Left Breast, and the Woman Who Brought It In

[This time, the story has a happy ending…but here’s to Kim and Sandee and Susan G and John H and Patti, to my mother and your sister and our dear friend’s uncle…to all of those for whom the follow-up appointment was not closure, but the beginning of a frightening and unexpected journey…]

********

Years ago, after I’d had my mammogram, I complained to my doctor that surely a male had invented that machine. And he–that shambling, wild-haired, guffawing man—he laughed outright. In Europe, he said, they have developed a machine that gently cups the breast instead of flattening it.

Well, I suggested, let’s get one of those.

Nah, he said. That was the day he had a piece of gauze sticking out of his nose, stanching a bleed. You ought to see a doctor for that, suggested his sharp-tongued nurse, eyes twinkling. He shooed her away with a flapping hand and turned back to me.

Nah, he said again. Whaddaya want? That we treat you like some kind of person?

********************

Don’t move, they tell me, and so I don’t. I lay on my belly; my head rests in the crook of my right arm. I hook my left foot around my right ankle just in case my right leg, which tends to get crampy, starts to twitch. I am buffeted by warm flannel, and I am floating on a Valium cloud–all of me is, that is, except my left breast.

My left breast hangs through a hole in the weird, strong plastic table; it, and I, are suspended above three practitioners, a doctor and two nurses. They all seem like lovely people, but they situated me, then they elevated me, and then they ducked under my floating table to deal with my breast. I hear the murmur of their words, but I am detached, separate, not part of the goings-on.

It is easier, maybe, to forget that there’s a person attached. They need to focus. I am merely the pleasant woman who brought the breast in for them to work on. I am left breast needle biopsy, Thursday, 3:15.

***********************

One morning this fall, after months of avoiding the idea, I woke up with an imperative, fully fledged, in my mind. Make your OB/gyn appointment. Do that today.

I called as soon as the office opened, called before I left for work; they had an appointment for me the next week.

I met with a nurse practitioner, Abby, who looked as though she might be all of 25. But she was calm and capable and friendly; we had a good discussion about career choices and how it is that she came to work in the OB/gyn field.  A tough field, I thought, as Abby apologized for pressure and prodding and cold steel instruments. Gynecology, to me, seems to have the potentials of extreme joy and of total disaster.

The joyful days, Abby said, balance the depressing ones, but she was glad to be a part of the process either way. Sickness and health. Babies and menopause. Prevention and cure. Diagnosis and management.

Are you doing your breast exams? she asked, and I allowed that I was, and I found nothing  amiss. She did her own exam, and she agreed. She wrote me a scrip for a mammogram and ushered me out.

See you in a year, she said.

The receptionist set up the radiology appointment; there was an opening that Friday afternoon.

Good, I thought; let’s get this over with so we can concentrate on packing for our Thanksgiving trip, and then on Christmas preparations. But I had a sort of nubby suspicion, free-floating.

********************

Diana came out and got me within five minutes of my check-in; I’d barely had time to crack open my book. She walked me through a cheerful hallway maze, and told me she’d be taking my mammogram pictures. She ushered me into a pleasant changing room where the ubiquitous pink flowered cape waited.

I changed and pulled the cape around me, and I cracked the door open to let Diana know I was ready. Diana was a wiry, attractive grandma, just about my age. She was excited about her new grandbaby coming for Thanksgiving. We talked about brining and roasting bags and just cooking the damned turkey; we compared notes on stuffing (sausage? oysters? in the bird? out?) as she shaped first my right breast, then my left, like Playdough and sent the top clamp pressing down. The machine buzzed and clicked while we chatted.

Then her talk wound down.

Let’s just try this again, said Diana, and she re-situated me, a different left breast view, and took more shots.

I’ll just take these to the radiologist, she said, smiling, patting me on the shoulder. And then we can get you dressed!

I heard her cushioned shoes pad down the hallway, heard her stridently cheerful voice greeting a colleague. She was back quickly to steer me back to the dressing room, and she waited while I dressed to guide me back through the maze to the door.

“Bye, now!” she said brightly. “Have a nice Thanksgiving!”

“Happy Thanksgiving to you,” I said, and I knew: there was something. I’d gone from being a friendly woman to talk with to being Left Breast, mass identified.

**************
The second mammogram was scheduled within in a week. A different radiographer, Lois–substantial and forthright. See? she pointed out. See there? And there?

