Wells COMPRESSION SCARS (the title track story). Also, (for fun) THE MAGICIAN’S ASSISTANT by Ann Patchett.

    love,

    Alison

  16. Hany Abdallah October 9, 2010 at 7:50 pm #

    Colleen,

    Sorry to hear you are sick :(. Clearly no one here has experienced what you have, but I bet with your go lucky attitude you’re just smiling it off. I feel like a lot of students from the outset (including myself) don’t see the big picture in medicine nor see patients as people instead of just patients. I guess our only experience together was ICDM but that’s how I got to know you and understand you were probably going to be that doc that people clung to, due to your comfort and reassurance. Honestly, I think this will make you an even better doctor in the future. So I hope you feel better and I’ll see you next year! 🙂

    -Hany

  17. Nory October 10, 2010 at 10:10 am #

    Zebra,
    You are such a strong woman!! I was reading your blog and then I started to cry and laugh at the same time, my boyfriend must think I am a little loco, lol. I am so sad to hear the news, but I know you are a strong lady and can kick cancer ass! Sending lots of love, hugs, good energy and good everything your way!!! Bendiciones!!

  18. Kati Anderson October 10, 2010 at 3:45 pm #

    Zebra,

    Wishing you the best! Thank you so much for your blog, right now I needed hope and humor and you provided both. A fabulous friend of mine said this when finding out devastating news about her daughter and it resonates with me every day. “Blessed are the cracked, for they let in the light.” (Spike Milligan) Keep letting the light in!!

    Love
    Kati

  19. Heather October 11, 2010 at 5:02 pm #

    Dear Zebra,

    Your blog is the most inspiring, moving, and eloquent piece of writing I have read in some time. I’m sorry that we didn’t get more time to talk in these first few weeks of medical school, and I’m sorry that you now have an entirely different (and much more real) challenge to tackle. I am amazed by your strength and wisdom, and I know that some day you will make an incredible doctor.

    I am so happy to hear that you are getting a new puppy! I must have had a sixth sense about this because I got you a copy of one of my favorite books – Marley and Me. As a new dog owner I’m sure you will appreciate this story.

    I wish you all the strength, peace, and love possible to overcome this (though it seems you have it all). You are an amazing woman.

    With love,
    Heather

  20. Siobhan October 12, 2010 at 7:44 pm #

    Colleen-
    Life is so not fair!!!!!!!!!!! Obviously, you know that first hand. Your incredible positive attitude is inspiring. I look forward to reading future posts. Your Ohio cousins send you love and good wishes and we’ll be thinking of you all day Thursday as you begin treatment.
    Love, Siobhan

  21. Beth Collins October 14, 2010 at 11:22 pm #

    Colleen,

    Like a lot of the other med students who have commented, I wish that we had gotten a chance to know each other better during the first few weeks of med school. But even though we don’t know each other well you made a lasting impression on me from the first time we met. It was at second look day in May, your mom was there too, and the three of us spent a while trying to find the women’s bathroom in between sessions, haha … You were so pleasant, enthusiastic, and bubbly, and I remembered your name long after I forgot everybody else’s. This is saying a lot, because I am extremely terrible with names! I always think of you as the girl with the great attitude, great scarfs!, and most genuine smile. I had realized that you were missing at school, and was so sad to hear the reason why. You are in my thoughts and prayers. Keep that positive attitude and your awesome smile!

    – Beth

  22. Kate October 17, 2010 at 4:44 pm #

    Colleen: If you’re as good a doctor now as you are a writer, you’re going to be one amazing doctor! You are going to do both, right? Thanks for this extraordinary report. You’re brave, brilliant, beautiful, and bigger — MUCH bigger — than this thing. It doesn’t stand a damn chance. Go kick its ass, girl. I love you! Kate

  23. julia marko October 23, 2010 at 9:42 am #

    hi colleen,
    i just read this/ found out. please please please feel free to call if there is anything i can do to help you or chris – like making foods or dog sitting or watching the twilight movies with you – stay brave. love you. you are an AMAZING writer.
    love, julie

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