The Next Conflicting Phase
Part Ten
It wasn't at all what she was expecting. She and Harm had spent
almost two hours researching Dr. Phillips this morning, reading the
many accolades and citations; so the obligatory degrees and
certificates on the wall didn't surprise her. What did surprise her
was the wall to the right of his desk. It reminded her of the
Roberts refrigerator, with children's drawings and photographs of
smiling families framing the big picture window that looked out over
the courtyard below. Intrigued by something that seemed so out of
place, she leaned closer for a better view, and saw the words `thank
you' spelled out in childish handwriting across the drawings with
various degrees of accuracy. And in every picture, there was at
least one person, almost always a woman, who bore the obvious signs
of illness in the lines of her weary but genuine smile.
These were his patients, she realized, and felt a small sliver of
hope for the first time since entering the room. None of the
research, or the assurances that he was one of the best oncologists
around, reassured her as much as those bright smiles and sincere
expressions of gratitude written in crayon by grateful children.
She turned in her chair to catch Harm's attention, to show him what
she'd discovered, when the door opened and the doctor strode in.
Habit had Mac and Harm snapping to attention. He was, after all, a
superior officer, despite the fact he was in the reserves, and that
neither he nor they were currently in uniform.
"Sir," they chorused in unison, and were surprised when Captain
Phillips just laughed and told them to sit down, waving a hand at the
chairs in front of his desk.
"Okay," he said quickly once they were all seated, "Let's clear that
one up right now." He pointed a scolding finger at them and said
with mock severity, "No sir's, no Captain's. I would prefer no
doctor's either, but most patients aren't comfortable calling me by
name." He shrugged before adding a little hopefully, "However, if
you'd like; Joe, Joseph, Doc, or Dr. Joe are all welcome."
"Um, I think I'd prefer to stick with Doctor for now," Mac told him
hesitantly, a bit taken aback by his easygoing manner. Pictures on
the wall or not, she had been expecting someone more formal, more
serious. Doctor Phillips, with his twinkling eyes and graying beard,
reminded her more of a tall, skinny Santa than a decorated Naval
officer and doctor.
"Fair enough, Colonel," Phillips said giving her a friendly smile to
show that he was okay with her decision. He turned to Harm. "How
about you, Commander?"
Harm grinned. The man's good nature was contagious, and the fact
that he'd taken a close enough look at Mac's case to know who Harm
was greatly impressed him. Besides, the guy really did look like a
skinny Santa Claus.
"Well, Dr. Joe," he told the older man easily, "I prefer Harm."
"Good man," Dr. Joe said approvingly. He held out a hand, and Harm
shook it firmly. "It's a pleasure to meet you, Harm." Turning to
Mac, he raised an eyebrow and asked, "Well, Colonel, what's your
pleasure? Name, rank, or serial number?"
"Name. And it's Mac." She smiled in spite of herself, as the
feeling of warmth and hope she'd felt before he walked in, returned.
Holding out her hand, she added shyly, "Nice to meet you...Joe."
Joe beamed. "You are now my new favorite patient," he told her as he
shook her hand, adding with a wink, "But don't tell."
Pulling his hand away, his face grew serious. Clasping his hands
together and laying them on the desk, he said briskly, "Now, I think
we should get down to business."
"Here's what I'd like to do. You let me tell you how I want to
handle things today," he suggested, "and you decide if it works for
you or not, and we'll go from there." His voice, calming without
being patronizing, set them both at ease and they silently nodded
their agreement.
"First of all, I have no intention of trying to overwhelm you with a
lot of medical terminology," he reassured them. "Not this early in
the game, anyway. So I've prepared a file, which goes into precise
detail on everything we're going to talk about today, for you to go
over when you feel up to it." He grabbed the top file off the stack
on his desk and slid it across to them. Unbothered when neither one
of them rushed to pick it up, he just continued to speak in that same
calm tone. "I'm also going to give you a copy of the biopsy results
so that you can seek out a second opinion if you want it."
His face darkened a little. "In fact, because of what happened, I've
already sent them to another independent lab to go over," he told
them, and when Mac saw the angry look in his eyes, she almost pitied
whoever was found responsible for losing her tests. Almost. "I want
to make sure that nothing else went wrong besides your tests getting
lost," he said, "although I looked over them carefully and I don't
think that's the case."
