I had shown only a little restraint in not searching every corner of the internet for information about fine needle aspirations and core needle biopsies of the breast – the latter sounding more ominous – before I showed up at Scottsdale Healthcare yesterday afternoon for a core needle biopsy.  Once again supine in a small room illuminated only by images on an ultrasound monitor and the kindness of two technicians, I was out of sync and discombobulated presumably by the not knowing what was in store for me. More in denial than fear, I went by myself, choosing to keep things light for my husband and for my best friend, relegating it to the level of an annual teeth cleaning or a pap smear.

In no uncertain terms, I told the technicians I did not want to be talked through the procedure. I just wanted it to be over. But when they veered from the script I had prepared in my head with the doctor announcing they would be doing three biopsies, panic rose the way it does when the pilot announces turbulence up ahead. “Three?” Nobody had said anything about a third; I had barely begun to accept the existence of a second. Again, “Three?” Were they sure? How could there possibly be three tumors in a breast that had passed four mammograms? Discomfited by the almost reassuring response that, yes, the other doctor had ordered three biopsies, I had no choice but to settle in and to be oddly transfixed by the images swirling on the monitor. Strangely hypnotic and relatively painless except when I allowed myself to consider the length of the hollow needle piercing my skin and making its way through three benign or cancerous somethings, and extracting tissue, it was surreal. Stuff of The Learning Channel.

Had I known what they were doing by the time they got to the third one under my arm, I like to think I would have protested the metal marker being placed deep within my breast tissue, in the shape of the ribbon synonymous with the Susan G. Komen Foundation and the search for a cure, a ribbon I have grown to despise. That, and doing things on the count of three.  “Relax. One. A little poke. Two. Lidocaine going in. Three.” And then a sound like a staple gun. “You’re doing great.” Three times, I did great. I did especially great on the third one, an awkwardly positioned tumor under my right arm. I didn’t realize just how awkward until the subsequent mammogram, an undignified and ungainly dance, my partner a cheery technician charged with compressing my small punctured breast between the two plates in such a manner that the surgeon would be able to see the new metal marker under my arm. Surgeon. Surgeon? Nobody had said anything about surgery. Or had they? I could not recall.  After much repositioning and squeezing and picture taking, someone in another room was satisfied with the X-ray picture, conjuring for me a fleeting image of the Wizard of Oz.

Finally, with a flourish and a big, beaming smile, the technician presented what had been declared a satisfactory mammogram picture of my breast. There it was. Right there on the bottom right of the screen. A new metal tissue marker, fashioned in the shape of the ubiquitous breast cancer awareness ribbon.

“See? There’s that cute little ribbon.” in my tissue. In me. 



All things considered, I should be thankful this took place after we had ushered out October also known as Breast Cancer Awareness Month (although early in November all those commercials are still airing). In October, there is no escaping the people in pink, scores of them, running their races, hawking merchandise emblazoned with pink ribbons, not knowing where all the money goes or who to ask to get a straight answer. There is just no escape from the business of breast cancer.

For the past week, I have been preoccupied with Susan G. Komen, the young woman who was only 36 years old when metastatic breast cancer killed her, and questions about the organization subsequently established by her sister are gnawing at me. Why has the foundation that bears Susan’s name failed to appropriately address the kind of cancer that killed her? Why has the Komen foundation relentlessly emphasized early detection and awareness all tied up in a pink ribbon? Until that tiny metal ribbon was placed in the tissue of my right breast yesterday, I had regarded Komen et al with a mixture of indifference and denial, blithely handing over an extra dollar at the store to go towards “the cure.”  I will never do that again.

I always thought – stupidly and selfishly – that breast cancer is the thing that happens to other people, to celebrities who grace the pages of magazines, to women who don’t show up for their mammograms. It does not happen to me. Oh, what a fool I have been – duped and manipulated by its mythology. How jarring it is now to contemplate disease and death juxtaposed with all the trappings of awareness – pink ribbons and teddy bears and perfume bottles and cupcake liners. Such trinkets would not be out of place in a 19th century nursery rhyme about little girls, but they are far removed from the ravages of a disease that kills.

By the time I arrived home yesterday, I knew I didn’t want to hear anymore of Nancy Brinker’s “conventional messages.“ I didn’t want to see pink ribbons embellishing yogurt lids and bottles of water and Facebook pages. Fat chance.

This new affront helped pass the time yesterday while I waited in another waiting room, unaware of the tiny patch of red seeping from the biopsy site through to the front of my hospital-issued blue and white striped gown. I had not anticipated blood or ice-packs or the surprise mammogram, but I am learning that in the realm of breast cancer, the surprises keep coming.  Sitting there, exposed and vulnerable, an icepack atop my bruised and bleeding breast, a lovely young woman, dressed in a gown like mine, put her hand on my shoulder and her earnest brown eyes looking into mine, asked conspiratorially if “they” had poked me. Wordless, I wasn’t sure what they had done. No matter. She assured me I would be in her prayers that evening.

It is a strange sisterhood indeed, where an instantaneous intimacy allows us to talk about being poked and staged and prayed for. It made me uncomfortable, but not as uncomfortable had I been left out by language. Language is everything. This I know. And, maybe it can be attributed to  my immigrant spirit, but I know I need to learn the vocabulary, the rules, the norms for breast cancer patients gathered together in waiting rooms. And I will have to learn quickly. Apart from the fact that I am well past the best age for learning a second language, I do not want to be immersed in this new culture.

I have other things to do. Christmas is coming. 

The pathology report will come back tomorrow, on November 11th, Veteran’s Day, a day for remembrance. The Breast Care Patient Navigator, a new one, just called to tell me I really should bring someone with me. Do I have a husband? I do? Oh, good. I should bring him along. She will see us both at 11AM on 11.11.11. One of us will listen, while the other will focus on hearing the only words worth hearing with Christmas around the corner.

Benign. Benign. Benign.