When the Black Dog Barks

After boxing 6,000 books, scrubbing floors in clouds of bleach, bringing in tiler guys, plumber guys, electrician guys and many others, the dear old lady is sold. She was on the market about a week. May she embrace the next family as warmly as she embraced us.

On Monday, my health insurance changed. So I convey this fact to the nice receptionist at my radiation oncologist’s office, the place where a gargantuan, white phone-like object beams rays at me every day. The receptionist asks: “And what is the phone number for Acme Health Insurance?” She is completely unfazed when I confess that I don’t have the number and didn’t even think to get it. She smiles. I may be a dithering fool, but she isn’t. She turns to her computer and starts browsing that Interwebs Thingy.

A few days later, I’m at the office of my medical oncologist. She works for a different agency than my radiation oncologist, though she’s located a mere four floors above him in the same building. Of course, mere proximity does not mean common access to my insurance info (thank you, Mr. Obama, for seeing the idiocy in this). I tell this receptionist that my insurance has changed. Being what as I’ve been just a little distracted lately, I still don’t know Acme’s phone numbers, just my own group and subscriber I.D. The receptionist stares at me, speechless at first. She, too, has a hulking big monitor on her desk but it sits unused. “I can’t do anything without that phone number,” she says. I don’t even tell her what I’m thinking: “I’ll just google this on my Iphone while you sit on your ass.” I recite the number for her. I’m too nice to even remotely suggest that I think she’s an idiot.

So, you see, even in a black depression, when I’m minutes away from getting what I presume is going to be some of the worst news I’ll ever get, I’m still a nice person. I know that I’m going to get bad news from my oncologist -- it only makes sense because I’ve had my allotment of good news for the year. With the contract on our house just a few hours old, it's now time for the universe to remind me that I am its plaything. This'll be a good time for chemo. With the house sold, I'll be able to leave beds unmade when I’m too sick to get out of my own.

My oncologist breezes into her office. “So, your Oncotype score came back. What would you guess it is?” I’m not sure why interrogating me in this manner is interesting to her, but I’m willing to play along. “Gray area,” I say. “The intermediate range.” And the gray area, I knew, meant chemo for sure. Then my oncologist lays it on me: “That’s what I would have predicted, too. But you are solidly in the low-risk range for recurrence.”

I feel the air rushing back into my throat. My first thoughts are of family and friends and how soon I can call or email them. My second thoughts are about The Bike, and how soon I can get back on it. My third thoughts are about plastic surgery and the tee-shirt I’ll wear after I’m finished with reconstruction: “Hell Yes They’re Fake! The Real Ones Were Trying to Kill Me!” My fourth thought: I’m going to see the kind of hair-stylist rich ladies pay for, the kind who looks at your face and says, “Oh, Madame, your nose is so short! With the right style, you will be the second coming of Grace Kelly.” After months of not cutting my hair because I figured it was all going to fall out anyway, I’m going to get it cut, colorized, and moussed to perfection. Or, you know, not. The bike is going to take a lot of my time for the next two months. And, the Sweet Gods of the Vine know, there’s nothing easier than a braid.

So what have we learned? I don’t know about you, but when I run into an old acquaintance who says they are suffering from some illness or tragedy, I say the usual platitude, because it’s true: “I can’t even imagine what you must be going through.” And if did try to imagine it, I’d get it wrong. Before I was diagnosed with a potentially life-threatening illness, I would have predicted that I’d stand up to it without any signs of depression. Oh, I expected to be a little downcast, but not depressed. I’m not the kind of person, I would have told you, who sees the black hole lurking in every fluffy cloud. Now I wonder what I’m really made of.

Winston Churchill called his occasional depressions his “Black Dog”. Brits are definitely the ones to teach us all a little something about putting that particular pooch back in his crate. Britain in the 1980s, when I lived there, was a poor place. At my first job, I made what was considered a good salary, but it was barely enough to keep a parakeet alive. The meager salary afforded me very little in the way of living quarters. I hated the tiny rooms in the tiny flat, the on-demand water heater that filled the bath while galaxies whirled. I hated our flat’s ‘nice’ wall paper -- Irish landlords and Indian restaurants have a lot more in common than you think. And then I bought a place, my first home to call my own! And things only got worse. There was no central heat. In the mornings, I dashed across the frigid hall from the warmed bedroom to the tiny bath where the on-demand water heater was the sole source of warmth. At least we didn’t have to put coins in the gas meter. That little feature of British life was spared us. The gas company trusted us to pay our bills.

