The Paper Gown Chronicles

A meditation on bureaucracy, bowel prep, and the kindness of strangers in underwire bras.

The week before I left Arizona, I became a full-time employee of the American healthcare system. No pay. No benefits. Just a rotating cast of receptionists and the supposition that if I followed all the rules—showed up on time, fasted when told, voided my bowels like a good little patient—someone would eventually tell me how bad my cancer really was.

That week, I had a staging MRI scheduled. One scan. One image that could have shifted the ground beneath me or confirmed that the ground had already disappeared. But instead of answers, I got a Kafkaesque loop of rescheduling, prep instructions, and bureaucratic apologies with no eye contact.

My first appointment was denied by insurance. I didn’t find this out until I got there—hungry, anxious, prepped, ready to climb inside the machine and find out what my body had been hiding. They sent me home with nothing.

I rescheduled, only for my GPS to send me to the wrong imaging center twenty minutes in the wrong direction. I arrived late. No slot left.

The next day, they called an hour before my appointment. The MRI tech—radiologic technologist, if we’re being formal—was out sick. No one else on staff could do it. “We’ll call to reschedule,” they said, like they were offering me a rain check for brunch, not a chance at my life.

The following morning I had to choose between my scan and my second colonoscopy—recommended urgently by my colorectal surgeon. I chose the colonoscopy. You can only pick one hole at a time, apparently.

After that, they rescheduled me at the Gilbert location, early morning, only to call me yet again: overbooked. No room. No apologies that meant anything.

By now, they were running out of options—and I was running out of time. I was moving to Idaho within the week. My insurance would change states. The new place needed to process everything again. So they tried a different imaging company. But that company required a new round of verifications: my doctor had to re-send the order. Insurance had to re-approve. The clock ticked.

When I finally made it to the seventh appointment—the one that was supposed to be it—the building was shiny and new. More spa than clinic. A slick imaging center with lockers that doubled as toilets, and a key card system to house your personal belongings like it was a luxury gym. The walls were beige but calming. The lighting was recessed and gentle, not quite fluorescent.

It didn’t matter.

The woman who checked me in had long bleach-blonde hair and braces. She looked at me, then looked at my hair.

“You won’t be able to get scanned with those in,” she said, nodding toward my extensions.

I blinked. “What?”

“Hair extensions. It’s policy.”

Not once—not in seven scheduling attempts, dozens of calls, or any of my prior imaging—PET scan, CT scan, nothing—had anyone mentioned that my hair might disqualify me.

I lost it.

I told them I was moving in two days. That my insurance would be in limbo. That I had followed every direction, cleared my body for contrast dye, flushed myself out, restructured my entire schedule, fasted for a week like some broken monk begging the gods for diagnostic clarity.

I told them I could’ve gone with a different imaging company if I’d known, but I trusted this one. I told them they were sending me away with nothing but silence and anxiety, and how would they like waiting in the dark for weeks or months without knowing what stage they were?

They blinked. Kindly. Uselessly. The kind of sympathy that changes nothing.

That’s when she walked in.

At first I thought she was a manager. She moved like someone who had permission to speak freely. But she wasn’t staff. She was a patient. A woman here for her own breast cancer scan. She saw me breaking in that cold, softly lit dressing room, and she didn’t flinch.

She sat beside me, in her underwire bra, socks matching mine, paper gown crinkled like mine. She put her hand on my shoulder and didn’t say anything at first.

Then she whispered, “I know.”

And then I started crying.

Not just tears—grief that had been sitting in the lining of my stomach for days. Hunger, frustration, fear, fury. It all came out in that moment. In that room. On that bench bolted to the wall.

She held me.

Of course she understood. Of course she had more compassion than the staff. Wrecked women know how to hold wrecked women. We’ve learned to be human the hard way.

I didn’t get the scan.

I didn’t get answers.

Just the weight of another “no,” and the ghost of a woman who held me while everything I had been holding in finally fell out.

I cried in radiology. Not because I was scared, but because I’d driven to this appointment seven times in one week, and was finding out I still wouldn’t be getting my staging MRI.

A blog post by Rachel Smak on grief, loss, and lessons from stage 3C rectal cancer