I was just thinking about all the people in the last year, all of these loved ones who died very shortly after abrupt end-stage cancer diagnoses. It has been awful. Not a single cancer was a so-called “lifestyle cancer” (like lung, which too often is NOT from smoking).
But many might have been treatable with earlier diagnosis.
I was thinking about this, not entirely because of my recent losses, but for the losses of others in my world, the recent losses others have suffered.
I don’t know what the answer is, but please, please, advocate for early detection, and PLEASE question your doctors, who are often awfully hogtied by insurance regulations and have to always treat the simplest symptoms rather than testing for the horrible thing they suspect.
When she was just three, my oldest child went for almost two weeks with undiagnosed pneumonia. Her only symptom was a fever. That’s it. No coughing, no sore throat, no stuffy nose, no rash, no nothing. For days — days, and then weeks — the well-meaning but rule-following doctors put us off for lack of other symptoms. Wait and see, they said. It’s just a virus, they said. Hydrate. Give Tylenol. Eventually, the (way overdue) chest x-ray told a different story. After two weeks, by the time they figured out what was going on, her chest — not just her lungs, but her ACTUAL CHEST CAVITY — was filled with fluid. She needed surgical intervention to save her life, to drain the fluid and repair the damage, and spent more than 10 days in a hospital. (Incidentally, this event may or may not have triggered the years-later onset of Type 1 diabetes, an autoimmune disorder which many experts believe is directly related to an emergent viral or bacterial onslaught, such as was her pneumonia.) Had anyone done the chest x-ray earlier, just days or a week earlier, perhaps the outcome would’ve been different. On many levels.
But insurance companies — and because of that, well-paid and well-intentioned doctors — don’t approve anything at first. When it could count. Err on the side of statistics is the motto.
After all, most fevers are not chest-cavity-filling pneumonia. I get that. But an x-ray after, say, day four? Maybe justified. Maybe more than justified.
And then there is this.
My dad died of end-stage, too-late-undiagnosed liver cancer, but his doctors for many, many months treated his symptoms with prescriptions aimed at relief of reflux and related stomach issues, never once scanning for something else — despite his prior cancer history.
My mother-in-law is battling for her life. She conquered cancer twice before, yet despite that documented history, no doctor was able to effectively test early on based on her new complaints. The protocol was just not approved, based on a checklist which had nothing to do with any apparent rational thought. She bested cancer twice before and might lose the war now simply because nothing was done sooner. Because steps could not be skipped.
It’s not entirely the fault of the medical practitioners.
As patients, we are routinely assessed by medical professionals and treated for the simplest diagnosis. Because that is the rules of the insurance chart. You can’t move up the chart unless all the other steps are checked. There are rules for tests, depending on age, medical history, cancer statistics, etc. Days, weeks, months pass. And all the while, disease marches on, destroying everything in its wake.
I had a mammogram today. Not because it’s on the medical charts as “necessary” (I think I might be younger than the recommended age, but these days only just?) but because 7 years ago I had a lump.
It was a scary time, that lump and all the lumpy-related scans and biopsies and nights cuddling with four kids under the age of five and reading Good Night, Moon and The Very Hungry Caterpillar and Where The Wild Things Are and wondering when someone would give me an answer and whether or not I would be alive to see my four tiny kids be potty-trained, never mind being alive to see them get married and have babies of their own so I could know they read Good Night, Moon or the story of Max — or all the stories yet to be written — to those yet-c0nceived babies I absolutely would spoil in the way only grandmas can.
I wondered whether or not I would be alive to see my babies get to third grade.
It was a scary time, and thankfully, that ended okay. So now I get an annual test. It’s not the best way to spend part of the day, but the clear scans make the boob-smushing worth it.
Yet many women of my age (mid-40s) don’t have this exam. (Insert gratitude here for my lovies who survived even worse than I went through.)
Even more of us don’t get colonoscopies.
Insurance companies are even starting to question the funding of routine pap smears for anyone younger than, oh, 80 or something?
And almost no medical practice authorizes the regular chest screenings of patients who smoke (choose to smoke? Are addicted to nicotine? Maybe that’s why they don’t authorize tests? Because dirty smokers deserve to die?)
Almost none of us are screened for heart disease, other than through lifestyle questions.
I am in awe of the medical tests we have available to us in this lifetime. It is STUNNING to think of what doctors can see, can visualize, can touch and fix with all this technology! What we can do healthwise — what illnesses we can stop, what awful we can fix — it is amazing to consider.
We HAVE to become a society that not only expects, but demands our trusted doctors (not the faceless robots that answer our button-pushing insurance phone calls) to err on the side of caution. We HAVE to insist on something more than the wait-and-see. We deserve more than the lowest-common-denominator health care.
We have to insist on early testing. By doctors — not the paid lobbyists. We have to insist that doctors be allowed to save lives, and not just the lives of 3 year olds whose moms write poignant essays on social media, or the lives of all people who shop at Trader Joe’s and Whole Foods and somehow proved something about their commitment to quality of life and are subsequently more deserving than everyone else, especially those who eat hot dogs. Or Cheetos.
We have to insist that everyone deserves proactive health care, that no one should be denied appropriate care because some chart dictated otherwise.
Babies, moms, dads, drummers, cashiers, homeless, lawyers, teachers, taxi drivers, florists, waiters, mail carriers, the owner of the yarn shop in the town square.
Everyone deserves more than the lowest-common-denominator health care.
Even the dirty smokers.