Thread by @TheRealDoctorT

The cell grows, like all cells do.

But something is wrong in this particular cell. A signal that normally tells it to stop growing doesn’t activate the way it’s supposed to. The cell grows and divides, and grows and divides, and grows and divides.

It becomes immortal... 1/

She doesn’t know anything is wrong at first.

A year from now, when she finally discovers what grows within her, she will think back to this moment and wonder when that first cell turned traitorous.

For now, her mind is filled with the beautiful mundane. 2/

She is enjoying making plans, vacations with her family, working on some art projects she loves, spending time with her husband and kids, reading her beloved poetry.

The sands of time stretch infinitely in her mind, the edges of the hourglass hidden just out of sight. 3/

Inside her, as the days turn to months, the cellular machinery in one tiny spot continues to malfunction.

The endlessly growing cells generate their own blood supply and start to push upon, and into, other structures.

Blood vessels and lymph nodes become involved. 4/

The Greek word “methistanai” means “to change.”

She doesn’t speak any Greek. But the word we derive from “methistanai” will become a word she tearfully fears, passionately hates, then eventually comes to peaceful terms with:

“Metastasis.” 5/

Her first symptom is fatigue. This is about as vague as it gets. She’s always juggling ten thousand things, her kids need her, her husband needs her, her friends need her.

Of course she’s tired.

When she starts to lose weight, she ignores that too. 6/

But the pain she can’t ignore.

It begins as a sort of dull ache deep in her left shin. She assumes she must have hit her leg against the edge of the coffee table.

There’s no bruise, however, and the pain doesn’t subside no matter how much ibuprofen she takes. 7/

Inside her, the cellular disarray is metastasizing alarmingly fast now.

Clumps of cellular growth run amok are hijacking her nutritional intake, stealing blood supply, and suppressing her immune system.

She is increasingly aware that something’s wrong.

She’s scared. 8/

When she was a little girl, her favorite thing to do was ride horses.

She has fond memories of the horses at the stables she used to visit.

She hasn’t been riding since she was a child. In the depths of her illness, she has the sudden urge to ride again.

To be free. 9/

She sees her doctor, who sends her to a specialist. They talk about things like “growth” and “mass” and “lesion.”

The words seem alien. She is detached from them, but she can sense their weight.

They are heavy words.

She is sent to the hospital to get a biopsy. 10/

The pathologist looks at the biopsy slide labeled neatly under the microscope.

She changes magnifications, surveying from a low-level, and then zooming in for greater detail.

Her sharp gaze is honed by years of experience. Recognizing cell types and structures. 11/

She looks away from the microscope for a moment to re-read the clinical history.

A mother. Young. Advanced disease.

Even though she never meets her patients, the pathologist knows them on a level of cellular detail nobody else ever will.

She sees inside. 12/

Through the tiny aperture, focused by crystalline lenses, she peers into a keyhole. A window into the universe within us.

At times like this, though, the job can become particularly difficult.

It’s not too tough to imagine this patient, this woman, not so unlike her. 13/

She knows the words she is dictating now will change this patient’s life forever. This woman she will never meet.

“Poorly differentiated, high grade.”

She sighs as she speaks the words into existence.

Reviewing her report one last time, she exhales, before finalizing it. 14/

As the pathologist heads home that evening, her mind goes back to the day’s cases.

She keeps a certain level of clinical detachment, making sure she sees clearly and objectively at all times.

But she’s human.

Patients linger.

Diagnoses.

Stories.

They’re never far. 15/

When she gets home, she greets her husband, and her daughter.

Her daughter is excited to see her, and, as always, has so many amazing stories to tell.

She smiles warmly, and feels the day’s burdens start to leave her as she sits down on the couch and listens. 16/

Her daughter is showing her a drawing she made at school today. A horse, with her daughter sitting on top of it.

“I want to ride horses,” is the concise caption.

For reasons she can’t explain, the pathologist feels a strange tugging deep inside her.

Her heart aches. 17/

Her daughter sees her eyes fill with tears, and asks what’s wrong.

“Nothing’s wrong, sweetheart. It’s beautiful. It moved me. I love it so much!”

She takes her daughter into her arms, and holds her close.

And she feels the world turn on an axis that only she sees.