Douglas Kennedy - Five Days

I SAW THE cancer immediately. It was right there in front of me. As always, I found myself taking a sharp intake of breath as the realization hit: I am looking at the beginning of the end.

The cancer was shaped like a dandelion. Sometimes this sort of tumor looks like a cheap Christmas decoration a five-and-dime star with ragged edges. This specific one was more like a minor-looking flower that had been denuded, stripped down to its seeds, but with an insidious, needle-like design. What radiologists call a spiculated structure.

Spiculated. When I heard that word for the first time I had to look it up. Discovered its origins were actually zoological: a spicule being a small needle-like structure, in particular any of those making up the skeleton of a sponge (Id never realized that sponges have skeletons). But there was an astronomical meaning as well: a short-lived jet of gas in the suns corona.

This last definition nagged at me for weeks. Because it struck me as so horribly apt. A spiculated cancer like the one I was looking at right now might have commenced its existence years, decades earlier. But only once it makes its presence known does it become something akin to the burst of flame that combusts everything in its path, demanding total attention. If the flame hasnt been spotted and extinguished early enough, it will then decide that it isnt a mere fiery jet stream; rather, a mini supernova which, in its final show of pyrotechnic force, will destroy the universe which contains it.

Certainly the spiculated species I was now looking at was well on its way to exploding and, in doing so, ending the life of the person within whose lung it was now so lethally embedded.

Another horror to add to the ongoing catalog of horrors which are, in so many ways, the primary decor of my nine-to-five life.

And this day was turning out to be a doozy. Because, an hour before the spiculated cancer appeared on the screen in front of me, I had run a CT scan on a nine-year-old girl named Jessica Ward. According to her chart shed been having a series of paralyzing headaches. Her physician had sent her to us in order to rule out any neurological concerns. which was doctor shorthand for brain tumour. Jessicas dad was named Chuck; a quiet, hangdog man in his mid-thirties, with sad eyes and the sort of yellowing teeth that hint at a serious cigarette habit. He said that he was a welder at the Bath Iron Works.

Jessies ma left us two years ago, he told me as his daughter went into the dressing area we have off the cat scan room to change into a hospital gown.

She died? I asked.

I wish. The bitch scuse my French ran off with a guy she worked with at the Rite Aid Pharmacy in Brunswick. Theyre livin in some trailer down in Bestin. Thats on the Florida Panhandle. Know what a friend of mine told me they call that part of the world down there? The Redneck Riviera. Jessies headaches started after her ma vanished. And shes never once been back to see Jessie. What kind of mother is that?

Shes obviously lucky to have a dad like you, I said, trying to somewhat undercut the terrible distress this man was in and the way he was working so hard to mask his panic.

Shes all I got in the world, maam.

My names Laura, I said.

And if it turns out that what she has is, like, serious. and doctors dont send young girls in for one of these scans if they think its nothing.

Im sure your physician is just trying to rule things out, I said, hearing my practiced neutral tone.

Youre taught to say stuff like that, arent you? he said, his tone displaying the sort of anger that Ive so often seen arising to displace a great fear.

Actually, youre right. We are trained to try to reassure and not say much. Because Im a technologist, not a diagnostic radiologist.

Now youre using big words.

Im the person who operates the machinery, takes the pictures. The diagnostic radiologist is the doctor who will then look at the scan and see if there is anything there.

So when can I talk to him?

You cant was the actual answer because the diagnostic radiologist is always the behind-the-scenes man, analyzing the scans, the X-rays, the MRIs, the ultrasounds. But he rarely ever meets the patient.

Dr Harrild will be talking directly to Jessicas primary-care physician and Im sure youll be informed very quickly if there is

Do they also teach you to talk like a robot?

As soon as this comment was out of his mouth, the man was all contrite.

Hey, that was kind of wrong of me, wasnt it?

Dont worry about it, I said, maintaining a neutral tone.

Now youre all hurt.

Not at all. Because I know how stressful and worrying this all must be for you.

And now youre reading the script again that they taught you to read.

At that moment Jessica appeared out of the changing room, looking shy, tense, bewildered.

This gonna hurt? she asked me.

You have to get an injection that is going to send an ink into your veins in order for us to be able to see whats going on inside of you. But the ink is harmless.

And the injection? she asked, her face all alarmed.

Just a little prick in your arm and then its behind you.

You promise? she asked, trying hard to be brave, yet still so much the child who didnt fully understand why she was here and what these medical procedures were all about.

You be a real soldier now, Jess, her father said, and well get you that Barbie you want on the way home.

Now that sounds like a good deal to me, I said, wondering if I was coming across as too cheerful and also knowing that even after sixteen years as an RT I still dreaded all procedures involving children. Because I always feared what I might see before anyone else. And because I so often saw terrible news.

This is just going to take ten, fifteen minutes, no more, I told Jessicas father. Theres a waiting area just down the walkway with coffee, magazines.

Im goin outside for a bit, he said.

Thats cause you want a cigarette, Jessica said.

Her father suppressed a sheepish smile.

My daughter knows me too well.

I dont want my daddy dead of cancer.

At that moment her fathers face fell and I could see him desperately trying to control his emotions.

Lets let your dad get a little air, I said, steering Jessica further into the scan room, then turning back to her father who had started to cry.

I know how hard this is, I said. But until there is something to be generally concerned about.

He just shook his head and made for the door, fumbling in his shirt pocket for his cigarettes.

As I turned back inside I saw Jessica looking wide-eyed and afraid in the face of the CT scanner. I could understand Jessicas concern. It was a formidable piece of medical machinery, stark, ominous. There was a large hoop, attached to two science-fiction-style containers of inky fluid. In front of the hoop was a narrow bed that was a bit like a bier (albeit with a pillow). Id seen adults panic at the sight of the thing. So I wasnt surprised that Jessica was daunted by it all.

I have to go into that? she said, eyeing the door as if she wanted to make a run for it.

Its nothing, really. You lie on the bed there. The machine lifts you up into the hoop. The hoop takes pictures of the things the doctor needs pictures of. and thats it. Well be done in a jiffy.

And it wont hurt?

Lets get you lying down first, I said, leading her to the bed.

I really want my daddy, she said.

Youll be with your daddy in just a few minutes.