Fingers on My Breast, Questions on My Mind

While my doctor’s fingers massaged my breasts and cradled my almond-sized lump, we had a peculiar conversation. She was from the Bay Area but traveled to my tiny community for a brief assignment. My husband and I discovered the lump the previous evening in a romance-busting moment. “I’ll call the clinic in the morning,” I whispered, wishing Dr. Kirk hadn’t closed his practice.

In rural America, it can be hard to get good care. We rely on traveling medical professionals, people who come for brief stints from far away places and often make me feel as if they’re on an assignment with National Geographic. These physicians and nurses sometimes carry the air of an educated foreigner studying lesser life forms in the uncivilized wild.

The next morning, I put on a pretty wool skirt, thick tights, and a beautiful sweater. Dressing up to see a doctor is part of my strategy to get better service, to be taken seriously. I styled my hair and applied makeup carefully. “So many drugs in your community,” the doctor commented while she probed my breasts. “It’s a shame.” I stared at the ceiling feeling the coolness of her fingertips. My county produces a tremendous amount of pot, and it comes with cash, guns, mean dogs, and other drugs. We’re one of the poorest areas in the state and endure problems associated with poverty.

“I know,” I said. I worried about drugs a lot, especially since our daughter had just turned 10, and isolating her from that world was getting harder. Once, standing with other moms by the soccer field, I overheard a conversation about blow-dryers and fungus. They were talking about a disease on their pot crop while toddlers circled their knees like cats on steroids.

That’s why, last week, I found myself thinking about Lake County while I was in Guatemala. I was doing volunteer work and met a physician at the airport. She told me about a friend there suffering from a serious medical condition. “I looked at his labs,” she said, “and the data was wrong.” The medical resources her friend relied on threatened his survival. “I’m going to manage his case from the U.S.,” she said. We talked about unfairness, how being born poor impacts access to basics other people take for granted.

While we talked, my mind drifted to the consultation that nearly cost me my life. “Don’t worry about it,” the doctor told me after I pulled my beautiful sweater back over my head that day. “Your lump doesn’t meet the characteristics of cancer.”

That didn’t sound right.

From the parking lot, I scheduled a mammogram and put myself on course for survival. An oncologist later told me that without immediate chemotherapy, I’d be dead within three months.

That experience taught me a lot of lessons, but two stand out. First, there’s a world of difference between the haves and the have-nots. Second, poor doesn’t have to mean bad. The doctor who dismissed my lump, who told me “not to worry about it,” could have ordered a mammogram. I wonder if she would have treated a Silicon Valley patient the way.

I know she didn’t mean any harm. And truly, she was an outlier in the army of people who treated me with respect, compassion, and competence.

In an ideal universe, things would be more fair. Wealthy people wouldn’t sip imported seltzer while poor people endure water that makes them sick. Cancer has made me more aware of the gaps in our world, and I’m grateful I didn’t lose my life to one of them.