Unfounded Fears

Thursday, July 24, 2003

Some years ago, a study was done, seeking to correlate the fear level of people with their TV watching patterns. It was found that the more television people watched, the higher they thought their chances were of being personally involved in a violent crime. As I recall it, people who watched four or more hours of television a day, actually believed the odds were 75% that they, personally, would someday be mugged, raped, or murdered.

If this belief were accurate, it would mean that 3 out of every 4 persons you know would be victims of at least one violent crime.

But, of course, those aren't the odds at all. Far fewer people fall victims to violence than that. The actual statistics are about 1 in 84. And, interestingly, among people who never watched any TV at all, most of them guessed pretty close to that.

I haven't watched any TV at all, to speak of, in the past year. I didn't take a TV set with me on my truck. The last truck I drove, the Jeff Roadworthy, had a TV set in it but I never actually watched it. I've also never smoked. Nevertheless, I was now in fear that I might have lung cancer.

I would never have had this fear if it hadn't been for the hernia surgery. My surgeon insisted that I have a surgical clearance which consisted of a chest X-ray and various blood tests. I passed the clearance, but just before I was to go into surgery, the doctor who performed the clearance called and asked me to come back for an MRI. We found something on your chest X-ray, he explained, and we need to clarify it. The MRI, he continued, would provide a far more detailed picture of my lungs than the X-ray did.

So the problem is in my lungs? I asked, trying for a bit of clarifying of my own. You mean, like a tumor or something?

It looks like a nodule, the doctor explained. But it isn't clear enough to be certain. That's why we need the MRI.

MRI, of course, stands for magnetic resonance imaging. Instead of using X-rays to pass through the skin, muscle and bones and taking a picture of the resulting X-ray shadows, MRI uses high-energy magnetic fields to cause the atoms of the body to vibrate and then uses the resulting magnetic resonance—the sympathetic vibration of those atoms—to generate an image of those atoms. The level of detail is, indeed, far greater than that of an X-ray.

The level of fear of MRIs is also greater. Most people have X-rays taken without a thought, even though X-rays have been associated with the creation of cancers and birth defects. (That's why X-ray technicians hide behind a lead wall before turning their machines on you.) But X-ray projectors are fairly quiet, and the procedure is fairly short; so people don't seem to mind.

Are you at all claustrophobic? The MRI technician asked when I showed up today for my MRI.

No, I said, considering that I had lived in the cab of a truck—a smaller area than the typical walk-in closet—for a year. Why do you ask?

He shrugged. Some people get nervous when confined. Do you have any metal in your body, other than tooth fillings?

No, I replied.

Did you ever have metal removed from your eyes? he continued. Have you ever been shot, by either a bullet or a B-B, or worked at a sheet metal plant?

No to all of those, I answered. But you've got to tell me why you want to know.

He shrugged, wearily, even though it was early morning. Obviously I was going to be a high-maintenance patient, even if I wasn't claustrophobic. The magnetic field is so strong, it can affect even metal flakes that might be left in the body after a bullet is removed. If the flakes are a certain distance apart, they can spark, like the times of a fork in a microwave oven. If that happens near the optic nerve, it could blind you.

Then what about the fillings in my mouth? I asked. I have quite a few.

They're made of amalgam, the technician explained. That's a mercury-silver alloy, and isn't affected by magnetic fields.

Oh.

Are you allergic to shellfish or iodine? he continued.

No…why?

We're going to inject you with dye. The doctor wants to know if the nodule on your lung is receiving blood. If it is, the dye will enter it slowly. If not, the dye won't enter it at all.

Why would he care?

He probably wants to do a biopsy, the tech explained. If it is receiving blood, a biopsy would cause it to bleed into your lung, and you wouldn't want that.

No, I wouldn't, I agreed, thinking so it is a tumor. But, in that case, what would he do?

The tech shook his head. That would be up to the doctor, he dismissed. Please remove all jewelry, even your wedding band, and put on these paper shorts.

There's no metal in my regular shorts, is there? I was wearing parachute shorts.

The handle to your nylon zipper is probably metal, he replied. The paper shorts will be safer.

