Ignorance

Your blood was thick with sugar – around six hundred milligrams per deciliter, far above the threshold where the urine begins to sweeten – and as a result, you could barely lift your eyelids. After a shot of insulin, you were sitting in a chair, wearing fleece-lined slippers and guiding a spoonful of scrambled eggs to your mouth, but one of your blood tests was still askew, so I ordered an ultrasound of your abdomen, only half conscious of what I was looking for. I was in the cafeteria chewing on a sun-dried tomato when I got the phone call from radiology: there was a large tumor in the head of your pancreas, and it had infiltrated your liver. I thanked the voice on the phone and looked down at my sandwich. It did not feel true. My thoughts turned to last fall, when I noticed a vague, recurrent ache in my abdomen; I'd felt the pain on and off since medical school, but it had become worse, so I saw a doctor who sent me for an ultrasound. That afternoon I lay on an examination table covered in goosebumps as the technician slathered hot gel onto her instrument; when the probe touched down on my skin, a white oval appeared on the screen, casting a dark shadow across my liver, and I realized immediately and with great surprise that it was a titanic gallstone. This fact penetrated me sharply, sending off waves of simultaneous thought: like Galileo peering through his telescope, I felt humbled to have discovered the rock and satisfied to know the truth, but also deeply alarmed, even betrayed, to know that crystal of bile had been present in my body all along, enlarging slowly, forming a new shell every year like the trunk of a tree. They cut out my gallbladder around Christmas, but they would not cut out your cancer – no one could. When we told you, you handled it with remarkable grace; I won't forget how you raised your chin and said, I have no regrets. Your family was standing outside in the hallway. They didn’t know yet. There must have been eight of them.

This post was written by Emily Silverman, MD.