Having cancer is similar to reading the newspaper. The worst is waiting to happen. Each morning glancing through the New York Times, I’m reminded that the threat of annihilation is breathlessly waiting for expression. Underground volcanoes might erupt, asteroids might hit our planet, terrorists could destroy our cities, the West Nile and bird flu is coming our way, Iran is building missiles, North Korea might send them, the local sociopath just broke out of jail, etc… but somehow we carry on with our day.
One night this past July, I take my usual shower and my usual look in the mirror, and began to wonder. Why did my left breast have a dimple? This had been going on for some months now. Was this some whimsy of my ageing body, or could it be… I Google. Sure enough! A breast turning inward is one of the symptoms of breast cancer.
I quickly got into bed and lay on my back. I felt my left breast. There was a lump the size of a quarter. I felt my right breast. Nothing. I flattened it. Nothing. I tried to flatten my left breast. It stubbornly refused. The lump grew to the size of a golf ball in my mind. I was in trouble. Yet it was 11:00 o’clock at night. There was nothing I could do. I went to sleep.
The next morning I had my power drink, fed and walked my dog Ruffy and ran to the telephone.
“This is an emergency, “I said. “Can I see Barbara today?” One usually can’t get an appointment for months. This was a Friday.
“She’s not here,” Angelina the receptionist said. “Can you come in Monday at 12:15?”
“Sure,” I said.
“When were you here last?”
“Ten years ago.”
#
At noon, Monday I’m outside what I thought her office. There’s no usual brass sign. Barbara must be so well known now, that she doesn’t need identification. Either that or her practice has become a secret society. I push at a likely door and find fifteen chairs filled with well-dressed well-groomed nonchalant women waiting. About eight plaques were on the wall naming Barbara Edelstein as one of New York’s best doctor’s of various years.
“You look just as beautiful as years ago,” I said, as she enters the consulting room. She seems unimpressed.
It was the truth. She’s beautiful, but in a different way now. There had been radiance about her. She had looked like a socialite. Today, she looks softer and more worn.
“Why haven’t you come sooner?” She asked touching my skin.
“I thought I would die of a heart attack not breast cancer,” I said.
There was a ladylike snicker as if to say: “You fool.”
“Can you feel it?” I asked.
“Yes.”
“What is it?”
“Don’t know yet.” She walked out of the room.
After a mammogram and sonogram, I go back towards her office. At her door I blurt out, “Whatever you have to say, I want you to know I have the utmost faith in you.”
“It’s definitely cancer,” she said. “Do you have a surgeon?”
Now my left breast feels like a bowling ball’s in there.
Outside the world seems the same; I’m the same; but also not…. in my chest an uninvited Visitor has been freeloading and for it the party’s over.
The day I saw Dr. Swistel was a seething hot August afternoon. In the taxi I clutch my manila envelope of radiology pictures. Betsy Ann is with me. She survived a close call on 9/11. She was in the 9th building, the Marriott and managed to escape before it crashed. I figure she would bring good luck. However, she just started a new program of anti-depressants and is talking non-stop. She brings a present for me.
“Do you want it now, or later?”
“Later,” I said.
The waiting room is large and cool and pleasant. Betsy Ann and I sit by the magazine rack and begin reading. Betsy Ann talks and reads simultaneously. We sit across from a lovely young buxom woman. She oozes sex appeal and youth and the good life. She is wearing a light green dress and a chunky diamond wedding ring. Her radiology pictures lay in a manila envelope in the chair next to her. After about 20 minutes she starts loudly complaining that it’s a half an hour after her scheduled appointment. She’s the mother of young children that she must attend to and can they get on with it. Soon, she is ushered into the doctor’s inner office.
“Do you want me to cause a fuss?” Betsy Ann asked.
“No, no,” I said. “It’s okay.”
Betsy Ann’s monologue resumes. And then after about ten minutes:
“Do you want your present now?” Betsy Ann asked.
“Sure,” I said.
She brings out a plastic sandwich bag full of little black things from a small purse attached to her waist.“These are licorice Scotty dogs,” she said. “You can bite their heads off and then finish the rest. See…” She gives a demonstration of the decapitation, and then wolfs the main body.
“Gosh,” I said.
#
I sit on the exam table and Betsy Ann continues talking. She’s going on about her animals. She has a little puppy bought on a whim at a puppy store. It’s a nervous maltese who she calls Kingy. Kingy gets pieces of food that Betsy Ann has for her meals. These leftovers are tossed onto the bed. Kingy being a small dog leaves half of it. The other pet, Twingy, is a big black cat that has a “condo” in one of Betsy Ann’s closets. She rarely leaves her abode but when she does she chases Kingy around and around and around. The variations of this theme are the topic of Betsy Ann’s monologue.
The office is a small room and chilly but clean and brightly lit. I have the distinct impression I’m on a glass slide they put samples to be viewed under microscope. It’s getting difficult to concentrate on what Betsy Ann says now. Her voice is becoming metallic and seems to radiate from a great distance.
With the very pregnant doctor’s assistant we go through the whole routine of questions and then she palpates my breasts. My breasts haven’t had so much activity since when I was married.
“It’s in a hard place to find,” she said. .
Whilst she and Betsy Ann discuss pregnancy I feel smaller and smaller and colder and colder. After determining the gender, the birth order, the approximate date of birth and how the husband was feeling about the baby with Betsy Ann, the assistant said:
“Dr. Swistel will be with you shortly,” and left the room.
‘Yeah, and so will Christmas,’ I thought.
Betsy Ann is silent. I take another look around the room. It feels like a prison.
And then the door flies open and a man of medium height with a mustache, glasses and bow tie blows in followed by a woman in a white coat. He looks like Harry Potter might if allowed to grow up.
“Hi,” he said,” I’m Dr. Swistel and you’re…” he glances at the folder he carried in his hand.