But, on the whole, it didn’t seem so bad. I’d like to think that if I was a little more stalwart then than I am now, it was because of the British themselves, infecting me with their air of gratitude. For almost anything. Put two sugars in their tea and they start glowing with delight. At my office, the tea ladies would come around every morning and afternoon with a trolley loaded with Digestive and Rich Tea biscuits. My co-workers would become unreasonably excited, especially given that they’d rarely take more than a single “biscuit”, if that. Brits back then didn’t over-stuff, though I hear young Brits are getting that habit. Anyway, though I found my new mates just as repressed and reserved as they were famous for being (hey, not as bad the Finns!), they had a real talent for feeling grateful whenever there was even the slightest glimmer on the horizon.

So I think I know something about counting one’s blessings. But if that doesn’t work next time the Black Dog barks, I may turn to pharmaceuticals.

Stopping by Pots on a Sunny Afternoon

The house has been on the market for three days and we've had three lookers. And you know the worst part? The fear. The fear that there's no upside to having three lookers. That in this economy, we're all simply doomed. My mother, ever helpful, told me that one of her bridge cronies had prospective buyers by the coach-full, but no one ever made an offer. These particular cronies closed up their house and moved on.

But next to the anxiety, I have hated the shopping most. Endless rounds of tchotchke hunting; endless trolling for the Perfect Little Thing that will show the house off to its best advantage. And there were repeat visits to Home Desperate for duct tape, paint blades, window cleaner, grout. Sweet gods of the vine, I'm sick of it. Sorry to sound so negative! But, as I gazed out at a cluster of pots, thinking I'd buy one to smarten the garden up with, I could only think, "One day, they'll all be cracked."

Speaking of crack-pots, my Famous Big Mouth has probably run off the only potential buyer we might have had. A few days before the house was scheduled to go on the market, I sat down to my laptop and quickly flicked through the emails from the neighborhood listserv, a Yahoo group for homeowners living in the Rosedale section of Austin. The rules for Rosedale are sensible: you can talk about home-ownership issues all you like. You can alert others to lost dogs and break-ins (which are rare) and another visit from the Phantom Coyote (Mike prays the Phantom will carry off the Shih-tzu). You can blather on freely about color-safe bleach and organic vs toxic pesticides. But please keep your mouth shut on anything relating to religion, politics, your small business, and anything you want to sell rather than just give away. I have strictly observed these rules all these years. After all, there are plenty of places on the internet to yak shamelessly on as if you were an NYT pundit.

Now, the better part of wisdom says to just be quiet when the rules are broken. But I was feeling a little blue on this particular Friday afternoon. The news had finally reached my ears that Royal Worcester, the manufacturer of Spode china, was no longer in business, that some ropey outfit in China was making my beloved Blue Italian. So I found myself responding to some local gas-bag's advertisement of a community meeting where we could all hear some famous social conservative talk about the "strengths and weaknesses" of evolution. The gasbag said that this would be good for "us" (by which he meant everyone but himself), since we were Austinites and clearly needed to hear other points of view. Almost before I could engage my conscious mind, my fingers flew, writing, "What a pity I won't be able to come. The Flat Earth Society is meeting at the same time." I hit SEND.

Before I knew it, I was engaged in a bit of an email altercation with a gasbag defender. I was very polite in my response. Just as I hit SEND again, I noticed an earlier email from the defender. Apparently, she had a client who wanted to see my house. Balls, I thought. I hadn't realized that she was a realtor. And, no, she's never brought this client around to see the house. So, you see, that was the guy who might have a) wanted the place and b), have had the money to pay for it. And I royally ticked his realtor off, who has no doubt informed him that the house has a cracked slab, Africanized Honey Bees, and three previous suicides.

******

A few weeks ago, NPR asked listeners to send in their suggestions for what the current economic crisis should be called. I was a little taken aback by how unexciting the suggestions were. "The Second Great Depression"? "The 00 Recession"? I mean, I realize that NPR can't take the liberties that a Jon Stewart can take ("ClusterF**k to the Poorhouse"). But surely there's something a little livelier to be said? Economist Paul Krugman, writing before the recession started, suggested the next recession be called "The Great Reckoning." Dull. If my mother had a vote, it would be called, "The Great Boomer Smack-Down." That's better.

