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Ken schwartz4/17/2023 Debra Reich, who took my pulse and blood pressure and said gently, “You’re pretty nervous, huh?” She medicated me with tranquilizers, but that did not stop me from asking about where she lived, where she had trained, and whether she was married. I was greeted by a resident in anesthesiology, Dr. An hour later, I was wheeled to surgery for a biopsy of the chest nodes and the mass in my lung. The nurse left, and my apprehension mounted. But the briefest pause in the frenetic pace can bring out the best in a caregiver and do much for a terrified patient. Looking back, I realize that in a high-volume setting, the high-pressure atmosphere tends to stifle a caregiver’s inherent compassion and humanity. This small gesture was powerful my apprehension gave way to a much- needed moment of calm. Sure enough, the following day, while I was waiting to be wheeled into surgery, she came by, held my hand, and, with moist eyes, wished me luck. By the end of our conversation, she was wiping tears from her eyes and saying that while she normally was not on the surgical floor, she would come see me before the surgery. We talked about my 2-year-old son, Ben, and she mentioned that her nephew was named Ben. But once the interview began, and I told her that I had just learned that I probably had advanced lung cancer, she softened, took my hand, and asked how I was doing. The nurse was cool and brusque, as if I were just another faceless patient. Already apprehensive, I was breathing hard. Eventually, a nurse who was to conduct a presurgical interview called my name. The presurgery area of the hospital was mobbed, and the nurses seemed harried. The day before surgery, I was scheduled to have a series of tests. Until this point, I had thought that I was at low risk for cancer: I was relatively young, I did not smoke (although I had smoked about a cigarette a day in college and in law school and for several years after that), I worked out every day, and I avoided fatty foods. Lynch, I was scheduled for a bronchoscopy and a mediastinoscopy, exploratory surgical procedures to confirm whether I indeed had lung cancer. Pressure, which used to be a normal 124 over 78, went to 150 over 100, and my heart rate, which used to be a low 48, ran around 100. Lynch, who seems driven by the ferocity of the disease he sees every day, told me that I had lung cancer, lymphoma, or some rare lung infection, although it was most likely lung cancer. Thomas Lynch, a 34- year-old MGH oncologist specializing in lung cancer. Vega, assuring me that he would continue to be available to me whenever I needed him, referred me to Dr. I remember leaving my office for home, saying quickly to my secretary, Sharyn Wallace, “I think I may have a serious medical problem.” Indeed, the CT scan confirmed abnormal developments in my right lung and chest nodes. He called within hours to say he was concerned by the results, which showed a “mass” in my right lung, and he ordered a computerized tomography scan for more detail. Vega spent an hour with me and ordered tests, including a chest X-ray. Jose Vega, an experienced internist affiliated with MGH. My brother, a physician who had trained at Massachusetts General Hospital, arranged for an immediate appointment with Dr. Disappointed with the inaccessibility of my physician, I decided to seek care elsewhere, with the hope that a new doctor might be more responsive. By mid-October, I felt so bad that I decided I could not wait until November 11 to be seen. Despite continued abnormal blood counts, she assured me that I had a post-viral infection and didn’t need an appointment with my physician until mid-November, if then. The nurse practitioner diagnosed me as having atypical pneumonia and prescribed an antibiotic. During September and October of 1994, I made several visits to the outpatient clinic of a Boston teaching hospital for treatment of a persistent cough, low- grade fever, malaise, and weakness.
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