Ten: Dr. Varma of UCSF 2nd Appointment, May 8th, 2009

Asilomar May 1, 2009

Finally, the following Friday, we got to see the great Dr. Varma.

“It’s like seeing Sinatra,” I joked.

Before Varma came into the room, however, we had to talk to the nurse practitioner for 20 minutes. We had seen her while we were out in the waiting area, as she darted up to the front desk and back into the rooms beyond, her long light brown hair bouncing around in a ponytail. We were in one of the rooms beyond now.

She asked the usual questions. Being a patient is like being a prisoner, except the line of fire is a different set of queries. When did you discover something was wrong? When was the diagnosis? What does your diet consist of? Do you drink? (Since I was there she probably dropped the sexual relations question.) Are you married? How old are you? She seemed experienced and her manner was respectful yet warm. Yet she was not Dr. Varma—she was an appetizer rather than the main dish.

Finally, when the doctor knocked on the door, we had practically forgotten about her. Dr. Varma had blunt cut short dark hair, younger than I had imagined, for all her power. She must have been similar in age to Dr. Goetz and Dr. Dixon. Dan and I had found out that they had all studied together, under a man named Dr. Garcia-Aguilar. It was his name which was still on the UCSF web pages as the head of colorectal cancer, but he had abdicated the throne and gone to work for the City of Hope in Southern California, a cancer facility specializing in cutting-edge work. Dr. Varna had inherited the position.

Varma was top dog now. She was serious, to the point, and it was clear that she was overbooked. She examined Dan, using an old-style metal scope to look up the rectum, which looked like it from Shakespeare’s time.

She said she had looked over the records and discs. She could do a resection, even though the site was very low. “It’s more complicated with women down there than for men.”

Somehow, the comparison was supposed to make us feel better? Complete removal of the rectum would be necessary in any case.

There was a knock on the door, followed by Dr. Varma’s muffled voice as she popped her head out the door.

She reeled her head back in. “I’m sorry. I must go now.”

And then she left, without waiting for an answer.

The nurse practitioner calmly explained that the appointment was over. “Do you want to say goodbye to the doctor?”

We said yes. We talked more with the nurse practitioner before she went out to retrieve the doctor.

 Dr. Varma popped her head in. “Let me know if you have any more questions,” she said.

She shook both our hands, before fading away again, out the door.

Dan and I made our way out, down the hall past the construction zone with its loud jack hammers and pounding, and down the elevator to the parking garage. I told him I felt cheated after all that led up to this appointment. Yet, Varma was obviously competent; beyond that, she was highly experienced, and we respected her opinion. We had gotten our outside opinion—the answer we wanted. The site of the polyp was too low.

I joked that the reason Dr. Goetz had gone to Kaiser was that Varma had been chosen as Garcia-Aguilar’s successor, and bitter, Goetz defected.

While Dr. Varma seemed more positive about a resection than anyone else, perhaps we didn’t trust her, coming as late as her opinion did. Or, maybe it was that Dan’s Kaiser insurance didn’t cover UCSF care beyond a minimum. We didn’t even find out if it covered 20% or 50% or what, out of pocket.