Gadolinium, a rare-earth element forged in the violent deaths of ancient stars, will enter my bloodstream tomorrow. It feels surreal to think that something born billions of years ago, long before Earth even existed, is now being used to help diagnose what’s happening inside me.
It will arrive already chelated, safely held in a molecular cage so it can move through my body without reacting. Once inside, it will subtly change the way water protons relax after being excited by radio waves, creating brighter MRI scans so doctors can see abnormalities more clearly.
I’ll admit… I was nervous at first. I’ve never needed this procedure before. Learning the science behind it….the physics, the chemistry, the careful design… helped. Knowledge can have a calming effect sometimes.
I became curious about where this element comes from. Gadolinium isn’t called “rare” because there’s so little of it, but because extracting it is difficult. If my contrast agent turns out to be Bayer’s Gadavist or Bracco’s ProHance, odds are the gadolinium was mined at Bayan Obo Mine in Inner Mongolia, the largest rare-earth element mine on the planet.
Inner Mongolia and Outer Mongolia were once both part of the greater Mongol Empire under Genghis Khan in the 13th century. Outer Mongolia declared independence in 1911, later solidified with Soviet support in 1921, while Inner Mongolia remained under Chinese control for its proximity to China. Still, both regions share deep cultural and historical roots. I didn’t expect my MRI prep to lead me through this history… yet here I am.
Tomorrow, I’ll lie still for about 45 minutes, listening to the rhythmic pulse of the machine. I think I’ll picture the gadolinium moving through my veins, guiding my mind across the region where it was mined. I’ll imagine the hum of magnetic resonance blending with the low, resonant tones of Mongolian throat singing. Somehow, this image brings me peace and I’m not even in the machine yet.
It’s strange…. almost comforting…..to think of this element’s journey: born in exploding stars, trapped in ancient rock, mined, refined, chelated, packaged, transported halfway around the world… just to arrive here, inside me.
It feels like a thread……something cosmic……. woven through time, now intersecting with my own story. I don’t fully understand the bigger design, but I hope there is one. Tomorrow is just another step, to help me heal.
5:30 a.m. I woke up and checked my email before my eyes were even fully open. A new test result has been posted…read the alert.
I reached for my glasses on the nightstand, opened MyChart, and there it was….. the pathology results I’d been waiting on all weekend.
Invasive carcinoma…… Not the words I wanted to see.
I woke my husband and whispered, “They posted the results… carcinoma.” He didn’t need any more explanation. He just held me. “I’m sorry” he said
I made a joke……because that’s what I do when things get too real. “Well… can I finally get the long-haired dachshund I always wanted?” “Yes,” he said. “We can get a dog now.”
Small victory.
I pictured an elderly rescue…..one who just needs somewhere soft to land for his final years. Definitely a boy… I have no energy for a dramatic little girl dog.
Around 10 a.m. the physician called. I pretended I hadn’t read the report already. “Do you have time to talk?” “Yes.” I said. “It is cancer. Not benign.” She said.
“Ok.” I answered. She paused……. maybe waiting for emotion I didn’t have yet. I wasn’t sure what the correct response should be… so I stayed quiet.
She then proceeded to tell me the MRI would be moved up and went through the details of what happens next.
“We’re still piecing everything together.” I listened, and then I drifted…..”She does this every day…” I thought.
Delivering life-altering news to strangers. I couldn’t do what she does.
So… the waiting is over. Now it’s one day at a time……… But then again. It’s always been that way, hasn’t it?
I don’t want any of this. I wish things could simply unravel the way nature intended.
Or maybe nature did intend this.
I don’t know.
Life makes no sense to me.
But…. there’s an adventure waiting for me next summer, so I’m choosing to move forward with whatever…. I can’t say I really care at this point.
If I’m being honest… I’d rather die in the desert anyway.
But for now—today—I’m still here. So we keep going. I’ll just have to shift my mental focus… that’s all.
This is where I met a man named Niles at reception. His nameplate gleamed under the soft lobby light as he greeted me and asked for my name. I was forty minutes early……pacing at home had done little to pass the time, so I left home just to get this visit over with.
