Around the Sun

Lana--Chapter 1

I stood outside the automatic doors to the clinic in a Wonder Woman costume. I don’t typically consider myself superhero material, but Nurse Lavelle had joked that I should wear something special to each appointment to celebrate a milestone of life in remission from triple negative breast cancer. She was likely thinking I’d throw on heels or a nice sweater or something. But that just wasn’t my style.

It was also February in Minnesota, so I was freaking freezing. Why couldn’t I get the music to work on my phone? I pulled up the Batman theme song because it was close enough and raced towards the doors, arms outstretched in peak superhero form, cape flailing behind me in the frigid wind.

“Oh, my goodness! Lana!” Mindy, the cancer center’s bubbly receptionist, bounced up from her office chair. She was the only one in the waiting room. So much for making an impact, but I had snagged the first appointment time of the day.

“Love the music!” Mindy laughed.

“I’m pretty sure Batman and Wonder Woman had a fling?” I paused the tunes as I grinned and handed her a small paper bag. “My friend Dani brought back that spicy Mexican chocolate from her trip. I know you love it.”

“That’s so sweet! Literally.” Mindy brushed her highlighted fringe out of her eyes and signaled me to spin around to model my outfit. “Adorable, if a bit risqué for my tastes.” She accepted the bag from me and gestured toward the doorway beyond us. “Just wait until Lavelle-"

As if summoned by her name, Nurse Lavelle appeared in the doorway that divided the waiting room from the part of the cancer center that houses the nurse’s station and the main infusion room. I’d spent far too many days in that beige-walled space almost two years ago, watching poison drip into my veins, but it had killed the cancer. I was officially one year into remission. I was alive, albeit one fewer breast and several fewer lymph nodes than I’d originally entered this planet.

“Lana Parkins, I see you’re as feisty as ever! How did you find a Wonder Woman costume in your size, though? I think she’s more my height?” She straightened up to her full six feet and offered me a wink. Nurse Lavelle was my favorite: affectionate but frank with her patients, sturdy in all meanings of the word, and intimidatingly beautiful with her impressive height, umber skin and natural curls. She was about twenty years my senior and practically an aunt to me after all I’d been through in this building.

“It’s a children’s costume.” I returned the wink. Everyone was forever teasing me for being vertically challenged, and I was convinced that chemo had shrunk me farther. Last summer, an operator at the Six Flags had measured me before letting me on Xcalibur, which seemed a bit extreme in my humble opinion. I’m not that tiny. The kids behind my friends in line had giggled; I’d crossed my eyes and stood on my tiptoes.

Nurse Lavelle eyed up the unitard and fishnet leggings I’d paired it with. “No child of mine would be caught wearing that unless they want a special talk with me afterward.”

I curtsied teasingly. “How are your kids doing, by the way?”

“Well, my daughter thinks she’s the next TikTok superstar, but at least she’s still working hard at school. My son just got accepted to U of M!”

“Congratulations to Jayden! Those two sound like the real superheroes.”

She smiled and jerked her head back toward the door. “Come on, get in here. We’re ready for you. I’m sure the doctor will be amused to see what you’re wearing.”

“Oh, goody!” I rubbed my hands together. “I live for amusing Dr. Mitra! He’s too serious.”

“Oh, trust me,” Nurse Lavelle began, leading me down the hallway to the first exam room. “Before we met you, I swear I could count the times I’d seen that man smile on one hand. But he adores your antics.”

I blushed behind her, thankful that she couldn’t see my face in the moment. I had somehow developed a harmless crush on the doctor. His brainy seriousness had lured me in, along with his accent and the way he runs his fingers through his black hair when in thought. It certainly didn’t help that he was only about a year older than me.

Alas, a love affair with the mysterious (though single-- yes, I’d checked) Dr. Mitra was not in the cards, nor was any sort of romance lately. I felt like I’d hit a brick wall after cancer treatment when it came to romantic relationships. More than a brick wall-- it was like I’d run headfirst into an impenetrable fortress. I didn’t know how to move past the physical and emotional rollercoaster I’d been on this last year and a half. I’d powered through cancer treatment only to find that I didn’t know how to live after cancer.

Nurse Lavelle weighed me and checked my vitals. “Happy belated 30th birthday, by the way! I see that was last month. Big milestone!”

I smiled. “I’m over the hill now. Still half the age of most of your patients here, huh?”

She patted my shoulder. “You’re one of a kind, Lana.”

“Speaking of which--” I wiggled my eyebrows at her and flourished a book out of my messenger bag. “I’m now a published author! I wanted you guys to have my first copies!” I pulled out another copy for Dr. Mitra and set it on my lap.

“What are you up to now…” Nurse Lavelle mused, peering at the cover.

There was a knock on the door and Dr. Mitra entered, wearing his serious suitcoat as usual.

“Good morn-- Lana, what are you wearing?”

“Good morning, Doctor. This is just my normal clothing that I wear when not at the clinic. You know, when I’m busy at my day job, off saving humanity and swinging my lasso of truth. Also, as I was just telling Nurse Lavell, I’m now a published author!”

