day 2: choices
In the first 24 hours my online and interpersonal communication quotient increases by 300%. One friend, and then another, responds with love, hope, and offers of help. I tell them it’s Ok to share the news, which means I only repeat the story three or four times. I go down in history as the first woman to give thanks to the speed and efficiency of the Lismore lesbian lightning communication Network.
R- picks me up from work and we find the surgeon’s rooms for the four o’clock appointment. I fill in the usual form, and we discuss the daily minutiae. R- had a successful fitting for a new pair of shoes today, we’re both starving for dinner, and I would really love to get to my yoga class at five-thirty.
30 hours after the diagnosis, R- and I are shuffled into the rooms of Dr S-, another female and the most highly rated cancer surgeon on the North Coast. Her pink knitted sweater and the blonde bob curling around her face signal a resurgence of 50s femininity that is miles away from my own. Along with us is M-, the Specialist Breast Nurse. Her job title supplies the punch line for the next few days of interaction with the Network.
Right now we are paying close attention to computer screens showing the cancerous culprit, the invasive ductal adenocarcinoma. She shows me a picture of it, nasty white cancer cells busting out of the breast duct like a furious facial pimple just squeezed.
I learn that there are several weapons in the cancer battle armoury:
1. Surgery – breast and armpit
2. Chemotherapy
3. Radiotherapy.
Dr S- lists these on a pad which has already been printed in pastel pink with a set of breasts and armpits on one side, and a cross section of a breast on the other. She draws in the lumps that need to be removed and notes their dimensions: one is 19 x 14 x 8 mm, the other is 25 x 15 x 16 mm. This seems extremely large to me, and I have a sudden high school English class flashback to The Merchant of Venice and Shylock’s pound of flesh.
Dr S- outlines two surgical options. The first is a lumpectomy plus radiation, removing the sentinel lymph nodes. This sounds reasonable theoretically, when it’s disconnected from my own skin, flesh, blood, and wounds. In this scenario, she cuts out the two lumps, including a zone of flesh around them to ensure a ‘clearance zone’. After surgery they test the lymph nodes and the removed flesh, and determine whether further surgery is required, or whether to move on to radiation.
She pauses and looks directly into my eyes, her own large, round and crystal blue.
“It’s important you understand that we will be taking quite a bit, you will definitely be able to see it. There will be a scar for the lumpectomy, and one for the lymph… we will need to take some of the skin then sew it back together.”
She talks about things that can go wrong. The flesh can stick to the chest wall as it heals. Puckering. This time it’s Frankenstein that pops into my head, and the word ‘disfigured’. I realise that my main concern is not my health but how I will feel about how my chest looks. Just when I had fooled myself into believing there was some depth to my character.
I haven’t visualised this meeting at all. I haven’t imagined the kind of options we discuss, instead I have been focussing my attention on just keeping it together to get to work, following up emails, writing reports, responding to phone calls. This morning at work I facilitated a networking event for 40 people.
“Your second option is a mastectomy plus reconstruction, although I am not in favour of immediate reconstruction. We may need to do a range of other treatments…”
Mastectomy. The image in my mind is from some horror film where a husband performs the operation on his wife in some nineteenth century kitchen job without anaesthetic, a huge serrated scythe in his bloody hand.
Dr S-‘s voice fades to a distant pulsation, like we are under water. One part of my mind is screaming like a terrorised teenager in a b-rated horror film. I notice another part of my mind slide away out the door, saying ‘Ok, yeah, I’m out of here, that was WAY too much.’
***
Functioning on pure adrenalin and in perfect patient mode, I get through the rest of the appointment. Either choice could lead to chemotherapy or radiation. There could be more surgery. The surgery and tests will tell us more. She has two dates available, and I book in for the earliest, just six days away, on Valentine’s Day.
R- asks some questions but I just want to get out of here. We’ve only been digesting this for 24 hours, is there any reason we can’t slow down?
“You don’t need to decide everything now. You can choose to change the surgery to the other date, on the 28th, and you can change your mind about the type of surgery right up until the day before you come in.”
But I’m not engaged anymore. My yoga class starts in 35 minutes and they are NOT going to stop me getting there. Perfect Patient thanks Dr S- profusely and waits patiently to pay her bill. R- heads down with the Specialist Breast Nurse to get me some kind of information kit from the Breast Cancer Network that outlines my choices.
Once she’s gone I am sent down to Hospial Admissions to fill in more paperwork, the same forms and information I’ve just given upstairs. This takes another 12 minutes. I interact politely with each of the nurses and administrators, and feel my yoga class slip away.
R- drives us home as I cry and cry with the rain pouring down the windscreen. She holds my hand all the way, and when we get there she tells me she won’t let me down, she will be there with me through this, and she wants to be my main support person. I cry into her arms and she holds me through the night.
