The Wandering Gene and the Indian Princess Page 18

  The anxiety attacks, the sense of being overwhelmed, were past, but in relating this, Iona spoke promptly, as if she were answering a study question at the Kingdom Hall. More by rote than reflection, perhaps, and giving wide berth to her emotions. Experience shows that even the most highly educated of individuals have difficulty using intellect to dominate emotions. Iona knew the answer deep in her DNA, yes she knew. She knew what her headstrong sister hadn’t, though Shonnie would not have cared.

  Chapter 8

  * * *

  LAST DAYS OF THE INDIAN PRINCESS

  On February 18, 1997, Shonnie Medina mailed a card to her sister in Texas. Iona and her new husband had been living in Odessa, his hometown, but they had recently decided to return to the San Luis Valley. Shonnie picked a Garfield the Cat greeting card. The exuberant cat flings his arms into the air, asking, Guess Who’s Thinking of You? And inside, leaving plenty of room for her note: Me!

  Iona: Hi there! So how are things going with you? Me, I’m excited for you guys to come. Hope you guys are too. I’ve been positive lately. I guess that’s the way to be so we don’t get discouraged huh? I’m sorry I never write to you. I always say that I’ll get to it and I never do. Mom came over last week and spent the night, do you believe it! Just to come? (Of course, I had to ask her to.)  When you move here I know they will visit us more. I had to go to the clinic the other day because Michael got scared for me. I found a lump in my breast. I have to go to the Doctor on Monday. Man, if they have to take off one of my boobs, everybody will notice—Ha Ha!

  Anyways . . . everybody says hello and are excited for you guys to come. Hope you like it here. Tell everybody up there “hello” from Mike and I hope to hear from you soon. Call me to let me know for sure when you guys are coming down. Thanks for being such a great sis!

  Love you lots,

  “Shaunee”

  Write Back Soon!

  The lump Shonnie detected in her right breast was about the size of a pea. Mom, she told her mother, I know, it’s a gut feeling. It’s cancer.

  It’s natural to fear cancer, even if you’re only twenty-six, and the cancers on her father’s side of the family were no secret to her. Still, Shonnie often had dark presentiments. People in Culebra remember her vivacity and poise, but her mother and sister knew she experienced bouts of dejection and jangled feelings, which she tried to keep private. One of Iona’s small duties in life was to cajole her sister when she was down. That’s what Shonnie had been referring to in the card when she said she’d been trying to stay positive lately. She was more emotional and moody than I am, Iona recalled. I’d balance her out. But if I’d go overboard on being positive in my own life, or being too timid, looking the other way and letting things go, I mean, Shonnie would say, Don’t let people take advantage of you.

  Dr. Gladys R——, a primary-care physician at Alamosa Family Medical Center, saw Shonnie on the same day that Shonnie sent the card to Iona. Since Shonnie was a new patient to R——, the doctor probably spent a minute reviewing her medical records. They are for the most part unremarkable, showing a dozen visits to the clinic since 1992 and covering the normal complaints and routine checkups of a healthy young married woman. Shonnie needed a birth-control prescription, a gynecological workup, and a couple of modifications to her birth control. She also requested treatment for allergies, colds, and acne. After February 1997, however, the case notes, test results, and medical opinion shift radically, revealing a breast-cancer patient at odds with her medical providers—so those early, unremarkable visits by Shonnie may merit a closer look. When a life is carved at the joints and cast onto a page, don’t clues lie everywhere, pointing back to her DNA and rushing ahead to her end?

  The very first record that the medical center filed for her, in March 1992, probably had to do with her being molested as a child. Engaged to be married in August of that year, a virgin who may have felt less than virginal, Shonnie reported being bothered by mood swings. She attributed them to a childhood incident that she didn’t specify. She was referred to a counselor in Alamosa, and apparently she went to a session or two. The trouble came to a head a year or two later, in a confrontation with the offending uncle, and then, according to her family, Shonnie put the incident (or incidents) behind her. How much it colored her outlook is impossible to know. Her mother thinks this was why as a little girl she felt she would die young. That, plus the gene whispering in her blood, made her the way she was, Marianne maintained.

