Jacob Brogan

The world is always ending

Seen and Unseen

            A few months after my surgery I cold called the pathologist who had dissected my thyroid. I had found her name buried in the report my surgeon had handed me, a sheaf of baffling documents that I studied with a fervor most would reserve for sacred texts. Wanting to know what it was like to hold the organ, to pull it apart, to place it under a microscope, I rehearsed my questions as the phone rang, only to freeze up when she answered.

            More puzzled than I was, she stayed on the line longer than she would have liked, speaking grudgingly at first, but gradually warming to my hesitant queries as we spoke. Growing bold as the thaw set in, I asked her whether she would be willing to show me the slides of my thyroid. Words slowing, her tone once again became glacial. There is nothing to see, she said. Nothing you would understand.

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            For months more I saw nothing at all, nothing but the flush of the scar on my neck. At my endocrinologist’s office, someone handed me an ultrasound order, the first I remembered holding since the barrage of tests that revealed the cancerous nodules. This one, I was told, would be routine. No one expected to find anything, but they had to look twice a year, just to be sure. Accepting the form with one hand, I counted off months with the fingers of the other. Had it really been six months? It had.

            Six months, largely unseen. Time enough that I no longer feel the time passing. Unmarked by illness, the days accumulate invisibly. Six months. Half a year. A good one too, maybe my best. Our New Year’s traditions almost always invariably assume that we are leaving behind troubled times. Last year, our resolutions say, we ate too much, loved ourselves too little. Rushing onward, we make like inverted images of Lot’s wife, refusing to look back. Standing at the edge, I found myself wanting to linger. My therapist laughed when I told him I had resolved to make this year more like the last one. That’s fine, he said. But maybe try not to get cancer this time?

            Looking back is no more a sin than looking close, but neither comes easily. In the days just before and after my surgery, I refused to watch as the lab techs drew my blood. Feeling I had already lost too much, I could not stand to see them take more. Always afraid of needles, I had grown more so during the biopsy following that first ultrasound. Reassured by the procedure’s fussy name – “fine needle aspiration” – I nevertheless recoiled when a doctor offered to present the long, thin implements that she would plunge into the soft tissue of my neck. I think she meant to comfort, to show me I had nothing to fear. This will be, she said, a minimally invasive procedure, one that would leave no mark, and cause no pain. I appreciated the gesture, but I still turned away, dreading both the instrument and what it might reveal.

            My neck craned back, I couldn’t see what she was doing as she worked, but I was close to tears at the possibility that I might. Somewhere outside, Catherine was lost in the labyrinthine corridors of the hospital basement, trying to find the room they had taken me to. Glad she couldn’t see me like this, I still wanted nothing so much as to have her there. In her absence, one of the techs took my hand and held it tightly. It was this kindness that finally set me to sobbing. Comfortable with the knowledge that others would hold me up, I collapsed into my own anxious sorrow. My eyes were fixed on the ceiling where someone had pinned a picture of tulips, newly blooming, to the acoustic tiling. The tech remained faceless to me, perfectly caring in her anonymity.

            Afterward, another doctor arrived to study the slides of my purloined tissue. Cheery, she broke protocol as she looked over the first batch. I see inflamed cells, she said, evidence of Hashimoto’s disease, but no sign of cancer. If the tech was still gripping my hand, she must have released it then. While the rest of us bantered, the doctor continued her work in silence. Standing, she told me that she would pass her report of to my endocrinologist, that I’d get my results soon. She made no mention of what she’d seen on the second slide.

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With Catherine, after the biopsy, mid June 2014

With Catherine, after the biopsy, mid June 2014

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          Six months out, an ultrasound tech ushered me out of the waiting room, introducing herself as R--. Following her as she wound her way through baffling corridors, I felt a tingling sense of familiarity. It took me the full walk to recognize her – I had hardly seen her face – but the warmth of her tone, clipped with the careful precision of post-colonial schooling, called back the steady pressure of her hand around mine. Were you there for my biopsy? Do you do that sort of thing too? I asked. She studied my chart for a moment, perhaps feigning incomprehension. Not today. Just an ultrasound today. As I leaned back, she coated my neck in gel, and I was surprised by its heat, as if it were the first time I had been in such a room, endured such a test.

            Before I left, R— handed me a CD, images of my neck, the ones she had just made. My laptop sputtered and growled at me when I slipped the disc into its drive, unfamiliar with the feel of physical media. I did not hesitate before opening the images, but I could make no sense of what I saw there. Indeed, there was nothing to see, just the tattered expanse of an unmade bed. Hard as I looked, I could find no sign of the thing I’d feared. I didn’t understand the images, of course, but I also knew enough to know that there was nothing left to see. My thyroid was gone and the cancer with it, leaving only a tangible absence where a butterfly had been.

            These days, I sometimes turn to watch as the vials fill. Somehow the process goes faster when I do. The techs seem to approve. Hurts less that way, doesn’t it? one of them tells me, slipping the needle into my arm. Strange how the veins do the work, tricked into releasing that which they hold dear. And yet that steady stream is not lifeforce leaving so much as it is a reminder of life carrying on.

            In the future, I will not mark the time since my surgery in days or months, but in drops of blood and waves of reflected sound. I will watch the shapes they make as they wash up on my shore.

The tattered expanse, January 31, 2014

The tattered expanse, January 31, 2014