But because I'm a little bit depressed and therefore inclined to look no further than my own ego, I call this recession "It's Time To Give Sherry a Good Pooching". The current recession is -- wait for it -- a bit like going through chemo. And, like chemo, you may end up dead before the cure kicks in.

On that front (do stop and take a nip of gin if all these vertiginous segues are starting to get to you), I have no news. I should know by the end of next week. Or, you know, not. While waiting for the last test to be completed, Mike and I gradually perfect our plans of what we'll do if chemo is indicated.

A neighbor has a small apartment she could rent to me for a couple of months, just four houses down from where we live. It may sound crazy to take on a third property while all this is going on, but it's even crazier to live in our beloved house while trying to sell it. I can't so much as bite a cookie for fear of crumbs, or brush a dog for fear of hair. I need to be in a setting where my kid can finish middle school and I don't have to deal with people any more than I'm inclined to and where I don't have to get out of bed if I don't have the energy. The idea of going up to New York while my kid lived in Texas with her gran has fizzled. Keeping Mother mentally organized enough to handle the job would become, for me, as odious a task as making beds and dropping to my knees like a nun to bleach the bathroom floor. If only I had a clone of myself to do the job of being me while I went on holiday for a couple of months.

If the house sold quickly and solidly, I would stay in it until school is out, grateful for the extra time together. And what a lovely time it's been. We brought our 3-year-old into this home, 11 years ago. I knew it was the right place for us on the first night in the house, as I carried her down the hall to put her to bed in her new room. Right outside the door to her bedroom, underneath a dingy carpet we replaced as soon as we could, there was a reliable creak. Nowhere else in the house was there such a noise. Step on that one spot a few inches from the obvious 'Child's Room' in the house, on whatever kind of day it is, humid or dry, and you get a creak, the house's little sigh of contentment. At least a dozen parents before me, also checking on their sprats in the night hours, were doubtless the cause of that imperfection. Others have been here. Please add your own weight.

I need to remember that little creak in the floor as we go house-hunting in the months ahead. I'm sure I'll again be tempted by a property that's spanking new. Years ago, we had a large Queen Anne on the edge of the Blackland Prairie north of Austin. Built of cypress, with a dozen gables, it had been beautifully restored. All the original molding, the golden pine floors, were intact. But the time came to sell -- the commute into Austin was killing Mike -- and there was a frenzy then, too, to get it ready. Old homes require a lot of maintenance, which we had not kept up with. Nearly every surface needed painting. The black clay of the prairie is hard on pier-and-beam houses and there were hairline cracks in the sheet-rock, every one of which had to be filled and repainted. Gormless buyers came forward and withrdrew just as the season was coming to an end. Thoroughly pooched, we stayed in the house another eight months, fixing, and filling, and painting. When at last a buyer who wasn't a feckless idiot came forward, we fled to a new home in Lakeway.

And started loathing it almost immediately. There was simply no there, there. And the people next door, an older IBM exec and his trophy wife, were not our kind of people. You could sense their disdain: "Democrats," they were probably thinking, with a sneer. The house seemed to sneer at us, too. Instead of feeling the lives of families before us, we felt only a builder's lame sense of design and his lust for cutting corners. There was no trim around the windows. The doors were hollow like papier mache. I must keep these memories fresh as I feel myself yearning for the spankingest new house on the North Shore of Long Island.

Must resist the shiny new object. Must listen for the creak in the floor.

Going Fetal

My mom has a serious love for this economic crisis. As she sees it, her kids have spent like sailors instead of living like the virtuous sodbusters she knew in her own youth. And she’s ready, so ready, for “the good Lord” (in whom, it must be noted, she does not really believe) to show her kids and the rest of their wastrel generation that Paybacks are Hell. No more lattes. No more organic beef. It’s time to load up the wagon with Grandma in the back. If we git hungry, by golly we can eat one of the dogs. And maybe soap’ll go back to being a nickel a bar.

So at least there’s one American out there who is having a ball.

My blithe heart, on the other hand, has pretty much collapsed under the weight of Cancer Anger. The anger appeared suddenly when my oncologist cleared up a little misunderstanding. When, a few weeks ago, she said that chemo was a definite, should I be positive for a particular marker, she didn’t mean to imply that there would definitely be no chemo if the reverse were the case. When I got the negative report, I clicked my heels in the air and got back to the business of life. The only niggling worry was the way my oncologist sounded when she left the message about the HER-2 report on the phone. She didn’t sound happy.

