"Mr.  Evans?" I looked up from my hard, uncomfortable chair in the crammed waiting room.  The noise of the disheveled teenager in the corner nearly shouting into his cell phone, to the annoyance of all present, and the toddler continually begging his mother for a cookie filled the room. Still in his surgical garb standing next to me was the doctor I had briefly seen that morning when Edith had checked into the surgical wing. He carried a clipboard in his left hand as he extended his right and shook mine softly.

"I'm your wife's surgeon. She did fine and is in recovery. You can see her shortly after they get her settled.  Can we step over to the conference room", he said as he motioned to the small anteroom several steps away.

I noticed the immediate silence in the room as all eyes furtively turned in my direction although they tried to be casual as they heard the doctor's words to me. I managed a small smile as I met eyes with the thin, dark-haired young woman who also anxiously awaited word on her husband's results. She must have been in her late twenties or early thirties and, judging by the fit of her oversized man's shirt, worn jeans, and men's work boots, , she was probably from somewhere in the rural countryside. She and I had spoken briefly as we sat nearby sharing bits of information on how we came to be here.  The surgeon and I walked past the other stoic family members in the waiting room as I tried to read the expression on the doctor's face, but he was all professionalism and his expressionless demeanor disguised any emotions he may have felt.  He brushed back his thick, graying hair and sighed a deep breath that betrayed the fatigue he must have felt. Edith was his third patient that morning and it was only shortly past nine in the morning.

We had traveled to Atlanta's Emory University Cancer Center from Columbus that morning leaving before six o'clock in order to make the appointment. My own fatigue and anxiety must have showed in my face as I nodded to the surgeon.  A few weeks earlier Edith and I had received news from Walter Reed Medical Center through our military family practice physician that Edith had a carcinoma.  We hadn't shared that information with anyone as we decided to see just how serious the diagnosis was.  An appointment was made for her at Emory in order to more precisely determine what we faced.  Mutually we had agreed not to panic and let our fears unsettle us.  First, we agreed, we must get the facts and go from there.

Shutting the door, the doctor motioned for me to sit down. I clenched my teeth and told myself it will be fine no matter what it is. We have been through lots of difficulties before and this would work out fine as they always did.

The doctor sat down and took a deep breath. He relaxed his shoulders and slumped forward slightly while looking at the tile floor. He was clearly about to say something that he didn't want to say. Looking directly into my eyes and pausing a microsecond before speaking, he finally let the words come out.

"Your wife has an advanced metastatic carcinoma.  Stage four.  It's a fairly uncommon type and not a great amount of medical research has been done on this particular type. There just haven't been many cases of it. She is in no immediate danger; however we need to begin an aggressive treatment as soon as we can. The primary site is unknown, although it has metastasized to the liver. There are several large, 6-8mm sized, lesions as you may know from the earlier MRIs.  The left lobe of the liver had eight lesions and there's some activity in the right lobe as well. I've removed the left lobe and about one third of the right lobe of her liver in hopes that it will regenerate and extend her life. The liver is the only major organ of the body, other than our skin, that will regenerate.  I am fairly positive that the remaining part of her liver will increase in size.  "

I had expected to hear that the cancer was isolated and surgery could remove most, if not all of it. This was much more serious that either of us expected.  "I understand, Doctor. How soon can she begin the treatment?"

"First, I want you to know that I don't think we got all of the cancer in her liver. It is entirely possible that she will have continued growth of the cancer cells and there are most likely cancerous cells elsewhere in her body. The liver is not normally the primary site. Now, as to her treatment, that will depend upon her recovery from this surgery, although I don't see any complications that could prevent scheduling chemotherapy and possibly radiation therapy in a few weeks.  Are there any other questions, Mr. Evans that I can answer right now?"

"No, I appreciate your candor. I'm sure I'll have many questions later on. Thank you."

Dazed, I stood up, shook his hand, and he walked out of the room.  I stood there for a few minutes with the unexpected reality swimming around in my head.  I fought to keep my composure as I walked into the crowded waiting room and hastily opened the door to the hallway looking for somewhere I could be alone for a few moments. I turned to the right and heard a female voice behind me calling. "Mr. Evans. Are you OK?"

I recognized the young woman from north Georgia whose husband was still in surgery.  I weakly smiled at her and nodded "Yes", as I felt moisture forming in the corners of my eyes. I had to get out of there.  My vision was becoming clouded and I was slightly light-headed.

"I knew when the doctor asked you to step in the small room that he had some serious news for you.  I just want to make sure that you're OK."

"I'll be OK in a few minutes. Thanks. Just need some fresh air." I turned and quickly strode down the lengthy hallway frantically searching for the front exit of the building. I wished that I still smoked because I sure needed a cigarette right now.