On November 4th, 2011, I remembered first to post a happy birthday message on my brother’s facebook wall and then made my way to SMIL, ironically pronounced SMILE, for my mammogram. On the doctor’s handwritten order, I noted “12 0’clock” and “ultrasound.” The other words were indecipherable, but I wasn’t concerned. Initially. I’d had mammograms before and lived to tell the tale. For me, a mammogram is less about pain and more about indignity and discomfort. Ungainly too, the mammogram dance in which a strange partner tells me to relax while she positions my small breast, compresses it between two plates, tells me to hold my breath while she flees to another room to take a picture. And then repeats the process for the other side. Unsuccessfully, I try to read her facial expressions, because I am quite certain these technicians always know if the impending news is good or bad, but they aren’t allowed to break it to us either way.
As mammograms go, it was routine enough, until she announced that another technician would perform the ultrasound. In my adult life, I’ve had only two ultrasounds, the former bringing sheer joy with its whooshy-hearbeat soundtrack and a grainy black and white picture of a fetus sucking its thumb. Conversely, the latter was altogether boring and helped confirm a rather unglamorous gallstone. I wasn’t quite sure how the ultrasound would add anything to the mammogram, other than to determine if “the lump” was a fluid-filled cyst. It took much longer than seemed reasonable to me, given the small area that comprises my right breast. Unfazed by that, the technician patiently moved the transponder across the breast, pausing to take scores of pictures. Finally, and by way of preparing me I’m now convinced, she told me not to be in the least bit alarmed if the doctor came in to do the ultrasound. Apparently, the doctor liked to do the ultrasound and look at the pictures herself. That’s when the fear started knocking. Not the fear I’ve known thus far in my life – the fear of being fired, the white-knuckle fear of flying, the fear of public speaking, the fear of running out of gas on the freeway – but a new fear that has to do with “I don’t know.” “I really don’t know.” I thought I’d felt this fear of not knowing before, recalling for a split second the fear that came right when I’d given birth to my daughter, when I’d asked all assembled in the delivery room to check once again that she indeed had all her fingers and toes. No. This was a far different fear.
In this dark ultrasound room, when a doctor I didn’t know started talking about a tumor, no – tumors – I knew I was entering unchartered territory. Words and more words kept tumbling from her lips, until I summoned the presence of mind to make her go back to the part where she said “tumor.” And that’s when she patted my knee and said she knew and that it was scary stuff and, by the way, had I brought someone with me? Well of course I hadn’t brought anyone with me. My husband was at home, being annoyed with the painters who were moving at a glacial pace. My daughter was at school. I had a meeting that afternoon at work. Nobody was “with me,” because this appointment wasn’t supposed to be about a tumor or tumors. It was supposed to be like all my other mammograms. I was supposed to go to work, and my regular doctor, the one who knows me, was supposed to have her office simply leave a voicemail with the number I needed to call for my results. Right? Wrong.
Big fat tears fell, and the doctor disappeared. Just like that. I don’t remember her name. I think it was something that didn’t match the gravitas of the situation – a Smith or a Jones. I don’t remember sitting up, walking out, or being walked out of that room, but just like that, again, I was in a pleasant office, in the arms of a kindly woman, Liz, who I thought was just a nurse. “Just a nurse.” I will never say that again; Liz was the kindest of kind strangers I’ve ever encountered. I suppose it makes sense that her business card identifies her as something more specific than “nurse.” She is a “Breast Patient Navigator, ” but that doesn’t begin to take into account the humanity that is surely a pre-requisite for such a position. Regardless, more than her hugs and her sincere assurances that I would get through this, I remember her utterances involving new vocabulary that would, within days, become part of my personal lexicon: “tumor,” “lumpectomy,” “radiation,” “core needle biopsy,” “MRI,” “malignancy,” “radiation,” “staging.”
More than anything, I wanted to talk to my mother. To get on a plane. To go back home where it’s always raining or about to rain, where people would bring cups of tea or something a bit stronger and wax lyrical about how I could be far worse off. A hallmark of growing up in Northern Ireland is that no matter what befalls you, you will invariably be reminded (and it is strangely comforting) that it could always be worse. But I couldn’t talk to my mother without having something to tell her. What was there to tell? Tumors, yes. But what kind? Benign? Malignant? Wait and see. The Breast Patient Navigator had taken over and was beginning to help me navigate a journey through “wait and see” with a team of people that would only grow bigger. Again, I don’t remember how I broke away from her or how I made it out of the building, but I did. I sat in my car, called my husband, and scared the hell out of him with news of the two tumors. One, the one I’d found, was at 12 o’clock, and the other was under my arm, or – more scarily – in the lymph node. I don’t remember what my husband said. I cried. He probably cried. And then, to my amazement now, I went to work. I really did. I went back to work where I laughed and even made the people with whom I work laugh. I even found time to fret about work at some point during that day. Seriously and stupidly, I fretted about work. I actually went to a relatively new boss and told him about the tumors, because I was worried that he would wonder why I wouldn’t be at the meeting which was scheduled at the same time as the Breast Patient Navigator had scheduled my core needle biopsy. Seriously. Stupidly.
Life IS what happens when you’re making other plans, thank you very much, John Lennon. And so I had to plan to fill the next five days with something other than fear and worry.
What would I say to my 73 year old mother on the other side of the world? How could I avoid telling her I was scared to death? Literally scared to confront the possibility of a life-threatening illness. She would surely know by the time I exhaled the first syllable of “hello,” that something was wrong. So I avoided her. I took advantage of the eight hour time difference and made myself unavailable for the entire weekend. That way, I could keep it all to myself until after the core needle biopsy, which would surely alleviate the fear.