The Size of a What?

Some of the world’s great minds are now asking questions about weighty matters like war and peace, homeland security, and human cloning. My question is far simpler: What’s the connection between citrus fruit and tumors? This can hardly be discussed without sounding like Andy Rooney. “What is it about tumors?” he might rasp. Or, “Didja ever notice how doctors give you the bad news?” I’m trying to be serious here, but the specter of Andy looms large, and frankly, I just don’t have the eyebrows for it.

Let’s get to the root of the matter. We humans get sick, and we go to our doctors for information, advice and help. Sometimes our worst fears are realized, and the doctor must put on his most sensitive face, look compassionately at the floor, and say, “We found a mass.” Now, for the uninitiated, mass is code for tumor. They just don’t like to say the word tumor. In fact, it’s not allowed. A doctor can lose his license for such violations of semantic protocol. This is also true of the word dead. They’ll use expire, pass on, pass, anything to avoid any form of the verb to die. Not that we’re talking about a library card or a football, but it makes no difference. To your doctor, you can expire or pass, but you will never d-- uh, uh, uh! When my father died, his doctor actually told me that they would pronounce him. Period. I kept waiting for the end of the sentence. It never came. Anyway, back to our mass.

For some reason, as soon as the doctor imparts this information to the mass-holder, we want to know how big it is. This is not unlike our unfailing need to ask the age of someone we just learned has been pronounced. “Oh—I’m terribly sorry. How old was she?” As if the response somehow makes the individual’s death more or less acceptable. We don’t ask if this was a kind and decent person, or whether she lived well and did good works. Do we all have some arbitrary age in mind that marks the difference between the acceptable deaths and the unacceptable ones? But again I digress. Our doctors, bless their hearts, always tell us the same thing. “It’s roughly the size of an orange,” they mutter grimly. Unless, of course, the mass is more advanced, in which case it is likened to a grapefruit. Why is it that you never hear of someone with a tumor the size of an apple or a kumquat? The physician has yet to be born who will look down at his hands and say, “It’s the size of a pomegranate.”

So the question is, what do they have against citrus fruit? How did that come to be the gold standard by which the morbid overgrowth of tissue is measured? I mean, if it made any sense, you’d see groves of citrus trees illustrated with tumors hanging from the branches. Now that’s just not right. If I worked for the Citrus Grower’s Association, I’d be organizing lobbyists to be at the AMA conventions pushing the doctors to switch to another standard of measurement. How about the gauge of the ball? A small tumor could be a ping-pong ball, then labels would gradually advance to tennis ball, baseball, softball, volleyball, and God forbid, basketball. I guess Rawlings might not like it, but the grove owners would breathe a little easier. Or consider the more aesthetically pleasing notion of likening each tumor to a flower. Mine may be the size of a tea rose, yours may be roughly the scope of a sunflower, may you rest in peace. In any case, it seems like a far more pleasant way to break the news to a person with a swollen, uncontrolled neoplasm, than to invoke the citrus analogy. Besides, once you’ve been told that they’re going to surgically remove this grapefruit-sized blob from your anatomy, could you ever reasonably expect to enjoy eating one of those luscious Texas Ruby Reds again? It doesn’t seem likely to me.

You hear about someone’s cancer. They found a tumor the size of an orange in his abdomen. He’s doing well, but what if it had just been described as “a four-inch diameter mass”? Wouldn’t that have met the two cardinal rules of doctor-speak? That is, one, don’t call it a tumor. And two, look compassionately at the floor. An engineer I happen to be married to once drew fire from a creative writing teacher for describing a tree as having a three-foot diameter. Creative it’s not, but clear it is. Maybe doctors should learn to communicate a little bit more like engineers, and a little bit less like greengrocers. They can take care of their patients, and keep me from sounding like Andy Rooney. Didja ever notice that his eyebrows look like kiwi peels?