By the time I walked into her office, I was half expecting her to say what she did say. “Your case is still under review”.

A few days later, I met with my radiation oncologist. I knew he’d be the one to tell me what the docs at the tumor board had decided. I could hear him out in the hall, talking about me. He was referring to his colleagues as “mental masturbators”. He swept into the office, sat down and drew a breath. I drew a breath, awaiting their decision. And here it came: LET’S RUN ANOTHER TEST!

Why all this ire and no decision? There is concern in the breast cancer field that low-risk cases are being over-treated. And there’s the background radiation of collegial disdain: surgeons don’t like oncologists and oncologists don’t like surgeons. Radiologists don’t like anybody. But surely, I found myself thinking, they can put their entrenched positions aside long enough to make a decision about my care. Or maybe it’s time my lead oncologist just brought the hammer down and told them what she was doing. I’ve served on committees, too, and I recognize the signs: you ask for more data because you hope it will stop the argument.

This next test is the new hotness in tumor analysis. In post-menopausal women with stage 1 disease, the Oncotype DX test has been proven the best predictor, so far, of recurrence. But the test is not binary. It has a big fat gray area. I called my primary oncologist and asked her what she would recommend if the test came back in that gray area. I didn’t like her answer at all. Unless I was solidly in the low risk range, she would recommend chemo, partly because of my pre-menopausal status (still a lot of estrogen kicking around in my body) and partly because the test itself is only verified for post-menopausal women in large, randomized trials. No oncologist expects the trials on pre-menopausal women to yield very different results, but it adds extra uncertainty.

So I’m braced for chemo, because my case has been nothing but gray areas. One pathologist grades my tumors at grade 1 and the other at grade 2. I’ve been as yet unable to determine what the recommendation would be if both pathologists agreed on grade 1. Would chemo not be recommended then? If that’s true, then why shouldn’t I just decide that Mr. Grade 1 is in the right?

Yes, I’ll be seeking a second opinion from a separate institution. Right now, I’m awash in second opinions from the same institution, with the exception of the low-scoring pathologist from the Mayo Clinic.

At a recent meeting of the newly diagnosed, I met a woman whose case was very like mine: pre-menopausal, stage 1, Estrogen positive and Her-2 negative. She had thought she was completely in the clear, when her onc decided to run the Oncotype DX test. Her score came back at the very high end of probability for recurrence. She’d tolerated the chemo well. Her hair was growing in nicely. She had emerged from the wretched Babushka Phase of treatment.

The probability of chemo has eroded whatever confidence I had in the future. I don’t think I can face wearing a scarf. Nor a head-tie, or a gimme cap, or a wooly. If I find wigs too hot and scratchy, maybe I’ll wear a burka and pretend to be a member of the Taliban. If I can stand a wig, I want a red one, so I’ll be mistaken for Nicole Kidman. I don’t want to look like what Betty Cracker described as “that crazed fetus, James Carville.”

But fetal is definitely how I feel.

And could the timing be worse? My husband works thousands of miles away. I’m getting my house ready to put on the market. That market is crappy but just buoyant enough, I’m sure, to mean that any potential buyer that does emerge will, unfailingly, want to see the house 12 hours after any infusion. After eight visits, the buyers will disappear into the night, without making an offer. Meanwhile, Jesse’s band director, a malicious sadist, will schedule even more competitions and performances, to which I will have to drive her.

It’s no good telling me not to be shy about asking for help. I don’t want to think about the help I need or who to ask for it. I want Mike here. I want him working here. I don’t want to be thinking about selling and moving or, worse still, moving and not selling. Living in a tiny rental without A/C was fine for a summer, but living in any place that’s not mine would be brutal coming on top of everything else. I could deal with any two of these problems, but not all of them at once.

So something’s got to give and I’m mulling over alternatives. I could pay my mum to stay at my house for two months and look after my kid (taking her out of school early is not an option) while I go ahead and move to Long Island. I would start treatment in LI. My mum would of course do this for free, but it would be a huge commitment of her time and she could use the cash. Also, it’s not good to over-indulge her feelings of martyrdom. In her mind, she’s already Mama Joad in the back of a broken down Model-T. Excite those longings and she’ll be underfoot forever. Paybacks really are hell in the Coldsmith family.

