Called Back

My Reply to Cancer, My Return to Life

Mary Cappello

• Publisher: Fordham University Press
• Year: 2021
• Print ISBN:
  9780823294046
• Edition: 1
• eBook ISBN:
  9780823294053
• Topic: Social Sciences
• Subtopic: Social Science Biographies
• Index: Social Sciences

Foreword Book of the Year Award
Independent Publishers Award (IPPY)
Lambda Literary Award Finalist
Publishing Triangle Award Finalist
GAMMA Award, Best Feature from The Magazine Association of the Southwest for "Getting the News, " The Georgia Review, Summer 2009
Notable Essay of the Year Citation in Best American Essays 2010 for "Getting the News"
Named one of the Best Books of the Year by the Guerilla Girls On Tour and by WILLA: Women in Literary Arts and Letters An extended meditation on the nature of love and the nature of time inside illness, Called Back is both a narrative and non-narrative experiment in prose. The book moves through the standard breast cancer treatment trajectory (diagnosis, surgery, chemotherapy, radiation), with the aim of discovering unexpected vectors of observation, meaning and desire inside each phase of the typically mandated four-part ritual. A lyrical feminist critique of living with cancer at the turn of the twenty-first century in the United States, the book looks through the lens of cancer to discover new truths about intimacy and essential solitude, eroticism, the fact of the body, and the impossibility of turning away. Offering original exegeses of the work of Marsden Hartley, Emily Dickinson, Gertrude Stein, and Marcel Proust, Called Back relies on these artists' queer aesthetics to tease the author back to life. What might a person tutored as a reader of signs "see" inside breast cancer's paces, protocols, and regimes? What does the experience occlude, and what can we afford to liberate? The first chapter paves the way for the book's central emphases: a meditation on the nature of "news" and the new, on noticing, on messages—including those that the body itself relies upon in the assumption of disease—and the interpretive methods we bring to them in medical crisis. Language is paramount for how we understand and act on the disease, how we imagine it, how we experience it, and how we treat it, Cappello argues. Working at the borders of memoir, literary nonfiction, and cultural analysis, Called Back aims to displace tonal and affective norms— infantilizing or moralizing, redemptive, sentimental or cute—with reverie, rage, passionate intensity, intelligence, and humor.

1

Diagnosis:

news

God hasn’t forgotten me.

Look—he sent an illness!

—Russian Proverb

at first there were only looks and very few words. I didn’t even have a name, so I asked her her name, assuming that if I called her by her name, I might begin to have one.

“She” was the ultrasound technician who was examining an image of the inner contours of my breast on a screen. Prior to my meeting her, there had been a mammography technician who called me back into her room in the hope of gaining a better purchase on the mystery, on getting the machine to hone in, to bore down into, to see. Behind the scenes, I also knew there was a doctor. Invisible as Oz’s wizard, she was planted somewhere, in an inner sanctum, reading. She was neither chewing gum nor drinking coffee in my mind’s eye; she wasn’t leafing through the empty paragraphs of a waiting room’s magazines; she was reading, undistracted I hoped, by her love life, the pain in her left foot that was requiring an undue emphasis on the right, the impending visit from her estranged daughter, the whiff of a near nightmare she’d had the night before, the matter of her refrigerator seeming to be on the fritz with the dinner party upcoming, or the unsettling because no longer disturbing news of that morning’s death toll from Iraq.

Mammograms, there’s no question, are painfully unpleasant, but at least you stand for them. In the ultrasound room, you are supine—which, in medical situations, as far as I’m concerned, is never good. Rather than look at the screen, I watched the ultrasound technician watching. I tried to read her face. It was peering, and at a certain point it became more alert, the way a scuba diver’s might when he’s found the endangered anemone he was in search of. But this nearly jubilant alertness turned almost immediately into its opposite. The nameless woman’s face turned, there is only one word for it, grave. She gave me her face, her sad face, and she said, “You stay right here while I show this to the doctor.”

Now the doctor and the technician returned together, the wizard revealing herself to be simultaneously buxom and long-nosed, a kind of Wallace and Gromit figure with a British accent. She neither asked me my name nor greeted me, but hurried. She bustled all aflutter toward the screen as she took the matter literally into her hands. She began to wield the ultrasound wand as if to suggest that if she did this herself, she’d see something different and better than the technician had. The doctor didn’t quite know how to angle the instrument, so the technician helped her saying, “Do you see the shadow?” “And the peaks?” The words recommended to me a painting by Caspar David Friedrich.

Now the doctor looked at me as though I were an out of focus text and she was without her reading glasses. “Yes, you need to arrange to have a biopsy. This is concerning,” she said. And I said, “But I’m leaving town tomorrow. I’m a writer, and I have a new book just out, and I’m giving a series of readings from it beginning in California.” She looked at me sadly and said, “You’ll have to figure something out.” And then she left the room.

“What’s your name?” I said to the ultrasound technician.

