I have never been a fan of the annual physical. Back in 1993, my partner at the time urged me to see her gynecologist. “You are long overdue an exam,” she scolded, so reluctantly I went. In the indelicacy of stirrups, the doctor exclaimed that I had a large uterus. I wasn’t sure if it was a compliment or concern. Turned out to be the latter. After a kidney scan, she determined I had a large growth inside and set a date for surgery. I began referring to it as my baby but more seriously, I began asking my body, what is it trying to be born? I heard a reply: you are giving birth to the tree of your own knowing.
After the large benign cyst and all my reproductive organs were removed, much to my delight, I got a tattoo of that tree of knowing on my left shoulder blade. The downside to putting it where I could not see it is that it’s easier to forget.
The same woman who had been my partner in 1993, who long since morphed into my chosen sister, began telling me five years ago I really should get an annual physical. She often extolled the many virtues of her much beloved primary care provider and finally I relented and made an appointment. In 2017, the lovely physician examined me and did bloodwork that revealed microscopic red blood cells in my urine (microhematuria). I was not particularly concerned but she was, so I had the kidney ultrasound and the urine cytology she requested, both of which indicated nothing cancerous.
This did not surprise me because I remember at age thirty-four, hearing a clear message from my body: that cancer just wasn’t part of my body narrative in this life. I know to some that may sound ridiculous or naive. I understand. Few of us imagine it will be part of our story unless there is a strong family history. There have been two times in my life when I have experienced absolute knowing and that was one. The other time was seconds before a bodysurfer slammed into me on Nauset beach when I heard the line in my head: he’s going to hit me even though at the moment he was probably a hundred yards further down the beach.
We do much in contemporary culture not to cultivate our own knowing. It’s as if there’s a collective tinnitus that makes it harder to hear the whisper of wisdom our bodies murmur. We get drowned out by experts and instructional videos. New products and AI interfaces that seem to anticipate our needs and complete our sentences. What do we surrender when we lose attunement with ourselves? When the tree of our own knowing grows bare?I
Early this year, I returned to the doctor for an annual visit. I had no complaints or concerns. I know myself to be healthy. I eat well. I exercise. I have abstained from alcohol, drugs and tobacco my entire adult life. I dwell in gratitude and good fortune so when my primary care provider said, “You still have microhematuria and I want to do a CT scan of your bladder and kidneys because I need to figure this out,” once again, I reassured her I wasn’t worried. Here’s where the story turns.
She had fear. A close family member of hers, otherwise healthy, had developed bladder cancer in middle age. As a doctor, she always fears she will miss something with a patient that might turn into a potentially fatal condition. She implored me to get the CT scan. When I should have glanced in the mirror, turning my head to glimpse the tree of my own knowing on my back, I capitulated to her fear.
I got a call from the radiology department of the local hospital notifying me my kidneys and bladder were fine but the scan detected something in my chest. What? I thought. I have never had any pulmonary issues or infections, never smoked. I recalled the knowing I experienced at thirty-four. I had no reason to suspect anything wrong. But I allowed the seed of self-doubt to sprout. I thought of a friend who recently got diagnosed with lung cancer who also never smoked. I guess it’s possible, I thought but it just didn’t feel true to my body. Still, my doctor insisted I get a chest CT just in case. And I did. This time, radiology phoned to report nothing in my chest other than a few thyroid nodules, but the scan indicated a suspicious growth in my stomach. The person I spoke with asked me to come back to the hospital the same day for a stomach CT. I drove back and politely informed the radiology technician I had no interest in more radiation.
I went back to my doctor and she urged me to get the stomach CT and to get a thyroid ultrasound. The latter identified at least two nodes that warranted a needle biopsy but by then, the coronavirus had changed the priority of hospitals and that got pushed aside till May. Meanwhile, I listened to my body and heard no interior concern that I had stomach cancer. My lovely doctor however, remained afraid. She had cared for other patients, who like me, presented healthily yet something untoward later emerged. I understood her fear. It was legitimate. But if was her fear, not mine.
Consider the moments any of us might succumb to someone else’s fear— of consequence or judgment. We toggle between the capacity to listen with absolute attention, attuning ourselves to the wisdom of our body and the desire not to seem cocky, foolish, even errant. We want to be sure. We’re wired to prefer certainty and one thing that’s certain: we rarely receive adequate encouragement to trust ourselves.
