Two women this week shared their stories of finding a breast lump. One woman was in Iceland, and one was Tennessee—and the difference is astounding.
Hugo Award-winning science fiction author Mary Robinette Kowal tweeted on Monday to chime in on the American healthcare debate, in the way many folks do: by showing just how much easier things are in other countries. For Kowal, that experience came in Iceland when she found a lump in her breast.
When I lived in Iceland, I found a lump. I had no idea how to navigate finding a doctor, so I went to our show's production manager.— Mary Robinette Kowal (@MaryRobinette) June 3, 2019
Me: I found a lump. Can you help me find a doctor?
PM: Just go to the cancer center.
Me: Okay. How do a get a referral?
PM: What's a referral?
It was a different experience from the get-go. She asked a coworker for advice, and he told her to go to the cancer center. When she asked him if she’d need a referral, he didn’t know what that was. She called the cancer center and asked when she could have an appointment. They replied, “You found a lump!” and told her to come in right away.
Having accepted that I don't need a referral, I say, "How do I make an appointment?"— Mary Robinette Kowal (@MaryRobinette) June 3, 2019
CC: An appointment? Yes, we can do that if your schedule is very busy, otherwise just come in.
Me: I don't need an appointment?
CC: You found a lump! You know your body, yes? Come in.
The appointment only cost the equivalent of about $3, which Kowal said the nurse was very apologetic about. If she were an Icelandic citizen, it would have been free. Within minutes, she was in an examining room with a physician who determined they’d have to do a mammogram. Kowal again expected to have to make an appointment, but instead, they just walked across the hall.
She escorts me into an examining room and palpates the area.— Mary Robinette Kowal (@MaryRobinette) June 3, 2019
CC: Yes, that does feel like a lump. Let's do a mammogram.
I prepare to hear about making an appointment for that.
CC: I'm sorry, but it's across the hall. Do you mind following me?
The mammogram was followed by an ultrasound. Within 45 minutes, Kowal had an answer: It was only a cyst. She said in the U.S., a similar lump took two weeks and three appointments for an answer.
But two weeks is faster healthcare than a lot of people get in the U.S. Another Twitter user and writer, Kelly Gregory, shared the story of her breast lump. When she found it in 2009, she didn’t have insurance due to a pre-existing condition, and it took three months for her to find care. By that time, the lump had grown, and she was diagnosed with Stage IV metastatic breast cancer. Although immediate aggressive treatment helped, her case is still terminal.
By this time, lump was the size of a deck of cards. Because of the quick work of that first line care at .@PPFA, by the way, things moved quickly. But still, testing soon showed the cancer had spread and I had StageIV MBC, a terminal diagnosis.— Kelly Gregory (@KellyLGregory) June 4, 2019
While Kowal had her lump seen to in less than an hour in Iceland, in America, it took Gregory months, and that time will end up costing her life. “I’m about to hit my 9th anniversary as a MBC patient,” she wrote on Twitter. “But it will eventually kill me and I will die because I didn’t have access to healthcare for a few years in my late 30s.”
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