We never saw it coming.
As the second half of 2002 began, I was still watching the calendar, with an eye on February 12, 2003. I felt we were getting closer to calling her a survivor. As I’ve noted before she wasn’t paying attention to that.
Joanie was as busy as ever, with her position as director of the Hoeven Committee and her work on the building committee at Trinity Lutheran, and never had much spare time. What spare time she had was on the weekend, which was spent in the back yard, and with quiet time on Sunday mornings.
I thought she was doing fine, until in late 2002, she began to develop a dry cough. At first I chalked it up to a cold, but after it persisted for a few weeks, it became clear it was being caused by something else.
In mid-November, Dr. Carson ordered a chest x-ray, and the results came back indicating “there is no evidence of any pulmonary disease.”
We were happy with that, and I thought we were back on schedule toward the five year mark, and we made it through the holiday season without any problems. Her cough was still there, but it was not as pronounced as it had been earlier.
In March, 2003, we met with Dr. Carson at the clinic, and she ordered a CT scan of her thorax along with another x-ray. The scan was set up for March 31st. Now, we began to be a little bit concerned.
By now I didn’t give a damn about the five year thing. I had a feeling something was wrong, and when we got the results of the CT scan, we knew there was.
The findings in the radiologist’s report said, “There is an endronchial lesion involving the patient’s right lower lobe bronchus. Just past this lesion there is a 2 x 2 cm infrahilar lung mass. This finding is suspicious for lung malignancy.”
Translated by my non-medical training, it meant there was a lesion that involved the right bronchial tube and her right lower lobe, and there was a suspicious mass in the same area. That’s all we knew at the time.
The news fell like a boulder on our house, and we were both crushed when we heard the findings, for it unleashed all of the fear and uncertainty we had lived with those first two years again..
Dr. Carson ordered a bronchoscopy for April 11th. We met with Dr. Jim Hughes at St. Alexius Medical Center in Bismarck. He would be performing the procedure. A bronchoscopy is a diagnostic procedure done under a local anesthesia. The put scope down through your nose, and it makes its way to the trachea and into the bronchial trees of both lungs. There was no problem with the left tree. The problem was in the right tree and the lower lobe bronchus. That would be the branch of the bronchial tree that branches off to the lower right lobe of the lung.
I waited in the outpatient surgery waiting room for Dr. Hughes to make an appearance. I didn’t wait too long that afternoon, when he came out to see me and to show me a photo of what they were looking at. It looked like a Polaroid picture that could have been anything, and tried to point out to me where the problem was. He told me it looked like cancerous tissue. Then he left me alone to try and process what I had just seen, and wonder what it meant for Joanie.
He was in Joanie’s room when I got there, and she obviously knew that we were dealing with some kind of cancer. She had been crying, and when I came in, she started again. Hughes left, and I just sat there holding her hand, not knowing what I should say. We were both stunned.
Hughes said at the end of the procedure it could be non-small-cell-lung cancer, but we would have to wait for the biopsies until we knew for sure. If that was the case, we would have a whole set of new problems and treatment to worry about. On the other hand, if it were metastatic squamous cell cancer of the cervix, there would be another set of problems. Both terminologies scared us.
By the time Joanie had a chance to recover from the procedure, it was late afternoon. We went home, both lost, and much as we had done that day in May some seven years ago, we wondered what the hell we were going to do now.
We didn’t make any calls that night, calls seemed to us to be premature. We stayed home, and though neither one of us was hungry, I ordered a pizza. Joanie took her position on the couch, and was joined by Muffin. We opened a bottle of wine, and as the darkness of the night crept into our little house on Mandan St., we sat there and tried not to think about what might be next. We just listened to the music and wondered.