“Marian Hailey-Moss,” I said. “I’ve heard from everybody what a wizard you are.” I immediately like him. He’s warm and personable. He even looks me in the eye.
“Yes, well, “he said. “What seems to be the trouble?”
“I have this bowling ball in my left breast.”
“Let’s see,” he said and sets down the file. He starts that palpitating again. “Hmmmmm….”
Then he sits at his desk and opens the file. Did the radiologist take a biopsy?
“No,” I said. “After the mammogram and sonogram she said it was cancer.”
“Well, whatever it is,” he said. “It shouldn’t be there. I want you to get a biopsy, and we’ll go from there. You’re in good hands,” he said as he disappears on out the door.
#
Betsy Ann and I go on up to the ninth floor.
“I don’t want you to come in with me,” I said. “Too gruesome.”
Betsy Ann doesn’t argue.
In the inner offices behind a dark curtain stands a rather grim middle-aged woman. She leads me to a room and points to the slab of upholstered plastic. The only light in the room is over to my left where she’s now setting out needles that have very large tubes attached to them. I look away.
“What’s your name?”
“Stella,” she said.
She finishes lining up the equipment. “The doctor will be in shortly.”
“Can I get another Ativan from my friend?”
“The doctor’s coming any minute,” she said and leaves the room.
I take a look around with my head frozen to the upholstery. It’s dark. The ceiling’s low and seems as if it’s slowly moving further down. Eventually, I will be squished like a breast in a mammogram machine. I cough to relieve tension. Twenty minutes ever so slowly passes by.
Whenever I get a haircut, I notice other people’s hairstyle for a couple of days. When I’m dieting, I’m aware of other people’s figure. And since being diagnosed I now look at breasts.
“Are you all right?” Miss Grim asked.
I open my eyes and see the faces of two very pleasant looking women.
“This is Doctor Horn and Doctor Rosenblatt,” Miss Grim said.
“Hello.”
One woman is young and elegant and unsure. The other woman’s older and thin and has a confidence about her. But why two doctors for one little breast? Then I realize: this is a training biopsy session.
The pretty one the learner.
Miss Grim sets up the sonogram and the two doctors adjust the sonogram screen view. That done, the young and elegant one, takes a giant needle in hand.
“This is anesthesia, it won’t hurt but a little,” she said.
The older doctor lets me hold her hand. It was chilly cold. Is she nervous?
“That wasn’t bad was it?” the young doctor asked.
And so the training session begins.
Both doctors look at the sonogram screen to gauge where to insert the needles.
I launch into gossip mode, taking over where Betsy Ann had left off. I never stop chattering. Nor do I stop wringing the older doctor’s hand.
“If you hear a pop,” the younger doctor said, “don’t move.”
I tell them about Dr. Eidelstein’s roller blade accident, about an oncologist we mutually know who has acquired a new wife and two new children, that Peter Pressman who is working for Dr. Swistel was my previous surgeon for a surgical biopsy, that since the cancer is on the left that must mean it comes from the discord of the right brain - the emotional creative nonverbal part of the brain… yappity yap on and on. The talk, I suppose, is to remind them that they are sticking needles in a human being not just a breast.
“I saw some really big ones in the waiting room,” I said. “Must be a challenge.”
Everyone laughed.
“Let me do it,” the older said. Two more samples of tissue are taken and it’s over.
The two doctors breathe a sigh of relief. Even Miss Grim smiles.
#
I call the next day just in case.
“Call tomorrow,” Loretta the office manager said.
I call and get the answering service.
The weekend goes by as slow as a snail stuck in glue.
Monday morning I call again.
“Dr. Swistel’s going on vacation, Loretta said.
“Can he call before he goes?” I asked.
“There’s a long list,” Loretta said.
“Any news?” asks Bill, my dear friend in London.
“Not yet.”
“Well, you either have cancer or you don’t,” he said and hangs up.
It’s 3:00 o’clock in the afternoon. Soon Dr. Swistel will be on vacation.
I run to the local florist. There’s a purple orchid for Dr. Swistel and a red rose for Loretta.
“Loretta?” I asked. “Did he get the orchid?”
“Yes,” she said. “Was that you?”
“Uh huh. PUL….EASE can I have my biopsy report now?”
“Hang tight.”
At 5:30 the phone rings. “Hello,” a very deep voice said.
“Yes, this is me…. Marian…”
There are strange and heavy noises reverberating on the line. “I’m sorry, I’m in the airport. I never take vacations but my wife said she’d leave me if I didn’t. So here I am. I suppose by now you know its not good news.”
“Oh…”
“But it’s treatable.”
“Okay.”
“Let Loretta or Shelly get you an appointment for an MRI and then see me next week.”
“Thanks so much.”
“You’re early,” Amy the office manager said.
“She’s nervous,” her colleague at the desk explained.
I hand Amy a packet of rubber bracelets I got on the Animal Rescue Site for hunger, breast cancer, literacy, peace, hug a tree, and wildlife protection. Each of the office young women gather round Amy and pick their favorite.
I do the paperwork, go on into the inner office, undress, put on two gowns because it’s cold and check out a magazine. I’m right in the middle of the story of how Diane Von Furstenberg survived tongue cancer when Duane a black technician asks me to enter a glass-encased room.
“Where’s the open MRI?” I ask in astonishment.
In front is a huge white and grey machine with the initials GE stamped on the hood of a long tube. This long, tunnel-like contraption, it’s easy to see, will suck me into eternity. At the same time I will be unable to breathe, while my breasts morph and shrivel into a molecular dot.
“There is no open MRI for breasts,” the technician replies.
“But Amy said…”
“There’s none for breasts.”
“I need an Ativan,” I said and run to the dressing room.
“Those two holes are for your breasts,” Duane the technician said, putting his two arms through them and out.
“They’re too big.”
“They fit everybody.”
