day 25: backless is the new black

Waiting for the nurse to call me for the mastectomy and sentinel lymph node biopsy, I am hungry. I listen to my stomach grumble and growl, percolating away on bile juices. This morning we have already been to the radiologist, to have my breast injected with radioactive dye, then images taken of the lymph nodes as the dye spread and dissipated away from the cancer. The location of the sentinel lymph node, first and most likely to be infiltrated by cancer, is marked with a black marker pen, ‘x’.

The node is situated right over my heart, at the base of my lungs. I rejoice, in the mistaken belief this is a good thing. Surely this means the surgeon won’t need to cut into my armpit, causing a second and painful wound? For me it also reinforces that the mastectomy was a good choice. If the aim of surgery had been to cut out only certain lumps, the location of the node would have meant an additional crevice in an already pock-marked landscape.

Despite several attempts standing in front of the mirror and squishing my left breast out of the way, I can’t really imagine what the mastectomy will look like. The Scar Project images helped for sure, but I wonder what craggy, curvy kind of scar the surgeon will leave on me.

Nurses keep coming in, asking if I need anything and explaining the hospital processes. I wonder what it’s like for men with prostate cancer, whether they too experience a web of supportive nurses like clucking hens bustling about them, fluffing, flapping and fussing.

I prance around in my navy backless hospital gown, proclaiming ‘backless is the new black’. Once the second mastectomy is complete in a matter of months, I will never have to wear a bra again. I can’t imagine the freedom of this, but I can imagine a wardrobe full of backless numbers: backless t-shirts, dresses and smocks draping elegantly.

My father looks deeply into my eyes, his own welling with tears, and suggests I cool it with the bravado. But strangely, this isn’t bravado. I am ecstatic, as if all the processing in the last three weeks has freed me to go with the flow for a change.

My friend A- is a theatre technician at St Vincent’s Hospital. She has wide rosy cheeks that radiate when she smiles, kind of like Santa Claus in a blue surgical uniform. She comes to walk me down to the pre-op room and I meet the scrub nurse, anaesthetist assistant and finally the anaesthetist, with rugged sporty good looks and that gray hair men get when they are called ‘distinguished’. I am guessing all the straight girls are a little bit in love with him, and he’s a little bit in love with his job. We discuss the state of my health and he jokes around, sharing out his charm freely with perfect patient and nurses alike.

Eventually Dr S- comes in, wearing a surgical cap made from bandanna material you’d expect to see on a Harley-riding Outlaw at Alstonville pub. She draws a purple arrow on my left breast.

“Just to make sure I get the right one.”

I giggle, then realise she isn’t joking.

“So isn’t it great the sentinel node is all the way down here?” I say, pointing to the x-marks-the-spot above my heart.

“Well actually it’s not that great for me,” she says. “Firstly, I will probably need to go through your ribs to get to it, and secondly it’s right next to your heart and lung. So we could end up with a pneumothorax or a whole bunch of other complications.”

I wonder if she has a backup plan, but after 30 seconds of silence I realise there’s no other option. I am guessing pneumothorax means a punctured lung, not a great option for someone who has smoked for 25 years.

“But you’re the best surgeon on the North Coast, I told everyone in my blog… You’ll do a great job. It’s going to be ok,” I say.

Surgeons perform well under pressure, right?

“Hmmm…Ok… That settles it then… Are you Ok in here on your own for a while?”

She seems to have made a decision, and I wonder if this is the kind of thing she will discuss with R- before commencing surgery. R- is on strict instructions to do her best to make the decision I would make, and not be influenced by everyone else. I imagine some tasteless 1980s hospital drama unfolding in the corridors of St Vincent’s Hospital Lismore.

****

About two and a half hours later I wake in extreme pain, tears flowing from my eyes. Nurse A- is here with her beautiful smiling cheeks and hands me a mobile phone just as someone pumps my cannula full of something warm. I am carried into a fur- and feather-lined nest of softness. R- is on the end of the phone, incredulous that we are speaking already.

Nurse A- says “I saw your heart beating,” and I feel so safe and cared for. I find out later that A- has been doing her job as well as keeping my girlfriend and parents informed the whole way. Sometimes angels just arrive in your life and all you can do is say thank you.