I could possibly delay treatment. Hell, what’s two more months? I don’t know how long the delay between radiation and chemo normally is. The way my Rad Onc talks about it, radiation is a day at the beach. He accepts that I feel tired, but feels that exhaustion is more likely a reaction to the full spectrum of what I’ve been going through.

The downside of delay is that I’d be starting treatment at what should have been a happy time. Whether it’s a spruced up house of our own or a dumpy rental, we’ll be reunited again after a year of separation. Plus, my kid will be very stressed and very needy. But just as I’ve been largely ignoring her for the last few weeks, I’ll be ignoring her again while I have chemo.

My illness has, sadly, brought out the Coldsmith in her. My dad, never sick himself until he was claimed by dementia, had little patience for the ill health of other adults (kids were and are for me too, entirely another matter). His favorite line, upon hearing that some adult close to him was ill, was, “Call me when you’re better!” And he never asked for more sympathy than he was able to give. Doubtless, his attitude made dealing with a semi-bi-polar and somewhat neurotic woman a little easier. Resist, he must have thought, or they’ll suck you in to their own bottomless despair.

My daughter, tired of my whining about all the work our house was requiring to get ready for sale, said over pizza that, “Lately, Mom, you’ve been moody and unpredictable and you haven’t smiled in weeks.”

Funny, I thought. That’s exactly what I would have said about her. “Baby, I’m just a little stressed what with the medical issues and all.”

She rolled her eyes. You could tell what she was thinking: Not the cancer card again. I thought about mentioning my terrors about the economy, because that’s her second most hated subject these days. Must be calm, I told myself.

I patted her hand, said I hoped she would forgive me.

Let me whine a bit. And please forgive.

Taking Advil on Dover Beach

Radiation is not so bad, just grueling. The room is too cold for the patient, who must lie still while others move around. The arm brace stretches my shoulder a bit, so that I have to follow the therapy with Advil. And you have to sit around waiting, waiting. Usually I forget to bring the newspaper (or I remember to bring it but leave it in the car), so I end up having to read some inspirational cancer rag: Mandy Patinkin says cancer is the best thing that ever happened to him. My name is Inigo Montoya. You killed my father. The grief made me an idiot.

So, no, cancer is not an occasion for joy. I want to be stuck in a time-warp before I was ever diagnosed.

Years ago, my husband talked me into reading some of his favorite poems. This has ruined me. Now, a bunch of Great Writers have preempted all my thoughts on my own experiences. Whenever I try to formulate what an atheist, particularly this atheist, might see as the upside to a recent diagnosis of breast cancer (low grade!), I find myself giving up. Because Matthew Arnold, writing in 1860, has already said it all:

Ah, Love, let us be true to one another! for the world which seems
To lie before us like a land of dreams
So various, so beautiful, so new
Hath really neither joy, nor love, nor light,
Nor certitude, nor peace, nor help for pain;
And we are here as on a darkling plain
Swept with confused alarms of struggle and flight,
Where ignorant armies clash by night.

My daughter finds something depressing in those words, but I find such a solid measure of joy in that first line, it sustains me for the rest of the poem: "Ah, Love, let us be true to one another!" That's all there is. The universe is just one damned thing after another. If you are dealt a terrible hand, the deuce of clubs and the four of spades and some trash to go with it, it means nothing. NOTHING. But we can still be true to each other (exclamation point). The message really isn't so different from that you can hear in the more mystical practices within many religions, particularly, Christianity. In other words, God is, well, God. Try not to take it personally.

And when you have no luck at all, when you find out about the cancer inside or the loss of a loved one, it doesn't mean that those fortunate others, the ones who look on you and count their lucky stars, are more beloved by the universe. And, really, it could have been worse. Think of all the young people who died in crashes and wars while still not out of their twenties. I could have died screaming like my great grandmother, because evolution cursed her with a 10 pound fetus when her hips were only so big. Or like my great great grandfather who died in his youth, fishing off Nantucket, trying to feed his family. Cancer at 53? The universe does not even blink. But I am still here to ponder the one, the only commandment: "Ah, love, let us be true to one another!"

And at least the world offers a little more "help for pain" than when Matthew Arnold was alive. Now where is that Advil?

Safe as Houses

This house is not presently for sale, on Long Island, or anywhere else:


But it's a fine example of the sort of thing I'm looking for. Or wish I was earnestly looking for.