"Now," he continued, rising from his desk and coming around to the
other side, "while I encourage all of my patients to seek out second
opinions, I still want to come up with a plan to begin treating
you." He pulled a chair from the corner and placed it between them,
waiting until they shifted their chairs to face his before
continuing, "If something changes, or you find another doctor you're
more comfortable with, that's fine," he assured her. "But if not,
then I don't want to waste any time doing what we need to do to get
you to the point where you're a cancer survivor, instead of a cancer
patient."
"And make no mistake about that, Mac." Joe leaned forward in his
chair, his gaze intense. "If you decide to stick with me as your
doctor, that's what we're going to do. I have only one rule for my
patients - as long as you're breathing, you're fighting." His tone
was firm and unyielding. "You promise me that, and I'll promise you
the same. I don't give up, and I won't let you give up either."
The power in that statement, the confidence and determination,
reminded Mac that this man was more than a doctor; he was an officer
in the Unites States Navy. A damned fine one, she imagined. She could trust him to keep his promise; he wouldn't give up on her, no matter what. And that was all she needed to know.
"I promise," she said simply. Whatever was in store for her,
whatever challenges were ahead, she would meet them head on, like the
Marine that she was. As long as she breathed, she would fight.
Joe stared into her eyes for a moment, and then, satisfied with the
conviction that he saw there, nodded his head approvingly.
"Good." He shifted his gaze to Harm and started to open his mouth,
but Harm interrupted him before he could speak.
"I'm not giving up, either," he told Joe immediately, "Whatever
happens, I'm here for the duration."
"Okay." Joe leaned back in his chair, and his voice took on a
clinical tone. "Now, let's talk about what we know at this point."
"Mac, you have cancer," he said bluntly. When she flinched at the
word, he told her, not unkindly, "You need to get used to hearing
that, and you need to get used to saying it. Because that's going to
be your life for a while."
He paused for a moment to let that sink in before continuing. "Now,
once we discovered that the tumor was malignant, we ran some more
tests. And the results were very encouraging." He gestured towards
the file still lying on the desk. After a glance at Mac to get her
approval, Harm slowly reached out and picked it up. He opened it
gingerly, as if afraid something was going to jump out of it and
attack him, as the doctor went on with his explanation.
"We appear to be looking at a Grade I tumor. Basically, what that
means is the tumor has a low degree of malignancy. Obviously that's
a good thing." He gave them a small smile, before adding, "Unfortunately, that's about all we know at this point. And while it's a good sign, it's not enough. We can't determine a full course of treatment until the tumor is staged, and to do that, it needs to be removed completely," he informed her. "Which means surgery."
"Surgery," Mac repeated, before taking a deep breath and asking
bravely, "Do you mean a mastectomy?"
"That is one option," he conceded. "The other option is a
lumpectomy, followed by a course of radiation."
"What's the difference?" Harm asked curiously, unable to make sense
of the file. The terms they were using were only vaguely familiar to
him, and what little he did understand was just enough to worry him
further.
"A mastectomy is the complete removal of the breast." Joe answered.
He was looking at Harm as he spoke, but his explanation was for both
of them. "If the tumor is localized, which we won't know without
further tests, then we'd be done. However," he cautioned, "If the
tumor has spread, then we're still looking at radiation and chemo."
"A lumpectomy, on the other hand, only removes the tumor itself and a
small rim of surrounding tissue to remove any remaining cancer
cells. Again, if the tumor is localized, then you're pretty much
considered cured. Although most doctors, myself included," he
hastened to add, "recommend a course of radiation treatments, on the
off chance that any stray cells might have broken away."
After taking a moment to digest the information she was being given,
Mac asked him which option he would recommend.
"A lumpectomy," the doctor answered immediately and without
hesitation, "followed by radiation, and if necessary, chemotherapy."
"Mac, your tumor is small, and from the early results, is most likely
localized," he explained to her, "Removing the entire breast would be
unnecessarily traumatic, both physically and emotionally. If the
cancer IS localized, and we do a mastectomy, then we've removed a lot
of healthy tissue for nothing."
"And if it's not?"
"Then we might need to go back in and do more surgery," he conceded,
but added, "But it's a heck of a lot easier to take more out than it
is to put more in."