My breast tightly vised, I turned and looked. One spot was  the dark open end of a flower stem; the other, a tiny, bright asterisk.

Definitely there, said Lois. Sometimes it’s just the way your tissue overlaps in the shot. But not this time.

We’ll get you down to sonography, she said, and handed me over to a firmly cheerful young woman who told me about her three year old and likened this kind of sonogram to a search for a needle in a haystack. But she found the needle; she snapped shot after shot, typing in a description on each.

***************
An appointment with a specialist, who was brisk and professional and reassuring. Benign properties, she adjudged (but I recollected uneasily that Sandee’s doctor told her the same thing), and she set me up for a biopsy the following week.

It’s not a pleasant procedure, she told me, but it’s not horrible. The worst part is getting numb, she said, and cheerfully left me to get dressed.

(I remembered Kim and Kathy talking about their biopsies. I remembered them talking about being placed on a table with a hole cut out for their breast, so that people underneath them could perform the necessary rites.

I remembered one of them saying, fighting back tears: This was the worst thing…)

******************
And so, Mark and I came to be in an inner hospital waiting room on a snowy Thursday afternoon.  A young woman in bright scrubs came and beckoned me, took me into a back room, and asked, Would you like a good strong dose of Valium?

Oh, yeah, said I, forgetting my strong stance against over-medication: Yes, ma’am. I do.

Good, she said, and she gave me the pill and a big glass of water. As I walked back to sit next to Mark, I could feel the fizz entering my veins. I was free-floating when the nurses came to get me.

There were two; their names have wafted away on a Valium tide, but one was young and dark-eyed and plump. The other was thin and taut and in the throes of hot flashes. She pulled her long-sleeved uniform jacket off repeatedly, grabbing it when goosebumps rose, flinging it off again when she began, suddenly, to sweat. We talked about menopause, and I admitted, feeling guilty, to having had very little trouble.

And they gave me a cape and introduced the doctor and helped me onto the table.

Don’t move, they said; you can’t move now.

And the table rose and their voices receded. I was strangely alone above the fray. I wanted to say to them, I’m a little bit scared here. I have a 26-year-old son with autism who’ll be terrified if he finds out I’m sick. I’ve got a lot of stuff I’m working on, and my husband and I are looking forward to traveling, post-retirement. I’m thinking, I wanted to say, of writing a book.

But they were huddled below me, intent on their tasks.

I felt the needles for numbing.

Now you’ll feel PRESSURE; that’s okay. But tell us if you feel anything SHARP, said the dark-haired nurse, popping up, patting my jutting elbow, then ducking beneath the table.

But I DID feel sharp things, pointed things, crisp flashes. There were tiny, glancing, interior pops of white light. It felt like the needle lanced my breast through to the other wall. There were murmurs and pushing and lightening pops below me; cushioned shoes scuttled to a monitor. Muted discussion. Tissue harvested!

And then the three abortive efforts to seat a minuscule marker deep in my breast–the lights popping more quickly and more crisply, the nurses murmuring encouragingly, and the doctor calling up, each time he started over, “Thanks for your patience!”

The Good Girl part of my brain thought, with satisfaction, “I’m a good patient.”

The other part of my mind snapped back, “What damned choice do I have?”

Done, finally, and the doctor soft-shoed away while the nurses lowered me down and said, Just stay still a minute while we clean up the blood.

I hadn’t thought about blood; I’d thought of a slender tubular needle zipping in, flashing out, process done.

I hadn’t thought about bleeding, or bruising, or about being suspended above the process itself, as if someone had said, in brisk annoyance, “Can we hide that person, please? While we tend to the breast?

******************
This story has a happy ending: the doctor danced in to our next meeting with the word, “Benign!” quick on her tongue.

So we’ll watch things a little more closely for a bit. I’ll have mammography a little more often, just to be sure that nothing changes or grows, no desperate tendrils unfurl in dark places, snaking out to grab healthy bits  and choke them.

And I will remember, warily, the feeling of disconnection, of being ancillary to the whole medical process.

The woman who brought in the breast–what shall we do with her while we’re busy here?

Just lay her down; we’ll raise her over our heads so we can concentrate on what’s important. Then ready Left Breast and let’s get cracking.

******************

I am thankful every day, for my undeserved, unearned health–health that beloved dear ones, and health-conscious young ones, and many someones’ precious, precious ones, do not enjoy. Then  I ponder the advances in medicine that float away the person, leaving only the silent, uncomplaining part of the body to attend to. I met many kind and caring people on this short journey, but I realized, in our time and in our system, that medicine is often about the limb, the lump, the blip, the blood…and not always about the complex personality affected by the pain.

