My head snaps up.
“I thought I was dying,” I say. “You said at my last visit, and I quote, ‘This doesn’t look good.’”
“I’ve been told my bedside manner could use some work.”
My doctor is trying to make a joke to lessen the tension.
“Some work?” I ask. “I’ve spent the last few weeks digging a hole in my backyard for my own funeral. So, cut to the chase. How long do I have to live?”
The doctor shakes his head and pulls his chair toward me. I guess he believes this gesture equates sympathy.
“I don’t look at your situation that way,” he says, voice calm as the desert air in the morning. “We have a number of treatment options available, including external beam radiation therapy in conjunction with long-term androgen deprivation therapy.”
My doctor pauses.
“It sounds like—to make an obvious pun—there’s a big ‘but’ in there,” I say.
I pivot on the exam table and give my rear a little slap.
He doesn’t laugh.
“My suggestion would be to deal with this aggressively,” he says. “And as soon as possible.”
“Meaning?”
“A radical prostatectomy.”
“Is that a new pop group?”
“It involves the surgical removal of the prostate gland and a small amount of normal tissue surrounding it to—in the simplest of terms—make sure we got it all,” he explains. “You’re fortunate that the cancer has not yet reached the seminal vesicles or lymph nodes.Yet!Nearly eighty-five percent of patients who have this surgery are alive and doing well five years after surgery. Most of those patients—like you—who die do so of causesotherthan prostate cancer.”
“And this is good news?” I ask.
“It actually is.”
“Give it to me straight, Doc,” I say. “And I rarely utter those words.”
“I have to be honest with you. The surgery is quite invasive, which makes it less popular than any other treatment options,” he says. “It poses distinct complications, including risk of death following surgery, long-term sexual dysfunction and urinary incontinence.”
“Is there at least a gift with purchase with this option?” I ask.
No laughter.
“However, this procedure would—I firmly believe—be the best option for your long-term health and survival.”
“You have just described the ultimate living nightmare for a gay man,” I say. I look my doctor in the eye. “Little chance of sex again combined with an ever-present aroma of tinkle rather than a Tom Ford cologne. No, thank you. I think I’d rather die.”
“Mr. Copeland, many women today who have the BRCA1 or BRCA2 mutation opt to have a bilateral mastectomy in order to survive,” he says. “It reduces the risk of breast cancer by at least ninety-five percent for those who have this harmful variant. Most patients would be grateful to have a surgical option that would allow them to live.”
I think of John.
I think of the havoc, stress, and financial and emotionalburden his death placed on me. I think of the havoc my surgery and recovery would cause my family.
My mind turns to my mother. How quickly she went.
Wouldn’t that be for the best?
For me? For everyone?