“Joan,” she said, and I said, “Joan, my name is Mary. Can you tell me something about what you’re seeing?” And she used the doctor’s word, “Well, it’s concerning,” she said. “It’s suspicious.” The euphemisms were coming thick and fast, and then her face turned grave again, and I thought she was going to say, “It’s your cat, your little cat with the graceful lilt and upturned tail, something fell on your cat and smothered her, and well, she’s dead,” but what she said was, moving her head to one side as though she knew I would want to punch it, “It’s definitely not a cyst.”

“So what does that mean?” I asked.

“It means it’s a mass. It’s concerning.”

I’m not sure at what point I moved from lying down to sitting up, but I remember saying to Joan, as though I didn’t have to think about it, the words came so naturally, I said, “I guess it’s my turn.” Joan gasped a little, my words annoyed her, and she addressed me as though I were saying something self-punishing or inappropriately not nice about myself. “Don’t say that!” she said, still with the long face. So I explained myself because Joan clearly wasn’t understanding me. I said, “I’m not saying I’m going to die, but every other woman I know has cancer, so I’m just saying I guess it’s my turn. I mean why shouldn’t I have it?” And hearing myself say this, I cried a little, but not for long because I knew I had to gather my real clothes from their locker and I didn’t want to disturb the other women in the waiting room. I didn’t want them to know what I was being told about myself, so I quickly wiped my tears.

Now Joan offered help. She told me they were going to call my gynecologist and that maybe the biopsy could be performed that afternoon. “So this is him, right, that’s Dr. Timothy Speers?” she asked, looking at a chart, and I corrected her, “No, it’s Dr. Beaumont, Rene Beaumont.” She showed me the form with the wrong name on it, and I noticed that the name of the radiologist was wrong, too, because I’d just met the buxom woman with the long nose and I don’t think her name was James L. Fraser, M.D. Maybe this world was like marriage: all of the female doctors had to take on the names of their male peers. It was clear to me I was entering a world in which names didn’t matter, nor words, when both were everything to me.

---

I’m amazed by how my mind never slows down, how it gathers together in a flash multiple points of compatible referents as a means of making sense of things, or is that only something it’s doing now, confronted as it appears to be by the c-word: not the dirty word for woman, nor the kiddy name for shit, but the rampant and yet still tabooed emblem for a disease entity that scrabbles sideways like its namesake among crustaceans and hosts patterns much less wondrous than fractals. I’m sure through the right set of eyes something marvelous must lurk inside a c- cell, not only something horrifying.

Joan had cut a path through my gynecologist’s waiting room upstairs, and within an hour I was seeing her but with a different sense than I had ever felt before: suddenly I was in love with my gynecologist for the way she stood for someone I had known and in whose care I’d been—however routine that was and intermittent. She introduced me to a word other than “mass.”

“So it’s not a cyst,” I said, and she said, “The thing about it is that it’s solid. Ultrasound is very good at telling the difference. And it could be a kind of fibrous mass that women get, but the thing that is concerning is that its edges are ragged where the edges of most benign tumors are smooth.” Prior to trusting me with such an important distinction, she had complimented me on finding the lump because she found it hard to feel as she examined me. She shared her sense of hopefulness that it was small.

“Would that this too, too solid flesh would melt, thaw, and resolve itself into a dew.” Literary references immediately entered my mind. I felt like reciting Hamlet’s words, but checked myself! Alice James’ description of the lump in her breast also occurred to me, and almost as though her impeccably wise face were nearby, Susan Sontag whispered to me a line from Illness as Metaphor about illness depositing a person onto “an island of difference.” (I heard this line even though nothing about a potential breast c-diagnosis made me feel “distinct.” It’s really utterly banal.)

Watch the mind so as not to spin off course try to interpret the situation it finds itself in with metaphors. Without metaphors, I’m hopelessly alone. With metaphors, I’m like, I’m kin. So I gave myself, not trying to, I gave myself two metaphors when I went back to get my clothes outside the room where I’d earlier chatted with the other women and even made them laugh as together, waiting, we blankly faced the obligatory TV screen whose loop of tales of necessary prophylaxis against all the illnesses in the world, and hopeful skits about autistic boys who do karate, and quizzes about which fruit juice was best for your kidneys, went around and around and around like an idiotic song on a player piano. Two metaphors tried to help me imagine what I had become, or at least what I felt like: the first was an image of a rotten apple discovered among the good apples. Maybe because our smocks were red. I’d been identified as rotten, or at least rotting, and picked out from among the barrel of women in the waiting room to be deposited somewhere else. Fast upon the rotten apple idea, I thought of someone else I felt like: the person taken out of line for execution. Somebody had to be picked, and this is what it felt like. This particular raft, however bereft, bobbed consolingly up to the surface out of the basement suite of a storehouse of movie images that I, like anyone else, have stowed in my tiny, struggling brain.

This is what it feels like to be the one arbitrarily pulled out of line. “Go with that!” I told myself. Hmmm. It’s not the same as being chosen or not for a team in the lineup in gym class, but images of adolescent popularity or lack thereof hung nearby.

