Cat Scratch Fever
In the beginning of the year I came down with cat scratch fever. Yeah, I had never heard of it either. The name calls to mind a disorder in which the sufferer acquires cat-like flexibility allowing her to drop to the floor, whip her leg up past her shoulder and scratch like crazy behind her ear with untrimmed toenails. In my head this scene is accompanied by the tune to Stray Cat Strut, and the infected woman is snapping to the jazzy beat and lip-synching “I strut right by with my tail in the air.”
That, however, was not at all what cat scratch fever was like for me.
My symptoms began on the tail end of a cold. It was an easy case of the sniffles, only requiring a couple naps and a few water bottles spiked with Airborne to beat. Somewhere during that time I noticed a sore spot in my armpit. I wrote it off as the beginnings of an ingrown hair and forgot all about it.
A few days after I started feeling better the soreness in my armpit grew. If I poked around, I could feel something under my skin. It felt like one of those giant cystic zits that hurt so badly they wake you up in the middle of the night. You are sure that by morning it’s going to look like you’ve sprouted a prehistoric horn in the center of your forehead, but the mirror shows barely a bump for the pain you feel every time you blink.
Every time I moved my arm, I could feel the lump, but on the surface there was nothing. I was sure this was going to be an ingrown hair of epic proportions. I started sharpening my tweezers in preparation, giddy with anticipation for the upcoming excavation that only an expert pimple-popper like me would appreciate.
As the week went on the bump in my armpit grew to the point where—unless a full Rastafarian dreadlock was going to pop through my skin—it could no longer be an ingrown hair. I had an education in physiology and so I knew there weren’t many things that resided in the armpit, unlike, say, the abdomen where you can find an array of organs as well as useless gallbladders and troublesome appendices. Because anatomically there were only a few possibilities, I concluded that one of my lymph nodes was infected.
I wasn’t too worried about it. I picked a lighter set of dumbbells at the gym and brought it up in conversation saying, “It’s the strangest thing, I think my cold settled in my lymph node.”
That was something I had heard of but never experienced—colds settling in strange places in the body. A coworker once told me that she had the flu and it had settled in her back causing her leg to go numb. I’d thought she was crazy at the time, but now it seemed I was experiencing the same thing.
Part of me was proud. I liked to picture my body very efficiently gathering all of the invading cold germs and assigning them to one lymph node to take care of. I could almost picture a pile of bacteria overflowing an in-box on the desk of a busy lymph node who wanted to get through his e-mail before he finished obliterating the disease. I laughed as I tried to explain this to friends and family, miming as if I were the busy lymph node, letting work pile up in my cubicle.
Just behind the laughter were my worries. I thought of the woman in My Big Fat Greek Wedding who told the story of her undeveloped twin being found within the goiter she had removed from her neck and wondered if there could be a tooth developing in the soft tissue of my armpit as well. Even when I managed to convince myself that my story was sound, that it was just an infected lymph tissue, I wondered how exactly lymph tissue became infected.
Wasn’t that where all of the disease-fighting cells in the body were produced? It was like having a fire at the firehouse or a robbery at the police station. Sure those things happened, but if my body’s disease-fighting factory was unable to kick a couple of common-cold bacteria, could that mean there was something seriously wrong?
Eventually the lump swelled to the size of a ping-pong ball. And it was sore. I mean don’t even tap me on the left shoulder sore. Just resting my arm against my side of my body or wearing a shirt that wasn’t sleeveless became a problem. Of course, as with all real medical emergencies, my lymph node swelled to the point of intolerability on a Sunday afternoon. The only options were the emergency room or one of those walk-in medical care centers where you are guaranteed to never see the same doctor twice in your lifetime. As I wasn’t bleeding from the armpit or passed out cold from the pain, I opted to leave the ER for the true emergencies.
As we pulled up to the clinic, my husband asked me if I was sure I wanted to waste my time and money. “They’re just going to tell you it was a viral infection that turned bacterial and give you a prescription for antibiotics.” Every time we visited the clinic we never saw the same doctor, and yet—regardless of our symptoms—we always walked away with the same diagnosis and prescription. I pushed on, desperate for something that would end the pain.
An hour and a half later I walked out to meet my husband in the waiting room. He asked me what they had said. I told him I had been right, it was an infected lymph node. He asked what they gave me for it. I held up the prescription for antibiotics. He snorted and shook his head.