"Well, that’s exciting.” He caught sight of the fishnet stockings and averted his gaze. He crossed the room and sat in his office chair. “I thought you were a first-grade teacher?”

“Yes, all of the above.” I checked the roles off on my fingers. “Part superhero, part author, and part first-grade teacher.” I waved the book. “A life of pieces, much like this beauty. It’s part memoir, about my experience as a cancer patient in my twenties, and part helpful guide to both medical staff and other young patients who unexpectedly find themselves in a similar situation.”

Nurse Lavelle browsed through the book, nodding along. “Putting a positive spin on what you’ve been through.”

“That’s admirable of you,” Dr. Mitra added, “using your experience to help others.”

I shrugged. “I just felt like I couldn’t find the resources for someone like me when I received my diagnosis. I don’t blame anyone for that,” I quickly added. I don’t know if they would feel any responsibility for the complete lack of resources for young adults with cancer at our clinic. “How many twenty-eight-year-old people are in your average cancer center, really?” I rolled my eyes. “I was an anomaly. Now I can use that role to make this experience less painful for the next young cancer patient.” I handed my second copy to Dr. Mitra. He thanked me and turned it over to read the back cover.

“Oh!” I nearly bounced in my seat. “I almost forgot the best part!”

Nurse Lavelle raised her eyebrows. “You mean there is more? You sure have been busy!”

I nodded. “Oh, yeah. Well, I discovered that when you think you’re dying and then suddenly you’re not dying, you can sure cram things into your to-do list.”

“Oh, honey.” Nurse Lavelle shook her head slowly.

“You’re in remission now. Try to relax.” Dr. Mitra offered one of his rare smiles and it made me feel tingly inside.

I blinked my eyes quickly. “Well, that’s not how I operate. 100 MPH, Fast-forward, right?”

It was an inside joke for the three of us from my chemo treatment. I wouldn’t sit still for my infusions, taking on extra tasks while they were insisting that I rest. Nurse Lavelle had called me “100 MPH” and Dr. Mitra added “Fast-forward”. Now they both nodded slowly at me.

“Anyway, I have an amazing marketing assistant who just happens to be one of my best friends. She finagled it so that I can speak at this oncology conference in Chicago at the end of March.”

“I will be at that same conference,” Dr. Mitra jumped in. “It should be a good one, and now I’ll have to go see you speak.”

“No way!” I raised my eyebrows at him. “Want to carpool?”

He actually laughed. “I already have my plane ticket.”

“Ugh, doctors,” I rolled my head on my shoulders in mock distress. “It’s only like 400 miles. Just drive, dude.”

Nurse Lavelle chuckled. “Only 400 miles, she says! Yeah, why don’t you just drive, Doctor ‘Dude’? You’re too special for the Interstate?”

Dr. Mitra rolled his eyes at us, but he continued to smile, which I took as a good sign. “You Midwesterners are crazy.”

“I’m just excited for this chance to market my book. This is super cool, guys. Okay, quick-- tell me everything there is to know about oncologists. How can I make them like my book?”

Dr. Mitra was practically chuckling now, which made me smile. “We are all very boring. Our only hobbies are golf and cancer research.”

“Pshh!” Nurse Lavelle laughed. “You are way more exciting than all that, I’m sure, Doctor. We’ll just never know because you’re so tight-lipped.” She motioned as if zipping her lips shut and tossing a key over one shoulder.

He shook his head. “I can only speak for myself, but I assure you, I am quite boring.”

Nurse Lavelle laughed again, but then started walking to the door. “I have to go check on our next patient. It was so good to see you, my dear Lana!” She was carrying my book, but then paused mid-way out the door. “Oh, wait now! Do I owe you for this book?”

I beamed at her. “You guys saved my life. It’s on the house!”

She winked and left the room, closing the door behind her.

“Same for you, Dr. Mitra. You can have that copy.”

“Thank you. Very generous.” He placed the book beside the computer and typed something into the keyboard, pulling up a screen with a bunch of tabs that probably contained everything about me from my ACT scores to how often I flossed. Or maybe it just seemed that way after about two thousand visits to this place in the past two years. “Now, how have you been doing?”

“Uh, great!” I lied. He didn’t need to know how tough it has been adjusting to life after cancer. How the everyday aches and pains freaked me out, how I felt like I was a 30-year-old trapped in a 70-year-old body some days.

He peered at me with disbelief in his entrancing brown eyes. “Really?” After two years, he could see right through me despite my carefully constructed façade.

“Uh…okay, some days I feel so tired, still. It’s like my body just can’t catch up with pre-cancer me.”

“Probably because you’re trying to write books and teach a room full of busy 7-year-olds, and--” here he gestured toward my outfit-- “saving the world?”

“Well, okay, I lied about that bit. I would suck as a superhero. I think I’m too self-centered. And as hard as I’ve tried, I can’t learn how to fly or shoot lasers from my eyeballs.”

“Same.”

I smiled. “You’re a superhero in other ways, right? Saving people’s lives on a daily basis?”