"There are two basic reasons why women choose mastectomies over
lumpectomies. One is necessity. If the tumor is too large in
relation to breast size, or there's good reason to believe that it's
spread beyond the initial site, then a mastectomy is the only
option," he explained. He held up a second finger. "Number two is
that despite all of the studies that show that a lumpectomy followed
by radiation is just as effective long term as a mastectomy, some
women just feel safer having the whole breast removed."
"Now, you're not one of the patients who fit the necessity criteria
for a mastectomy. Which only leaves reason number two."
"If you want to have a mastectomy, if it would make you feel safer,
then that's what we'll do. And I'm not going to criticize that
decision," he told her honestly. "I don't think it's necessary, but
I'm not the one who has to live with it for the rest of my life."
"But there's no difference in the outcome?" she asked, trying to wrap
her mind around all of the facts and details and options. "I mean,
the statistics are the same whichever one I choose?"
"Yes." He reached out and tapped a finger on the file Harm held
loosely in his lap. "The exact statistics are in here with everything
else for you to go over, but the short answer is there's no
difference."
She nodded silently and paused to take it all in. After
considering everything Joe said, and weighing her options, she took a
deep breath and announced firmly, "Then I want the lumpectomy."
"Mac, are you sure?" Harm asked, leaning forward to take hold of her
hand. He searched her eyes to see if there was any hint of doubt or
confusion. Not that he wanted her to choose the other option, but he
didn't want her to make her decision hastily. But one look into her
eyes told him that she hadn't.
"I'm sure. I'll get the second opinion," she told him, "but unless
it says something vastly different, then I don't want them to take my
breast."
"Okay." He said softly, squeezed her hand to silently reaffirm his
support. For obvious reasons, he couldn't completely understand the
motivation behind her decision, but he understood enough to know that
it was the only one she could live with at this point.
She gave him a small smile, grateful for his understanding and
support. Reaching down, she covered their joined hands with her free
one and then turned back to face Joe, ready to find out what came
next.
"So what do you think?"
Harm's voice pulled her away from her contemplation of her new
dietary restrictions, and she looked up with a frown. She pushed her
salad half-heartedly around her plate a couple of times before
throwing her fork down in disgust. "I think this sucks," she told
him grumpily, crossing her arms over her chest.
Harm smiled as he watched her glare at the offending pieces of
lettuce. "That goes without saying," he said wryly. But he wasn't
talking about food and they both knew it. He gestured with his fork
to the file lying between them on the table. "I meant about all
this."
"I don't know," she replied honestly. "I mean, I'm glad that the
initial tests were good, but I'm still trying to wrap my mind around
everything Dr. Phillips told me."
"Yeah," he agreed quickly; he felt the same way. He gave her a
little smile. "But it's not Dr. Phillips, it's Dr. Joe, remember?" he teased lightly, before asking sincerely, "Seriously, Mac, are you
okay with him? Because if you're not comfortable-"
"No, I like him," Mac assured him. She grinned thinking of her new
doctor's unusual style. "He takes a little getting used to. But I
like his attitude, and even though I know we just met him today, I
trust him."
"What about you?" she questioned Harm. "Are you okay with him?"
"More than okay," he said, grinning. "I think he's the first doctor
I've ever met who didn't make me want to run screaming from the
building." The grin faded as another thought occurred to him. "I
just hope we have the same kind of luck with the surgeon."
"Well, he did say that he and the other doctor worked together
often," Mac pointed out. "So it should be okay."
"Yeah," Harm allowed before asking hesitantly, "but are you sure you
want to wait that long for the surgery?"
"That long?" she said incredulously. "Harm, it's in thirteen days.
That's not long. Especially when you consider all the tests I have
to have beforehand."
"I know." He sighed, putting down his fork as he gave up trying to
force down any more food. "I just hate the idea of having to wait
even longer to know for sure," he admitted. "I mean; I know that all
the early signs look good and all, but I'd just like to have definite
confirmation, you know?"
She reached out and squeezed his hand. "I know." She looked down at
their half-eaten lunches and realized that neither one of them was
going to eat any more, so she gestured for the server to bring them
the check. Harm pulled out his credit card, and quickly handed it to
the young woman who was waiting on them. Once she had walked away,
he brought up the next thing on his list of things to deal with.
