BY BECCA MACLAREN NOVEMBER 7, 2014
I walked through a hospital door marked “Nuclear Medicine Department” knowing that when I left, I’d be radioactive.
It took just a few minutes for the doctor to administer 100 millicuries of radioactive iodine, or I-131. He wore a surgical mask, gloves, and a heavy lead apron. He removed the pill, with tongs, from a cylindrical canister and dropped it into a paper cup. Then he backed out of the room. “As soon you’re ready,” he said from the hall, “make your way out of the hospital.”
I took a deep breath. Get on with it, I thought. This pill was the last step of my treatment for thyroid cancer. Taking it would ensure the cancer was all gone, and that was all I wanted.
But first the pill would make me dangerous to others. For at least 24 hours, I’d emit radiation. For several days, my sweat, saliva, and urine would be radioactive. For 10 days, I was supposed to avoid contact with other people.
These days, quarantine is all over the news: Several states have instituted mandatory quarantines for healthcare workers and anyone else exposed to Ebola, and Americans overwhelmingly support these measures. Like many people, I’ve been following the story of Kaci Hickox, the Maine nurse put under mandatory quarantine after returning from Sierra Leone. She has resisted the order, saying that she doesn’t pose a threat to public health and the quarantine violates her civil rights.
But as I prepared to swallow that pill, being quarantined was exactly what I wanted. In the summer of 2008, I spent so many hours in waiting and exam rooms wishing I was somewhere else. That morning, though, I wanted to stay quarantined at Alta Bates Summit Medical Center in Oakland, California. I wanted to stay in a lead-lined room until it was safe for me to be around other people.
Instead, I ingested radioactive iodine, then walked out the door marked “Nuclear Medicine Department” and immediately collided with a man in the hall.
I got my diagnosis two months earlier, on May 30, 2008. It was my 32nd birthday.
“If you have to get cancer, this is the one to get,” said the endocrinologist who called with the news.
I had papillary thyroid cancer, which has a survival rate of 97 percent over five years—in large part because of radioactive iodine (I-131). Unlike chemotherapy, which attacks healthy and cancerous cells alike, I-131 is targeted. Since thyroid cells alone absorb and retain iodine, the radioactive iodine pill essentially acts like a “heat-seeking missile”: It finds and destroys thyroid cells.
In July, a surgeon removed my thyroid, the butterfly-shaped gland that produces hormones that help regulate metabolism, heart rate, and body temperature, among other things.
Five weeks later, I met with a doctor to prep for my I-131 treatment. His weary, clipped manner suggested he was tired of dealing with anxious patients. He gave me a handout with instructions like: “Stay seven feet away from other people for 5 to 11 days.”
On the verge of going radioactive, I wanted to be told exactly what to do. There were only two things about which the doctor was absolutely clear: I was to have no contact with children and pregnant women. And I could not get a ride home from the hospital.
If I had taken that same dose of I-131 in Europe, I probably would have been quarantined in a hospital for a few days. But the U.S. did away with required hospital quarantines for radioactive iodine in 1997—in fact, it’s rarely an option. Many hospitals have eliminated their radiation isolation rooms.
I went home, but before I got out of the car, I wiped down the steering wheel, gear shift, and door handle with disinfectant wipes. Then I headed into the guest bedroom of the house I shared with my boyfriend at the time.
Time dragged in those 10 days. Lacking the concentration to read, I watched the first season of Lost on DVD. I was totally confused, but riveted, by the plot: plane crash survivors marooned on an island where nothing is what it seems.
Every time I prowled into the kitchen for food, I wore surgical latex gloves. I always hurried back to bed to eat on paper plates with plastic utensils.
I wiped down the sink and flushed the toilet twice after every use. At the end of the week, I tossed out the sheets and towels I’d used. I filled a trash bag with radioactive waste, which I put in the garbage bin with some concern. I hoped I wasn’t endangering sanitation workers or causing radioactive alarms to go off at the dump.
I emerged from the room after 10 days, and burst into tears when I got my first big hug. I had stayed isolated for the longest time recommended by my doctor. Still, I worried about having trace amounts of radiation inside my body for another month or so.
I had been given a paper card to carry in my wallet listing the dose and date of my treatment in case I traveled by plane and needed to explain why I was setting off the radiation alarm. I visited friends in Seattle one month after taking the pill and held my breath as I walked through security.
I don’t think Kaci Hickox, the nurse in Maine, was being cavalier when she went out for a bike ride. She hasn’t shown any symptoms of Ebola, which is the only time a person is contagious, and her work in Sierra Leone demonstrates her selfless concern—at the risk of her own health—for others.
Thinking about Hickox on her bike, I’m also thinking about the 60,000 people diagnosed with thyroid cancer in the U.S. last year. Many of them, like me, will need to swallow that strange pill, and then wonder how to leave the hospital and where to go.
Becca MacLaren is history and engagement editor at Zócalo Public Square.