So when I went to La Patisserie in Waitsfield to buy a Dresden coffeecake last month, I expected the friendly exchanges of goodwill and obligatory comments on the weather and the day's skiing. I now know that this is part of the charm of doing business in Vermont. What I didn't expect was to come out of there with a sobering lesson in healthcare.
There was one customer ahead of me at the bakery. As he was paying and preparing to leave, Arno, the owner and, along with his wife, Karen, coffeecake-maker extraordinaire, asked the man if he'd like to give his speech. The question took me aback. Were we about to get into a heated political discussion? Or some rant about the Patriots not making the playoffs? Happily, no. The man may have felt sheepish about being put on the spot, but he overcame it gracefully and began to tell his story.

In a matter of seconds I learned that Robert and his wife had been together for 38 years, that she had recently died from ovarian cancer, and that she had been in her early 50s. I am closing in on my late 40s, so "early 50s" sounds young, indeed.

The man wore his grief quietly, but what he wouldn't be quiet about was the manner of his wife's death. He certainly hadn't known about the importance of ultrasound tests to screen for ovarian cancer, nor had she. Nor, as it turns out, did the 80 or so other women to whom Robert had spoken, informally, in just the way he was doing at the bakery. He had encountered only one woman, a medical professional, who was aware that ultrasound could be an effective method for detecting ovarian cancer before symptoms occurred.

As he spoke, three more customers entered the store, all of them women. They stood, as my mother and I did, transfixed by what Robert was saying. He told how his wife had been diligent about her health, how she had gotten check-ups every year without fail, and how she had been treated by some of the finest doctors, at some of the most prestigious hospitals in New York City. Within 48 hours of her diagnosis, surgeons removed an eight-pound tumor. Eight pounds. My mother and I wrestled with this on the drive home. What's the density of a tumor? Just how big is eight pounds? The size of a large lemon? A small grapefruit? I notice three pounds in the waistline of my jeans. None of the brainiac New York physicians noticed an eight-pound growth inside this woman?

A Google search on the subject yielded 4,350,000 hits, and an even greater realization of how little I knew about ovarian cancer. From what I read, successful treatment depends greatly upon early detection. But, according to the American Cancer Society, early-stage diagnosis stands at only 20 percent because the symptoms, such as bloating and frequent urination, can easily be dismissed as inconsequential. By the time symptoms become exaggerated enough to be deemed significant, the cancer may have spread to the ovaries. Then the real trouble begins.

Given this, it's surprising to me that an ultrasound screening is typically only offered to women known to be at risk, such as those with a strong family history of the disease. This puts the burden on the rest of us to ask for the test -- or to at least ask about the test -- the next time we go in for a physical.

I certainly got more than I bargained for at the bakery that day. And while the coffeecake I bought is long gone, Robert's words will forever stay with me. "Be aggressive about taking care of your own health," he said. With that, he left, and the rest of us stood in silence for what seemed like a long time after the door shut behind him.

 
Sharon Johnson lives part time in Warren.