The ENT.

I actually ended up having my Ear, Nose, and Throat (ENT) specialist appointment at noon on 29 January. Walking in, I’d already knew what to expect to some degree, however.

One of the benefits of the beleaguered Military Health System “Genesis” portal is the centralization and digitization of all your medical records as soon as they are entered into the system. I saw the radiologist’s report of my CT scan, and unprompted, CPT Bennett had called me earlier that morning to see how I was feeling. She read the notes and saw the big scary “T word,” tumor in the notes.  She mustered her best positive, but grounded, reassurance that it may still be something else… but I’d been too deep down the rabbit hole at that point. I’d spent a couple days reading up on lymphoma. Hey, grandma had it and beat it, so I should be fine, right?

Enter CPT Bruner, the resident ENT that was my first contact in the ENT clinic. She was affable, professional, and upbeat while preparing to, and then running, a camera down my nose into my throat.  I had no idea if you could see my lymph nodes from inside there, but I’m a Public Affairs Officer, not an ENT, so I did what I was told. 

After about 90 seconds she withdrew the scope and showed me the replay.  She paused it at 56 seconds and pointed at something, “That right there on the left, see how it’s asymmetric with the other side? That’s consistent with what we are seeing on the imaging. Your lymph nodes are absorbing cells from that.”

I was grinning with nervous laughter as she calmly explained to me that everything I was experiencing was consistent with a “oropharyngeal squamous cell carcinoma” which is a type of cancer of the throat and neck.

I’ve cried real tears a handful of times in my adult life. Losing a pet, losing my grandfather, the darkest day of my divorce, and now this. When she asked, “Is there someone you want me to call and talk to and explain this too, like a parent?” I melted into a puddle of tears. No, I don’t want you to explain this to my parents, I need to know how I’m supposed to explain this to my daughter, to my kids.

I’m 37 how in the fuck do I have cancer? I’m not a smoker!

She wrote the name down on a little note for me and left the room. She walked back in with a woman that looked roughly my age, LTC Sierra.

“This is LTC Sierra, the chief of ENT and she wants to look over you and answer any questions you might have,” CPT Bruner explained. Exit stage left CPT Bruner, this was now LTC Sierra’s show as I was about to find out.

After her own exam, she basically repeated everything her junior partner had said. I knew I was “cooked” as the youths say. I didn’t have many questions. I went in there expecting to be told I had lymphoma, not some other wild bullshit.

I’m not a smoker and barely drink, why is this happening?

“We can’t say for sure without a biopsy, but given that you’re a never-smoker, not a drinker, that leaves us with some strong guesses based on your age. This may be due to HPV exposure, but since we have no way to test men for that like how women get their annual pap smear, we need to biopsy the tissue just to be sure. So what are you doing tomorrow morning?” LTC Sierra asked, barely concealing the sense of urgency this now took on.

Nothing. I was doing nothing. This was now the only thing I was doing until I wasn’t.

Of course, I had work to do, but I knew as soon as I dropped the news on my boss that she would clear my plate. A Soldier that has a major life issue is seen as distracted at best, depending on the issue, and a liability at worst. This is a fact of life in most careers, but amplified in the Army where there is still a lingering negative stigma around people who fill their calendar with medical appointments. This was not the culture of my office or leadership, but when you’ve been in the Army as long as I have, the biting sensation of that stigma remains no matter how legitimate your issue.

The chief of ENT was signing me up for surgery at 0600 to perform four biopsies, and needed my consent to remove at least one tonsil (this type of cancer is sometimes referred to as “tonsil cancer.”) I needed to have a driver show up with me and be on hand at the end to pick up my meds and drive me home.

Enter the next hero in our story, Rena.

Between the doctors and nurses coming in and out I was on the phone texting people on a “need to know” basis. My boss, my parents, a couple group chats, and Rena.

See, Rena is the only other young person I know that had cancer. She’s a breast cancer survivor from when she was 27 years old. She’s also on my co-ed hockey team and is one of my daughter’s surrogate moms from the rink (when you’re a single dad and have a little girl that plays hockey, all the boy moms that don’t have daughters adopt yours by proxy). Her husband is a stand-up guy and fellow veteran to boot; I’m like a rental brother-in-law to their small family.

“Hey, I need a ride to the hospital tomorrow at 0600, will that fuck up your life,” I asked, on my way back to my office.

“No, I will talk to Jeff and we’ll figure it out,” she said in a conversation that lasted about 15 minutes.

While I didn’t have an “official” diagnosis, both ENTs and the radiologist were confident I had cancer and that this was the one that was causing the lump. I was slowly collecting the cancer Infinity Stones of specialty doctors to confirm. Next was pathology.

Rena arrived at 0500 sharp to my house and we made our way into Madigan; most of the discussion was centered on contingencies in case a catastrophe occured. She was to keep my parents updated of any significant events, but otherwise just be ready to drive me home after discharge.

We arrived at the surgery waiting room as the first people in. Slowly it began to fill up and names began to be called. I even saw my old boss while waiting, who was there to get dead guy shoulder parts installed. I told him if I didn’t make it through this he could have mine since they were probably fresher and in better overall shape.

I was taken back where I was given a diagnostic, changed into hospital attire, and placed in a bed. Then the black parade really kicked off.

First up, my nurse for the day confirmed who I said I was and what I expected to happen. After signing and initialing a bunch of “don’t sue us, bro” forms, the anesthesiologist rolled in. He asked his battery of questions and I mentioned that I had a high tolerance for opiates. He stopped, glared at me, and said, “I will win.” Then, feeling his point was made, left.

No sooner had he left than LTC Sierra, CPT Bruner, the other ENTS, and a gaggle of interns and residents from other specialties filed in. This is when it first hit me that my age and condition made me somewhat of a science project, an oddity, something worthy of show-and-tell. At the time I interpreted this as, “Hey, look at our cancer kid! John Cena will be here any day to set his pyre alight!”

This, of course, was not at all their intention- after all this is a training hospital- but the longer this process goes on, the more I realise I’m probably going to end up as a data point in someone’s dissertation or study.

As soon as the parade of doctors left, I was stuck, laid back, wheeled out, and faded into oblivion.

I returned to reality feeling like I’d just been high-sticked. The inside of my lips were chewed up from the intubation, my jaw was sore, and my throat sorer. I was, however, still heavy a pair of tonsils. Hooray for small mercies I guess.

LTC Sierra came over, asked me how I felt, explained in detail what happened, and if I had any questions.

“Is it what you think it is?” I asked, still slightly drowsy.

Her face changed. Almost like I’d asked if her dog had been run over by a car when we both damn well knew that it had. She just looked at me and nodded. That was the only answer she offered, and the only one I needed.

Well, fuck.

The views and opinions presented herein are those of the author and do not necessarily represent the views of the Department of Defense or the U.S. Army.