“I’m smaller than most.”
“You’re lucky we’re doing breasts,” Duane said – kinda mocking his vanity, kinda not. “You get to look out to me the whole time.”
“Yeah, breast cancer has its rewards.”
I get onto the sliding tray. Duane gives me earplugs to wear: coming close enough for me to clutch his arm. He pries off my fingers, but it took him awhile, and then sweeps out the door and enters the glass control booth.
For half an hour I hold real still while through the earplugs a mélange of African drums, Philip Glass and other cacophonies vibrate through my body and in a sound halo above my head.
Then a Doctor Math makes an appearance, to insert a needle in my arm and inject the dye. Doctor Math is young, quite heavy and with a good sense of humor.
Being next to him, I feel more like I’m going to make it.
At the conclusion, Duane lets me see a couple of the pictures. There’s a silver circle, the size of a quarter that gleams in my left breast and sort of winks at me.
“That’s the cancer,” Duane said.
“Is it in the lymph?”
“We really can’t tell.”
“Thanks guys,”
“Thanks for bringing the bracelets to the girls in the office,” Duane said.
I get dressed and go out onto the bright sunny street. Doctor Swistel is five days away.
This time I don’t have Betsy Ann as my companion. She’s off to Iceland on a month’s cruise. Beth’s in her place. Sometime back she had been a companion for a couple of years, to a celebrity who had terminal cancer. She’d been around. Beth is in her mid thirties and is always falling in and out of love. I’m hoping she will find a nice doctor to fall and stay in love with. However Dr. Swistel’s not an option. Besides being extremely busy, doing over 400 operations a year, he’s married.
Today Dr. Swistel, Beth and myself are squeezed into the brightly lit exam room. Dr. Swistel has a red bow tie on and looks crisp and sort of Monty Python jaunty. “You can do one of two things,” he said. “We can operate now and have a mastectomy, or we can try shrinking the tumor with chemotherapy first.”
For Beth saving my breast is a cause worth fighting for.
“If she had chemo first, could she have a lumpectomy?” Beth asked.
“Probably not.”
“Why?” Beth asked.
“Because of the size.”
“How long would the chemo be?” I asked.
“Three to four months,” Dr. Swistel replied.
“Let’s do surgery,” I said.
“You may want to consider reconstruction,” Dr. Swistel said.
“No, I was an Amazon in my former life,” I explain.
Dr. Swistel looks uncomfortable. His Monty Python air wilts.
I tried again: “You do know that Amazons cut off one of their breasts for archery, for pulling the bow easily?”
I see from his expression in spite of the explanation, this still isn’t funny. However the world has benefited from his inability to find breasts a joke, I later learn. Dr. Swistel has developed new ways of reconstruction that could save a woman’s confidence and pride in her body. He also was one of the doctors who developed the sentinel node biopsy, which protects a woman from having more lymph nodes removed. Removing lymph nodes can lead to a condition called lymphedema. This is where chronic swelling occurs in the arm.
“When’s the quickest we can do this?” I asked.
“You’ve picked the worst time,” Dr. Swistel said. Everyone in town is on vacation in August. Whoever’s left - wishes they weren’t. Do you have an oncologist?”
“Two are recommended.”
“Set up the schedule for surgery with Shelly,” Dr. Swistel said. “You’ll have to talk with an oncologist sometime or other.” And he disappears out the door. Shelly must be the friendly looking woman who’s now standing in the doorway, papers in hand, looking expectantly at me. I set up everything with her. Then Beth drives me to my lawyer’s where I’m to sign my will. ‘Really that Amazon joke wasn’t so bad,’ I muse to myself. Well, maybe he thought me a dummy, but I know he’ll come through for me.
The morning after seeing Dr. Swistel, I start wondering if I’ve made the right decision. Maybe chemotherapy before the operation was the best choice. And so it goes with doubt and anxiety: they lead to the second opinion circuit. Me, I seek the advice of no less than three oncologists.
I begin with a figure out of my past, Bernard Kruger. I think of him as first a Rabbi and then a doctor. Not the traditional Rabbi that presides over events like briss and funerals, but the happy-go-lucky type, who’s orthodoxy is in giving his patients what they want. Of course they want to be healed. But like Leonard Cohen’s song: Ain’t no Cure for Love – there ain’t no “cure” for cancer either. It’s a crapshoot really, with no unqualified wins. So what Bernie gives out is happy forgetfulness– for a while anyway.
It’s a cloudy Thursday late August afternoon when I step down from the sidewalk into the entrance of the large waiting room on East 78th street. . Bernie’s office has a pizzazz that drives any thought of cancer out of mind.
There are large original art works on the walls, balloons tied to some of the paintings, and a faux fireplace, while a colorful banner of HAPPY BIRTHDAY letters sway in the air-conditioned breeze over the reception desk.
“Whose birthday?” I asked.
“The doctor’s, on Saturday,” the receptionist said.
It was here, ten years ago, when I ran into Jeff, my ex-husband by accident. He was here for a chemo shot. At the time, I used Bernie as my general physician and was getting a check-up. I ended up in the clear, not my ex: still, Bernie kept him alive for five years and then couldn’t work his magic anymore.
Bernie shows me to an exam room next to his office. I take off my clothes, put on a gown opening to the front. I feel fragile. That’s why I stopped seeing Bernie as my general physician, I feel vulnerable taking off my clothes in his presence.
“That’s where the biopsy was,” I said pointing to a large bruise.
“You didn’t have to tell me,” Bernie said. He palpates my flesh and I feel deeply embarrassed and out of shape.
“You’re fine,” he concluded. “Have the surgery.”
“Oh great,” I said. Something’s right.
“I’ll call Swistel,” Bernie said. “He’s a nice fellow.” And then he added, “You’re nice too.” And goes out the door.
“Thanks.”