  Complaining of red and itchy eyes, Shonnie appeared at the clinic in early 1996. Normally the nurse prepped her for the doctor by taking her temperature, blood pressure, and weight. But Shonnie refused to be weighed today. Since she’d been married, her weight had risen from 120 to 143 pounds, according to the records, and 143 was also her weight when her cancer odyssey started, a year later. At five feet seven, she’d gone from slim to statuesque. Marianne said that Shonnie obsessed over her weight. Marianne also would say, with nothing but love, that her daughter was vain. Shonnie was bothered by any imperfection in her body, however minor. Today, her eyes oozing from an allergic reaction of some sort, the young woman was in no mood to get on the scale, and she didn’t.

  A third entry is worth mentioning. Although the medical system did not handle her very well after February 1997, five years previously a staffer did teach Shonnie how to do a breast self-exam, without which she might have missed the lump until it became larger.

  Shonnie’s first move after detecting the lump had been to visit the walk-in clinic run by Planned Parenthood in Alamosa. The staff there thought it was a benign cyst, and Dr. R——, examining Shonnie the next day, reassured Shonnie that it was a cyst. The doctor described the cyst as single, mobile, and tender; a half-centimeter in diameter; and located in the lower, outer quadrant of the right breast. The doctor asked Shonnie to let her know if the cyst got any larger or did not shrink in a few weeks.

  When Shonnie returned five weeks later, the cyst had doubled in diameter. R—— tried to draw some fluid out of it with a syringe but failed. Sending Shonnie to Radiology, R—— made a note to involve Dr. William W——, a general surgeon at the local hospital, pending the results of a mammogram.

  Rather than a mammogram, which is an X-ray, Shonnie had an ultrasound scan on April 3. Ultrasound does better than X-rays at resolving the dense breast tissue of young women. It was the radiologist’s opinion that the object he saw was a complex cyst. But since Dr. R——’s attempt to aspirate fluid had caused some inflammation and made the cyst a little harder to read, the radiologist called for another scan in a month’s time. A biopsy might be in order if the cyst didn’t clear up. Telephoning the information to Shonnie, R—— again asked her to get in touch if the cyst got any bigger before the next ultrasound.

  Shonnie let nearly three months elapse before she made the appointment for her follow-up scan. No doubt she hoped that the lump was indeed a cyst and would go away. The cases of breast and ovarian cancer in the Medina-Martinez clan should have been a wake-up call to her medical providers long before this, but nothing about her relatives appears in her records yet, not even a denial by the patient that she had a family history. (Shonnie would not have lied if she were asked.) It suggests that the doctors never inquired. A twenty-something-year-old with breast cancer? Very unlikely. When Marianne and Iona are questioned about Shonnie’s diagnosis, they bring up the mistake the doctors made by calling it a cyst, and they magnify the time until the doctors corrected their mistake, yet they forget or collapse the time that Shonnie herself let go by, as her worry mounted, maybe as all of their anxieties mounted.

  So now, in late June, the mass was about eight times as large as it was in February, and on the screen it was more solid-looking than before, with some irregular internal striping. The radiologist (a different radiologist looking at the image) termed the mass suspicious and recommended a biopsy. Shonnie was sent to Dr. W——, the surgeon. He becomes th
e villain of the piece in her relatives’ recollection, the other doctors having been forgotten.

  The first meeting with the surgeon, on July 14, went smoothly. W——’s case notes, to quote them exactly, say that Shonnie is a real pleasant, twenty-seven-year-old Hispanic lady. He recorded that the skin of her right breast was retracted (pulled back) at the place where he felt a two-centimeter mass. The biopsy was scheduled for the next day, and he explained the procedure to Shonnie and her husband, including the risks of scarring, bleeding, or infection from the excision. Shonnie wondered if the procedure could be done by laser surgery instead. No, W—— said. The couple agreed to go ahead. He noted that she was a Jehovah’s Witness not wanting to receive any blood products, which was not a problem for him.