Other images I gave myself were more implicitly soothing. Lying on my side, readying myself for a biopsy—no one had ever described to me the parts of this procedure—I’d hoped to gaze at the ocean mural painted by a student from the Rhode Island School of Design onto one of the hospital’s ceiling panels. But the gurney got pulled around, turning the image upside down. The steps of a core biopsy go like this, and, remember, you’re awake: first a needle filled with local anesthetic is inserted into the affected breast. Then a small incision is made through which a doctor guides a tube, into which she inserts an instrument that she’ll use to take samples of the tumor, the contours of which she simultaneously watches on an ultrasound screen. She needs to withdraw five samples minimum and the instrument makes a loud stapling sound with each extraction. Sometimes the samples “break up,” and she has to take more.

I told myself I was of “strong peasant stock,” and called up an image of my great-grandmother, all of whose six children but one died in childhood. At a certain point in the litany of child deaths, she made a pilgrimage to Rome where she climbed the Scala Sancta, penitently, on her knees. “This is nothing!” I told myself, and when the doctor and technician beheld my calm—“You didn’t even flinch!” they said—I lied a little: I told them I had practiced Tai Chi.

They sent me home with a prescription: “Go out and buy six bags of frozen peas,” Maya, the technician, said, “and keep them tucked inside a tight fitting bra for the next twenty-four hours. That’s going to be the best thing you can do for yourself.” Again, an image came: this time, in the form of a memory, of an afternoon of terrific heat in a town outside Milan. It never got so hot there; no one had air conditioners, and the two pugs of the woman I was staying with were nearly hyperventilating. So she applied a pack of frozen peas to the sides of their heaving jowls, but the method didn’t work well because the dogs in each case bit through the bags and ate the peas.

---

Given a choice between descriptors for your tumor, which would you prefer? That the edges be “ragged,” “pointed,” “peaked,” “starlike,” “spiculated,” or “finger-like”? Does a tumor’s edge by any other name rage as fiercely? Each of these adjectives was delivered to me in a twenty-four hour period, and I was struck by their range. A finger has to be unfurled, a peak scaled, a star—well, a star is simply beyond reach, but I appreciated it for its fanciful dimensions. As though the sheriff’s badge I wore as a kid embedded itself, as though the fairy who’d touched the tip of her wand to me while I was sleeping, meaning to bejewel me, had harmed me. In an ultrasound image, edges look like pieces of a moth’s wing, the moth caught inside your chest, the tumor’s changing form, its batting. “Ragged” suggests unkempt. “Star-like” invokes the heavens. “Fingers” emit a body within the body that can encroach, grab, and strangle. As such, finger-like is my least favorite descriptor.

Words do matter, and yet there’s a way in which a tumor is like nothing but itself in that same way that each of us is told by someone in the earliest days of our lives, when everyone is saying, “You look like your mother!”, “You look like your father!,” one brave, wise soul looks you in the eye and says, “You look like nobody but yourself.”

---

Words do matter. What if instead of saying, “I have breast cancer,” I said I had EPM—Environmental Pollutant Marker or, if you prefer, Environmental Pollutant Mangler? Or PPP—Plastic Polymer Perverter? I’m not “suffering” from anything just yet: PPP in its earliest stages is symptomless. In fact, I’ve never felt better in my life. I’ve only been duped, despoiled by global capitalism and imperialism, in which case, I’m a benighted victim of GCI syndrome, just like you, and I was such a “productive citizen,” too.

Names are key. The answering machine can be a devilish device once the news is out.

Message #1: “Hi you guys, it’s Lori White. I just got the news of Jeannie’s diagnosis from Laura in an e-mail, and I just want to give you such positive thoughts. Having beat this myself, there’s so much to be hopeful about, Jeannie, and I really want to talk to you. I hope you’ll call me tonight.… Tomorrow I’m participating in a triathalon. I’m in great shape, and I’m going to show the world I can run a triathalon with one breast! I hope you’ll call me!”

Message #2: “Uh, Jeannie, Mary, I’m so sorry. I just re-read Laura’s message and I see it’s Mary who has cancer. Mary, I’m so sorry. To be honest, I was a little bit in shock when I read the news and I wasn’t thinking clearly. So, Mary, I hope you’ll give me a call because I really want to talk to you about this, ok?”

You can’t blame people. Their being upset must be a sign that they love you, right? But you perhaps should be forewarned that their reading and listening faculties are likely to go awry at this time, so you’ll have to keep them on track and stay clear for them.

Mary: “Hi Lewis, it’s Mary. I know you got the message that it is cancer …”

Lewis: “Oh my God, Mare, I can’t believe it, do you really have stage 5 cancer then?”

I had explained to this beloved friend, face to face in my garden, that the radiologist’s code for my tumor was 5, or “highly suggestive of malignancy,” but stage 5 cancer? I had to explain to him that if I had sta...

Table of contents

• Cover
• Praise for Called Back
• Half Title
• By the Same Author
• Title Page
• Copyright
• Dedication
• Contents
• Epigraphs
• Half Title
• 1. Diagnosis: news
• 2. Surgery: measure
• 3. Chemotherapy: feelings
• 4. Radiation: story
• CODA. Called Back: the voyage out
• Afterword to the 2021 Edition
• About the Author