The antibiotics didn’t do anything. Two days later the lump seemed to be the size of a golf ball, and I had developed a kink in my neck from only being able to sleep on one side. Nights were the worst. My right side was all but worn out, and I had begun waking up every three hours shivering in a puddle of sweat.
As you can imagine, by this time I had passed plenty of hours researching my symptoms on the internet. “Armpit” was too vague and returned remedies for body odor or alternatives to shaving. “Infected Lymph Node” was too scary. All that came up was information about lymphoma. The one thing I did determine from my searches was that the girlie doctor was the place I needed to go for help.
Who really does breast exams? Once a year, while I’m draped in a wax paper gown that opens in the front, my OBGYN asks me if I’ve been doing them on a regular basis. Like everyone I lie and say yes, and then don’t think about them for another twelve months. This time I told the truth. “I don’t really do them,” I said. “I never would have noticed this lump if it didn’t hurt so much.” I stressed the end of the sentence, making it sooo MUCH. I wasn’t playing for sympathy. I wanted her to tell me everything was fine and based on what I’d read on the internet, breast cancer tumors were hard lumps like mine, but didn’t tend to hurt.
She felt around in my armpit, scribbled some notes in my chart, and told me to get dressed and meet her in her office. My numb fingers fumbled to hook my bra and I put my shirt on inside out. In her office she gave me a referral to a nearby breast cancer diagnostic center. “They’ll do an ultrasound and see if it’s anything to worry about.” I waited for her to add that it was probably nothing, but she didn’t and so I went ahead and amended her sentence in my head. I walked across the parking lot, repeating to myself that the ultrasound would reveal more and that it was probably nothing.
It took weeks to get in for my ultrasound. By the time the appointment came around, the lump was much smaller and hardly even hurt. I wanted to cancel, but I knew that if I did, the moment I got off the phone, the lump would swell up again and then it would be another month before I got in.
I went to the appointment swathed in dread, terrified that as I described how big the lump had been, the doctors would raise their eyebrows at one another, the universal sign for, “looks like we’ve got another hypochondriac here.” All of the women in the waiting room of the breast cancer diagnostic center looked drawn and serious. I imagined that several of them were sporting well-crafted wigs. It only made me feel more ridiculous for wasting everyone’s time, and taking an appointment away from someone who really needed it.
The ultrasound technician was an extremely tall woman who chatted with me about books as she stepped on the mechanical lever to raise the table until it was high enough to be at her level and possibly induce a nosebleed. I pointed at the general area where the lump had been. Within seconds, a dark almond-shaped mass filled the ultrasound screen. She clicked to measure the size and printed out a copy to show the doctor. I wiped the goo out of my armpit and put my shirt back on. When the Amazon woman returned, she touched my hand in a way that made me yearn for a skeptically raised eyebrow and said, “I’m glad you didn’t cancel this appointment,” as she handed me a card displaying the time of my biopsy appointment and a me-and-my-breast-cancer pamphlet.
This time as I walked across the parking lot, I didn’t tell myself it was probably nothing. I let myself cry, and I didn’t care who saw me.
My biopsy was on the unluckiest of days: Friday. The labs would be ready after twenty-four hours, but because I had a Friday appointment I would have to live through the weekend before finding out the results.
The biopsy was a simple procedure—for someone who doesn’t mind needles. I, however, have never been a big fan. I once passed out after getting a flu shot. It wasn’t that the shot was painful. I got through mine just fine. The problem was that once I was done, I watched my brother get his. I saw the needle tear through his flesh. Being that I was in college at the time and fully immersed in my study of physiology, I was able to picture a hole forming in each layer of dermis. I couldn’t shake the image and passed out while we were paying the bill.
Through the years I’ve learned to close my eyes and picture myself lying on the beach or eating an ice cream sundae even when I’m giving a blood sample. This was my plan of attack while preparing for the biopsy. I knew the biopsy involved an array of needles of increasing thickness. My only hope was that if I did pass out, they would finish the procedure before waking me.
