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I don’t know when tattoos became mainstream, but I am obviously late to the party. I have never considered a tattoo for myself mainly because of its permanence, which, ironically, is the very thing that others find appealing. For a very long time, I thought my mother and I were the only two women on the planet without a tattoo. Even the British Prime Minister’s wife had a dolphin inked on her ankle, and then Susan Sarandon got one. Another one. While my pristine canvas remained bare …

I live a life that is peopled with wildly wonderful, creative women from all generations, only a few of whom are inked. I think. There are the women who have been around longer than I have, to whom I turn for stories of the way we were or should have been and why the hell we are still forced to make so many compromises. There are the women my age, with whom I grew up in Northern Ireland, most looking on now as daughters and sons set off to make their mark on the world. In one dizzying instant, my childhood friends are grandmothers. (Of that group, I think I am the only one with a child in the throes of early adolescence). Then there are the younger women I encounter in my working life, some barely 30, infinitely more assured and a lot smarter than I was at the same age, dipping their toes in a profession that has not matched their expectations and wondering if they should take it and make it better, or just leave it. In this circle of women friends, I am also the only one with breast cancer. So far. I am the 1 in 8, the one none of us expected to get cancer, the one in reasonably good shape with no family history and clear mammograms. It chills me to know I will not be the only woman in this international circle to be struck by cancer. At the same time, it inspires me to know we are writing about it, talking about it, stomping out those myths and taboos that have so easily duped us all within a flourishing breast cancer culture.

Not so easily led are the strikingly young women I know, those who are still in their thirties, many of whom sport at least one tattoo, an inky celebration of something significant to them, discretely placed on some part of their bodies where it is rarely seen during the work day. A Celtic knot, a Japanese symbol, a butterfly, a dragonfly, initials of names of someone held dear. (This last invariably brings to mind Johnny Depp’s “Wino Forever” tat which prior to a soured relationship with an actress, was “Winona Forever.” This must be true; I read it in a tabloid one afternoon while having a pedicure).  Some tattoos I notice entirely by accident, especially those that appear in my professional life. Occasionally an otherwise hidden piece of body art, an exotic bird perhaps, will peek out from behind an errant bra strap or at the nape of a neck at the end of a long day when hair is pulled up in a ponytail. Once, I spotted an over-sized bandaid covering the ankle of a young woman at a parent-teacher conference. It must have been a nasty nick sustained during a hasty shaving of the legs. Some time later, (though why my eye was drawn to her foot, I do not know), the ankle was healed, and in place of the bandaid, was a rotund Disney cartoon character with an attitude. Home-made and done on a dare, by all accounts. I haven’t seen her for years, but that tattoo is indelible in my memory and comes to mind every time I encounter A Mother’s Prayer for her Child in Tina Fey’s Bossy Pants:

First, Lord: No tattoos. May neither Chinese symbol for truth nor Winnie-the-Pooh holding the FSU logo stain her tender haunches.

But this is about me, and notwithstanding the issue of permanence, there are other reasons why I am resistant to tattoos. When I was a girl, a tattoo was neither a fashion accessory nor an objet d’art. Early on, I knew it only as the annual Edinburgh Military Tattoo, a ceremony involving pipes and drums, broadcast on the BBC to a global audience. Eventually, my view of the tattoo expanded to include those designs inked on a human canvas. But far from mainstream, “the tattooed” of my youth were typically stigmatized, viewed from afar as having been up to no good, an unsavory bunch, degenerate, even. The truth was that more often than not, many tattoos were of the home-made variety, done on a Saturday afternoon when there was nothing else to do, by someone who could spell, with access to a needle or a large safety pin hastily disinfected in Dettol, and the obligatory bottle of Quink ink. I recall a quiet girl, a couple of years older than I was, with long hair and freckles, and pale teenage knuckles that spelled out L.O.V.E. in indigo. Aside from her, the only other people with tattoos (Union Jacks, anchors, daggers, or a combination of all three) were the young men who spent interminable hours hanging around outside the bookies, usually out of work and, given the time spent outside said bookies, most always out of luck. In truth, these lads were less menacing than they were reminders of our economy and our certain destiny if we didn’t “keep at the studying.”

Then one day, I woke up and everybody was doing it. People’s mothers had tattoos. Tattoos were as ubiquitous as Tupperware, and tattoo shops were no longer at the end of a street in a dodgy part of town. In fact, there seemed to be as many tattoo parlors as there were Starbucks. Into the bargain, most of those patronizing the latter were adorned with tattoos; entire collections of body art were on full display every day for avid people-watchers like me. And just as I was beginning to appreciate the artistry involved (remember I am late to this party), I became aware of the burgeoning tattoo removal business. Right next to the hardware store, across the street from my local Starbucks, is such a place, aptly named Delete. I suppose it makes sense; as the erudite CEO of Dr. Tattoff, explains, “what happens is life changes and that [tattoo] may not represent who you are anymore.” Wise beyond his years, that Dr. Tattoff.

