Rejecting conventional wisdom

San Juan de Dios Hospital, in San Jose, Costa Rica is a place I’ve come to know fairly well since my breast cancer diagnosis in June of 2012. Or at least I know the places that have to do with oncology.

The tiny, dark room to which I’m called on this occasion contains only a hospital bed, a computer table and an ultrasound machine. The technician tells me to take off my top and underwear and lie down. Hospital gowns are a luxury here, but the care is first rate, so I deal with its lack, though I feel vulnerable.

It’s that time of the year when I receive the battery of tests that constitute my annual breast cancer screening. I’m scheduled for blood work, an ultrasound, and a mammogram– except that I’ve decided, with the approval of my oncologist, not to have the mammogram.

Rejecting the status quo in medical matters, especially when one has had cancer, is daunting. There’s always that voice whispering about how stupid you’ll feel later on, when people just might be claiming they told you so.

There is no place for me to put my things, so I toss my top and bag on the cot and lie down on top of them.The door opens, admitting a youngish-looking doctor who asks me why there’s no record of my mammogram.

Uh oh. I answer in my baby Spanish that I didn’t get one, and hope he’ll go away, but he wants to know why. The test is both dangerous and ineffective, I murmur, wishing I’d had the sense to pretend I hadn’t understood.

He launches into a diatribe that seems unending. There’s something very intimidating about lying half naked while a doctor berates you in a foreign language. He’s yelling, and my heart is pounding so loudly I can hardly hear him. Yo entiendo, (I understand) I mutter, and tune him out.

I’ll have breast thermography, an alternative to mammography, though I’m sure a majority of medical professionals will insist that it is not an alternative, but an adjuvant diagnostic tool.

At my next appointment, my doctor tells me the good news. All the tests indicate my cancer hasn’t returned. I ask him if he knows thermography, and if it’s available in Costa Rica.

He does, and writes a prescription. I’ll go to a private clinic for the procedure, an option that pleases him. The test will measure the temperature and vascular signature of my breasts. With this method, it’s possible to detect changes that precede the actual development of a tumor.

I’m jazzed to have a safe, non-invasive way to detect what’s going on in my breasts. As for the young doctor, we’ll have to agree to disagree.