The Plan

He came to the office with an idea.

He came to the office with a plan.

Because his mother told him that a cough could be a sign of cancer. And his wife reminded him of his history of smoking. And his cousin's friend's sister's fiance's grandfather had died and his doctor hadn't bothered to get a cat scan.

He refused to entertain questions. He dodged and darted to avoid my probing stethoscope. He asked for...nay demanded a cat scan.

He was unperturbed when his symptoms magically disappeared with an antacid. He was downright sullen when I warned of the risks of radiation....when I cautioned about incidentalomas.

So in Berwickian fashion I gave in. I ordered the cat scan. I waited.

It was a lung nodule. To big to ignore. Reluctantly I offered biopsy.

He wanted to see a pulmonologist. The pulmonologist offered biopsy. He wanted to see a cardiothoracic surgeon. The surgeon offered the same.

After many phone calls and much discussion and great trepidation he entered the radiology suite for a ct guided biopsy.

He left with a chest tube....a short hospital stay....and the most physically painful experience of his life.

On the day of discharge I entered his room with good news.....It's benign

Benign....great. And then he paused a moment. Maybe we should take it out anyway.

I want to see the cardiothoracic surgeon!