Perhaps he’s just being polite, but I feel grateful he said that. In the cab ride home I’m strangely elated that he agreed with me, the great Rabbi. And I even can forget I have cancer . . . for a while.
My friend, Jane, a breast cancer survivor of twenty-one years, recommended her doctor, Anne Moore. And now we’re there on a cloudy Thursday morning. Dr. Moore’s waiting room’s empty. It seems the doctor is not only an excellent clinician but is unanimously liked. “You’ll fall in love and you don’t have to be gay.” Dr. Swistel’s secretary said about Dr. Anne Moore.
The office décor seems restful and subdued with grey-blue colors, much like the doctor herself. After hearing from many people of Dr. Moore’s sterling reputation. I expected something like WOW! POW! But au contraire! She is understated, wears no make-up, is well groomed, dresses in dark colors and seems to have no discernible age. No one could accuse her of being stylish.
In her presence, I feel cancer wants to be understood like a neglected child. As with any living thing, cancer needs love – though loving might be difficult indeed. Yet without it, the cancer could turn defiant and wreak havoc within. These strange, not to say bizarre feelings, were my response to her cool compassion.
She hears every one of my questions with respect, and weighs them carefully. She listens without any self-consciousness and seems unawares that time is money. You don’t find that too often, much less with a busy doctor that’s tops in her field.
The examination finished, she concludes that I most likely have infiltrating ductal carcinoma, the most common type of breast cancer. On the way out, all the seats in the waiting room are now filled with patients. Strange, I thought, how little anxiety I feel: as if Dr. Moore had pacified my cancer with a cup of hot cocoa and sent it to bed with its teddy bear. With her I would be safe and everything would be in harmony.
The oncologist I pick is Doctor Ellen Chuang. I think the Chinese name may portend a culture divide. But she turns out to be as American as myself, which is a lot.
In her late thirties, attractive and petite, she has little even spaces between her teeth. “Do you have children?” I asked as she’s examining me.
“No.”
“Do you have a husband?”
“No.”
I don’t either. We have something in common – things missing. I wonder, is that why I’d ask her, to find a bond?
I’d consider taking alternative herbal cures. But she doesn’t want me to do so, while doing chemotherapy – it might cloud what the chemo is doing. Of the now three doctors I have consulted, she has the most upbeat view on surgery before chemo. She said the tumor will not be compromised – we will be starting fresh, so to speak.
I show Dr. Ellen the picture I carry of Master Ching Hai, my spiritual leader and teacher of the Quan Yin method of meditation. Master Ching Hai had her first ashram in Tawain, Dr. Ellen’s birthplace. There are many Asian people who have not yet heard of Master Ching Hai, and Dr. Ellen Chuang seems to want to remain one of them. She graciously acknowledges the image with a tight little smile but there was no rapture of interest that I hoped might spring forth. In regards to the practical matter of cancer, dealing with Dr. Chuang has been like bathing in a deep pool of cool water. It was a refreshing meeting even if no epiphany has taken place. I’m still hopeful.
Dr. Mia Talmor is like a fresh spring morning or perhaps more like a bouquet of lavender and jonquils. That’s why I picked her as the plastic surgeon to consult.
I had wanted only a mastectomy, nothing more. But Anne Moore suggested I at least I talk with a plastic surgeon about reconstruction. So here I am, telling Dr Mia of my fear of those procedures where they take skin off your tummy and your back.
Dr. Mia explains other options. For one, she could put a temporary expander behind the chest muscle at the time of the operation. Then in follow-up sessions, she would slowly fill the expander with saline solution. Eventually, the expander would be removed and an implant permanently placed where the breast once was. The process is more complicated than a simple mastectomy. And another drawback is that here is a higher risk of infection and the operation takes longer. All this I ponder, sitting before this beautiful young woman who today wears delicate sapphire blue earrings. Then I notice her hands resting on her desk. They look rather ordinary – could they be trusted to do the extraordinary? Our eyes meet. I see a shining confidence in hers. I feel dizzy and take a deep breath… “OKAY! Let’s do it,” I said.
Now there came the ordeal by pre-operative testings. My family doctor did the EKG and blood work, pneumonia shot, a lung X-ray and suggests that I have a pap smear. To my startled look, he answers, somberly, “Often times all the female organs are involved (i.e. have cancer) not just the breast.”
Next stop is gynecological center. The nurse practitioner is very special. I hardly feel a thing. For the sonogram of my uterus and ovaries, I visit the Westside Radiology. I’d followed the instructions to drink four glasses of water an hour before the scheduled time. They take me early. I wear a T-shirt with an "Abandoned Cocker Spaniel Rescue” logo across my chest.
“I love Cocker Spaniels,” Sonja the technician said. “I’ve rescued one and it’s now my precious angel. I would do anything for that dog.”
After I change into a gown, we went to work. From the sonogram screen she can tell my bladder is not yet full. We will do an internal sonogram instead. She then produces a dildo-like doo-dad.
“What’s that?” I asked.
“The camera,” Sonja said.
I’m to insert it into my vagina whilst lying on a table. The room feels terribly cramped and dark. It isn’t easy. Getting it in there hurts! I finally insert it far enough for Sonja to then push it in and move it for the best pictures.
“Pretend I’m a Cocker Spaniel,” I whimper.
For me the defining thing about New York Hospital is that a dear friend passed away from leukemia somewhere within these walls. Now it’s my turn for their ministrations.
“I’m here to part company with my left breast,” I announce, straight-faced, to the receptionist at the desk.
“What is your name and birth date?” is her reply.
I look at my watch: it says 9:00 o’clock. I feel an unexpected rush of loneliness. Why didn’t I make sure a close someone would be with me?
As if in answer to my thoughts, Dolores rounds the partition of the waiting room. I’d told her not to come but was overruled.
I finish registering, when Beth, who I hired for the day, steps along side of me. “Sorry,” she said. “Traffic was terrible.”