Within all this tattoo talk is a story I am just dying to tell, but worried that I might offend somebody, although why this would be a concern for me at this late stage escapes me.  It is one of those “a-funny-thing-happened-on-the way-to-the-end-of-my-breast-reconstruction” kind of story. As I have said ad nauseum, a diagnosis of breast cancer changes everything. Words and relationships take on new colors, different things matter more and less, what used to be irrelevant may become almost mandatory. Kale. Blueberries. Exercise. A tattoo. A tattoo. The thing I would never have considered.

I’m drawn back to the day my favorite physician (tattooed, I think) told me there was no way she would risk not getting clear margins by preserving the nipple of my right breast. It is important to note that at the time, I knew nothing about margins other than setting them in a Word document. I remember well how she turned her body away from the MRI picture on the screen, folded her arms, and looked right at me to tell me in no uncertain terms that given the location of the tumor and my small breast size, it would be horribly disfiguring if she tried to remove the tumor in order to spare the nipple. Basically, she didn’t have a lot to work with. So she recommended (and I nodded sagely in agreement) a skin-sparing mastectomy which entailed removing only the skin of the nipple, areola, and the original biopsy scar to create an opening – a small opening – through which she would remove the breast tissue. Duly spared, the skin would then accomodate a reconstruction using my own tissue. (Along with tattoos, I also have an inexplicable reticence about implants). I was fascinated by the MRI pictures and was also beginning to understand why it would have been possible for mammograms to miss so spectacularly the cancer that had been growing gradually for who-really-knows-how-long – five, ten fifteen years? In the course of a long conversation, I grew increasingly comfortable with and confident in this surgeon. I liked her. We talked about the mastectomy which would happen after the holidays, which seemed an eternity away, along with a DIEP flap reconstruction which would ensure I woke up after an 8 hour marathon surgery with a new right breast. Sans nipple. Maybe we talked about that. I honestly don’t remember and didn’t have the sense to bring anyone with me to listen.  Nipples are not really standard conversational fare, except in the inane chatter on Entertainment Tonight, Inside Edition, and television shows of that ilk, and only, apparently, if the nipple in question belongs to Madonna or Janet Jackson and has previously been exposed to the world via Youtube.  For me, “nipple” is a frivolous word, the kind that might belong in a limerick, perhaps to rhyme with “Raspberry Ripple,” a chocolate bar from my childhood. “Nipple” lacks the gravitas of “malignancy” and other scary cancer words. “Areola” is not a necessarily serious word either, but it has an elegance, like a constellation of stars. Yes, this is exactly how my mind wandered off, as my patient surgeon described the mastectomy, the removal of My Right Breast (which by that stage, I swear to you, had become the third person in the room). As the information washed over me, much of it technical, I feigned the role of the empowered patient and asked a few sensible questions, the answers to which I would immediately forget: about how long the surgery would take, how much it would hurt, and when I would be able to start running again. But I didn’t ask about the nipple.

Time passed. Slowly. My little trio of a family survived Thanksgiving, Christmas, and the New Year in a surreal denial that a) I had cancer b) we had been married for 21 years, and c) our daughter was turning 14. I wish now that we had expended less energy on the damn cancer and focused instead on a 21st wedding anniversary and a 14th birthday, but learning the rules of engagement took so much time. And we were frightened. And time spent waiting for surgery passes very slowly. And then not slowly at all, and in a twinkling, the woman looking back at me in the mirror has a wretched scar that stretches from left hip to right, a repositioned belly button, and a perfectly reconstructed right breast, small like its partner on the left, but instead of a nipple, there was its absence. This should not have been a shock. I knew that was going to happen. I knew that around where it used to be would be a large circle, through which the nipple, the areola, and the right breast had been removed. (See skin-sparing mastectomy above). Removed. Cut out. Excised. Severed. And other scary words.

If there was some way to avoid seeing the circular scar that defined the space through which my breast et al had been removed, then perhaps I could avoid thinking about the cancer. But after every shower, every day, I find myself taking a trip down memory lane, and it is not without some guilt. It’s only a nipple, I know, and in the grand scheme of life, it’s a minor detail. The major detail is that my brilliant, funny, warm, physician removed all the cancer she could find; she found the best plastic surgeons to do the reconstruction, and I should be pleased. That’s what matters. I know. I’m lucky. I’ve been told so many times. Except I hate that scar. Because I cannot not see it, it reminds me that I had a large tumor hiding in dense tissue below it, for a long time. And that makes me angry. But not for too long, because there is something akin to a solution on the horizon. You’ve guessed it. A tattoo. A tattoo. On my body, which as you know, until now has been a blank canvas

So last week, the very nice administrative assistant called to schedule my “nipple tattooing.” She asked if I would like Rick or Michelle, and surmising that Rick was probably a man, I asked if it wouldn’t be too much trouble could I please have Michelle. I subsequently felt even better about this decision since Rick apparently bears some resemblance to a jolly Santa Claus erstwhile biker. I cannot bring myself to discuss nipples with either Santa or a biker.  Well, Michelle was a hoot. Following my announcement that this experience would definitely be on a list of the most unlikely things I have ever done in my life, much hilarity ensued about the other things that would surely be on my list and hers, which for obvious reasons cannot be divulged here, although some would argue are probably entirely more appropriate than nipple talk. Within seconds, I was sharing confidences with her in the way one does with a trusted hairdresser until she executes that one really bad hair cut … but we always go back to them, in the end.

