Warning: Breast Ahead

If you wanted any further proof of the broken American health care system, you should have come with me yesterday to the hospital where I had a biopsy after my annual mammogram showed something troubling.

First of all, the volunteer who checked me in, took my information, my health care card, and had me sign forms acknowledging the receipt of information I had not been given, was in the early stages of Alzheimer's. The signs? Fixation on certain phrases ("why," she kept mumbling, "do they have two pieces of paper when they could have one?"), hostility, lots of fumbling around to explain simple things I already knew, like how to find the parking lot in which I'd just parked.

But the centerpiece of the failure to create a system that works for its patients was the biopsy itself. A room that was neither a doctor's office nor an operating room, the chosen site looked like a mop closet that had been converted temporarily and hurriedly into a spot for this procedure. There was a stain on the floor where water appeared to have leaked. It was messy. The machines — and there were several because the biopsy is guided by an ultrasound — did not really fit in the room. The general feeling was of something furtive and slightly shameful. But then that could just have been my own anxiety about my mortality speaking.

The worst thing of all was that the procedure was conducted with so little regard for the patient, and by people of such good will, that in the end I concluded they could only have set things up like this because their workload was utterly crushing and they simply didn't have the luxury to consider how they might have made the process something other than dehumanizing and humiliating for the patient.

Some of the features of the biopsy that were particularly humiliating — you are asked to lie face down, for about an hour, on a hard table, without moving. There is a hole cut out in the table where the suspect breast is placed. It dangles in space. Out of your view, something like a vise is put around your breast. And then, when you are in a position of what I think we'd all agree is maximum discomfort and unease, the doctor comes in and introduces himself. I don't know about you, but it doesn't make me feel great to meet, for the first time, the person who's going to make a cut in my body when I'm face down with one breast through a hole. And one other thing — the table is jacked up, kind of like a car at the oil changers, so you're hanging there in the air while you're being worked on from below.

The doctor was a nice man — someone who clearly wanted to connect with his patients and comfort them. He kept patting me on the shoulder and he was good about saying when he was about to do something. So I do have a tip for him. Sometimes, in women's magazines, you run across this piece of advice: spend a night in your own guest room. See how the light is, how the mattress feels, that sort of thing. I think if he really wanted to lower the difficulty of what was, going in, already a difficult experience, he might have tried lying on that table for an hour without moving — only with his penis through the hole, since he doesn't have breasts.

We do our best work for other people when we forget ourselves and think about them. This is obviously not easy to do. But perhaps if this doctor had spent an hour on that table in the broom closet, he would then have felt it more urgent to come up with a better way to do his work.

And that, I'm pretty sure, is the last time this blog will ever discuss the human breast. Tomorrow, it's back to food.

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9 thoughts on “Warning: Breast Ahead

  1. Penis in the hole.. great quote.

    But more importantly, as far as I know, no women in our family have had breast cancer. Hopefully it's nothing.

    Also I see why there isn't a photo with this entry. 🙂

    Feel better.Soon

  2. What a terrible story! Sounds like the Dutch health system… Lots of good will but not enough money and therefor not enough time. Hope everything’ll be alright!

  3. I’m sure it will! I don’t generally write like this or about these kinds of subjects, preferring as I do those things that make me happy. But I’ll say one thing: I feel more the master of this situation now, having written about it, than I did lying face down on that table! Thanks to both of you for your good wishes. Best, BL

  4. Poor you! What an unpleasant process to add to a worrying situation. I’m really glad you spoke about it, though.I’ve often found doctors and medical testing in general to be verging dangerously on the inhuman. Why only last year when I had a ‘flu jab, the nurse stuck the needle in with a chopping motion, plugged it out, stuck it in, wriggled it around, and sang out ‘you’ve got tough skin, haven’t you?’ I found the whole experience ghastly and, sisters, we need to speak out about this.

  5. I agree that we need to speak out about this. I had a scare, which required minor surgery, some years ago and chose to be treated in the public system in Australia. Similar experience with one difference: the doctors who treated me didn’t seem to get that they were dealing with a human. I felt like nothing more than a number and one that they had to cross off the list as quickly as possible. My unconscious mind dealt with this by trying to escape from the operating theatre after the surgery but before I started waking up from the general anaesthetic. Apparently.

    I hope everything goes okay for you BL – lots of positive thoughts coming from this side of the Pacific.

  6. You are all so sweet. You don’t even know me, and here you are being so lovely! I haven’t heard, but I just don’t think it’s likely anything’s wrong. For one thing, it took them four weeks to get around to scheduling the biopsy and really, would you wait that long to take a look at something that’s serious when the patient is also a lawyer? My guess is that the answer is no, but that could just be optimism and stupidity.

  7. Has anyone else noticed that mammograms become easier the more you have? Is it that the machines improve all the time? Or is it (as I suspect) that as you get older the skin is less firm and so the pressure isn’t felt as acutely? Best wishes for a clean result Lily!

  8. Hi Ruth, I don’t know — I’m the kind of person who tries to erase the whole thing, as soon as it’s happened! And thanks for the good wishes. I’d try to think of a couplet to end this message, as you so often do on your blog, but everything I can think of rhymes with “breast” and I just don’t want to go in that direction. Cheers, BL

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