A phantom

Hallowe’en is the time for ghosts and spectres. This Hallowe'en, I encountered a phantom of my own, one to whom I owe much.

There was a message on the answerphone reminding me of my medical appointment the following day. They do this in the US. It’s all part of the service to the customer, but it makes sense for the doctors too. I know they hate it when there’s a missed appointment. In our GP’s surgery in Scotland, they wrote up on a white board in the waiting room how many appointments had been missed the previous week, and a notice about how it wasted the doctors’ time. I was always tempted to write below “but how much longer would we all have had to wait if these people had turned up? Hurrah for them!” but I never did. I think the strategy worked, because the number did reduce over time. We were all afraid that they might move from a ‘weekly totals’ system to a ‘name and shame’ system, but I expect patient confidentiality requirements extend to reliability of appointment honouring.

My introduction to the American courtesy call for medical appointments came in our first few days here. We were staying with the sister of a colleague of Husband’s, and I answered her phone. It was her gynaecologist’s office calling to remind her of an appointment the next day, and I was acutely embarrassed at having to pass the message on when she returned home. I assumed that they had called to remind her of the appointment either because she was notoriously bad at remembering them and had missed several in a row, or because she had some very serious condition that demanded urgent attention, and they wanted to make absolutely sure she attended. And of course I didn’t know that every woman here has a gynaecologist, and they pop in to see them as often as you or I would go to the hairdressers. I think it was, actually, my first ever phone call in the US. Interesting to reflect that what now would prompt a quick “thank you for letting me know” on my part, then threw me into a tailspin of confusion and embarrassment. I exaggerate, but you get my drift.

So I received a message on my answerphone reminding me of the appointment next day, for a mammogram. “Huh?” I thought. “Shurely shome mishtake?” Then I remembered. When I had been back for the second of my diagnostic mammograms and ultrasounds, in April, and when they had said “nope, nothing there, you’re fine”, the radiologist had said “I’ll just make a note on your file to do an extra ultrasound, when you’re in for your annual screening in six months time". And then it got bureaucratic, because when I went to the front desk, it turned out that my annual screening wasn’t in 6 months time, but in 8 months time. When I suggested bringing it forward to 6 months time, the receptionist clucked her teeth and muttered darkly about the insurance not covering that. So I said I was sure that 8 would be fine anyway. But the receptionist said she should go and check with the radiologist, and when she came back, she said the radiologist’s response had been “oh, well, just make an extra appointment for 6 months then”. It was all very casual, just a fitting in with the bureaucratic demands of the insurance provisions.

That appointment, though, that appointment which has sat silently in the appointment book of the imaging centre since that day, that appointment served a purpose greater than I could have foreseen. For it was that appointment that caught my GP’s eye, when he got the report back. He phoned me and said, “I don’t like that 6 months appointment. Either there’s something there that needs investigating further, in which case 6 months is too long to leave it, or there’s nothing there, in which case it makes no sense to have a follow-up in 6 months”. Those of you who know the story, know that there was indeed something there, and that it did indeed need investigating further. Investigating, surgically removing, and chemically zapping.

Weird to think that an appointment which I haven’t even shown up to, has had such significance in my medical history… in my life, I would even say. I think of it as a phantom appointment. It has a presence, but it isn’t really here. An appointment to scan parts of me that no longer exist. The analogy doesn’t make sense if you analyse it too carefully, but it was the thought that lingered in my mind when I had puzzled out the answerphone message.

So I returned the call to the imaging center, and explained to the receptionist why I no longer needed the appointment. With a few taps from her on the computer keyboard, this phantom, like all good phantoms, sensed it had done the job it came to do, and disappeared into thin air.

Post-script

I know someone is going to ask why the imaging center failed to spot anything sinister, and gave me the all clear after two diagnostic mammograms and ultrasounds. I simply don’t know the answer to that, and in answer to what I anticipate will be your next question, no, I’m not going to pursue it. I prefer to concentrate on the living and the present, than the ghosts of shadows on mammogram films of the past.