Thursday, Jun. 02, 2011


I awaken on this chilly morning without speaking. I scoop a few bites of my daughters' oatmeal, then bend down to give them a kiss. The last thing I want to do is alarm them, but I can't resist. "Today's an important day for Daddy," I say, pressing my cheek against theirs for a second longer than normal. Then I get in the car and drive.

The date is not circled in red on my calendar. Often I don't even write it down. I don't have to. It gets locked into my inner Outlook calendar and gradually grows larger in size and gravity as the day approaches, as if I'm being pulled backward through a looking glass. Objects in front of you are closer than they appear.

It's my cancer scan. My regular date with my digital destiny, in which a few seconds of X-rays will show whether the handful of nodules that have been in my lungs since I was diagnosed with bone cancer three years ago have grown larger.

All patients have complicated relationships with their scans not unlike the hate-love relationships we have with other technologies in our lives. We first learn we have cancer from scans, then learn from them if that cancer has shrunk or disappeared, then learn if it has come back. Scans are like revolving doors, emotional roulette wheels that spin us around for a few days and spit us out the other side. Land on red, we're in for another trip to Cancerland; land on black, we have a few more months of freedom.

Scans are not all alike, of course. They come in all shapes, sizes, even flavors. I've had scans that required me to drink disgusting, semisweet liquids, scans that shot a Chernobyl-like dose of radioactive isotopes into my bloodstream, scans that inserted me into a giant doughnut of a machine and scans that used a machine that looks like a huge daddy longlegs and ran a coffin-size metal plate over my body.

But there's one thing all scans have in common: they engender "scanxiety" as they approach. Scanxiety is one of those uniquely modern maladies, like carpal tunnel syndrome and BlackBerry thumb, that arise because we're experiencing something entirely new to human beings. For millennia, doctors and patients would have given almost anything to be able to look inside the human body. Now we have an ailment for the fear of what we might find when we do.

The name scanxiety hints at the larger ambiguity we feel toward these medical miracles. On the one hand, as someone who was once months away from being overcome by cancer, I know that scans saved my life. Yet they could be killing me too. One aspect of scans that's rarely discussed is the damage the radiation leaves behind. I broke my left femur in a bicycle accident when I was 5 — the same spot where my cancer appeared 38 years later. When I asked my oncologist what I might have done differently had I known such an outcome was possible, he said, "Nothing. If you'd gotten regular scans, the scans might have given you cancer." What about all the radiation I'm currently receiving? "I'm trying to protect you from the cancer you have now," he said, "not one you might have in the future."

The medical profession is aware that patients suffer stress as our scans approach. Dr. Jimmie Holland, a psychiatrist at Memorial Sloan-Kettering Cancer Center, refers to the condition as PSP, or prescan psychosis. "Everybody feels it to one extent or another," she tells me, "particularly people who feel they have to know what's coming next. And if there's anything true about cancer, it's the unpredictability about what's coming next."

As my scans approach, I become increasingly wary and deliberate in my actions. I put off major decisions until after I hear the results. My breathing gets tighter. And those regular drives to the clinic are among the most tense I have — though there's nothing I can do at this juncture to affect the outcome.

On the morning of my latest scan, my lung doctor enters the room tentatively. My body tenses. "How are you feeling?" he asks. "You tell me," I respond. "The nodules haven't changed," he says. "If you didn't have a history of osteosarcoma, I would ask why you are in my office right now."

It occurs to me that scans may be the only area of modern life in which progress is not embraced. We measure success in sameness. As I'm leaving, I stop at the desk and set my next appointment; the calendar starts again.

Feiler's memoir of cancer and community, The Council of Dads: A Story of Family, Friendship & Learning How to Live, has just been released in paperback