I’ve had this conversation many times. It is tedious, but so expected that it would be outright rude to avoid it. Next, we will talk about where we are from. Many have traveled a great distance to be here; I am one of the fortunate few who live close by. Because of this, I often find myself making restaurant or weekend activity recommendations.
After this, I will hear a detailed history of this man’s misbehaving, malignant body parts, along with the related medical events that brought him to this proton therapy center, to receive this particular type of radiation treatment for his cancer. My fellow patients are alarmingly open about their illnesses — not surprising, I suppose, since many of them are in the same age group (60s/70s), same sex (male), same diagnosis (prostate cancer), same prognosis (highly treatable). I, on the other hand, am somewhat of an anomaly — decades younger (40s), female, and with a rare, aggressive cancer (a sarcoma of the sacrum).
We are both sitting in the “other” waiting room, located beyond secured double doors and down a hallway from the outer, main waiting area, where patients with later appointment times, along with their accompanying friends or family, luxuriously remain.
Out there, vaulted ceilings and panoramic windows offer natural lighting and the overall ambiance of a quiet, upscale spa reception area. Soft music plays in the background while patients — identified by photo badges hung around their necks — and their companions lounge in welcoming clusters of comfortable leather chairs and cushioned sofas. Because many of them are from out of town, with no daily commitments other than their treatments, patients tend to arrive quite early for their appointments. It may be a more pleasant place to pass time than their temporary accommodations.
Sometimes, they talk to one another about this wonderful city, San Diego, and the quality of care they are receiving at this facility. Sometimes, they discuss the science behind their treatments — a cutting-edge radiation treatment known as proton therapy. A number of cancers can be treated with protons, though certain types, including prostate, brain, breast and pediatric, seem more likely to be. I haven’t encountered another sarcoma patient, but sarcomas are relatively more common types of cancer in children. The pediatric patients, anesthetized daily so that they remain motionless during treatment, have a separate entrance and waiting area.
Many read from smartphones or tablets as they wait, or browse through a plethora of magazines that are carefully spread throughout the large room on coffee tables. There is a snack area, with vending machines, filtered water service and complimentary coffee. Beyond, there is an outdoor patio with umbrella-shaded tables, where some people enjoy picnic lunches, surrounded by an inviting lawn of soft, healthy grass — unusual, given the dry climate.
Unlike many of the patients who arrive daily with spouses or adult children in tow, I am usually on my own. My husband works full time, my kids are still in school, and my local friends lead busy lives. I don’t mind, because I find this main waiting area peaceful and pleasant; also, it is nice to have some independence back, after five months of aggressive chemo, involving several months of multiday hospital stays, when I was forced to lean heavily on all of them. Chemo shrunk my tumor but not as much as we’d hoped. Surgery was ruled out as too risky, probably not curative and definitely disabling, and so I am here.
Although nobody really wants to be here, the main waiting area is, nonetheless, a very nice place to wait until we are called, one by one, away from it.
Then, we each change into hospital gowns in our individual changing rooms, leaving our clothes and belongings behind. These changing rooms are nice, too — carpeted, private, each with a padded wooden bench, hangers, a full-length mirror and a cabinet stocked with freshly laundered gowns. From there, wearing just a gown and a pair of nonskid socks, we walk down the hall to the “other” waiting room, where the scene is rather different.
It is compact, windowless and fluorescent-lit — a visual cue of the depressing health reasons for which we all are here.
Three of the four walls are white and clinical-looking, the fourth “wall,” opposite the door, is an unattractive, hospital-style curtain that hangs down from the ceiling, concealing another hallway beyond that leads to our treatment. There is zero decor, other than four uncomfortable, stackable chairs and a small table with the same very old magazines, and no ambiance. This is the place where I have spent much of my time these past weeks, five days a week for almost eight weeks, waiting.
Today, in this room, I’m not only tired but also filled with self-pity, which I attempt unsuccessfully to push aside. Like most days, I just want to pretend this isn’t my actual life. I don’t want to hear about the size and weight of some older man’s prostate. I just want someone from my treatment team to come get me so that I can have my therapy, change back into my real clothes and go home to take a nap before my two teenage boys get home from school.
But my treatment is running late today, so I’ve probably missed the one other woman who comes in daily around my usual time. She is also older than me, a Mexican woman who speaks only a few words of English, a breast-cancer patient. One day, when I was feeling more affable, I greeted her in Spanish, and she lit up. Just like the men, she has things she wants to share with fellow patients. She regularly shows me her radiation burns, on her chest, shockingly red. My skin has held up better than hers so far, but it still doesn’t feel great.
I have learned a lot about my fellow patients while in this room. One man tells me he is an ex-fighter pilot, turned military doctor. Another shares that he is from Australia, where he says they don’t have proton therapy available yet, so he’s paying 100 percent out of pocket, while staying at a lovely beach resort to make the best of his time here. Another, from the Northeast, just bought a massive, brand-new pickup truck for the sole purpose of hauling his recumbent tricycle to nearby trails, being unstable on a two-wheeled bike these days. Still another, from Atlanta, refers to his treatments as a “radiation vacation,” which makes me laugh, though he was also the first who mentioned the “balloon” to me — something involved in the daily prostate treatments that conjures uncomfortable images, though I’ve actively avoided learning anything beyond that.
Mostly though, people in this “other” waiting room want to talk about cancer, and they share an awful lot. Perhaps, away from their spouses and caregivers, in this small and dingy room stripped of distractions, proper clothing and all things comforting, the facade of being “fine” — the standard answer to “How ARE you?” which we cancer patients are asked constantly — is exposed, too. It seems perfectly acceptable, after the requisite small talk, to share the gory, unpleasant details as well. These are the things they don’t talk about elsewhere, but clearly need to. Some, with a hushed confessional tone, have even dared to express doubts on whether this treatment will be effective.
Some patients seem to prefer it back here; they look forward to these hospital-gown-clad encounters — the openness, the candor, the raw quality of it all. Perhaps they are looking for some connection, some commiseration or some empathy from someone living through something similar. It is an interesting phenomenon, and I have seen it happen time and time again.
But, even in this, I find myself the anomaly. I have a difficult time relating to my fellow patients, despite our supposed commonalities. I prefer to pretend that I am normal, healthy — even while in this room, where I am clearly not fooling anyone. I’m quite relieved on the days when I walk in here and it is empty. I’m even more relieved on the days where I am called back for treatment before I’ve even sat down.
Yet, as these weeks of treatments have gone on, I have found myself arriving early to appointments, desiring to spend some time each day in the outer, main waiting area — before facing the “other” waiting room’s abundant authenticity.
In these moments, I absorb the natural light, listen to soothing music, escape into travel magazines and sip coffee with hazelnut creamer. Nobody asks about my diagnosis or prognosis; my radiation burns are covered and concealed; and if I leave my photo badge tucked away in my purse, I can probably now pass for a companion rather than a patient, as my post-chemo hair has finally started to grow back.
I like being in this space, where things seem calm and under control. Here, there is no need to worry about my husband or children, or any of my loved ones — even if things get worse, even if this treatment is not effective. In the safety and serenity of this waiting room, I can simply leave my valuables behind. I don’t doubt that they will be fine; I only wish that I could be so sure about myself.
Pawlak is a freelance writer based in San Diego.