I put on scrubs and lay down on the MRI table, facing up. One of the techs pushed a button and I moved inside. I am not claustrophobic, but spending 40 minutes inside a narrow tube is challenging. They had to keep telling me to be still. They were imaging my lumbar spine.

I’d once had surgery there, at L5, for a fragmented disc. A few weeks ago, I began to get pain down my right leg. It was the classic path of the L5 nerve root — along the outside of the thigh and shin to the big toe. After foolishly playing tennis and doing some heavy lifting, it was now so bad I could only walk a few minutes before having to sit to take the pressure off.

They rolled me out to inject dye, then did another 10 minutes of imaging, and I drove to work.

A few hours later, I got a call from my doctor. The MRI showed signs of disc impingement, but something else had come up.

There were spots on my spinal nerves. That’s where the cord begins to branch out in your lower back. The spots were described as “nodules” or “lesions.” I was told it was a rare finding.

The doctor was reading the report of the MRI radiologist. The report, I was told, included the word cancer.

I would later get hold of it. The relevant part read as follows:

“Several enhancing nodules in lumbar filum roots, the largest measuring 3.5 mm at the L2 level, and with equivocal more diffuse root enhancement at the L2-L4 level roots. Metastatic disease cannot be excluded, and correlation with history of primary malignancy is recommended.”

The same report also included this: “There is partial visualization of a right posterior iliac bone lesion, maybe also related to metastatic disease.”

Metastatic disease means spreading cancer. This implied that a yet undiscovered cancer in some other part of my body had reached my spinal area. There was suspicion that these spots were causing the pain I was having. The radiologist seemed to be alarmed.

That phone call was on a Tuesday, three weeks ago. It was 1 p.m. I’d already set up an appointment with an orthopedic doctor for that afternoon, thinking my only problem was sciatica. He would be getting the MRI films and now would be my next chance for an opinion.

I looked out my office window. It was raining. The weather had been unseasonably cold for several days.

I did not ask the doctor what would happen if it was cancer, perhaps because I didn’t want to know. Now I wondered: would this involve radiation and chemotherapy? Would they even know where to radiate? I recalled cases of metastatic cancer where it’s hard to find the original disease site. What if they couldn’t?

I decided not to call loved ones yet. I didn’t want to hear their alarm. Nor did I want my children to know. I had to think about how to contain this.

I went on Google, which was a mistake. There were several articles about cancers first discovered after spreading to the spine.

A few hours later, I was at the orthopedist’s office. He put the films up for viewing. I was able to see the spots. There weren’t a lot of them, but enough. He had a calming manner, and tried to reassure me. If this were metastatic cancer, I’d likely have other signs of systemic illness.

But just in case, he wanted me to get some blood work done. That wouldn’t prove or disprove cancer, but it could show anemia, or other worrisome signs. He wrote an order for it.

I asked what else the spots could be.

Benign nodules, he said. It happens.

I asked how often he saw such growths.

Oh, once or twice a year.

There was a brief silence as I took that in.

He was able to say that the spots were not causing the pain. That was definitely a disc problem, and I would likely need a cortisone shot to try to calm it. I made a joke about getting the shot soon, while there was still time, but it fell a bit flat.

My next step would be to see a neurosurgeon.

That night, I told a few selected people. Not all knew how to respond. Were it something like prostate cancer; the easy response is that it’s curable. But folks were taken aback at the phrase, “metastatic cancer of the spine.” It’s hard to be encouraging about that.

I thought back to six years ago when I had a lump on my chest that was thought to be cancer. It turned out to be a bone infection. Instead of now feeling this could be another false alarm, it made me think I could not be lucky twice.

The next day, I was in the exam room of the neurosurgeon. He put the MRI films up for review. Doctors are good at keeping a poker face. He studied the films and nodded. He said he does see cases of nerve nodules, perhaps a dozen a year, and most are benign.

I exhaled.

Then he said he couldn’t be sure. His tone was reassuring. Still, he said they would have to get a spinal tap. He would be looking for abnormal cells in the fluid. It was a Thursday. He would do the tap the following Tuesday.

A day later, I was sent back to an MRI machine. When there is a suspicion of cancer, the medical profession is thorough. They felt they needed to image my brain. If there was metastatic disease in the spine, it could have started there. I later saw the MRI order, which phrased it this way: “Evaluate for brain pathology. Evaluate for primary or metastatic intracranial malignancy.”

A few days later, I had yet another MRI that went 90 minutes. That was to image my cervical and thoracic spine. It was a long time in a tube.

Those MRIs showed no abnormalities. Then the blood-work came back. There were no signs of problems.

Still, it was a very long weekend, waiting for the spinal tap. On Tuesday morning, I went to the ambulatory surgical center at Roger Williams Hospital to have it done. You expect a bit of chaos at hospitals, but this was a pleasant, well-run operation.

I lay on my right side on the table. Spinal taps involve entries larger than needles to get fluid. The pressure is uncomfortable. The surgeon described what he was doing. At several points, he said the fluid was coming slowly. He said that was probably because I’d had back surgery near the entry site, and scar tissue affected things. I worried it was a sign of other problems.

The fluid had to be sent to a lab; it would be five days before I heard the result.

Meanwhile, the next day, I went for a cortisone shot — yet another spine invasion. By now, my leg pain was extreme whenever I walked. It was administered by an anesthesiologist at a pain management center, who guided the injection into just the right spot by fluoroscope. Over the next days, it slowly reduced the sciatica by about half. It was frustrating. I had hoped for an instant fix. I was told you often need two or even three such shots. As I write this, I’m scheduled for a second. If they don’t succeed in stopping the pain, the MRI indicated I will probably need surgery.

At last, on a Monday morning almost two weeks after I had first been told an imaging radiologist spotted signs of metastatic cancer of the spine, I was back in the neurosurgeon’s office to hear the reading of the spinal tap.

His office is near Rhode Island Hospital. It felt like Indian Summer.

He came into the exam room.

He began by asking me how my back was feeling. We chatted about that for a few minutes. It made sense; it was the more evident problem. I was still limping.

Then he took out the spinal tap report and said it showed there were no abnormal cells.

It took me a moment to absorb that.

I asked what this meant.

No atypical cells, he said — no blasts or leukemias.

“So I don’t have cancer?”

No, I did not.

Then what is it?

He said he wasn’t sure, but it was likely a benign growth sometimes seen on nerves called a schwannoma. Or it could be a similar, unknown benign lesion. It happens. He used the phrase, “nerve sheath tumor.” It was doing no harm at the moment

“So we just follow them,” he said. “If they get large, we do remove them.” He does a dozen such operations a year.

There was no explanation for why I have this.

He said it would have been unusual for it to be cancer, since I had no other signs of that disease. But he needed the tap to be sure.

Now he was sure.

I drove back to work. I parked and began walking toward my building.

Then I decided to take a moment.

I found a bench and sat outside, in the sun. There was a breeze, and a few leaves fell from the trees. They still had their autumn colors. I sat there for a long time.

mpatinkin@projo.com