“Did I hear right? Did the receptionist say ‘Go down to New Claire on the second floor?”
“Nuclear Medicine” it says on the door sign to the second floor
“I guess they’ll use atom bombs to blow away my cancer,” I said, leaving Beth and Dolores in the waiting room.
The radioactive dye is injected into what’s called the sentinel node. . The sentinel node is headquarters. If it’s clear, the theory is, the rest of the tissue is cancer free.
My left breast is marked with a big arrow. The radioactive dye doctor eyes me, as if I were a wild horse that will escape any minute. I tell her that she looks like Queen Elizabeth….young Queen Elizabeth.
She asks me my name and birth date and leads me to the room where the technician, Ahman, sits in front of two or three computers. The doctor leaves saying she’ll come back soon.
Ahman talks about America and its effect on his daughter. He worries she will lose her modesty. I rub my breast in circles as the doctor instructed that so the dye moves faster into my system.
“Let’s do it,” I said.
“But the doctor’s not back yet,” Ahman said.
“It’s been over a half an hour.”
And so he helps me onto the steel table – holds my wrist so my left arm is over my head. His hand is warm and comforting and earthy. I’m sandwiched between two steel slabs. He returns to the computer screens. There’s silence for a couple of minutes.
“See anything?” I ask.
(pause)
“Ahman?”
(pause)
“What are we looking for?” Ahman asked.
“LYMPH NODES!” ‘I hope the surgeon is better prepped,’ I think to myself.
Eventually he tells me there’s one lymph node the size of a pinhead on the screen.
“That’s the sentinel,” Ahman said
Minutes later I return to and Beth and Dolores and the waiting area. Ahman escorts us to the elevator that takes us back to the pre-operative room.
A nurse, who’s having a bad day, asks my name and birth date. She gives me a packet of pajamas and slippers and a head covering. Later she barks at me to try again. I have them on backwards.
I sit in the pre-op waiting room. The chairs are in a U shape against the wall, all facing one another. There are other pale-face patients in pj’s like me with their significant others in street clothes, most of them talking on cell phones. I’m next to a nervous young tattooed man, who’s crossing and uncrossing his legs.
“What are you here for?” I ask.
“Exploratory,” he said. “Every time I have sex, there’s blood all over the place and I’m having trouble urinating.”
“Gosh!”
Three chairs become vacant on the other side of the room. I move so Beth, Dolores and myself can sit together.
We’re waiting and waiting and then waiting some more. It’s passed my scheduled surgery time. My mouth is dry, my stomach - jittery and my mind…my mind is drifting to the clouds. I’ve had no water or food for fourteen hours. Nurses come and go to pick up patients. Hours slowly tick by. Cleo, a thin nurse that resembles a short Naomi Campbell, startles me from a daydream fugue. As if I were deaf, she asks in a loud voice my name and birth date. Then she takes my temperature and blood pressure. They want me to sign a paper agreeing to an expander being inserted after the mastectomy.
“I don’t want reconstruction now,” I said.
“Why’s that?”
“I don’t want to be under that long.”
“Once you’re under, you don’t know you’re under.”
I resort to visualization, recalling how beautiful Dr. Talmor, the plastic surgeon is. Such beauty can’t make a mistake. . “Okay, let’s do it,” I hear myself say. I sign the release. I’m somewhere far away looking down on all of this.
Finally at 3:00 o’clock Juanilla, a Jamaican, comes to the door. She asks me my name and birth date. They seem to have a very short memory here. “It’s time,” she said.
At the elevator, a rush of excitement fills my body. My mind flies to outer space. I hug Beth and Dolores goodbye. I may never see them again.
The elevator doors close. I grasp Juanilla’s arm. Her arm is large and steady and it seems as if she ….is it really…yes…. it seems as if she wears a dark suit. I feel secure and a kind of virgin purity courses through my veins.
We step off the elevator into a wide grey corridor. Are we…yes…it’s like we’re walking down the aisle. Ta da da ta….Da da da ta….the wedding march is playing softly. It’s like I’m marrying my first husband John all over again. Maybe this time we’ll get it right.
Suddenly two grand doors fling open. A handful of people in white stand waiting as Juanilla and myself enter. Oh God! And me with these ugly pj’s on!
We greet the wedding guests. Everyone’s masked but I hear someone asking my name and birth date. Another asks me to open my mouth and stick out my tongue. They help me onto a steel slab. Puffy bands are fastened round my legs. Someone puts a ring on my finger. Ouch! The ring is sharp and sticks into my flesh. The room swirls.
“Where is he?” I cry. “I want to see him.”
“Wait!” a muffled voice said. “She wants to see him…she wants to see him”…reverberates in whispers around my head.
“Where is he…?” I hear myself cry again.
“Hello there!” says a voice from nowhere that, it dawns slowly, is Dr. Swistel’s.
“I’m sorry we’re so late,” he said.
“That’s okay,” I murmur. Everything suddenly becomes clear and sparkling white. I’m not getting married. I’m getting my breast cut off. I’m in the here and now.
“I hear you’ve decided on reconstruction.”
“Well, it’s the “in” thing,” I said. “Were you able to have lunch?”
“Oh yes…two martini’s!” he says airily.
There’s much laughter as everything goes mercifully dark.
Four hours later Dr. Talbot plants a flower in my chest after the harvest. But I don’t know anything about it yet. For two and half hours more, I’m still in darkness. It takes a long time to beautiful.
“Where the heck are we?” I asked.
“Recovery room,” Beth said. She looked small and frail: the room was large with desks everywhere.
The nurse rolls me next to her seat.
“Looks like Corporate Heaven,” I said.
“You’re the only patient left,” a male nurse said. “You’ll get all our attention.” He takes my temperature and blood pressure, and then sets a cup with swizzle sticks next to Beth and peeks at my chest inside the gown.
