Monday, May 11, 2009

Cancer On the TV

I'm watching two TV shows right now where a character has cancer. The first one is the incomparable Breaking Bad, with Bryan Cranston. His character, chemist-turned-high-school-teacher Walter White, has a form of lung cancer that — we suppose — has been brought on by long-term exposure to chemicals. The other is In Treatment. One of Dr. Paul Weston's patients, April, has Hodgkin's lymphoma. She's not telling her parents, though, because they already have such a burden at home with her autistic brother.

Yeah, right. Like there's really a way a 23-year-old student without an income can enter treatment for cancer at a major hospital in New York and not get her parents involved. Do the idiots — that's right, idiots! — who wrote this understand that one of the things they talk to you about right before you go into an infusion room is HOW YOU ARE GOING TO PAY FOR YOUR TREATMENT AND WHETHER OR NOT YOU ARE CURRENT WITH YOUR BILL?

If you didn't catch my meaning, I'll say this another way. They don't start doing a thing to you at the oncology center until they sort out how any health coverage you may have will pay for it and then they make you understand what your share of that will be. Even with insurance, it is not free of charge to you. I'm afraid that, although it makes for fascinating TV, April cannot get treatment for her lymphoma without getting her parents' bank account involved. I will say this again — before you can even set foot in the infusion room, your first stop is the financial office.

Oh, even worse, Gabriel Byrne (the therapist) does for April what she cannot do for herself and takes her to "the hospital" for chemo … if you are getting in-patient chemotherapy, you certainly are not going there under your own power or even on your own two feet, much less all alone or with some stranger (yes, the therapist is basically a stranger). No, in her case, she's getting outpatient treatment and that doesn't take place in a hospital — again, the costs are the reason why, plus, you don't need to be in a hospital. Secondly, April subsequently refers to her port, which the unnamed hospital people somehow placed in her chest while she had fainted or something, and then they pumped chemo drugs that she doesn't know the name of into her right after that. Later, right in the good Paul Weston's office, she doubles up in pain because of the port … oh, for fuck's sake.

The port installation is a surgical procedure. You are unconsious when it happens, and it happens well before you get your first infusion. It doesn't hurt. You can't feel it. It's below the skin, right under your collar bone. I've blogged about this before.

In Treatment is based on a series from Israel, and maybe this all this shit happens in Israel, but not in the U.S. of A., honey. Scripts for In Treatment are written by Marsha Norman, author of a tiresome 1970s play called 'night Mother, in which a young woman argues for five acts with her mother about why she wants to commit suicide. She also wrote Getting Out, about a woman leaving prison. I had no idea Ms. Norman was still kicking around, applying fatuous and misguided notions to some of life's most dramatic moments — you know, offing yourself, release from prison, getting cancer, the list just goes on!

I know why doctors and police officers get so disgusted with television that purports to show the drama of their respective careers. And I have attempted to gently tell people that a diagnosis of cancer and the ensuing treatment doesn't play out in real life like it does on television. There are no blinded-by-the-light moments. There are no plateaus of sweet relief and angels singing. After spending your life watching how people do this on TV, you would be awfully surprised how much the same everything — and I do mean everything — is, and how uncertain everything still feels.

This is the truth that Breaking Bad gets to. In fact, they got to it in last night's episode. The unlucky Walt White, who's chosen a path of meth manufacturing because he believes he's going to die soon, learns that the heroic efforts of his medical team have succeeded in stopping the progression of his disease. Time to celebrate! Right everybody? But he tells the party crowd his unknowing wife had assembled in honor of this occasion that, when he got his diagnosis, he thought, Why me? and that when he got news of his remission he also thought, Why me? And then he proceeds to get mean, messy drunk. He's not happy and smiling. He's more uncertain and angry than ever.

Having reached the limits of what can be done to his body, now Walt has become obsessed with cutting out the sludge and rot from his house, sawing, welding, replacing, improving, trying to make it right, get the shit out.

This is the cancer experience. This is what the real thing is like.

Sunday, November 30, 2008

Plan B

Some people who know me may know that I have not shopped at Target for about the last three years. That's right! No Target. At some point I became aware that Target had a policy that if any of its pharmacists had "moral problems" with dispensing the so-called "morning after pill," Plan B, that pharmacy could refuse to fill the scrip. Turn your intercoursing ass away and send you to someone who can put up with you and your medical needs.

