“A man's most open actions have a secret side to them.”
-Joseph Conrad
He was bright, friendly, and gregarious ... and had a hole in his neck. My new patient had undergone a laryngectomy elsewhere and had just moved to town. He needed a doctor to follow him.
“I would be happy to help,” I said.
“Tell me about your treatment.” “My surgery was last October. They took out my voice box. The doctor said they got all of the cancer out and there wasn’t any sign of spread. I didn’t need any radiation treatments. I feel back to normal, except for my mechanical voice.” “You look great! Tell me where you had your surgery and I will ask the hospital to forward your records.” “I can’t remember the doctor’s name." He shrugged and smiled.
"I have it at home. I’ll bring it next time.” And so it went for a number of visits. He would show up each time dressed in a great looking leather coat, shake my hand warmly, and sit and talk. Each time he would slap his knee, shake his head, and tell me that, once again, he had forgotten to bring the contact information for the doctor or the hospital where his treatment had been done.
“Next time,” he promised at each visit.
One day, after a couple of years, he missed his visit. His girlfriend called. She was distraught.
“He can’t come in! They just arrested him! Oh, I’m so worried about him!” Over the next several months, we followed his saga — first the arrest, then the trial, then the conviction. It turns out my gregarious, delightful, well-dressed cancer survivor was also a major drug distributor. The government took all of his assets, including, presumably, all those nice leather coats.
Now, I finally thought I understood why he had persistent memory loss about where his cancer treatment had been completed.
At the prison system’s request, I forwarded his medical information with suggestions on how to continue his cancer surveillance.
I usually see long-term survivors yearly. When will this man have his next follow-up appointment? Well, in about 15 years …10 with good behavior.
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