“Suck on this,” Beth said as she hands me a swizzle stick.
“Oh God,” I said. “Now I know it’s heaven.” The ice-cold water from the swizzle stick seems to sparkle going down my throat. Like liquid diamonds. And there’s a hint of the orange from my mother’s homemade Kool-Aid Popsicles. My dry lips and throat are in ecstasy. I’ve never tasted anything so delicious. After a couple of hours, I’m wheeled on up to a regular room.
The night nurse is persnickety about names. “It’s KevAHN, not KevIN,”he said.
“I’ll be back tomorrow, KevAHN,” Beth said. “Take good care of her.” It was 11:00 o’clock and I don’t feel a bit sleepy.
I look to my left out the window overlooking the East River. Light twinkles on Roosevelt Island. I have a small private room that is unfortunately in the Burn Unit. KevAHN takes my temperature, blood pressure, and opens my gown to see my chest. Then he sways over to the computer in the far left hand corner of the room, gliding like a dancer instead of a walk. He’s very upbeat and friendly.
“You’re doing fine,” he said and two-steps out the door.
I’m awakened by a loud frantic alarm.
“What’s that? I asked as KevAHn leaps in the room.
“The oxygen,” KevAHN said. “You’re hooked up. The alarm rings when you’re not breathing deep enough. How’s the pain?”
“Actually my right knee hurts more than my chest does,” I said. “I must have overdone it in the gym.”
The large clock on the wall says three AM. “KAvin – KeevAn – I mean KevAHn,” I said. “I have to go to the bathroom.”
“Do you want a bed pan or shall I help you up?”
“I don’t think I can get up,” I said.
“You know what happens if you don’t get up by mid-morning?” KevAn said.
“What?”
“They put a catheter in.”
“I’ll go,” I said.
I try to sit up and can’t. The tubes that connect me to life bind me to a prone position. KevAHn unleashes the oxygen tube, undoes the undulating air bags on my legs, and moves me closer to the steel pole from which dangle the morphine and saline solution bags. I wriggle and scoot with KevAHn’s steady hand on my back and feel my feet connect to the floor. Then like an old lady I do the paper slippers shuffle to where KevAHn’s guides me. My bare behind is in full view for all of Roosevelt Island to see.
In disbelief I look at our final destination - the sink. “You’re going to lift me up there?”
KevAHn opens a cupboard door beneath the sink onto which a toilet is attached.
“Voila,” he said. “Call me when you’re through.”
The results aren’t much. I hadn’t had water except for swizzle sticks in about 36 hours. But at least I won’t have to wear a catheter.
“Why’s the pee blue?” I ask as KevAHn as we do a pas de deux back to bed.“
“Radioactive dye. Takes a day or two.”
I’m wide-awake now. The hours slink by and then I hear a nurse calling: “Breakfast!”
“Eat something,” Beth said. She pushes the breakfast tray closer to my bed.
“Too nauseous.”
“A teeny weenie bite?
“Not a teensy weensy.”
“I’ll ask for some anti-nausea,” Beth said.
“Beat yah!” I point to the plastic bag suspended on the steel pole next to me. There’s a tube running from it feeding morphine laced with anti-nausea into to my hand.
“Try my Fruit Punch I brought for lunch,” Beth said. Her head deep inside her large flowered bag as she rummages around.
“Hellooo!” It’s nurse Mirabelle, the medical establishments’ Aunty Mame. Her long vowels resonate around the room, ricochet off my head and flutter back to the original source - this very tall dark haired woman standing by the door. She smears on a big smile and steps forward towards the bed. The Age of Enlightenment can’t hold a candle to Mirabelle, who is ablaze with the inside story of how to survive after mastectomy. She’s on a mission. She asks my name and birth date and then drawing a deep breath, sits down, towering over me, next to the bed to divulge secret knowledge.
“I’m going to show you how to care for your drain,” she said.
“Drain?”
“Yes, here let me show you,” she said.
“ I haven’t looked yet and don’t want to,” I said.
“ We have to look,” she said.
“I don’t think I’m up to it now,” I said.
“Perhaps, if you sit up.” She said and starts to rise bracing herself to raise the head of the bed.
“I haven’t slept all night, and I’m nauseous and I hurt.”
“This is Friday. We don’t work Saturdays.”
Mirabelle unstraps my legs from the undulating packs, releases me from the oxygen and pushes my back to sit up. I grab the steel pole with the morphine pouch swinging in the breeze. Beth helps me shuffle over to the window. The bright light stings my eyes. I squint at Mirabelle who’s now sitting opposite me: between us - a small table on rollers.
She reaches into my gown and gently pulls out a bulbous thingamajig connected to a long tube that disappears into my left underarm.
“Oh my God,” I said.
“This is your drain and you have to empty it three times a day.”
“Oh my God”
“Now, now,” she said. “It’s very simple. Look, you just squeeze the liquid into one of these cups and write down the measurements.”
“All that comes from me?”
“When it’s about 10 or 15 ml. your surgeon will pull the tube out.”
“Yuck.”
Mirabelle talks and talks. She says something indistinct about if I would just sign in the right place the American Cancer society would give me a free bra. Noticing I wasn’t paying attention, she then exclaims:
“Ohhhhhhh…look at the boat!”
I take a peek. “Uhuh,” The Circle Line is puttering up the East River.
Beth comes to the rescue and suggests that perhaps I should lie down again. Once more I shuffle over to the bed and lay down. Tubes are flailing this way and that.
Mirabelle stands looking at me with disdain.
“What kind of work do you do?”
“I’m a psychotherapist.”
Her large brown eyes widen and a tiny smile of disbelief turns up one corner of her mouth.
“You don’t want a visiting nurse when you go home, now do you?”
“Oh yes, PLEASE,” I gasp.
