“So what brings you in today?” asks Melanie, a bright-eyed young student.
“Oh, well,” I stammer, not sure where to begin. “I’m just here to run some, uh, tests.”
“With the doctor?”
“Yes. Right. With the doctor.”
My fingers are latticed, and they clench themselves white. I stare off with darting eyes, run my tongue inside my cheek. Whatever it is I’m not saying, it’s really bothering me.
“May I ask what kind of test?” the woman says. Her voice is funeral-hushed.
“Well,” I say. “I found a lump. Just over my collar bone.” I let out a gruff sigh. I nod a little, as if confirming what I’ve just said. “The thing is, I’ve been through all this before.”
The students are dead silent. Our classroom is located on the far end of the building, as far from street-noise and hospital traffic as possible. The one window is suffocated by a concrete wall across the alley. There are no distractions here, not even a wall clock.
“Okay,” says Melanie. “So, um, that must be pretty scary, huh?”
But it’s more complicated than that. I’m actually enjoying cancer.
When actors first become SP’s (standardized patients), they usually imagine themselves with a terminal illness. We all conjure the same scenario: A sorrowful doctor enters the room. He runs his finger over the edge of the clipboard and fumbles for the right words. We have some bad news for you, he says.
BUT HE WAS RIGHT HERE! the SP shrieks.
We did everything we could, the doctor says. Is there anything you need right now?
No, the SP snarls. You’ve done quite enough.
This is how it happens in movies. Soap operas. Prime-time dramas. We’ve seen this interaction unfold a thousand times, starring all kinds of good and lousy actors, and the lines are beyond scripted—they’re a template.
As it happens, most SP’s never experience terminal illness. Yes, we contract all kinds of unpleasant diseases, and sometimes the pain is unbearable. But even our seizures and heart disease are usually under control. We’re frustrated, agitated, angry, frightened—but rarely do we face the possibility of dying. Only in the most advanced interviewing classes do we tempt death, and even then, there’s considerable hope for recovery.
But today I have a lump, and I’ve had lymphoma before, and I may not survive a second round of chemo. Once the “C-word” enters conversation, everybody gets serious. At this level, most med students are pretty comfortable with deadly cholesterol and Hepatitis C. But once cancer is thrown into the mix, everybody gets stoic.
“Have you told anyone?” Melanie asks. She’s practically whispering, as if a normal tone of voice will strike me dead.
“No, no,” I say. “I mean, I still don’t know. It might be nothing, right?” I stare at her, my eyes trembling. “Right?”
“How are you feeling?” Melanie says.
“I feel fine. I feel great. But that’s how it was the first time.” I run my hands through my hair. My palms meet at my lips, and I press my face into them. “Jesus. I can’t believe this happening. Like, again.”
My heart pounds. My head feels airy with adrenaline. It’s a feeling of elation, because these students believe us—me and Melanie. They know I’m an actor, they know we’re just improvising a scene, I’m perfectly healthy, I have no actual lump. But we are riveted to our fiction. Together, we are tense and brooding. Partly it’s because I’m a good actor who understands the gravity of the situation. Partly it’s because Melanie cares, deeply, about her ailing patients.
But mostly we are all bowing to cancer’s power. Because this is what will get us in the end. If we dodge cars, avoid fights, exercise, eat well—we’ll probably die of cancer. Cancer is the new “old age.” For people lucky enough to live in the First World, cancer is shorthand for mortality.
This is not daytime television. We’re giving this some serious thought. Melanie, me, the facilitator, everybody in this room. If these students ever become cold and callous physicians, I can tell this is the one disease they’ll never devalue.
“This must be really difficult for you,” Melanie says.
She’s supposed to say that, but it feels genuine. As if she’s speaking it to me, not to Gregory Schultz. As if reassuring me, an average guy who is just as cancer-prone as anybody else, that somebody will care, no matter what.
“Yeah,” I say. “It is. But I’m glad I’m here.”