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Ideas

Our home for bold arguments and big thinkers.

Fanqiao Wang
The edge of something.
COMING OUT THE OTHER SIDE

My brush with mortality was the wake-up call I needed

Emily Canal
By Emily Canal

It was the phone call I never expected would come. Fourteen days after my annual pap smear—an exam that takes cells from a woman’s cervix to test for cancer—my gynecologist said my results had come back “abnormal.” Usually, such test results are caused by the Human Papillomavirus (about 79 million Americans are infected with HPV) or, in rare cases, cancer, according to the Center for Disease Control.

But my abnormality was not HPV, as I would later learn.

I was spooked from the start, yet at first the idea of cancer seemed too unreal to be true. There is no known history of cervical cancer in my family and I didn’t display any of the usual symptoms: pain during sex or bleeding outside of a period. Hell, I was healthy and 28—the only reason I was in the doctor’s office at all was to ensure another year’s worth of birth control.

Up until the test results came back abnormal, I—like so many young people—believed myself invincible. And why not? All the youthful evidence pointed in that direction. I had never broke a bone, never had surgery, and besides the minor cold, never gotten sick.

Abnormality is a vague yet frightening term. An abnormality could be anything, or it could be nothing. As it turned out, the only thing “abnormality” indicates for sure is there will be a lot of waiting in your future.

Up until the test results came back abnormal, I—like so many young people—believed myself invincible. And why not?

Waiting to find out if I had HPV or something more serious shattered my sense of invulnerability. My future for the next few months would be dictated by a series of procedures followed by more waiting followed by results. Every two weeks inched me closer to learning if I up against the worst-case diagnosis–cancer. Two weeks became the quantification for my life.

The unknown is difficult to cope with. As a journalist, I get a thrill from tracking down answers quickly. The hunt for knowledge is something I have dedicated the last 15 years of my life to. But for once, all I could do was wait for the answer to come to me.

After my initial results, the next step was to get a colposcopy, a procedure in which my doctor used a magnifying device to inspect the cervix and biopsy for any irregularities. At first, I was only scared about the exploratory operation itself. But soon the dark void of my suddenly cloudy future began to monopolize my thoughts.

Two weeks later in the exam room, I started crying before my doctor even had a chance to break the hypodermic seals on her equipment. My legs quivered in the stirrups. I couldn’t catch my breath. The colposcopy is a simple procedure: There is pressure and pinching, but no need for local anesthetic. You can walk out directly after. But something about sitting in that chair made the reality of what was happening—what could happen—all too real.

The unknown is difficult to cope with. As a journalist, I get a thrill from tracking down answers quickly.

Test results can take some time, my doctor said, but she wanted me to prepare myself for what may come next. There was a chance these abnormalities would be revealed as harmful cells, precancerous or cancerous, and that they would have to be removed via surgery.

More waiting. More time spent living my life as if it was on pause. By the time my phone rang seven days later, I knew. My doctor said I had advanced precancerous cells that needed to removed, and immediately.  

A loop electrosurgical excision procedure, also known as the LEEP, uses a thin wire warmed by electricity to remove parts of the cervix. A doctor then takes the bad cells out, also removing part of the surrounding area (known as margins) to test if the precancerous or cancerous cells have spread. This is normally an outpatient operation, with local anesthetic applied to the cervix. 

When I explained the news to people close to me, they assured me I would be fine. I grew to hate that word. I wasn’t fine; I was terrified. I heard anecdotes and stories about friends of friends who had gone through something similar. I leaned on the people who were sympathetic, testing relationships with neediness and stress. But it seemed like most people couldn’t cope. Because if I had cancer, it would also mean they weren’t safe, either. It would mean they weren’t invincible, either.

Eventually I turned to the internet, where my imagination ran away from me. Radiation, hysterectomy and pathology: These words, once foreign, became a part of my vocabulary. That feeling of invincibility was gone, never to return. It had been replaced by what felt like a ticking clock.

More waiting. More time spent living my life as if it was on pause. By the time my phone rang seven days later, I knew.

On the day of surgery, I asked the nurse to hold my hand. I felt weak, but I wanted the comfort. She placed her purple-gloved hand on mine and told me I was doing great. I didn’t cry, but I also had the distinct feeling that my body wasn’t mine anymore. It was an incubator, and the real owner would be revealed two weeks later at my follow-up appointment. 

“And that’s to see if I have cancer or not?” I asked my doctor. 

“Yes, and to see if it has spread,” she replied. 

More waiting. Those days were the hardest of all. My fear turned into sadness and anger.  I was upset with my friends who remained cavalier, who shrugged off their missed gynecologist appointments. For them, the risk was still so unreal. I felt like most of the people in my world didn’t understand the battles being waged in my brain and body—couldn’t understand it—but that didn’t make me feel any less at war.  I felt isolated.

Two weeks passed and my doctor and I were back in that familiar exam room, her with an iPad, me with a knot in my stomach the size of my fist. There, on a device I normally used to watch Netflix, were pink and red images that looked straight out of a Rorschach test. My eyes tried to find the results faster than my doctor could read them, but the words and numbers meant nothing to me. 

When I explained the news to people close to me, they assured me I would be fine. I grew to hate that word. I wasn’t fine.

The news, when she finally divulged it, was the good kind. The surgery had successfully removed all the precancerous cells and they hadn’t spread further inside of me. But the cell that she had removed were festering harbingers of what could have been—if gone untreated, they would have metastasized into cancer in a matter of weeks.

January is cervical cancer awareness month, a time when health organizations stress the importance of screening exams and the HPV vaccine. Since the pap smear’s introduction to the US in the 1950s, the number of women who died from cervical cancer has dropped. In fact, between 1955 and 1992, the number of incidences and deaths declined by 60%, according to the US Department of Health and Human Services. However, the American Cancer Society predicts that 4,100 women will nevertheless die this year from the disease. 

In 2012, the American Cancer Society suggested women between the ages of 21 and 29 get pap smears every three years instead of every 12 months. For the foreseeable future, I will have to get regular pap smears every six months instead of the standard 12. Knowing that the precancerous cells could return is frightening, but there is relief in the reassuring predictability of regular check-ups.

Today, I no longer look at preventative exams like the Pap smear as a chore, but as a process that saved my life. Realizing that I was not in fact untouchable at first felt like a cruel loss of innocence. But it was one that needed to happen.