So, without my earring or wedding ring, and in paper shorts, I laid on a platform attached to a metal ring. The platform slid into the ring until it encircled my chest. A nurse appeared, to attach me to an IV, then inserted the dye into it. Almost instantly, my head felt like it was swelling and my tongue developed a metallic taste.

It'll be about twenty minutes, the tech called from behind a glass wall. Not being claustrophobic, but accustomed to sleeping in a confined space when I wasn't driving in one, I dozed off.

The tech awoke me after awhile. All done, he said, cheerily. You can get dressed. Don't forget your wedding ring. We don't need any more of them.

People forget their wedding rings? I asked, incredulously.

All the time, the tech replied.

So…how did it look?

I don't interpret the images, the tech cautioned. All I do is make sure it came out clear and sharp. And yours did. Your doctor will call you with the results, probably within the next couple of days.

So, now that the MRI procedure was complete, and even though I had to grapple with the possibility—indeed, it seemed like a probability—that I had lung cancer, my immediate concern was eating breakfast. I had had to fast since midnight, and I was starving. So, with all the choices open to me on where to eat, where else did I go….but a truck stop?

In my defense, I hadn't eaten truck stop food since the incident that resulted in my double hernia. Okay, that's not much of a defense. But there was a truck stop nearby, and somehow I found myself pulling into its parking lot. At least, I was aware I was driving a car and not a truck. I pulled into the automobile parking area. But I drove to the edge of it, and parked opposite the bobtails. In fact, I was headlights-to-headlights with a big Kenworth.

It was decorated with all the lights and chrome do-dads that mark it as privately owned by a guy very much into his truck. It caught my eye, as it would anyone who wasn't blind (and some who are borderline), and I craned my head to see it as I left my own car and headed for the truck stop restaurant.

In the restaurant, after I had ordered a steak omelet (I figured, late as it now was, this meal was basically brunch and should incorporate elements of both breakfast and lunch, like eggs and steak), my attention was drawn to a guy sitting two tables from me. His attention was riveted to the TV mounted high up on the wall. It was tuned to a 24-hour news channel; and, as usual, they were going on about the so-called war on terrorism.

I said, earlier, I hadn't seen TV for a year; but, of course, that's not literally true. A person can't walk anywhere in the USA without being in sight of a television set. They are in malls, bars, restaurants, truck stops, and so on. But, for the past year, every time I passed a TV set, it was usually tuned to CNN and all CNN ever seemed to talk about was the war on terrorism. I have to assume that other shows continued to exist, like Friends and Will & Grace and The West Wing. Were the Friends buying duct tape? Were Will & Grace worried about the erosion of their civil rights due to the Patriot Act?

I remember reading 1984, George Orwell's vision of http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2002/07/28/IN244190.DTL> life in a totalitarian future. In it, TV was everywhere, and owning a TV set was mandatory. The sets were always on—couldn't be turned off—and filled the citizens' heads with nonsense like War Is Peace and Obedience is Freedom. Well, here I was, in a restaurant where I, certainly, couldn't turn off the TV set, having the same sort of nonsense wash over me.

Anyway, my breakfast arrived (as did his). We both ate, each at his own table, each in his own world. And what very different worlds we inhabited!

Moreover, in his world, which he clearly inhabited with many packs of cigarettes (one of which resided beneath his rolled-up T-shirt sleeve), he probably didn't have to contend with lung cancer. And I, who did not smoke, did not inhale asbestos, and tried to live a healthy and natural lifestyle (at least as far as possible while ingesting a steak omelet), did.

I was resigned to the Big C. If I had it, I had it; it would be yet another adventure in an increasingly tedious string of them. That's the irony of true adventures; they're fun to talk about afterwards, but not usually fun to actually live through. Neither Frodo Baggins, nor Neo, nor Katherine Hepburn's character in The African Queen enjoy fighting dragons, computer agents, or Humphrey Bogart and Germans, respectively. Bette Davis certainly triumphed in Dark Victory, but her increasing blindness, a symptom of her encroaching, more serious, disease, wasn't fun for her; it was something to be overcome, spiritually if not physically.

So, if I had lung cancer, I could look forward to triumphing over cancer, or, if not, at least refusing to let it destroy my spirit even while it took away my very ability to breathe.

