“I’m glad everything looks good doctor, but these annual mammograms don’t seem necessary anymore.  Exactly what age do I have to reach before I can take this one off the list of my annuals?”  Tish is neatening her clothes on her delicate 5’8 frame and playing with her reflection in the paper towel dispenser. “Because I don’t have a family history of it and I can positively say that this is the worst of them all.  You’d think that with all that technology has to offer they’d come up with a less painful method for testing.”

“Tish, I understand your concern.  Most of my patients feel the same.  And despite your complaining, I know you’ll still come and get your annual mams.  You just wouldn’t be you if you didn’t have more to say about it.”  Dr. Leslie gives Tish a broad smile and closes the file. 

“Sure, doc.  But I know that one less test is one less doctor’s visit.  Meaning one less family vacation to Italy if you have a bunch of women who stop coming in.”  Tish returns Dr. Leslie’s smile and opens the door to exit.  “How about if I refer a few women I get to skip a test?”

Dr. Leslie laughs and follows Tish out of the room.  “Definitely one of my favorite patients.”

“Then can I get something free for a few referrals?”

Dr. Leslie retrieves a pen from the breast pocket of the lab coat and hands it to her.  “There.”

“Wow.  That’s right, doc.  You’re always on it.  Make sure I have a pen to sign that credit card receipt.”

“The receptionist will take care of you, Tish.  Good to see you.” 

Dr. Leslie still quite amused by Tish’s humor takes a detour to the next exam room while Tish walks the hall toward the receptionist desk.  She’s digging in her purse for her compact and lip balm when sobbing halts her pace.  Almost without thinking, she tunes in to the cries being heard from the suite to her right. 

“You can’t be serious.  I thought the free mammogram at the health fair was mistaken.  The lady told me it was probably nothing.  But you’re telling me there’s really a lump?”

“The good thing is that we’ve detected it and can make plans to have it removed as soon as possible.”  The person consoling her wasn’t very successful because hardly anything was audible through her weeping.

“But I don’t have a family history or anything.”

“Unfortunately, not having a family history doesn’t guarantee that you won’t develop a lump…”

Tish resumes down the hall toward the receptionist desk lost in thought at what she’s overheard, her head cast downward until she accidentally bumps into someone.

“Oh, pardon me, ma’am!  I’m so sorry.  I wasn’t watching where I was going.”  Tish almost melts away as she observes the woman wince in pain.  She’s bald and thin.  Looks tired and weak.  “Oh, no.  I didn’t hurt you, did I?”

The lady tries her best to smile through her pain and nods her head.  “It’ll be fine.”  Tish notices that she seems flat chested as she carefully tips around her.  She’s totally distracted by what she’s heard and seen when a voice from the receptionist desk catches her attention.

“Ma’am…”  Tish turns toward the receptionist seated at the desk.  “Would you like your next appointment same day a.m. or p.m.?”

“Oh, um… a.m. is fine.  Same day, please.” 

The receptionist hands her an appointment card.  “Insurance still intact.  We’ll see you next year.”

“Definitely.”  Tish turns to exit the waiting area realizing that gambling with her health is no laughing matter.  She pulls out her cell phone and presses quick key option 3.  After two rings, there’s an answer.

“What is it now, Tish?”

“Alesandra, have you ever had a mammogram?”