Let me back up.

Last November/December, The Fates decided to hand me a lemon with the whole breast cancer thing. Then, someone must have told the Fates that I'd soon be looking to sell my house in Austin and to buy something on Long Island. Intrigued, the gods wondered if there was any way they could add to my miseries. Clearly, they could. They sent along a couple, new arrivals to Austin, who begged my realtor to show them anything, anything in Rosedale that had four bedrooms. My agent didn't pressure us at all to show them our house, which we hadn't prepped for re-sale and certainly hadn't listed yet, it not even being Christmas. But I ignored my inner voice and let the couple come around to see the place. Five times. For several hours on the last visit. Mike joked that this very enthusiastic couple was enjoying his house more than he was. I, patting myself on the back, thought we had some serious lookers here. Being spared all the effort it takes to get a house ready to sell would be some tiny compensation for what I'd been through. I sighed with relief. I could enjoy my last months in Austin riding my bike whenever I could. And I was looking forward to picking out a new family home on Long Island.

When the couple finally made an offer, it was for almost 200K less than the asking price. We politely refused that offer and the next one, a mere 100K less than we were asking for. Finally, the buyers met our bottom line price. They signed a contract and forked over the laughable option fee. As it turns out, they were just wasting another week of the valuable real-estate season. When it finally came time to cough up real money for an inspection, they pulled out of the deal, claiming that something had suddenly come up. But in a classic example of a Freudian slip, the couple revealed that they hoped to get the house for their original price, later in the season.

So now I'm back at the Wee Cottage in Huntington, tooling around with a realtor on Long Island's North Shore, looking at houses with no real relish. Who knows what will still be on the market once we've finally spruced our house up and sold it (not to the aforementioned Fiends from Hell.)? Best not to fall in love with anything. But by not falling in love, I can at least enjoy being an anthropologist, observing the natives in their habitat.

And let me tell you, the natives are inordinately fond of crosses. Being the result of a typically Protestant upbringing, I've always been slightly embarrassed by the sight of a crucifix over the bed that husband and wife occupy. What is that little bit of symbolism about exactly? There you are, walking into a couple's master suite, not thinking about what must sometimes go on in there, and one of those things stares down at you and you're suddenly wondering why they have to put it there. What are they trying to remind themselves of? It seems to be saying, "Don't over-enjoy, darling, this too shall pass." The first house we visited, instead of having some delicately formed little cross above the marriage bed, had a hulking, yes, lurid, example of the form. Christ Twisted in Agony. I all but blushed.

The next house had crosses in every room, some with the body upon them and some without. What, are the home-owners worried about wandering into the kitchen to get some mustard and suddenly forgetting what their most profound beliefs are? I don't get it.

Anyway, in one of these houses, the owner was fond of crosses and dogs. The agent was anxious that the dogs, small but vicious little ankle-biters, would be loose. Fortunately, the dogs were locked up, but there was an oil portrait of them in the main hall. I mean, a nice oil portrait. Two yorkies and a chihuahua, in muted, earthy tones, were hung next to Jesus.

But one thing I can really appreciate is the abundance of in-home bars. A 'bar' is some piece of furniture or cabinetry, at which there is elevated seating and some clear indication that more than just coke is served. I've always felt that a shelf in the kitchen is adequate for the storage of the gin we occasionally enjoy, the wine we buy as needed, and the armagnac we get every Christmas, but clearly I wasn't thinking big enough. Most houses we visited at least had a wine rack in the kitchen or a wine refrigerator or both. Fully half of them had a bar in the family room or in the basement. One house had two bars in the family room, one in one corner, and one in the opposite corner. "One for wine and one for beer?" I thought. You could seat about four people at each bar.

God, dogs, and drink. Long Island may be without mysterious crewes and voodoo cults. It may not have a Willie Nelson or any flying saucer devotees. It may not have irritating Whole Foods fans who drink liquidized weeds for breakfast. It may not be, you know, weird, like Austin. But it's possibly weird enough.

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.

Don't Parton Me

"Lures slung around her neck," wrote Germaine Greer of the human mammary gland. Anthropologist Marvin Harris wrote more or less the same thing, speculating that the human female has larger breasts than other primates because human males, preoccupied with cave paintings and interesting piles of dung, won't man up for just any ordinary pair. Big boobs are the two-by-fours of human reproduction.

