One-breasted Girls Go Wild

You know what worries me? I'm worried that when I'm finally sloughing off this mortal coil, I won't be pondering life's profound mysteries. Oh, no. Instead, I'll be dwelling on really silly questions. Like, "Just how many calories are there in a potato chip?" or "I wonder why Cuba Gooding Jr. didn't make more movies?"

When I was told I would have to have surgery, a few days before Christmas, I let many gloomy thoughts about mortality surface. I suddenly cared about how my family would remember me. My memories of my dad, Pat, are mostly wonderful, but for a long time after his passing from a terrible, debilitating dementia, I couldn't focus on the man I'd known. Images of the withered alien who'd reshaped his body haunted my every thought about him. I didn't want my family remembering my maimed flesh. I banned husband and daughter from the sight of my wounded self, vowing not to unveil my body until after reconstruction, still some months away.

But, hey, I should have saved the gloomy thoughts for later! As it turns out, the pathology finally limped back in from the Mayo clinic: four tumors, two less than a centimeter in size, two more than a centimeter. The second to largest tumor was at the edge of the tissue that the surgeon could remove, leaving a scant millimeter of 'clean' tissue around that particular tumor. Radiation was inevitable. The only good news was that the Mayo clinic confirmed that the lymph nodes were clear, so there was no dispute about the staging of the disease. My wonderful breast surgeon, Dr. Brown, refused to commit himself on whether or not chemo would be part of the treatment. "Ten years ago," he advised, "No one would have treated a Stage One carcinoma with chemotherapy. But that's changed."

Well, I thought, at least my mother will shut up about how they cut my boob off just to cure a case of blocked milk ducts.

The thing I feared most, other than just hearing my name and "cancer" in the same sentence, was having to go through chemotherapy. To steal a line from Molly Ivins, it seemed awfully unfair that they had cut me, were planning to burn me, and were thinking about poisoning me, too. I don't approve of wallowing, but when I got the path report back, a good wallow seemed long overdue. Dr. Brown said to stay positive, but I can't say I much felt like it.

When I want to succumb to utter despair for a few hours, I find the internet very useful. You can't graze the blogs of breast cancer patients for very long before you come across a blog that is no longer active because the patient, usually a beautiful young woman under 40, has died, after months or years of grueling treatment. Pardon my French, but I hate this shitty disease. I came away from blog-grazing feeling lucky again, or somewhat lucky anyway.

After getting the pathology back, my breast surgeon scheduled me for a visit first to the oncologist and then to the radiation-oncologist. The oncologist I was being referred to, as far as I could tell from all my googling, was the closest thing Austin had to a breast cancer specialist in oncology. Her MD Anderson fellowship was in bioimmunotherapy (whatever the hell that is), but at least she had a fellowship from one of the major cancer centers in the US. I could find no oncologist in Austin who was a fellow of any well-known cancer center. Anyway, Dr. K's credentials did impress me. Despite the hemming and hawing over whether I had cancer at all initially, I came to realize that, at the end of the day, my cancer is pretty routine and pretty curable. With radiation, I would have a 95% chance of non-recurrence. And being healthy over all, I had no special considerations that might require an especially gifted clinician. So it seemed at least advisable to meet with Dr. K and see what she was like.

As it turned out, people-feel is not Dr. K's greatest asset. But, then, that's not what I go looking for in a doctor. Better to have the smart one than the friendly one. Dr. K. went to some lengths to get a clear picture of the time-table of my disease, who I'd seen, and what they had said. Then she went through the path report with me at some length. As she spoke, it was obvious that she had a decision table in her head about my treatment. She apologized profusely when she found that a key addendum was missing from the report. Without information regarding a key receptor in my tumors she could not rule chemotherapy in or out. She didn't seem to appreciate how anxious I was for this piece of information, though she did start making phone calls, to find out where the mystery information had gone or even if the pathologists had run all the tests they were supposed to run.

"If you do have to have chemo," she said, a trifle blithely I thought, "You'll lose your hair and you'll have to have a port installed in your chest, but you would not be prone to nausea and vomitting." Clearly, when you've had patients die from this killer, you have a peculiar definition of "the bright side".

Then came the news that she wouldn't be seeing me for two weeks. Two more weeks to find out if I would have chemo or not. I left the hospital near to tears. If she did declare chemo a necessity, I would get a second opinion, though from whom I wasn't sure. How's that for a scientific approach? I will challenge all the doctors who tell me what I don't want to here and sweetly agree with all the ones who tell me what I do want to hear. I called her the next day, to see if the report had turned up, but she never returned my call, possibly because the nature of my message, which of course had to go through Dr. K's nurse, was not conveyed.

Two days later, I went to the radiation-oncologist for a consultation. His nurse went through the pre-consult drill, going over the pathology again. I asked her if the addendum regarding certain receptors in my tumors had come back. Of course, nurses aren't really paid to break bad news and she would have been well within her rights to ask me to wait for the doctor. But she very kindly studied the addendum and said, "Woo-hoo, no chemo!" I felt the air rush back into my lungs. As my grandmother would have said, I felt like the extra chicken who the kids have picked to be the family pet.

By the way, do you know how to tell a good nurse from a great nurse? A good nurse weighs you and writes the numbers down as she sees them, not listening to all your yapping about how much your shoes weigh, how much your wedding ring weighs. A great nurse takes your own assessment into account and writes down the adjusted number you give her. I've had one great nurse in the past week and one good one.

Anyway, the radiation-oncologist (another Dr. Brown!) came in and turned out to have a lot more people-feel than Dr. K. I bonded with him instantly, especially when he whipped out his Iphone to check his dates. He would clearly allow himself to be drawn in on discussion of his apps vs. my apps, but I decided to play it cool. At least for this first visit. Plus, and I guess this says something about the nature of a radiation-therapist's work, he gave me his cell-phone number and said to call him personally with any questions I had. I've never had a doctor do that and I expect this to be the last time I get such an offer from any doctor.

So, now, I'm officially on the Cancer Train. There'll be years of appointments and nerve-wracking tests. There'll be tamoxifen and the arrival of menopause-like symptoms that I, even at 53, have seldom experienced. I've warned my husband that I may go crazy. But, though the news is worse than I was ever willing to contemplate, I'm no longer scared.

I realized just how not scared I was when I came back from a bike-ride with Mike. I'd dragged his butt up a few hills and he'd survived it well. We were having a lovely post-ride talk about nothing in particular. I had no desire to end our chat just because it was time to hit the shower.

I mean, this is The Shower. The place with a beautiful echo and two shower heads. The sea-foam tile is lovely, which means we couldn't afford it when we ordered it some seven years ago. We call it the Bob Dylan tile because, when we tried to rescind the order for the tile (Mike the Math Boy had never troubled himself to work out just how much these beauties were going to cost), the tile company sent us a list of all the stars and celebs who'd bought the very same tile. Bobby was on it. Joni Mitchell was on it. We would have canceled the order anyway, but the tile company refused.

So, anyway, we're in the bathroom, staring at The Shower. It was time to break up our chat so I could keep my body unseen until reconstruction. But whatever thoughts I had about mortality suddenly didn't seem worth the sacrifice of time I could be spending with a loved one. I decided it was time to forget about dying. It was time to stop insulting my husband's humanity. Just as he trusts me to love an imperfect body, I trust him to do the same. It was time for a good wash with a great guy.