Niles took my last name and handed me an iPad. The screen walked me through the usual verifications before unfolding into a detailed health questionnaire… women’s health, menstrual cycles, pregnancies, family history of cancer, vision, urinary issues. It felt like a full-body audit. Nothing out of the ordinary for me.
I took a seat in the waiting area, opened the book I’d brought, and briefly glanced around. Six other women waited quietly, all lost in their own thoughts. My husband sat among them, the only man there….steady, patient, supportive. When they finally called my name, I stood and gave him a quick glance. “You’ve got this,” he said with a smile.
The nurse took my weight, asked the standard questions, and measured my blood pressure: 120/68, same as always, I think. Then came a few more questions… prescriptions, smoking history, family cancer cases? She then asked me to change into a gown: “Opening in the front. Uma will be in shortly.” and she walked out of the examination room.
The gown was pink, actually, No, it was fuchsia. I remember the color, because I once had a middle school teacher who drove a fuchsia Saturn and was relentlessly teased for it. Yes, this gown was the same exact lilac pink shade.
Five minutes later, Uma walked in. Petite, maybe around my husband’s age, fluorescent pink Crocs, white coat. I stood to greet her and shook her hand. She apologized right away. “I’m sorry…. you were probably wondering why we said everything was fine at first, then called you back in.” “Yes,” I replied, “but no need to apologize. I wasn’t sure what was going on.”
She explained that ultrasounds are most reliable when a radiologist is on site, apparently, the center I’d visited no longer had one since being sold to new management. She opened the mammogram and ultrasound images and began reviewing each slide with me.
“You have dense breast tissue,” she explained. “Both sides are full of cysts.” She pointed out dark circles on the screen, showing which were fluid-filled and which were harder. Then she compared the solid ones to….of all things……..cement.
The word caught my attention immediately. “Cement?” I echoed in my mind.
She explained how a hardened cyst can cause pain when surrounding tissue shifts against it……“like when a cement filled nodule starts to move among other things” I smiled, finally realizing she meant concrete or perhaps even mortar.
A common mix-up. I didn’t correct her, of course. She was kind and thorough, describing every image, each black-and-white swirl gradually taking form in my mind.
Then she paused on one particular area. “This gray wall here, between two dark circle. We can’t be certain what that is. We’ll monitor it closely. I recommend every six months.”
Next came the actual physical exam. “So,” she said conversationally, “what do you do for a living?”
I laughed. “Funny you should ask. That cement analogy? Pretty fitting….. I actually work in the cement industry.”
She burst out laughing. “No way! and here I was, guessing you were an accountant!”
We both laughed as I stepped on to the examining table. Then she began the exam…..right side first, No issues.
Then the left. I tried to stay calm as she pressed firmly, but a few winces gave me away to a noted pain and discomfort.
“I noticed that upper side’s gotten larger since this past September” I said. “Yes,” she nodded. “That’s the fluid-filled cyst. But this other one—this is the one we’re keeping an eye on.”
I thought….”Of course, that’s the same one I have been complaining about…. the one I’ve had since last November…. the one that appears to be getting more firm and painful.”
She returned to her computer chair and sat. “We’ll order an aspiration for the fluid-filled cyst that has enlarged since last September. While we’re there with the needle, we’ll also look at the one in question.”
She asked me to get dressed and stepped out of the room.
A few minutes later, she returned with my risk assessment. “Because you’re over thirty and haven’t had children, that increases risk slightly. And since your paternal aunt had breast cancer, that adds more. Altogether, you’re considered high risk.”
She recommended adding an MRI screening, alongside ultrasound and mammograms. “Of course,” she said, “this could change once we have the aspiration results.”
Before I left, she mentioned she’d be retiring in January. “Don’t be surprised if your contact changes,” she smiled. “I’ve been doing this since the seventies……started at Trinity Health when I was seventeen.”
“Wow,” I said, genuinely impressed and for a moment, I thought about how many patients over the decades had heard her cement analogy and how many probably imagined little sacks of gray powder like I did.
All jokes aside, she had incredible bedside manner. I felt safe, informed, and oddly very calm.
Now, I wait… for the radiology team’s call…… for the next test…….for more data.
Still, I can’t help but wonder…….. Why did she picture me as an accountant?
Journaling was Recommended 