Cancer Again

Nov. 6, 2000 -- It was supposed to be just another visit for another routine test, the eighth time I'd been asked to come back to the hospital since my prostate cancer was treated. This time they wanted to take an ultrasound image of my bladder and conduct a "voiding trial." (In other words: Could I empty my bladder?)

"Come back tomorrow," the nurse had said, "and we'll check your bladder on the ultrasound."

I dutifully return and drink two liters of water. Two hours later, it's time for the ultrasound. The technician, a young woman with violet eyes, squirts jelly on my abdomen and begins sliding a transducer -- a microphone-like instrument -- across it. Strange black and white images appear on the screen, to the apparent satisfaction of the technician.

"Right," says Violet Eyes, "the bladder's looking fine. Totally empty. But while we're about it, I'll just have a look at your liver and kidneys."

She slides the transducer over my abdomen, and there, quivering on the screen, is my liver, to me just an amorphous mass, but to Violet Eyes something meaningful indeed.

"Lovely," she says, enthusiastically. "Pepper and salt."

She moves the transducer to my left kidney and pronounces it "pristine." Then over to my right kidney. She pauses. I crane forward to look at the image. This time, there is no commentary, no vivid description.

"I'll be back in a moment," she says quickly. "I want to ask my colleague something." Before I can ask why, she's out of the room. While she's gone -- a seeming eternity -- my imagination works furiously: What's wrong? What has she seen?

She returns with a colleague, a 50-something veteran, who takes his turn peering at the screen.

"There is something here that the doctor ought to, er, evaluate," he says, pulling a printout off the machine. Five minutes tick slowly by before he is back in the room.

"You've got something on your kidney we don't like the looks of," he says, his even tone underscoring the gravity. "The doctor has called downstairs to tell them you're coming down for a CT scan."

Less than an hour later I'm sitting in the office of Jay Gillenwater, MD, professor of urology at the University of Virginia Hospital, the very doctor who had operated on my prostate and ordered the tests that led to today's ultrasound. In measured tones he gives me the news: I have a tumor on my right kidney.

Gillenwater keeps talking as I sit stunned, tuning in and out as bits and phrases seep through: "early stage ... no symptoms ... remove kidney ... soon as possible." I can't believe it. Not again. Surely, this isn't for real. First a hip procedure, then a hip replacement, then my prostate, and now this. Four general anesthetics and four operations in nine months.