"We're going to need to talk to the Admiral first thing Monday," he
said quietly, "let him know what's going on."
Mac's gaze dropped to the table. "I guess," she murmured, picking at
a stray thread on her napkin. Harm looked at her in concern.
"Mac?" he asked worriedly, but she just shook her head. Stretching
out his arm and lifting her chin, he was shocked to see tears welling
in her eyes. He didn't understand; she'd kept her composure
throughout all of the talk of tests and surgery and radiation, only
to break down at the thought of telling the Admiral? It didn't make
sense to him.
She saw the look of confusion in his eyes, and tried to explain. "I
just...I don't want to tell him," she managed to choke out past the
lump in her throat. "Telling him makes if more real somehow," she
sniffled, swiping at her eyes. She bit her lip and shrugged self-
deprecatingly. "Pretty stupid, huh?"
"No, it's not stupid at all," he reassured her, rubbing his thumb
across her cheek to catch a stray tear. "Unfortunately, we don't
really have much of a choice," he told her gently. "You're going to
need time off for some of the tests, and for the surgery, and then
the treatments afterward."
"Only if I need chemo," Mac pointed out quickly. "Joe said I could
still work during radiation."
"He said it might be possible," Harm corrected. "Either way, until
we know for sure, we need to make the Admiral aware of the
possibility."
She started to protest again, but realized it would be useless. Harm
was right; however you looked at it, she was going to be missing a
significant amount of work. The thought rankled her, but she had no
choice but to accept it for now.
"You're right," she admitted to him. She sighed, and then reached
into her purse for her cell phone. It was still turned off from
being in the hospital, so she hit the power button and waited for the
screen to come up. When it did, the words `missed call' immediately
popped up, so she quickly checked the number.
Harm looked at her, a little confused by her quick turnaround. "What are you doing?" he asked as the waitress brought back the slip for him to sign, missing the way her face paled as she looked at the number on her phone.
"I'm calling to invite him to dinner tomorrow." She told him
shortly, going back to the main menu until she hit her phone
book. "I don't want to do this at work."
She scrolled down until she found the Admiral's home number, hitting
the talk button and putting the phone up to her ear before Harm could
say anything else. Fortunately for her, the Admiral was home. Doing
her best to keep her voice calm and even, she asked him to come to
their house tomorrow for dinner so that they could discuss something
with him. She could tell by his tone that he knew something was
wrong, but to his credit, he didn't push her to tell him over the
phone. He just told her what time he'd be over, and that he'd bring
something for dessert.
"He'll be there at 1700," Mac told Harm after they'd hung up. She
picked up her purse and put the phone back inside.
"Okay," he said slowly, wondering why she seemed so tense. "So what
do we do until then?"
"We get in the car and we drive up to Blacksburg," she told him
softly. She watched his face pale as he realized for the first time
what her diagnosis would mean for their guardianship petition. They
could fight as hard as they wanted to, and they would, but no judge
was going to let them take on a teenager when Mac's health was so
uncertain. Mac bit her lip and looked down at the table, before
quietly voicing the thought on both of their minds.
"We have to tell Mattie."
Captain Joseph Phillips office
Bethesda, Maryland
1025 EST
Harm and Mac's vow to stay positive got them through the long night
and past breakfast. But it faltered when they left for Bethesda,
fading faster with every mile; gone completely by the time they were
shown into Captain Phillips office. As the door closed behind them,
Mac moved to one of the seats in front of the desk and sat down
uneasily, trying not to let her fears overwhelm her. Needing to
focus on something other than how scared she was, and how Harm's
nervous pacing was rapidly getting on her nerves, she focused her
attention on her surroundings.
Applebee's restaurant
Bethesda, Maryland
1320 EST
Mac watched their server walk away before turning her attention to
the grilled chicken salad in front of her. She sighed; she'd give
anything for a Beltway burger right about now. Unfortunately for
her, Dr. Joe had banished that, and all other burgers, from her
diet. Along with all other forms of grease, starch, fat, and any other foods that made life worth living. She sighed again. It wasn't that she didn't like salads; she did. For all of her sarcastic commentary about Harm's diet, she didn't really have a problem with healthy food. She just didn't like being forced to eat it all the time.