I knew I had a bladder infection. I knew it because I’d worked as a nurse practitioner for twenty years and had heard the symptoms described hundreds of times. But I wasn’t in practice now, and I couldn’t verify my own diagnosis or ask a colleague to prescribe antibiotic treatment. Nor had I found another source of primary care for myself.What to do? I remembered that a nurse practitioner I knew slightly had opened a practice within a mile of my house. Perfect. I grabbed the first appointment I could get.
In her office, I filled out a comprehensive health history, deposited a urine sample in a cup, and waited for what I hoped would be a swift and straightforward consultation. But no, my nurse practitioner wanted to talk about my health in general.
“When was your last mammogram?”she asked, scanning the form I’d filled out.
“Two years ago, I think. But I’ve decided not to do them anymore.”
“I don’t believe they save lives,” I added defensively.
Her eyes dropped from my face to my family health history, then moved back up to me.
“Ah, I understand,” she said compassionately. “Your sister died of breast cancer and you’re still dealing with that.” She went on for a while, using words like anger and fear.
“No,” I resisted. “I don’t believe early detection guarantees successful treatment or extends life.”
“I understand,” she consoled me. “You’re not ready. But you really need to start getting your mammograms again. Your sister’s cancer puts you at higher risk.”
I left the office with the prescription I needed and recovered quickly from the bladder infection, but I couldn’t put the encounter out of my mind. I thought of all the things I wished I’d been able to say to my colleague. Maybe this: You’re wrong about the anger and fear. My sister’s cancer, discovered in her early forties during the course of a routine physical exam, sent me deep into the medical literature with an insatiable hunger for information. It’s this search for answers and twenty years of experience caring for women—many of whom bore physical or emotional scars acquired in the aftermath of suspicious or inconclusive mammograms—that led me to decide that I could no longer endorse the tests as routine screening measures for me or any other woman.
[Do you still get mammograms? Join the debate or ask the author a question here.]