My Thyroid and Me

On the Power of Negative Thinking

My thyroid is gone, and I’m faring pretty well without it. Recovery was both better and worse than I expected it to be. Better: because I wasn’t actually in very much pain, and because I was back on my feet, going for long walks, 48 hours after the procedure. Worse: because the thyroid is next to several small but apparently essential glands called the “parathyroids,” whose exclusive job it is to process calcium (who knew that the body was such an extensive and specialized bureaucracy, not unlike an academic department?). These glands are “traumatized” (the doctors’ words, not mine) during surgery. For a few weeks after a thyroidectomy, while the parathyroids are healing, you’ve got to take huge quantities of calcium supplements at regular intervals in order to avoid becoming calcium-deficient, or hypocalcemic. Most people will just take Tums for a couple of weeks until their parathyroids bounce back; a few unlucky people will become severely hypocalcemic and have to get calcium infusions in the ER. Because my body has what I can only assume is a journalistic investment in preparing me to write about my experiences by exposing me to every dark twist and turn of the thyroid removal process, I am in the latter group. My hands and feet kept falling asleep so thoroughly and painfully that the needling woke me up throughout the night, so I went to the ER and got pumped full of calcium. I’m feeling fine now. I have no vitamin deficiencies, no evil organ, and a gnarly scar. In a story in The Bloody Chamber, Angela Carter describes a ruby choker as a “precious slit throat.” I think about this line whenever I look at my not-so-precious slit throat. I’ve ordered a lot of scarves, which I guess will become a staple of my wardrobe from hereon out.

Although the offending organ is gone, it continues to haunt me, because it turns out that I did—and do—have cancer. There are two common types of thyroid cancer, papillary and follicular. Ever the maximalist over-achiever, I had both of them. My papillary tumor was so small that it was, as my surgeon put it, “nothing to write home about,” and it was entirely encapsulated within the thyroid. My follicular tumor is the real troublemaker. As I understand it (and I invite any physicians among my readers to correct me if I’m wrong), follicular thyroid cancer afflicts the part of the thyroid that sends cellular emissaries throughout the body to regulate metabolic processes. That means that cancerous thyroid cells are littered, hopefully in small quantities, in distant climes. (There aren’t any of them in my lymph nodes, though, which I understand to be a positive development.) Accordingly, I’ll have to undergo something called “radioactive iodine therapy,” a procedure administered by doctors called (I kid you not) “nuclear therapists.” Because the thyroid is the only organ in the body that processes iodine, I’ll take radioactive iodine pills, which will kill my thyroid cells but no other cells. They will also, insanely, make me and my waste (my sweat, my urine) radioactive, so I will have to quarantine for the duration of the treatment.

Papillary cancer has a near 100% survival rate, and follicular cancer has a 98% surival rate, so if you have to get cancer, thyroid cancer is the sort to get. I’m lucky that I don’t have a worse cancer—or a worse disease altogether—and I’m lucky to have excellent health insurance and wonderful doctors. Nonetheless, I think I’m entitled to feel just a little bit sorry for myself, because it’s unfortunate that I had to have an organ removed, and it’s unfortunate that I have to imbibe radioactive chemicals. I know that the standard advice for someone enduring a health crisis or emotional trial is to go in for that all-purpose American balm, Positive Thinking, but what about the consolations of wallowing, so much more potent than the comparatively meager temptations of optimism? I intend to be unrelentingly negative about all this. In my case, hating is medicinal: my will to live is in large part a function of my will to grouse and grumble.

What’s odd is that my thyroid is more present to me than ever before. I never thought about my internal organs at all until I learned that one of them was plotting my demise. I certainly never felt the presence or absence of my thyroid in any appreciably palpable way while I still had one, but in the weeks after my surgery, I became aware of its location because I became aware of the small throb of pain. Now I know that my thyroid and its poisons might be anywhere in my body, I feel downright infused by the wretched gland. I am, to myself, nothing but a series of organs potentially infested with rogue thyroid cells. This is an admittedly dramatic self-conception because I have almost certainly have very few of such cells. But I have some, and they could be anywhere, and I think those two facts are adequate grounds for paranoia.

I don’t really have any parting message. I regard my Substack as somewhere between a social media platform and a diary, so I’m sorry that this is less of an essay and more of a pointless outburst. A proper essay about all this is brewing. In the meantime, thanks for your indulgence! I intend to milk it (your indulgence) for all it’s worth. After all, I do have cancer! Milking it and whining about it are my two best compensations.