The Mountains of Moria

Today I had the first appointment with my Wellington oncologist, following the Sydney surgery. In preparation I had taken a blood test two days earlier.

Miang and I waited in the consulting room, expecting the usual greeting "you've lost more hair". Instead, my oncologist entered the room with a look of astonishment on his face and began, "your CEA is normal". "What concentration?", I asked. "3.0 ng/ml" was his reply. "Tell me about the surgery." I chatted with him for a while, recounting some of my extraordinary and somewhat bizarre experiences. "Not something I'd like to do every year", I said.

He asked me to lie on the bed so that he could examine my abdomen. Now I should say that the landscape of my scar-transected abdomen is more like the Mountains of Moria, than the Plains of Sixpack. I could sense him flinch as he glimpsed that landscape and started his examination, the gentle tapping of the finger with the two hands working together. He looked perturbed, and then after just a few taps he stopped. I read his mind at that moment. "Good grief, the contents of the abdomen were never like that in any anatomy lesson that I learned". He expressed that inferred thought as he recoiled from his brief examination with the words, "My goodness, you have had major surgery".

I tucked my shirt back , buttoned up and we both sat down again. We chatted some more about the new adjuvant chemotherapy course that I would start in a few weeks. The CEA data were compelling, and as you look at the graph Dear Reader, you may see that something remarkable has happened as a result of the peritonectomy. My oncologist was clearly struggling with the irreconcilable, the healing power of chemotherapy versus that of surgery. Of course, the cunning of the peritonectomy procedure is that it combines both.

"Might I suggest that you recommend this procedure to future patients who are suffering from peritoneal metastasis?", I asked, pushing the boundaries of the patient/physician relationship. He paused deep in thought for a moment and then said, "Not for everyone." I think he was still disoriented by the experience of feeling the strangeness of my abdominal interior.

I like this man very much. He is wise and kind and self-effacing, and I have forgiven him for telling me, so many months ago, that I was incurable. Perhaps he will be proven to have been right, but I think he and I now both believe that, rather than a few months, as earlier perceived, it may be a few years before we will know the answer. I thanked him, and Miang and I walked out the door with him, parting with best wishes for Christmas, and with that we strolled back out of the hospital smiling and laughing.

"Normal CEA!" I repeated several times, to Miang's evident amusement. "Better than a kick in the pants, I would say."