As Michelle and I looked in the mirror, arms folded, eyebrows furrowed, (me topless), we made observations about my left nipple like the Keno brothers appraising something that may once have been of value, on Antique Roadshow (which it must be said my husband faithfully watches every Monday evening). With a tape measure to bolster her argument about where the right nipple should be, the lovely Michelle, (and really, she is lovely), pointed out that I am something of a rarity with a small, but let it be noted, “awfully cute” left nipple. Perhaps she thought I wanted more from the tattoo, but when she painted on an idea of what it might look like, I almost wept. Immediately, my eyes were diverted away from the scar.

Well, of course there was more to it, and there I was once again supine on a table, staring at the ceiling, mind racing. In this instance, I was taken back to the early 1970s when Santa, not Rick, but the real Santa brought for me one glorious Christmas morning a Spirograph Set. It might be my all-time favorite gift. I spent hundreds of hours hynoptized by the geometric designs I could create with the handy templates provided therein. Any other spirograph fans will enjoy this old black and white commercial. I digress, but only a little.

Michelle duly numbed the area, using the aptly named “Numpot Gold,” which I of course heard as “Dumbpot Old.” Along with my failing eyesight (which has nothing to do with cancer) is the sad suggestion that I might actually be harder of hearing than I used to be. 50 is not a kinder, gentler 40. True. I resent aging, as I’ve said before. Anyway, following the numbing, (not that there is any perceptible sensation in the reconstructed breast), Michelle produced her faithful tape measure once more, and the lime green template reminiscent of my beloved Spirograph set. Then there was the choosing of colors, as difficult or as easy as settling on a color for hair or nails. When I go for a pedicure (a treat I only discovered in the late 1990s), the most time-consuming part is in the selection of the polish. It takes entirely too long. It’s not a matter of red or pink, but every imaginable shade of each and every other color of the rainbow too. I don’t know why I take so long, because I’m a creature of habit, and usually settle for something I know like “I’m not really a waitress,” (bearing in mind I have been a waitress and was good at it). Last week, however, I broke free from my comfort zone and went for the cheery, summery “Tarot Reader.” I liked the suggestion of foretelling whatever might be in my stars. My daughter always opts for “DS Magic,” a bluish sparkly concoction, and she is partial to a flower on her big toe. The darling pedicurist always asks “Would you like a happy toe?” and my daughter always responds as though she has never been asked before, ” Ooh, yes, please!” How I love that little exchange between them.  But there are other nail polish colors, the names of which are overtly sexual, a fact that troubles me and leads me back to what’s in Michelle’s arsenal.

Surveying the various pinkish and flesh toned inks she has chosen, I find myself wondering about the men who are diagnosed with breast cancer every year, and how they must feel about how every facet of this disease has been euphemized, feminized, and glamorized. Even in the face of estimates by The American Cancer Society that close to 2,000 new cases of male breast cancer will be diagnosed each year and that about 400 men will die from breast cancer annually, it’s still wrapped up in sugar and spice.

I tried to envision Michelle discussing with a man recovering from a mastectomy, the relative merits of the various inks that would ultimately create a nipple – ‘Kiss Me,” “Baby Lips,”  “Creme Areola,” “Nude Lip Mix.” Seriously.  I wanted to delve deeper into the subject of these suggestive colors and the creative mind behind them, but the issue is so much bigger than Michelle and me. So she went about the business of creating a nipple – it didn’t take long, given the size (see above, again). As she concentrated on fashioning a tattoo, I lay there thinking about gender and breast cancer, only vaguely aware of the sound of the needle puncturing my skin to make a new nipple. I thought about men with breast cancer and how they must navigate a culture that is decidedly girly with its lipstick-like colors for nipple tattoos, its fluffy pink pillows that help prevent the seatbelt from digging into the tender, biopsied and reconstructed breasts. I even paused to recollect the uber-feminine pink and black “sex appeal while you heal” bra that is just too much bra too soon for someone who can regularly score a very nice Calvin Klein bra for less than ten bucks at Marshalls, not to mention a bedraggled and traumatized well-medicated 49 year old, barely able to stand up straight with a JP drain sprouting, alien-like, from her right armpit and either hip. But that is another tale for another day. And I am on vacation. From breast cancer.