“I’ll see what I can do.” She seems disappointed and curtly says her goodbyes.
“That was almost unbearable,” I mumble. “Beth, why does the phone keep ringing?”
“You’re friends want to see how you’re doing.”
“Maybe they think we’re giving a party.”
Later, that afternoon Dolores comes to visit. I’m making a valiant attempt at conversation when I hear - “Hello.”
“Dr. Swistel!” I struggle to sit up.
“The good news is your lymph nodes are clear,” he said.
“Oh great!” For some reason this isn’t a surprise to me, but I’m thankful nevertheless.
“I hear you don’t like your drain.”
“Well… what’s to like?”
“You look terrible,” he said.
“I haven’t slept all night, and I’m nauseous.”
“Get rid of the morphine. I’ll tell the nurse.”
“Dolores, this is Dr. Swistel. He’s head of the whole Weill Cornell Breast Center.”
“Oh, the big cheese,” Dolores said regally.
“The Swiss cheese,” he said smiling making a pun on his name.
“Thank you, I…” but he’s already gone.
The morning nurse calls, “Breakfast!”
I turn my head and open my eyes to where I sense a presence next to the bed.
“Dr. Cameron!” He’s part of Dr. Swistel’s team.
“How are you feeling today?” Dr. Cameron asks.
“I was able to sleep.” I said. “They gave me a sleeping pill.”
“Are you ready to go home?”
“Not yet,” I said.
“We want you to go home,” he said.
“Why?”
“You can pick up infection in the hospital that antibiotics can’t cure,” he said.
“I’ll go home.” Dr. Cameron smiles as if I said what he wanted to hear and strides out of the room.
The nurse butts in: “You can’t go home unless you eat something.”
“I can’t eat yet.”
“You can’t go home,” she said.
“How about a slice of bread?” I ask.
“You have to have liquids before solids,” she said.
“Just an itty bitty piece?”
“The doctor says…”
“Okay, Okay,”
And so when she leaves the room I take a couple of bites of cold oatmeal and throw the rest in the wastebasket.
At the entrance to New York Hospital Beth waits. I barely can walk from the wheelchair to the car. The sun is clear and bold in the sky and its golden light reflects off buildings and trees and the people going in and out of the hospital. I feel like a newborn kitten– wobbly and weak and glad to be released, even if my walk is lopsided.
As we drive up First Avenue the city looks strange and unfamiliar. How could it all change in two days? Maybe I’ve changed. Or perhaps time itself warped. Maria came into the apartment with an armload of flowers and groceries. Then she dithers and fusses, as if I were made of glass and would break if everything was not perfect. Maria is from India who through struggle and effort has become a citizen. She’s in her forties, is petite and pretty and likes to chat. She has a handsome husband who she supports. Years ago, she cleaned this apartment until we had a spat. When she heard of my cancer she came right away to visit and offered her services. News of a new cancer victim has a similar effect on many people. The insignificant falls away, the past quarrels forgotten, and friends try to show in one way or another that they care. Even John, my first husband, who I hadn’t seen in a year, edited this that you are reading out of generosity and kindness given my health situation. (He hasn’t seen this last sentence, or he would delete it.)
So we arrange that Maria was to be with me on the weekends and Maxine during the week. Maxine isn’t as self-motivated as Maria. But then again, Maxine is nine months pregnant and due to give birth any day. She is a tall and large black woman of about twenty-five. When she and her sister were only six or seven years old they helped their mother who works as a caregiver. She has witnessed a lot of illness in her short life and seems neither impressed nor jaded by it. Although Maxine knows how to hold my drain while I struggle to take a shower, knows about how to freshen the bed, answer the phone, shop, walk my dog Ruffy, clean the bird cages – all this is secondary to the healing power of her innate sweet nature And she got along with Debbie Fox the visiting nurse. Debbie, in her forties, reminds me of an ex-show girl-- all legs. She is as crusty as Maxine is soft spoken and sweet. But underneath bark and brusqueness there is a kind and caring person with a heavy workload. Everyday there are between nine and fourteen people who she has to make sure are still breathing. She is a fount of folk wisdom, and cures my hospital dyspepsia – “prunes” she said. . The first time she pulls back my gown and looks down in there, I’m anxious.
“Does it look okay?”
“Looks beautiful,” she said. “I’ve seen some that look like they were operated on with a can opener.”
“Gosh!”
Another day of reckoning has arrived. There have been so many and going on for so long. I’m off to the Weill Cornell Breast Center to find more about my diagnosis and what I’m to do about it. Traffic is impossible on the East Side because President Bush is visiting the U.N. And so Maxine and I take public transportation. We trudge up and down the many subway stairs that I worry if the exertions won’t start Maxine into labor. At the reception desk we’re told to sit and wait for Dr. Ellen Chuang.
We wait.
After an hour I see Dr. Chuang scurrying at the other end of the hall. I give a little wave. She nods her head in recognition. Four professional looking men and women follow her into her office and the door closes. Another hour passes. I give Maxine money to take a taxi home and walk Ruffy, the dog. Then a nurse asks me to follow her to one of the cubicle offices. “Dr. Chuang will be right with you,” she said. Another half-hour passes. I catch a glimpse of Dr. Chuang going into the cubicle next to mine and hear: “Go see Hailey-Moss.” An overweight pleasant looking man of about thirty enters rather uncertainly. His shirt looks too tight around his neck and I wonder if he has difficulty swallowing.