He shrugged. “I don’t do anything special, just what any other oncologist would do. I wish I could do more.” He typed something else into the computer. “Your blood work looks normal. Everything looked great on your most recent mammogram. You’re physically healthy as can be right now.”

“Well, I did eat leftover pizza and a Reese’s peanut butter cup for breakfast.”

“I didn’t hear that.” One corner of his mouth crept up as he closed the application on the computer.

He completed the physical exam and asked me a few more health questions. Then, I was free to leave. He called behind me as I walked down the hall, “I hope to see you at the conference!” and I gave a little wave. Would it be weird to see him outside of the clinic? I wondered what he was like in the real world…as much of the “real world” as an oncology conference could be considered.

I hurried across the parking lot and hopped into my little turquoise Grand Am. I did still have to hurry over to the school today, since my principal had only promised to cover my first hour of class this morning, and I was already running behind. I somehow managed to swap out my skin-tight Wonder Woman costume and fishnets for black slacks and a sweater while driving across the city, only receiving a few honks and one wide-eyed reaction from an elderly gentleman at a stoplight. I hoped I didn’t give him a heart attack. Some superhero I am.

Alam Mitra -- chapter 2

“I don’t know why my surgeon sent me over here,” the man in my exam room began, shrugging his shoulders and looking around like he was still uncertain of his location. “Why do I need to meet with a cancer doctor? Can’t they just cut out my whole liver? How important is that thing anyway?”

“It turns out, quite important, Mr. Simpson.” I crossed my legs and tried not to let my face betray my surprise at his suggestion. As an oncologist, I’d heard much more ridiculous questions; it turns out, most people do not know how their body works. Surprise. “We would not recommend removing your entire liver; however, I believe your surgeon did remove the primary tumor from your liver?"

“Yeah, that’s what Dr. Limtel did. He chopped some of it up.” He made little chopping motions with his hand like he was dicing onions. From what I’d heard about Dr. Limtel through the hospital grapevine, probably not a totally inaccurate portrayal of the surgery.

Mr. Simpson shrugged his shoulders. “Now that we know the cancer's spread, I want to tell him to just go back in there and take the rest. To hell with it.”

“Well, that would be unwise if you enjoy things like metabolizing the food you eat or…” Or living, generally. It took a little more discussion, but I was eventually able to warm 62-year-old Chuck Simpson to the idea of undergoing chemotherapy for his advanced liver cancer. By the end of the appointment, he seemed confident in his understanding of what we were about to do, even nodding along and jotting down notes on some of the patient literature Lavelle had handed him early on.

Then, as I walked him to the door, he turned and placed a hand on his hip. “So, I think I'm starting to understand this process, but let me ask you one more thing. If we really want to get serious about stopping this cancer, why not just send me back to surgery? Take out more organs?” Probably seeing my shocked expression, he quickly jumped in. “Oh, not all of them, of course-- I just meant, just the ones that aren’t important? I hear about people taking out their organs all the time. Maybe toss a new one in there-- a sheep's lung or something. Like, who needs this--" He gestured toward a diagram of the human body on the wall, looking closely at the labels. "--what's it, a pancreas? Never heard of it.”

***

Every patient is different. I had my share of Mr. Simpsons, but there were also those like Dr. Walter Hood, my pancreatic cancer patient (turns out your pancreas is somewhat important) who was an actual retired rocket scientist and brought me the most fascinating questions and insight, and there were also those like Lana Parkins, who left an impression on everyone she encountered. I jokingly called her “Fast-forward” for she was constantly in motion, but I also had another name for her that I didn’t disclose to anyone: “the Sun”. She bursts brightly into a room; then, when she leaves, you’re left with a negative after image speckling across your vision.

Lana was one of my first patients when I started here after completing my residency, and I was shocked when she first came in. Not only was she, at 28, less than half the age of most of the other patients I’d seen so far (a third the age of some), but she was practically radiating energy, her long reddish hair whipping after her as she moved. “How can this woman have cancer?” I’d asked Lavelle later.

“You’re the oncologist.” She’d widened her eyes at me and waved her hands in front of her, wanting no part in it.

But the cancer was there. A grade two tumor had been recently biopsied. Her gynecologist had found the lump during a regular breast exam and had taken action on getting Lana scheduled for a mammogram despite her young age. I was surprised by but also applauded that gynecologist’s action; too often, we will hear in oncology of our youngest patients being bounced around from doctor to doctor without an answer as their tumors continue to grow, or, even worse-- young people whose complaints are ignored entirely until they’re finally reluctantly passed to radiology, their MRIs a lightshow of tumors covering vital organs. We have come a long way in oncology in the last fifty years, but there is still little we can do when someone comes in with metastatic cancer strewn throughout their body; early detection is key.

Lana was fortunate; her cancer was localized. We were able to treat her with chemotherapy and a mastectomy and she was now in remission. Cancer was finicky, though, so I was always a little wary of telling any patients that they were “cured”. “Healthy”, “remission”, “clear” …these terms I used comfortably, but I didn’t make any promises. There was some degree of predictability in modern oncology, but no guarantees.