Or not. I really have no opinion on how the human breast got to be so large. I just know that for many of us, the size is over and above the demands of mere lactation and pleasurable sensation.

I knew that at the start of this breast cancer journey,that I would probably have one, maybe two revelations that would come as a complete surprise. The nature of my revelation begins some six years ago, after my return from a spectacular vacation in England and Wales. On the first day back, I made the as-it-turns-out helpful mistake of stepping on the scales. The dial whizzed up to an astonishing 177lbs. On that 21-day holiday, there had been much feasting, many steak-and-kidney pies consumed with many pints of bitter. Get me going and I can strap on five imperial pints of Wadworth's 6X before the night is out.

So, not too surprisingly, I'd gained a pound every three days while on that marvelous trip. This new peak in weight was the crowning moment of a long march towards obesity that had begun when I'd returned to work after the birth of my daughter some seven years before. Stressed and unable to exercise, I'd packed on pound after unhappy pound. Jeans got too tight and then were discarded entirely in favor of nice, roomy chinos. To this day, I keep one dress from this period, The Tarp, as a chastening reminder of the whole process, a process that often had me looking in the mirror, and wondering where I went. I recognized the face, but nothing else seemed to belong to me.

But thanks to a kind spouse and a benevolent employer I returned from England, ready to go part-time. Seeing those unfamiliar numbers on the scales, I shelved plans to paint the house in my spare time and decided instead to get into shape again. I'd been a runner in my twenties and thirties. Where had that girl gone? As it turns out, I'm not cursed with a particularly fat-prone metabolism. All I needed was time on the bike. Within a few months, I'd shed the first 30 of the 47 pounds I needed to lose.

But nature is cruel. I lost weight from my face, my hands, my ankles, my fingers (I still wonder exactly where that first wedding ring slipped off, never to be found again). I even lost weight in a few places that clearly needed it, from a bum that, as David Sedaris' father would have said, was large enough to land a chopper on. But things weren't so happy in the upper hemisphere. True, I wouldn't have to buy my bras at Wal-Mart anymore, but neither did I dare attempt naked jumping jacks, lest I break my jaw. My knees were getting a break and were very thankful for it, but my upper spine, already curved from scoliosis, wasn't happy at all.

It never occurred to me that there were any options in dealing with the largely undiminished boob fat. I figured if I ever lost that last 17 pounds, my boobs would become something my spine was built for. Why I would have thought this is unclear, because I'd been buxom if not downright Partonesque ever since my teens. But, determined, I trained very hard for the Livestrong bike ride one year. I lost another ten pounds and was intrigued to note, again, how little came off the chest area. Just cursed, I thought. The very idea of a surgical reduction struck me as the sort of bourgeois self-indulgence that would get me hung when the revolution came. I didn't even consider it.

And now we return to that revelation that came with being diagnosed with breast cancer, be it stage zero or one. When I realized that I would have to undergo a mastectomy, I consoled myself with thoughts of a return to a perky pair. I didn't ever consider that I might just feel better with some of the weight gone. Even with the differential weight on one side, I feel stronger, less jiggly and ridiculous. At least on one side! Sure, I hate the scar. I hate the loss of nerve endings and I loathe the unnatural numbness that I suspect will always be there. I would never trade the healthy skin and nerve endings in the good boob for the lifeless concavity on the other side.

But in losing that one vat of jelly, I now glimpse, in those few hours of the day when I don't have The Blob stuffed in my bra, what it would be like to be normally proportioned. If you don't believe how much I'm looking forward to a further reduction, walk around with a five pound weight for a whole day, then walk around for an hour without it. You'll never go back.

If I could talk to that 49-year-old woman who'd recently done herself proud in the Livestrong ride, who was almost at her ideal weight but who still had to carry those swaying jugs around, I'd shout at her: "Get a reduction! Nature has done you no favors!" Big boobs may have been good for the species eons ago, but since the future of the species seems assured, perhaps now we could worry about what a bother these pockets of excessive flab really are.

(Though, thinking back on it, having a reduction just as I turned 50 may not have worked out. For my 50th birthday, my husband took us on another trip to England. I gained ten pounds in two weeks.)

I'm still awaiting pathology. I still don't know if radiation is in my future, or even worse, tho this seems unlikely. But I do know that more fat is coming off, with the help of a diet and a knife. I'll worry about the revolution later.

Which will arrive at about the same time I get around to painting the house.