Letting Go

Dr. Siddhartha Venkatappa, Oncologist

Yesterday Key West said goodbye to our two-day-a-week oncologist, Dr. Siddhartha Venkatappa (Dr. V), who will return, full-time, to his practice in Miami. Not to worry, people. The office will stay in its same location on the Boulevard, same wonderful staff, with a new oncologist taking over. We will not be without a cancer doc.
    After all these years, actually most of my life, in quirky, come-and-go Key West, it still makes me sad when a person or a place that has become a fixture in our community, leaves. I’m sure Dr. V’s wife and children are happy that he’ll be home more often. His partners in Miami will be pleased, too, to have another doctor to share patients every day of the week. But for those of us whose relationship with Dr. V is based on the most frightening and life-altering event life can offer, a deadly cancer, the connection is strangely intimate. And thus, important.       
    Dr. V has seen me taken down by chemotherapy to a pitiful, bald scarecrow. He has seen me choking on my own tears, and kindly waited for me to regain my composure. He has told me that he has no idea of how long my remission from cancer will hold. Of course no one does, but at least Dr. V has the honesty to say it to me, out loud, and to stand by that diagnosis a whole year down the road from my last cancer treatment. I appreciate knowing that truth, brutal though it sometimes feels.
    Through the two years we’ve known each other, we’ve made a few adjustments in how we communicate during in our brief encounters. For example, the first time I went to him as a patient, Dr. V referred several times to “the man upstairs,” and I had to remind him that I was there for medical treatment, not faith healing. There has been no more talk of the man upstairs.

Brother Rocky and me, August, 2010.   Rocky told me that when he left Key West that day he believed he would never see me again. Two days later our Mom died.

    I have learned that Dr. V will carefully consider each and every question I put to him, and respond as if writing the answer to an essay question, listing information and building a case for his bottom line.  One day, after one of his patients, someone I knew,  died unexpectedly when their cancer took a sneaky and vicious turn, I asked Dr. V “Aren’t you frightened by this cruel disease of cancer?” and he replied “Absolutely not! If I was intimidated by cancer I certainly wouldn’t have chosen to become an oncologist.”    
    I have heard that many of Dr. V’s siblings back in India are lawyers and that he is the first doctor in the family. Dr. V has told me that his was an arranged marriage and that by the time he actually met his wife, they were engaged to be married. Of course the Internet has taken away much of the mystery of the arranged marriage, he said. But isn’t it nice to imagine starting out a relationship with a grown up person who, like you, is seeking marriage and a family? So neat and scientific. Like oncology. You almost envy it. It’s so hard here in America finding The One.
    Once I saw Dr. V in the airport. He was deep in conversation with another guy, but I politely requested his attention for a moment, to explain to him how baffled and frightened we were about what we’d heard was going on with a loved one. I know this is shamefully akin to asking a doctor at a cocktail party to examine a mole on your foot—but like I said, there is an intimacy between the cancer patient and the cancer doctor that, in my mind, cancels out self-consciousness. My son and I were headed to the hospital bed of his suddenly very sick father. Dr V left his seat to come to where my very distraught son was sitting and explained to Miguel and me what would probably happen. And he was right. What he told us turned out to be pretty much what happened to Miguel’s dad—who is fine today, just like Dr. V said he probably would be.

Miguel and me (in a wig), November 2010

    Yesterday I told Dr V of a dream I’d had many years ago, before I came to Key West. In it, I was told that I would have a long, happy life and then die of leukemia. Dr. V told me about Freud’s theory of dreams, which he happens to be reading currently. He says dreams are bits and pieces of events from the past few days or weeks, aligned by the imagination, and arranged into a story that makes sense to the dreamer. He suggested that dreams don't actually predict the future, or even mean that much.
      He added that if I did get leukemia due to changes in my bone marrow brought about by the chemotherapy and radiation treatments, it would happen ten to fifteen years from now. And if that happened, if I were to live that long, my treatment would be considered to be very, very successful indeed. And dying of leukemia, he added, is really not a terrible death.
    Last night I dreamed I was jogging on the beach and then couldn’t find my way home to my downtown neighborhood. As I wandered, I found myself at the (defunct) Dennis Pharmacy Luncheonette, talking to an old woman, dead and gone now, who worked there long ago. I asked her to direct me to my house on Truman Avenue, and she pointed, saying, “right over there.” But no road ever took me home. I woke up, thinking Freud was so wrong. Dreams so do mean something.