by Bob Johnson
I have a theory. Stop! Do not turn the page. This theory is far more… theoretical than most of the hair-brained observations I share with Huckleberry Press readers.
It has been 17 months since I shared details about my journey with thyroid cancer — specifically, a rare affliction known as hurthle cell carcinoma. Why it’s called a “journey,” I have no idea. That word should be reserved for fun things such as whitewater rafting on the White Salmon River in the Columbia River Gorge or the Lochsa River in Idaho’s Clearwater National Forest, taking a scenic excursion on a train, or exploring a national forest.
The “journey” associated with cancer (or, as I prefer to call it, the “C-word”) involves far fewer miles but far more trips. Trips to local labs for blood draws. Trips to local medical offices for consultations. And, every so often, trips to hospitals for surgeries.
Since we moved to the Inland Northwest, the surgeries have taken place at Sacred Heart Medical Center for two reasons: my surgeon “practices” there, and the waiting area includes a news rack with a stack of the latest edition of the Huckleberry Press. During the month of my last surgery, my mug that only a mother could love was right on the front page, which made remaining anonymous nearly impossible, even with a fake nose and sunglasses.
But I digress — something regular readers had been anticipating. As my medical team — and it’s a great team — works to come to a consensus on the next step of my (insert better word than “journey”), I’ve been thinking about why some medical professionals are ists and why others are gists.
C’mon, admit it: you’ve thought about it, too.
I certainly can’t speak to all professionals who carry such credentials, so I’ll stick with those I’ve encountered since turning 60 — which, for those who may not know, is the age everything starts falling apart.
I began regular skin check-ups when I was 40, having heard that the “tanning” I’d done in my youth with the help of Coppertone and Ban de Soleil probably had ensured a future with skin cancer. Two months after my 60th birthday, I had my first Mohs Micrographic Surgery on my left cheek and was sent home with a half inch-thick bandage pressure-taped to my skin.
Two days later, the bandage came off and two weeks of daily wound cleaning, Vaseline application, and rebandaging began. After that, the stitches were snipped off, leaving me with a cool scar that could get me inside any biker bar in America, if only I had a motorcycle.
The original diagnosis had been made by a medical dermatologist, while the Mohs procedure was performed by a surgical dermatologist. Both gists; no ists.
If you’ve never had a Mohs procedure, here’s how it works in layman’s (that would be me) terms: they scrape a small sample of skin off the area suspected of being cancerous and take it to an in-house lab for analysis. If it tests negative, you’re good to go. If it tests positive, they take off another layer and test it. They continue making small cuts until the cancer is gone, and then they clean you up, stitch you up, apply the pressure bandage, and send you on your way.
While waiting for lab results, you have plenty of time to think about other ists and gists. Although I’m told I was delivered by an OB-GYN (obstetrician-gynecologist), my earliest memory of an encounter with an ist or a gist involved a dentist.
I had one of those mouths that brought plenty of business to dentists no matter how long I spent brushing, flossing, and water picking. As a result, at various times, I found myself in an elevated chair tucked close to dentists for general work, endodontists for root canals, and periodontists for gum disease. Prior to those adventures, as a kid, I spent three years having my teeth straightened by an orthodontist.
When it came to my mouth, it was all ists. Until, that is, we made the decision to invest in full dental implants, and that process required a maxillofacial surgeon to remove the teeth (a few of whom exhibited strong anti-extractionist personalities), prep the jawbone, and do some bone grafting. Interestingly, the surgeon was neither an ist nor a gist.
Shortly before that treatment, when we could still afford it, the lovely Michelle and I signed up for a cruise featuring “outlaw country” and “Americana” artists like John Prine, Lucinda Williams, Lyle Lovett, and Rodney Crowell. We flew overnight across the country to board a ship in Florida. I do not sleep on planes. After a few hours at sea, the ship stopped at an island where two blocks of shops obviously set up for tourists awaited. Our little group walked around, past the shops, in hot and humid weather for two hours, then headed back to the dock. As I boarded the skiff that would take us back to the ship, I blacked out briefly.
Fellow travelers said it looked like I’d had a seizure, and the ship would not let me reboard without being checked out by a doctor. I felt fine, other than slightly dehydrated, but had to be taken to a nearby hospital. There, everything was checked out and all my vitals were normal.
Still, out of an abundance of caution, I visited a general practitioner when we returned home and was referred to a neurologist. For a dozen years since, I have visited him once per year, when he performs the DUI test (“Watch my finger without moving your head”) and hits one knee, and then the other, with a small hammer. We spend the rest of the 30-minute appointment talking about how he’d love to go on a cruise but can’t talk his wife into it. Please don’t tell any of my other doctors, but he’s my favorite gist.
Now, as our primary focus has turned to my hurthle cell carcinoma, I have an endocrinologist (who monitors and manages my “numbers” since the removal of my thyroid), an otolaryngologist (a surgeon who specializes in conditions found in my neck of the woods), and a team of oncologists (who stand ready to act with appropriate treatments should additional surgeries be deemed not useful). Also, whenever a scan is needed to see what’s going on inside my noggin, we turn to a radiologic technologist.
My late dad, who lived to the age of 98 years and 364 days with only rare visits to ists and/or gists, always said that, if I ever had an X-ray taken of my head, they wouldn’t find anything. That was his sense of humor, and it has largely become my sense of humor. Sadly, in this case, he was not correct.
And let’s not forget my anesthesiologist, perhaps the most underrated and underappreciated of all gists because, as he once laid it out for me, “It’s my job to make sure you wake up” after undergoing surgery.
It has been an interesting few years, to say the least, having gone from a few ists to a whole bunch of gists. I went online to see if there is an actual defined difference between an ist and a gist and found a few interesting theories (some involving ancient history and others related to preferences at given times) but no hard evidence.
Here’s one thing I can say with certainty: compared to where we came from — a city where the population has overrun the medical system, causing long delays in scheduling scans, consultations, and surgeries — the medical system in the Inland Northwest is a breath of fresh air and a source of relief, even when one is dealing with the C-word.
Every day, we count our blessings that we found this special place, which is populated by a dedicated group of medical professionals — ists and gists alike.
Honestly, it’s quite possible I might not be around to entertain and annoy readers had we not made the move here.
And that’s the gist of my theory.
National award-winning writer Bob Johnson and his national award-winning photographer-wife Michelle are not gists of any kind (that they know of), but Bob takes pride in being a columnist, while Michelle is an erstwhile clarinetist.