“Hello,” he said. “I’m Dr. So-in-So.” Like Dr. Chuang, he gazes at the computer terminal as he talks. . “Now, why are you here today?” Oh God I thought, a doctor in training – this is what I waited for? This is what I deserve after everything? “Have you been here before?” He asked in reply to my stunned silence. “I just had a mastectomy from Dr. Swistel and I want to know my diagnosis,” I said. “Let’s see what we have,” he said referring to his computer. “What is your name and birth date?” These are the words St. Peter will use at the pearly gates. “Hmmm,” he said. “It says here: ‘Infiltrating Poorly Differentiated Ductal Carcinoma.’” “I know that,” I said. “Except for the ‘Poorly Differentiated’ part. What does that mean?” “It means that it doesn’t’ look like your normal cells.” “And what does that mean?” “Well it means that it’s much different from your regular cells.” “Yes…and?” “Just a minute, while I get Dr. Chuang,” he said. So we both end up on her doorstep. “Hi, how are you?” said Dr. Chuang typing on her keyboard and checking the terminal. “I just want to know my diagnosis,” I said. “Yes” Her typing gets frantic. “Don’t you have it yet?” “It doesn’t seem to be on this program,” she said. “One minute.” And then she and Dr. So in So breeze out of the room. Twenty minutes later she is back, flapping a document, with Dr So and So close behind. “Here it is!” “Dr. Swistel had it on his computer files.” She sits down once again in front of the computer, to access the page electronically. A ladylike “Aha” escapes from tightly closed lips. “The good news is,” she said, “it wasn’t in the lymph nodes.” “Yes, Dr. Swistel told me that in the hospital,” I said. “Okay,” she said. “This is what you have: Stage 2, because of the size of the tumor, Grade 3 because of its aggressivity, and you’re Her 2 neu Positive which is a type of gene that encourages the growth of cancers cells.” “Now this is what I recommend…” She takes up a pen and on a fresh sheet of paper begins to write with gusto. “First we do a series of Adramycin and Cytoxin for about three months. We have to be very careful with the Adramycin that it doesn’t get on your skin. Because if it does, you would need a skin graft. With the Cytoxin there is the risk of secondary cancer forming in your bladder. Then we would do a series of Taxol and Herceptin for another three months. You may develop neuropathy. That means the end of your fingers and your feet and toes have tingling sensations and go numb. After that we would give you just Herceptin” “How long would that be?” I asked. “About a year.” “A year!” “You’re lucky. You aren’t estrogen and progesterone positive and so you don’t have to take medication for four or five years. It’s all over in a year and three months. We would have to put a port in the side of your neck otherwise your veins would collapse. But we can talk about that later.” “A port?” “A tube is inserted in your neck so there is easy access to your circulatory system.” “Oh my!” “We have to be careful with the Adriamycin and the Herceptin mixed as you could develop heart failure. We’d have your heart tested every so often.’ Dr. Chuang was clearly excited at the prospect of deploying her weapons of mass destruction against the Big C. I gaze past Dr. Chuang to the seated Dr. So in So. It looks like the collar of his shirt was now seriously strangling him. He scrunches in his chair. He seems a trapped being – maybe oncology was too much and if it wouldn’t mean years of hard work and lots of money he would change his profession. “Are there any questions?” Dr. Chuang asked. “What happens if I collapse getting all these chemicals?” “Well, we hope you don’t do that,” Dr. Chuang with a deep and sincere expression. “Is there cancer in my body?” “The cure for cancer,” Dr. Chuang said, “is surgery. However there might be microscopic cells remaining in your system that travel elsewhere and blossom. That’s why chemotherapy.” “But is there any cancer now?” As if remembering something Dr. Chuang said, “We need to have a bone scan, chest scan and pelvic scan. We don’t want to lose any time. I’ll set it up now. Make an appointment to see me when that’s done. Okay?” “Okay.”
“To chemo… or not to chemo.” that is the question. Hamlet, however, didn’t have “second opinions” to drive him nuts. I get four, and stop there. One oncologist plays a meditation tape and serves tea. Another gives a lecture on how cancer is like a dandelion on a golf course that seeds its surroundings. Another is in Connecticut and impossible to reach by phone. Still another is as sterile emotionally as the hospital in which I see him is sanitary. One or two say chemo is my only chance. Other’s say there’s no guarantee. A couple says it’s okay to take nutrients. Others say “no” to nutrients. Googling only increases my confusions: some good information, along with hair-raising accounts of side effects. My friends feel chemo is the thing to do. Sally, who I haven’t spoken to since high school, writes e-mails giving me support. She went through chemo just fine. However another classmate of ours went to the same clinic got the same diagnosis and chemo recipe as Sally. Six months later, friends gather round her hospital bed as she passes away. I call the hotline of SHARE a support group of cancer survivors. One woman has been on Herceptin for six years. She can’t express how grateful she is for these modern chemicals that she feels keep her alive. I can’t match her enthusiasm. But I’ll give those magic chemicals a try. I have a dream the night before I’m to go to Weill Cornell for the first infusion. I’m standing with arms behind my back, my wrists handcuffed as I’m forcibly given chemo. Next day, I’m hysterical. I phone my hairdresser to say I’ll still be coming in for haircuts. Until that dream I wanted to believe the authorities who vouched for standard treatment. All along it hadn’t seemed right to put poisons in my body. Now I’m certain. It’s hard telling Dr. Chuang “no chemo”. So I take the chicken way out and e-mail. It’s even harder telling my friends - especially Jane who had gone with me to oncologist after oncologist. Jane is a chemo success story and is all for it. But eventually my friends realize I can’t be budged. I’ve been doing alternative treatments – a vegan diet, meditation, acupuncture, take the advice of a fine Korean Master that my acupuncturist, Marieliz Unwin introduced me to. I take oodles of herbs and do exercise. My blood gets checked every three months, and I participate in an on-line support group of kindred spirits.
Cancer has changed my life. It’s a job. It demands a lot of time and attention and work. Yet the greatest “work” has to be done within. There is a new and deep seed in my awareness, so that every day feels a lifetime.
The oncologist who had served me tea said, “I know this sounds unbelievable, but someday you’ll find that having cancer is a blessing.” I’m beginning to believe him. It’s been five years now since the beginning of the journey.