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16 thoughts on “Left Breast, and the Woman Who Brought It In

  1. So well told Pam. And as one who works in healthcare (in the periphery but also aware of the state of things), I commonly see the disconnect of whole patient care. It’s such a challenge. So happy you were blessed to be “one of the lucky ones!”

  2. Well done, Pam. Doctors have it tough: there are billions of us on the planet. If doctors had to account for our humanity every time they attempted a procedure, they wouldn’t get half of them done. Their tendency to treat us all like objects is a defense mechanism against losing their nerve when cutting upon and opening up the human body, an instrument sacred to us all, whether one is religious or not. To be able to operate upon the body, as doctors do, is both thrilling and deeply frightening. They have tremendous skill and tremendous confidence, but every one of them has to battle this fear: “what if I mess up? what if I do something wrong?” The only way to cope with that fear is to distance one’s self from it and from their patients’ bodies, which is what med students are learning to do when they dissect cadavers.

    Fortunately, the doctors I’ve had from 1963 to 2011 have all been warm, humane, skillful people, and I am aware every day of having had a fabulous, nearly life-long run of good luck. Whether my luck will hold up over the next twenty to twenty-five years is anybody’s guess. It’s entirely possible that I won’t able to be a good patient any more. I’ll be old and maybe frightened. But now, while I still have my mind and some good health, I realize that it’s mostly up to *me* to affirm my humanity. The doctor may not be able to do it. He or she is likely to be busy with saving the life that makes me human.

      1. Oh, I knew you weren’t. It’s just that our litigious society has forgotten that responsibility. Most of us (not you) have put *everything* on the doctors when we go in for a visit, and we have our lawyers at the ready. You, of course, are pointing to an entirely different level of treatment in your essay. Cancer is beyond our ability as individuals to care for; it is complex, requiring much help, and we may succeed or fail in treating it. In those situations we must, more than ever, try to remind ourselves that we are people–whole ones, happy ones–and we will be that way again. The certainty of that thinking is part of what heals us. As I said, I’ve been lucky. The doctors I’ve had have been very supportive, and I have done my part to make their job as easy as possible. Thanks for writing.I enjoyed reading it!

  3. Thanks for sharing this story, Pam. Timely for me (we are at an age, aren’t we!!) since I have to go for more tests because of a “shadow” on an xray….probably nothing, but still……….

    On another note, John’s response was most interesting. And yes, when I had a hemorrhoidectomy, I was pretty glad ALL the doc was thinking about was fixing my bum ; -) though I wish they had been more truthful about how long it would take for me to recover and how painful the recovery would be.

    So glad your lump was benign!!!!! I read Eva Saulitisis’ account of breast cancer last fall. She grew up in Silver Creek, went to Fredonia and then ESF. She conjoins the body with the earth in a beautiful, inspiring weave that will leave you desiring a deeper connection. Title is BECOMING EARTH.

    Another older one, you probably already know, is Terry Tempest Williams’ REFUGE.

    Be well, old friend.

    1. Carolyn…I just got Becoming Earth in last week’s mail! The Sun magazine featured an easy about her and an essay by her last month…I was amazed that I had never heard of her. Looking forward to reading it when I finish Ann Patchett….

  4. Thank you Pam for sharing such a personal experience. The gentle touch of the hand can often be all that’s needed to remind us of the human connection we share with one another. May you feel them all (now) reaching out to you, expressing how glad that you are well. Hugs!

  5. ‘The Good Girl part of my brain thought…’ I am definitely leaving a remark on that particular highlight! I enjoyed the shifts in narrative voice throughout your post. And the momentum returning to the positive happy continuing story is lovely. Very difficult subject and I really liked too how we might not be sure as a reader if the patient is male or female. We often forget that a man might have breast tissue cancers too – and that he doesn’t necessarily present with ‘manboobs’ to have those kinds of problems! Cheers Pam 🙂

    1. Colette, I walked in a Susan B Komen 5K a year or so ago (are those unique to the States, or do you such events in the UK?), and several of the folks we met along the way were male survivors. It struck me that I had been thinking of breast cancer as a woman’s disease. Although it affects more women, men get it too–an equal opportunity disease, sadly! We grow too old smart, as the Pennsylvania Dutch are known to say…

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