For all I knew, any pharmacy company in the U.S. could have exactly the same policy. But Target likes to brand itself as hip, urban, tasteful, and forward-thinking. (This is in contrast to Wal Mart, whose brand is traditional, family-values, and no nonsense.) Good design is for everyone at Target, but good medicine is not. It is important to note that Plan B is birth control. It's not an abortifacient. Birth control is still legal in this country.

This really pissed me off. Then I read about it again in the always-profane column "Savage Love," by Dan Savage. I contacted Target and told them that this policy amounted to discrimination and that anyone, anytime, anywhere, who had a prescription that was lawful was entitled under the law to have it filled. Here's what they said in reply:

Dear Target Guest

In our ongoing effort to provide great service to our guests, Target consistently ensures that prescriptions for the emergency contraceptive Plan B are filled. As an Equal Opportunity Employer, Title VII of the Civil Rights Act of 1964 also requires us to accommodate our team members’ sincerely held religious beliefs.

In the rare event that a pharmacist’s beliefs conflict with filling a guest’s prescription for the emergency contraceptive Plan B, our policy requires our pharmacists to take responsibility for ensuring that the guest’s prescription is filled in a timely and respectful manner, either by another Target pharmacist or a different pharmacy.

The emergency contraceptive Plan B is the only medication for which this policy applies.
Under no circumstances can the pharmacist prevent the prescription from being filled, make discourteous or judgmental remarks, or discuss his or her religious beliefs with the guest.

Target abides by all state and local laws and, in the event that other laws conflict with our policy, we follow the law.

We're surprised and disappointed by Planned Parenthood’s negative campaign. We’ve been talking with Planned Parenthood to clarify our policy and reinforce our commitment to ensuring that our guests’ prescriptions for the emergency contraceptive Plan B are filled. Our policy is similar to that of many other retailers and follows the recommendations of the American Pharmacists Association. That’s why it’s unclear why Target is being singled out.

We’re committed to meeting the needs of our female guests and will continue to deliver upon that commitment.


So the only barrier between you and a filled scrip for Plan B at Target was if you were unfortunate to encounter a pharmacist who possessed "sincerely held" religious beliefs against the drug. What if those beliefs were insincere? Would you just give me the damn pills then, you meddling jerk-off?

It was remarkably easy to turn away from Target after this exchange, and it's a habit I'm not prepared to change, in spite of the fact that Plan B is now available without a prescription for women over 18. (I suppose they can still refuse to give it you, even if you have bruises to show them.)

But do I need a "plan B," in light of this new development? I know I don't need new ways to spend money. But I do wonder if there are old habits that I'm hanging onto and can't remember why anymore. Yes, this is the sort of thing having cancer makes you think about.

No More Radiation

I am done with radiation treatments. It was an emotional moment, when my kid and the radiation crew threw confetti on me. My doctor presented me with a plaque has has a quote attributed to John Wayne: "Courage is being scared to death but saddling up anyway."

Tuesday, November 25, 2008

Two More Treatments Left

It is very busy in the radiation center because all patients are getting five days' worth of treatment in three days. You have to let at least five hours elapse in between treatments.

Things People Have Done For Me During All This

1. Brought my family meals, including incredible homemade chicken parmesan. Packed a lunch for my child once a week and brought it to school.

2. Called me immediately after one of my little handmade purses sold at Parts and Labour, then called me again about 45 minutes later after another one sold.

3. Taken me to chemo and brought me crunchy tacos from Hillbert's (getting chemo made me hungry).

4. Checked in on me to see how I was feeling (crappy! thanks!).

5. Knitted me a hat to cover my bald head.

Monday, November 24, 2008

Five More Treatments Left

I now have five radiation treatments left. I'm going in this morning for a treatment, then coming back five hours later for another one.

The skin on my clavicle and shoulder is all brown-red and starting to slough off, like when you get a bad sunburn. But last week's break from the regimen was really helpful. I feel a lot better. This week will be no picnic, but at least it will be over soon.

Saturday, November 22, 2008

I Want My Party Early

Yesterday I made a decision — I am doubling up on my treatments for Monday and Tuesday, and I am going to finish radiation on Wednesday, the day before Thanksgiving. I want my confetti party early, and I want to drink champagne after. I am probably going to cry.

I try to keep thinking how bad off you have to be to arrive at the radiation clinic in a private ambulance, how bad off you have to be to be in chemo and radiation simultaneously, and that's not me. I can walk in there and leave on my own two feet, and in my own car. And the people who work at the radiation clinic are the most professional and nicest human beings I have ever encountered. But I just don't want to be there anymore and I am going to get this over with.