News from the Doctor is not Good

Day 5

The next morning her mom dropped the boys at school. Both parents went to work expecting to return home shortly after noon to accompany Laura.

At 1:48 they were at Dr. Davis’ office. Laura was taken back to a room and helped on the table. Her mom and dad were seated in the room. A few minutes later the doctor came in with a nurse.

“Hi there, I guess we need to get down to the result of the bone biopsy.” He opened the chart and found the paper. He had looked at it just five minutes before but wanted to look again before he said anything. “They did three sites as we specified. The results on all three sites are negative for infection, negative for Osteoma and positive for Sarcoma.”

Laura and her mom broke into tears, the nurse helped her mom while the doctor took Laura’s hand and held it. Finally Laura stopped sobbing. “How sure are you of this test?”

“It’s definitive.”

“What does that mean?”

“It means if it is positive, you have Sarcoma. It is a nasty cancer. Even with amputation, it does not have a really great five year survival rate. You have plusses and minuses. The lesions are small. That’s a plus. That there are more than one is a minus.”

“But couldn’t the pathologist be wrong?”

“Sure. You went to General. We routinely have Memorial run a second check.”

“Why not have Mercy run the second check?”

“Because they are across town and the HMO pitches a fit about cost. They charge eight dollars more for the test.”

“What if I told you I am not having the surgery unless Mercy does the second biopsy and I’ll pay the eight dollars?”

“We could have General or Memorial send the slides to them, otherwise we have to do another biopsy and that is a lot of pain for you.”

“So is having a leg amputated. I’m not agreeing to have my leg amputated unless Mercy does the biopsy. I don’t want them to use General’s slides.”

“Laura, delaying this is putting your life at risk. This kind of cancer needs to be taken care of quickly.”

“Is one or two days going to kill me? I might not survive it even if you did the surgery now. Please do the additional biopsy at Mercy.”

“Why?”

“Give me my purse.” Her dad handed it to her. “Look at this.” She spread out the printouts from the internet. “On the surface it looks like you should never go to Mercy, you have less than a fifty fifty chance of survival compared to about four out of five in the other two hospitals. But if you look deeper you see that it looks possible that Memorial and General are having nearly forty percent false positives. That is why they get the great survival rate, over one third of the patients do not have Sarcoma. So all of that forty percent get better after they loose their leg because they weren’t sick. And they would have gotten better if they had no treatment or a less damaging treatment.”