Diagnosis

Editor’s Note: This article is the first in a new digital column called, “Slaying Survivorship with Salma”.

Everyone’s journey with cancer is different. And yet, everyone’s begins the same. One minute, you’re a person. The next, you’re a patient. A cancer patient.

While studying with my friends one day after school, my stomach started hurting. As someone who is both lactose intolerant and a great lover of ice cream—real ice cream, none of the nut-milk nonsense—I didn’t think much of the stomach aches at first. But as the feeling grew worse and worse over the course of the week, I began to have trouble focusing during class. When my dad drove over a speedbump on our way to school, the wave of pain was so intense I thought I might throw up. When I went horseback riding after school, I barely made it three steps on a trotting pony before I had to dismount, sobbing, feeling like I’d been stabbed in the gut from just being jostled around a little.

At this point, it was clear to my parents that this was no stomach bug. The next day, my mom drove me to see my pediatrician—the same doctor who had been seeing me since I was six months old. Sometimes she still treated me like I was still six months old, too— which wasn’t a bad thing, especially when I was at an 11/10 on the pain scale.

When she walked in the room, she read my face immediately. “Oh, Salma, honey!” She pulled over that rolling doctor-stool and sat down in front of me, gloved hands clasped in her lap. “So what’s been going on?”

“Well, my stomach’s been hurting since Monday,” I told her. “I don’t know, I think I might just be nervous for my first midterms or something.”

She beamed. “That’s right, you’re in high school! Wow! Well, I hope you’re not pushing yourself too hard.”

“Do you think that’s what the problem is?” my mom jumped in. “We just want to make sure we find the source of this pain. It’s been bothering her a lot, she even came home from school yesterday sobbing.”

“Mom!” I blushed, embarrassed as my doctor’s eyebrows rose in surprise.

“Tears? Oh, wow! So this is more painful than that time you broke your toe?”

I nodded affirmation.

“Wow. So… even more painful than that time you got a bruise under your nail and we had to poke a hole in it to relieve the pressure?”

I wrinkled my nose. “Ew, thanks for the reminder, but yes.”

My pediatrician raised her hands innocently. “No, no, I just remember being so surprised that an eleven year old didn’t shed a single tear while an ER doctor used a red-hot needle to release the blood under her nail. I mean, it was pretty impressive.”

“Right? I remember thinking that too! She has such a high tolerance for pain, which is why this stomachache is really concerning us.” My mom’s brows were knitted tightly together.

“Well, why don’t you lie down and let me examine you?”

“Sure.” I laid back on the crinkly white paper, cringing at how loud the sound was in the small room. I felt like a giant now that my feet hung off the edge of the examination table. They never used to do that when I was little. The table was still covered in stickers, like always, and I fidgeted with one, staring at the mural of stars on the ceiling, trying to distract myself from—

“Ow!” I howled the second she prodded at my stomach. My eyes watered. She reached for my stomach again and I tensed up.

“So sorry, honey,” she apologized, leaning over me and digging a hand into my side, feeling for a rib or an organ or whatever, basically conducting an entire scavenger hunt while I laid there, burning up in flames. Then, finally it was over. As my vision cleared, I saw her cocking her head above me.

“Okay, hang on one sec, I’ll be right back.” She raced to the door and with a whoosh, she was gone.

“You okay, sweetheart?” My mom came up next to me, holding my hand and rubbing my shoulders comfortingly. I nodded, exhausted.

“Knock-knock,” my doctor chimed, weaving her way into the room. Why did she always say that? She could actually knock on the door for once, I thought to myself, until behind her appeared another face, also with a stethoscope wrapped around her neck.

“This is my colleague Dr. Julian. Is it okay if she takes a look at your stomach?”

“Sure. The more the merrier.” I gritted my teeth, bracing myself for round two of the poking and prodding party.

I think they were murmuring to each other softly while my mother looked on with concern, but I can’t be sure. I think I honestly blacked out for a minute the second they touched my tummy.

“Okay, hon, why don’t you sit up for me?” My doctor’s usually cheerful voice sounded a bit brusque as she peeled off her gloves and tossed them in the trash with a rustle of plastic. “Now, Mom, I’m going to ask you to wait in the hall for a sec while we chat with Salma, okay?”

“You okay with that, sweetie?” my mom asked.

“Yeah, sure, I guess.” That’s weird. The only time I’ve talked with my doctor without mom there is when I got my first period last year. Maybe this stomach pain is just really bad period cramps?

“So,” my doctor began, smoothing her palms over her pants as Dr. Julian leaned against the sink in the back of the room. She tried for a smile. “So, we want to ask you… is there any chance you’re pregnant?’

I blinked. What did she just say?

“I said, is there any chance you’re pregnant?”

Okayyy I’m in immense pain and this is such a weird conversation to be having with a woman who has known me since I was in diapers. Don’t they think that I would have taken a pregnancy test before coming here if there was any possibility I was pregnant? I was just a kid! A very sheltered, innocent kid! “No, there isn’t, actually.”

She turned to exchange a glance with Dr. Julian and I felt my temper flare. “No, there isn’t! I’m not making this pain up, I swear, I—”

“Oh, honey, we believe you about the pain! We do think something is going on. Which is why we need you to tell us the truth. Think. Is there any chance you’re pregnant?”

At thirteen, my main concerns were my midterm grades and how I was perceived by my peers, in that order. I had never had a boyfriend, nor did I have any plans to have one. And my doctor knew that, we talked about it every time I saw her.

“No, there isn’t!”  But as soon as I said it, I hesitated. She was asking me what I thought she was asking me, right?

And suddenly, fear began to creep in. The trailer for Jane the Virgin that I had seen on TV last week began to play through my head. I had never seen the actual show, only the first scene. Jane is lying on a bed in the ER, her mother at her side, when the doctor hands her a positive pregnancy test. The shock and horror on her face had been funny when I watched it at the time, but now?

Now, that was basically my worst nightmare. How was Jane able to get pregnant? Could that happen to me? Am I some medical fluke? Am I pregnant right now???

Both doctors pinned me with their gazes. I squirmed but held my ground, staring right back at them until my doctor turned away, her lips pursed. She gathered some papers and turned back to face me. “Okay then Salma, we’re going to run a urine sample just to be sure, and as long as that’s negative, I’m going to recommend that you and your mom head to the ER so you can get some imaging done as soon as possible. Does that sound good?”

I nodded.

Five hours later, I found out a tumor had been growing in my abdomen until it ruptured, causing all of my pain.

While more tears and pain and heartache would follow my diagnosis in the coming weeks, my first emotion was relief.

“I told you I wasn’t pregnant!”