Up in my room a little later I sit up and take the plunge. I look down and see that the scar is fairly high, coming out from under my armpit straight and clean as if it was done with an ancient Japanese katana. My chest is flat, no lumps, bumps or south-park-style foetus growths. There are no alien life forms pulsing through the cavity. It looks, in a word, great. I feel beautiful and powerful as an Amazon Warrior.

I am so relieved I want to run and jump and shout for joy, but at the moment the narcotics they gave me have sway and I spend the next few hours telling the nurses how stoned I am.

That night I wake in the small hours to the constant chiming of the nurses’ bell. I get myself out of bed, find my cup, strainer and paw-paw tea, and make my way down to the tea room. I peek into each room on Ward 3, and my heart goes out to those stockinged pairs of feet and ankles, their ageing skin marked with sun spots; unable to get themselves up, to the toilet, out of pain. I am so thankful for my health, mobility and independence.

In the tea room I learn that I can’t yet hold a full kettle with my left hand, nor open a hospital door.

****

The next day I wake early and sit on the balcony as the sun rises over Lismore and successive parents pull up at the child care centre across the car park with little bundles of energy in their backpacks. The first to arrive are the nurses’ children, then the construction workers, teachers and finally the mums who stand chatting together and laughing out loud. I am amazed that most of the children walk straight up to the gate, eager to get inside and play. The early childhood workers are on at full volume from 6:45am until 7pm that night. Now there’s an undervalued profession.

That day I receive eight bunches of flowers and 12 visitors. I feel so loved, nurtured and held by all these big hearted women. The elated feeling continues and I wonder whether it’s not just the happy post-op hormones; whether all the processing has been done and everything really will be ok.

There’s a nurse in the room every hour; a nurse for every possible function. They are amazing:

• checking my blood pressure and other vital signs
• offering pain relief
• being kind
• acknowledging my relationship with R-
• being friendly and getting to know my family
• cleaning the room and my bathroom, which makes me feel safe
• consulting on my difficult diet
• showing me how to use a ribbon to hold up the drain so I can use two hands in the shower
• understanding, putting a hand on my foot or leg in camaraderie
• contacting the surgeon
• arranging the physiotherapist
• smiling, helping and caring.

Dr S- flies in at 6:15am, back in her 1950s retro femininity and wearing a Wonder Woman cape. She checks the wound and is pleased with her handiwork. She says the next step is the test results and our meeting next week once my case has been reviewed by a multidisciplinary team of oncologists, surgeons and specialist nurses. She cranks up her invisible jet and speeds off. I know she will work tonight until at least 6pm because that’s how late I have stayed in her consulting rooms going through my dramas. Respect.

M-, the Specialist Breast Nurse visits too, and sits with me both mornings on my balcony. She explains that there will be a physiotherapist referral to help prevent lymphodaema, and insists this is the best time to rest, before the results of the tests are known. I tell her that it feels like the hard part is over for now, that I am so surprised to be feeling good, better than I’ve felt in a long, long time.

“It was so excruciating watching you making the decision…I remember seeing that fear in your eyes…yes, I think that was very hard for you.”

Again I feel like I’ve made it through a test or initiation, as though I have been chosen for some spiritual journey. With all these women around me, the anticipation, the surgery and pain, the ecstasy of coming through it; it’s a rite of passage into another realm of humanity.

“But there’s a bad day coming,” says M-. “I want you to be ready for it, and when it comes, go with it. Be easy on yourself and just let it happen. No matter how bad it is, it will pass.”

I wander through the halls and find an exhibition of the nuns who were once the only nursing staff of the hospital. 1930s graduates, row upon row, their beautiful pale faces look out at me with kindness and brusque efficiency framed by white nurse’s habits that stretch out past their shoulders. Three 1960s graduates are flanked by four men, too dangerous to be photographed alone. 1980s graduates with blue and red capes, wry smiles and naughty smirks liberated from everything but their nurse’s habits which have shrunk to a tiny white cap with wings.

Two days after surgery I am released and leave the hospital in a flurry of flowers. There are hugs and kisses with nurses I may never see again. As I walk to the elevator to meet my parents in the lobby, I hear the chime of nurse’s alarms pealing through the ward, and Nurse G-’s last wave is cut short as her head turns and she marches off to answer the call of another patient.