I climbed up on the table, the ultrasound technician found the lump and I prepared to go catatonic as the doctor numbed the area. By the time the doctor was ready to begin, I was deep into a fantasy of riding horses on the beach and bridging into a scenario that involved a swim-up bar with blended drinks that featured slices of pineapple and mini umbrellas. I was about to join a game of water volleyball when the doctor told me I had to open my eyes. For malpractice reasons, I had to watch on the screen to verify that the thick needle she was jamming through my skin was indeed penetrating the ominous black hole of a lump in my armpit.
No, No, I told her, I trust you. I won’t sue. I explained that it would be best for everyone if I could just lie here, practicing my yoga breathing and pretending I am getting a facial rather than having my armpit aerated.
She laughed as if I was kidding and refused to start until I looked at the screen.
I was forced to watch as the needle entered the picture and wandered around until it pierced the dark circle. Try as I might, I was unable to trick myself into believing I was watching anything other than the sensitive inner sanctuary of my armpit being abused. Satisfied that she was deep inside the lump, she pulled the trigger on her needle. It made the same loud snap as a staple gun. I almost fell off the table. She told me she wanted to collect six samples and asked me if I was doing okay. I must have grunted an answer that sounded like yes, because seconds later the needle was back on the screen, coming in from a new angle.
Lingering on the edge of unconsciousness, I watched the ultrasound screen through the slits of my eyes and did my best to answer her questions. When did I first notice it? A month ago. Have there been any other changes in my health? No. Are you sure? I guess. Have you had any night sweats? Well, yes. Weight loss? About ten pounds, but I’ve been eating good. How good? I don’t know, a little better that usual. Ten pounds better? I don’t know, I said. I thought about the comfort ice cream cone I’d had the night before. The needle gun cracked through the silence. Sounds like Hodgkin’s, she said. I waited, but she didn’t burst out laughing after a minute, saying “I got you there, didn’t I!” I walked out of the building, facing an entire weekend of waiting before I would know if she was right.
Over the weekend I began to picture how my life would change if I had Hodgkin’s disease. I probably wouldn’t be able to run as much, maybe not at all. We were planning to have kids soon. That would have to wait. I tried not to get morose about the things I might never get to do like see the Great Wall of China or hold a sloth. The strange thing, which I didn’t admit to anyone, was that amongst the many regrets there was a tinge of relief. If I had cancer, no one would expect me to finish my novel, I could stop worrying about getting a real job, and I would probably lose weight without even trying.
On Monday, my husband and both of my parents came with me to find out the results. They had spent the last two days assuring me that everything was going to be fine, but I could tell they were just as worried. What doctor tells a person they probably have cancer if there was only a ten percent chance?
The doctor sat us down and told me I did not have cancer. “It’s strange,” she said, shaking her head. “I really thought it was Hodgkin’s.” The disappointment was almost audible in her voice.
She referred me to an infectious disease specialist who could help me figure out what was wrong. At that point, I didn’t even care. My lymph node no longer hurt, and I was going to live! Even though it was only ten in the morning, the four of us went straight to the ice cream parlor for shakes. Since I was not going to waste away from cancer, I knew it would go straight to my thighs, but we needed to celebrate.
A few weeks later the infectious disease specialist called me with the results of my lab tests. I had cat scratch fever. He explained that when a person was scratched or bitten by a cat carrying the disease, the bacteria would travel to the nearest lymph node and cause it to swell to an uncomfortable size. The normal treatment was antibiotics—score one for the Sunday clinic doctors and their antibiotics!—but there was no point in me taking any more.
I couldn’t even remember getting scratched. The doctor said that was common, but that sometimes the scratch took a long time to heal. There was a little dot on my wrist, a scab that I’d been picking at since the beginning of the year…certainly that little dot and my cat couldn’t have caused all this. As I hung up the phone, I cut my eyes across the room at my white cat sprawled across the couch cushions.
The hypochondriac in me is still mortified at how much medical time and energy went into diagnosing such a simple disease, but in the end it was more about the process than the result. I try to remember how I felt over that weekend. For a brief two days I was reminded of that was important. I would like to say that ever since then I have given up torturing myself mentally about what I will do with my life and become content to allow things to unfold. I’d like to say that every time I go for a run I notice the beauty of the waves and revel in the sound of the seagulls flocking overhead. But it’s not true. I’m just as neurotic as ever and I only notice the seagulls when they’re swarming the trashcans by the beach and fighting over a greasy McDonald’s bag on the strand. I’m lucky enough to be able to go back to taking life for granted again.