I get the stomach CT scan that reveals a mass slightly larger than an inch at the top of my diaphragm beside my stomach. My doctor consults a GI specialist she likes and unexpectedly, on a Saturday, an unfamiliar number scrolls across my cell phone and for some reason, I answer. A gastroenterologist I’ve never heard of tells me it could be a gastrointestinal stromal tumor. A slow-growing cancer, removable. Despite the shut-down in elective procedures due to coronavirus, he informs me his office will schedule an endoscopic biopsy under general anesthesia for Tuesday. “Expect a call Monday to confirm,” he says before hanging up.
I have heard nothing about this from my primary care doctor but as promised, I get a call Monday telling me to report to Concord Hospital Tuesday at 9:00 a.m. A week later I will learn my doctor heard nothing about scheduling this procedure. She first learned of it when I texted afterward to report the benign preliminary pathology results. Ironically, the mass had a completely different consistency than what the gastroenterologist had thought.
Relieved by the initial benign results, I felt badly I had subjected myself to so much unnecessary radiation and anesthesia brought upon by capitulating to the original scan, falling down the rabbit hole of subsequent scans—incidental findings that suggested to radiologists a need for yet another test.
After abdominal discomfort kept me awake most of Wednesday night, I mentioned that to the gastroenterologist when he phoned Thursday morning to tell me the final results of the pathology report confirmed benignity. I asked if there could be a relationship between the odd discomfort and the procedure. “I’d have no way of knowing without another CT scan and no one’s doing them right now. Monitor mild symptoms and if they get worse, call the ER.” And with that he hung up.
Thursday evening, I texted my doctor that I had a fever and she told me to get to the ER where yet another stomach CT revealed an abscess around the benign growth. While I realize now infection would be a risk of any invasive procedure, I find it neglectful the GI specialist never mentioned it: before or after, or even on the phone that morning.
Admitted to the local hospital, doctors there told me someone would need to drain the abscess. They administered IV antibiotics and sent me upstairs. Late the next afternoon, the hospitalist asked for my blessing to transport me to Concord Hospital so that the doctors there could address the situation. Each doctor I spoke to imagined possible scenarios. An interventional radiologist draining it. The gastroenterologist repeating the procedure but draining the abscess instead. A general surgeon removing it.
While immensely appreciative I sat in a hospital for a condition unrelated to Covid-19, mindful of all my good fortune, practicing gratitude every moment of my stay, the persistent pain in my left shoulder I’d felt all weekend, would not abate. All I could attribute it to was the amount of one-fingered texting I had done on my iPhone Friday and Saturday, perhaps irritating a muscle with repetitive motion. Eventually, that discomfort prevailed over my unhappy gut.
Sunday morning, dreading the thought of surgery necessitated by an invasive biopsy I never believed I needed, I fought hard to regain my posture of gratitude and wished to hell my shoulder would stop hurting. When the GI specialist strode in and announced interventional radiology looked far too risky; any gastroenterological approach could lead to peritonitis; and general surgery could result in more infection, he had decided to send me home on oral antibiotics. Massively relieved, I gathered my few belongings and awaited discharge.
At home, in the loving care of my chosen family, surrounded with the good thoughts of many friends, I have hunkered down, even more minutely attuned to my body. Finally, the tree of my own knowing has taught me this: never again will I service anyone else’s fear.
My white cell count is normal. My energy rebounds as I continue to listen and take it easy. Finally, the inexplicable pain my left shoulder that didn’t respond to electrical stimulation, the massage chair, or my insistent prodding, has finally lifted, now that I’ve looked in the bathroom mirror at the tattoo on my left shoulder and thanked it for the unignorable summons.
I have long relied on the wisdom of the trees—crawling into their welcoming branches, strolling among them, praying with hands splayed on a trunk. gazing daily from my bedroom window at the ones in the back yard. In this time of forced stillness, I have no doubt the trees invite all of us to listen far more intently. To embrace and honor what our bodies know.
When I told my primary care doctor yesterday, I would decline the needle biopsy for the thyroid nodes, she simply replied. “Of course, I understand.”
The tree on my shoulder soughs with relief.