  After the patient was sedated in the operating room, W—— cut out as much of the lump as possible and sent the fragments to the lab to be analyzed. It was an invasive carcinoma, originating in the milk duct and breaking out into the breast tissue: a malignant tumor.

  Shonnie, Michael, Joseph, Marianne, and Iona arrived at the doctor’s office on July 17, two days after the biopsy. They already knew she had cancer. Shonnie needs a mastectomy, Dr. W—— explained. There were two options, modified radical mastectomy or partial mastectomy, one more severe than the other, but she needed surgery, no question, with additional treatment likely, chemotherapy and/or radiation. The family said they wanted to get a second opinion in Denver. W—— said sure, adding that he would be happy to take care of Shonnie here, in Alamosa, after she and her consultants decided on the best course. W—— asked to be informed of her plans the next week. The meeting lasted twenty minutes. He didn’t seem to suspect that she was headed in another direction entirely, that she sought another kind of provider.

  If breast-cancer treatments were not toxic and disfiguring, and if they cured every woman, then alternative therapies would not allure a substantial minority of the patients. As it is, one of three Americans reports using alternative or natural medicines, also known as complementary medicines, because patients will add them to the conventional approaches rather than substitute them. Cancer patients are particularly prone to hedge their bets this way, and good oncologists don’t object unless there are unfavorable drug interactions. The murkiness of the disease’s causes, the imperfect prognoses, even the occasional spontaneous remissions can shake a woman’s faith that her oncologist knows what he’s talking about. A good doctor, recognizing the uncertainties, moves carefully.

  The two parties in this particular cancer dialogue were very far apart when they started their negotiation on July 17. W—— had a lot of experience with cancer, but he was a general surgeon nearing retirement at a small, rural hospital in Colorado and was used to having his way. Shonnie, well, she was Shonnie. She wouldn’t do synthetic medicine, said Marianne, who was a strong influence on her daughter’s decision. She didn’t want medicines that had been tested on animals. She prayed on it. She said, Give me something else. Shonnie’s uncle Bill championed the alternative approach from his more New Age perspective. Their influence aside, the decision Shonnie made was relatively easy because she could not, would not, have her body marred. As she told her sister, If I get to live, if I have the remission, I want to look decent.

  The person Shonnie went to see in Denver was a homeopathic practitioner named Larry K——. Homeopaths try to stimulate the so-called healing energy fields of people whose energy fields have been disrupted by disease. The theory is that if you are able to mimic the symptoms of a disease, at a very mild level, by administering tinctures of natural medicine at very low doses, the body’s vital force will respond. It’s immunotherapy without good biology behind it. Popular in Europe and America during the nineteenth century, homeopathy held that like could cure like. The rival school of medicine was allopathy, which tried to cure disease by cruder means, unrelated to the style of the symptoms. To the practicing homeopath, the scientific medicine that came to dominate the twentieth century is allopathy, and cancer chemotherapy is quintessentially allopathic. Doctors with conventional medical training think that homeopaths are no better than quacks, and that their tiny bottles of diluted herbal medicines are placebos.

  It’s not clear how the Medinas found Larry K——. He was said to have cured a cancer patient they knew, or knew about. At his office in Denver he treated his clients—he did not call them patients—while his wife was in charge of ordering and preparing the special pharmaceuticals. K——, who is still active, travels beneath the radar of Internet search engines. According to a state government website, he was disciplined by Colorado for practicing acupuncture and chiropractic medicine without a license, the only official sighting of him.

  Ten years after treating her, K—— said he couldn’t recall much about Shonnie Medina. She had a viable cancer, moving quickly, he said. It was deadly, the way we saw it. It wasn’t an average breast cancer. Most of these we can turn around. . . . K——’s voice drifted off for a moment. She didn’t feel it was that disastrous. We can wait, seemed to be her attitude.

