I was never really all that good at math.  To this day it remains my father’s greatest disappointment in me that I can’t do anything but the simplest of addition in my head.  I figure if I really needed to do complicated long division on my own, they wouldn’t have invented calculators.  Even simple problems confound me and leave me stumped, grasping for answers that don’t seem to come even with they are probably obvious to everyone else around me.

Today was a bad day, in part because it involved numbers.

In addition to three waiting rooms, two doctors, one fellow (the medical kind), one randy nurse, two separate sets of paperwork (including one set of forms that was 11 pages long), and an interminable three hour wait, I also had my last infinitesimal shred of hope crushed under the heel of modern medicine.

I started at my regular general practitioner for my pre-surgery physical.  My doc, who I’ve been with for about a decade, is a nice enough guy but he always seems like he’s in a hurry and distracted – like my very presence there is something of an inconvenience.  He also isn’t very good with the optimistic bedside manner. When I told him about the esophagectomy, and every time I have seen him since then, his commentary usually goes something like this: “Oh… Geez… that’s too bad… Yeah, that’s a rough one… golly… that’s a shame.”

For this reason we shall call him Dr. Demi-Doom.  He hasn’t come right out and said “Well, you might as well start picking out caskets” but he sure is acting like there is a satin pillow in my near future.

Dr. Demi-Doom just moved into a new office and along with the new digs came a new set of support staff, including a woman that I am calling Nurse Jackée.  She thinks she’s fabulous and sassy and funny and a bit scandalous when in fact she’s just inappropriate and a bit creepy.  She keeps commenting about my tattoo and how “hot” it is.   Today, when I had to disrobe so that I could get an EKG, she handed me a gown and then stood there staring at me for a few moments before saying, “Okay, I’ll give you some privacy.”  When she was putting the electrodes on my chest, the gown started fall open around my nether regions and I grabbed it to keep it closed – she said, “Shoot, I thought I was going to get to be a perv.”

I understand what she’s going for – hence the Nurse Jackée reference – but she doesn’t get the nuances of black woman campiness.  I can say this with authority because it’s almost identical to drag queen campiness and I have known more than a few drag queens in my life.  See, there’s a fine line between diva and disaster on both sides of the target.  Go too far and you come across as desperate and shrill; don’t go far enough and you wind up with inappropriate and creepy.

By the way, I thought of the Nurse Jackée thing and then when I got home I Googled it and of course Funny or Die had already beaten me too it.  Go watch this because it’s really funny and from here on out things in my story aren’t.

I got my EKG and my blood drawn and my urine collected and then had to go to a different place to get a chest X-ray.  This of course meant another waiting room (bland, utilitarian) and more forms (two pages, not bad).

Then this afternoon I went for my second second opinion, this time at UCLA.  You may remember me telling you that they have the #6 ranked gastroenterology department in the country and that they specialize in these types of esophageal cancers.  You may also remember me telling you that the reason I am not having anything major done here is because they don’t take my insurance.  But I wanted to get their take on the situation, even if it meant paying for consultation out of pocket and filling out 11 pages (!!!) worth of forms.  Well, mostly filled out.  I’m sorry, but I don’t know how old my grandparents were when they died and I certainly can’t recite our entire family’s medical history back to the time they came to this country.  I wanted to list a fictional great, great uncle and indicate that he died from syphilis but I figured that I would be the only one who would think that was funny.

The thoracic surgeon I was meeting with sees patients at UCLA’s hematology and oncology center, so it was a big waiting room filled with other cancer patients.  This is where the day really started to go down the toilet.

Last week, the USC cancer hospital waiting room I was in was also filled with cancer patients, but most of them looked like me – healthy-ish, probably just starting or maybe just finishing their journeys with the disease.

But at UCLA the room was filled with people in the throes.  There was one woman in a wheel chair who was so weak she could barely carry on a conversation with the nurse.  A man had a prosthetic leg that was obviously fairly new because it seemed to be causing him a great deal of pain whenever he walked on it.  Another woman with a big hat covering her chemo burned hair broke out into tears as her husband tried to calm her and her teenage daughter furiously played some sort of game on her smartphone.  This was not a good room.

And unfortunately I had a lot of time to absorb every last little detail of it.  There was no traffic going to UCLA so I got there about 45 minutes before my 4:15 appointment.  Then the doctor was running behind so I didn’t actually get brought back into an examining room until 5:00 so about 90 minutes of that room’s desperation and I was ready to go quite, quite mad.  Or quite, quite madder, perhaps.

Then I sat in the examine room for another 45 minutes until finally the doctor came in, or at least who I thought was the doctor. Psych!  He’s the med student doing his fellowship with the doctor, who wanted to go over the case with me before the real doctor came in.  So fine, I talked to George O’Malley and told him why I was there and he told me that the surgery was my only shot and I really didn’t have a choice.

Excuse me, Little Grey, I didn’t come here to hear your opinion on the subject, I came here to talk to the real doctor.  So scurry along Izzie and go get Dr. Shepard.

These are all Grey’s Anatomy references by the way.  Just go with it.

Anyway, so Dr. McGeeky comes in and won’t look me in the eye and immediately starts drawing on a piece of paper, explaining things that I already understand.  He told me that I had a PET scan and an endoscopic ultrasound.  I thought, “I know… I was there.”  Then he told me about my tumor is and how far it has progressed and where it’s located.  All of this I already knew so I gently prodded him to get to the good stuff: what do we do about it?

“Surgery is the standard of care in these cases and it is your only chance for a cure.”

Well, fuck.

I don’t know what I was hoping for.  I guess maybe I wanted him to tell me that because they are the #6 gastroenterology department in the country that they have a special procedure known only to the Top 10 that involves being healed by unicorns with rainbows and cotton candy kisses.

Failing that, I at least wanted him to tell me that the surgery was no big deal.

Instead he kept throwing numbers at me.  10% (that would be mortality rate of the surgery), 20% (the rate of incidences in which the place where they join the stomach and esophagus leaks and they have to go back in to repair it), 30%, (the percentage chance that there really is lymph node involvement even though the scans didn’t show any), 30% (the risk of complications both big and small), and 40% (the chance that despite all of their best efforts, the cancer will still come back within 5 years and kill me).

This was my last shot; my last hope that I had a good option.  I don’t.  And so now all that is really left to do is decide whether or not I’m going to have the surgery.  I know it should be simple.  It’s basic math.  Add the chances that I’ll make it through the surgery fine and will live a long life cancer free, subtract the risks and the pain and the recovery and the major lifestyle changes, and then compare that against the chances that I’ll have of surviving if I don’t have the surgery.

I just wish I was better at math.  And I really wish it was all that simple.