I could look forward to being the patient all the nurses use as an example to the other patients. Here, Mr. Alexander, I can't believe you're objecting to a little enema when Mr. Cilwa has had both of his lungs removed, and you don't hear him complaining! Here, Mr. Alexander, how dare you ask for another pain pill when Mr. Cilwa has nothing left but a head, and he can still smile all day!

And how dare my restaurant two-tables-over companion worry about terrorists just because that's all he hears about, when I have lung cancer!

Well, probably have lung cancer.

Might have lung cancer.

Actually, no one but me had used the C word at all. All I knew, and that from a phone call, is that there was a nodule in my lung. And I didn't really know what that was. I don't know that many details about the workings of my lungs. Really, if the doctor had told me the batteries needed to be changed, I couldn't have argued with him.

My restaurant companion, the avid TV-watcher, was behind me in line to pay for his meal. He followed me out of the restaurant, and towards my car. Actually, of course, he was headed for the fiercely-decorated Kenworth parked directly in front of the convertible I was driving. He walked faster than I—his lungs were working perfectly—passed me, and I caught a glimpse of the inside of his truck. There, in addition to The Club—he actually had a bar fastened to his steering wheel!—he had, leaning against the driver's seat, a sawed-off shotgun. He must've heard me gasp, because he turned and grinned. No terrorists gonna mess with me! he chortled.

I exploded. Don't you realize your fear is based on an overdose of television? I cried. Don't you realize that, every month, more people die in car accidents than did in the 9/11 attacks? Don't you realize more people die every month from cigarettes than from all the terrorist attacks all over the world in the last three years? Including, I added bitterly, any number of people who don't even smoke?

He stared at me as if I were insane, and I stared at him the same way. We both shook our heads and got into our respective vehicles. I started my engine and he, of course, put up his satellite dish so he could stay overinformed.

I could only thank my lucky stars that my fears, at least, were well-founded. How much better to be terrified of a real danger, than a media-magnified one!

Friday, July 25, 2003

The doctor's office called this morning. It wasn't the doctor, but one of his nurses or receptionists. I didn't mind; her English was better.

I am calling about your MRI yesterday, she said.

I sat down and took a breath. Yes? I replied, questioningly.

It's clear.

I was glad the MRI had come out well, but—How bad is it?

It's not bad, she replied. It's clear. There's nothing there.

There's nothing in my lungs? My God, had the cancer progressed to the point where I had no tissue left at all?

Nothing that shouldn't be, she corrected herself. You're fine. There's no problem. You're fine.

I paused. There's nothing wrong with my lung? Either one of them?

Nothing at all.

Then why did you guys send me for an MRI? That I would have to pay for, I added mentally.

We had to be sure, she said. The X-ray you had earlier wasn't clear, it looked like there might be a spot. The MRI presents a clearer picture, so that's the next step.

What did you do before MRIs were invented?

Well, in those days, we probably wouldn't have done a thing. After all, these little X-ray spots usually turn out to be nothing. But, nowadays, if it turned out to be something and we hadn't used every test at our disposal to be sure, you could have sued the doctor for malpractice. This way, we know nothing is wrong with you. Aren't you glad?

I admitted I was, and we hung up a few minutes later.

So, I had agonized over nothing. Just like the truck driver yesterday, I had girded myself for an attack that would never come, or, at least, wasn't immiment. I had laughed at his ability to be fooled by his fears, when I had done the same. For, where do I have any knowledge of lung cancer but from TV news and scraps of doctor and hospital shows that might be broadcast when I'm in the same room as a TV set?

Of course, it might have been nice if the doctor's office had told me there was a spot in my X-ray that was probably nothing. But would it have changed anything? I was the one who had filled myself with fear and then wallowed in it, not the doctor. And not TV; TV just provided the raw material. I had the choice of how to use it.

Still, I thought, wasn't it great in the old days when love made the world go 'round? Instead of fear doing it?

Well, I wouldn't be part of the problem. I would be part of the solution. Fear-free me.

Except for the remaining, nagging dread that, in this paroxysm of clichés, I was about to consider that today was the first day of the rest of my…

Well, you know.