Doctors, Doctors and More Doctors

Sorry this has gotten a little behind. Actually, quite a bit has happened over the last week and a half so I'll try to condense it here.

Dr. Hermansen had scheduled an appt. for me with one of her partners, Dr. Josef Gurian, for Friday, July 7. Part of the reason for the referral was for a second opinion although I'm not sure how viable a second opinion is within the same practice. The other reason for the referral was because if I were to have follow up neck surgery to remove what was left, he would be the one to do it.

Dr. Gurian immediately presented himself as a kind and empathetic man with a friendly smile that seemed to tilt a little to one side. He spent a considerable amount of time with Michelle and me answering all of our questions. He told me that he and his partners had been reviewing my case and debating the merits of having surgery first or radiation and chemo first, possibly eliminating the need for surgery. I responded that I want this thing out of me as soon as possible and I insisted on surgery first... and fast. I also asked him about seeing an oncologist because while he was a specialist in head and neck surgery, he was not an oncologist. He then referred me to one of his friends and colleagues, Dr. Bruce Davidson who is the ENT Oncology Chair at Georgetown University Hospital. In fact, he made the call to Dr. Davidson himself and had me sit in his office, on HIS phone to make the appointment which was scheduled for the following Wednesday, July 12. Things were moving fast.

I arrived at Dr. Davidson's office early on Wednesday. Walking through the parking lot, I noticed a ten dollar bill that someone had dropped on the ground. As I picked it up, an elderly couple was pulling into the parking lot next to me and they commented on my good fortune. It occured to me that I should give them the money which, despite their protests, I insisted on doing. "Pay for your parking," I said. Finally, they took it and I went into the building feeling like karma was on my side.

Karma decided not to follow me into the office.

After checking in, I was first examined by one of Dr. Davidson's students. Maybe he wasn't a student but an intern. I don't know. I've never understood the difference between an intern or a resident or a fellow. They've got so many designations. But whatever you call him, I was amazed that this kid was a doctor. He looked no more than 19 and I'm not that old. I don't remember his name so we'll call him Doogie Howser. Doogie completed a somewhat uncomfortable exam of my mouth and throat and proceeded to tell me that Dr. Davidson would be coming in to do the very same exam. What struck me about Doogie besides his pre-pubescent appearance was the fact that he seemed to look at me with a mixture of pity and pure clinical detachment. He certainly didn't look at me as a human being.

When I finally saw Dr. Davidson, it didn't get any better. I had left the exam room to use the rest room for a minute, and when I returned, there he was with Doogie and another young woman, I assume also a student/intern/resident who didn't say a word the entire time. I understand this is a teaching hospital but it's a little disconcerting to walk into a tiny exam room with three very serious looking people waiting for you. As Dr. Davidson conducted his exam, which included him reaching all the way down my throat to press on the back of my tongue as well as seemingly trying to impale my tonsils with his fingers, both Doogie and the mute would lean to one side in unison, carefully noting every detail.

Don't get me wrong. Dr. Davidson is a nice enough guy but truth be told, the bedside manner is a little lacking if you ask me. Once his exam was completed, we discussed my treatment options and he confirmed what I already knew. I then asked him his opinion of my prognosis. Now, I asked this same question of Dr. Gurian and he did not want to talk in terms of "cure" for some reason but he did at least say my chances overall were good and that he was optimistic. No such words of encouragement from Dr. Davidson. In fact, I couldn't decipher much of an answer at all in his response which led me to believe it was a purposeful "non" answer. He was then kind enough to share with me that the staging information from my PET scan was wrong and that what I really had was stage 4 cancer since more than one lymph node is involved and by strict definition, that is stage 4 disease. Great. Thanks for the heads up on that.

I could go on but at this point, I just wanted out of there. We wrapped the meeting and I headed home. I had yet another appointment scheduled the following Friday with yet another ENT oncologist, this time at Johns Hopkins. I left this meeting feeling so depressed that I wasn't sure I wanted to see anyone else. I'm glad now that I did.