  How did K—— know her cancer was growing quickly? We do measurements, he said, referring to insights from homeopathy and Chinese acupuncture. Cancers have predestined pathways. Lymph points, for example. We have measures of toxicity in blood cells, the red blood cells, if it’s getting worse.

  What kind of measures?

  Traditional medicine can give you names, but we don’t need to know them, because we’re not allowed to diagnose. His words had a sleepy, veiled quality, as if he might be dreaming a conversation. But I can tell if a degenerative meridian is changing. The lymph points for cancer have a rate of degeneration. For diseases like cancer and arthritis, I measure all the meridians.

  Didn’t your measurements show that Shonnie was getting better because of your treatment? At least that’s what she said.

  That’s not my recollection, K—— said sharply, as if slapped awake. I confirmed what the traditional doctors said. . . . We needed a sense of urgency. . . . His voice was veiled again. He sounded like a clogged drain. [Later] I sent her for natural health [treatments] to people in Mexico, to get her some opinions, some more education. She was exploring it from a natural standpoint. . . .

  Here are some of the alternative medications that Shonnie took for her illness during the summer and fall of 1997, followed by Larry K——’s short explanation of each:

  •Bioactive Botanical Complex. For muscle repair, sore muscles.

  •Radiation (a liquid). To restore the body after exposure to toxic X-rays, ultraviolet rays, rays from TV sets, etc.

  •Serotonin. For stress and sleep disorders.

  •Lymph Tonic III. To help the lymph glands eliminate swelling and toxicity.

  •Candida Albicans 200X. An antifungal agent. In diluted form it mimics the effect of Candida infection and stimulates the immune system.

  •Sciatica-HP. To reduce swelling. She was a skier, said K——. It appeals to certain parts of the body, to the electrical values. It tells the nerves to settle down.

  •Botanical Gingerplex II. It builds energy when the adrenals are worn down.

  •Shark Cartilage 2X. An anti-tumor agent, to dampen the growth of her tumor’s blood vessels.

  Meanwhile Dr. W——’s nurse in Alamosa attempted to find out what was going on with Shonnie. On November 7, about four months since their last visit, the family reappeared in his office. The gathering was the same as before, minus Joseph Medina, according to W——’s notes, although Iona recalls that Joseph was there because he scolded her afterward for her part in the encounter. Either way, it was the women who did all of the talking to the doctor.

  W—— dictated an extensive, self-protective account of the stormy meeting. He appears to want to be covered in case he were sued. They tell me, W—— began, they have been having homeopathic treatment by a Dr. C—— [sic] in Denver. They brought some pap
ers that showed some type of medication-type of test that showed regression of her “disease.” They wanted to discuss all of this at length concerning whether or not I could do a test to see if her cancer was gone or if it was better. She told me she still had a lump on her breast.

  Shonnie told the doctor of a machine that indicated her cancer was going away. The machine was probably K——’s meridian health monitor, an electrical device. The way K—— described it, electrodes are placed on the patient’s body to capture the flow of energy along the meridians of the arms and legs. Again, this relates to Chinese acupuncture. The patient squeezes the handle of the device while the examiner passes a sensor over the meridian lines. A computer analyzes the results for excesses or deficits of energy.

  All of them were quite surprised and at a loss, Dr. W—— went on, to understand why there was not some type of test that we could do to know whether or not she still had cancer. The doctor explained that imaging tests like MRIs and X-rays can show if a mass is present or not, but that only a biopsy could tell if the mass was cancerous.

  Addressing Shonnie with a lot more force than before, the surgeon reiterated that she should have a mastectomy. He again went over the two surgical options. If the tumor were left untreated, he said, this cancer might possibly erode through her breast into the skin and out onto the skin and cause pain, bleeding, stinking, and it would be a very terrible way to die. Surgery was the only justifiable and scientifically proven alternative. Chemotherapy and radiation might be needed too.