God hasnât forgotten me.
Lookâhe sent an illness!
âRussian Proverb
at first there were only looks and very few words. I didnât 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.
âSheâ 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 Ozâs wizard, she was planted somewhere, in an inner sanctum, reading. She was neither chewing gum nor drinking coffee in my mindâs eye; she wasnât leafing through the empty paragraphs of a waiting roomâs 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 sheâd 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 morningâs death toll from Iraq.
Mammograms, thereâs no question, are painfully unpleasant, but at least you stand for them. In the ultrasound room, you are supineâwhich, in medical situations, as far as Iâm 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 diverâs might when heâs found the endangered anemone he was in search of. But this nearly jubilant alertness turned almost immediately into its opposite. The nameless womanâs face turned, there is only one word for it, grave. She gave me her face, her sad face, and she said, âYou stay right here while I show this to the doctor.â
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, sheâd see something different and better than the technician had. The doctor didnât quite know how to angle the instrument, so the technician helped her saying, âDo you see the shadow?â âAnd the peaks?â 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. âYes, you need to arrange to have a biopsy. This is concerning,â she said. And I said, âBut Iâm leaving town tomorrow. Iâm a writer, and I have a new book just out, and Iâm giving a series of readings from it beginning in California.â She looked at me sadly and said, âYouâll have to figure something out.â And then she left the room.
âWhatâs your name?â I said to the ultrasound technician.
âJoan,â she said, and I said, âJoan, my name is Mary. Can you tell me something about what youâre seeing?â And she used the doctorâs word, âWell, itâs concerning,â she said. âItâs suspicious.â The euphemisms were coming thick and fast, and then her face turned grave again, and I thought she was going to say, âItâs your cat, your little cat with the graceful lilt and upturned tail, something fell on your cat and smothered her, and well, sheâs dead,â but what she said was, moving her head to one side as though she knew I would want to punch it, âItâs definitely not a cyst.â
âSo what does that mean?â I asked.
âIt means itâs a mass. Itâs concerning.â
Iâm not sure at what point I moved from lying down to sitting up, but I remember saying to Joan, as though I didnât have to think about it, the words came so naturally, I said, âI guess itâs my turn.â 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. âDonât say that!â she said, still with the long face. So I explained myself because Joan clearly wasnât understanding me. I said, âIâm not saying Iâm going to die, but every other woman I know has cancer, so Iâm just saying I guess itâs my turn. I mean why shouldnât I have it?â 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 didnât want to disturb the other women in the waiting room. I didnât 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. âSo this is him, right, thatâs Dr. Timothy Speers?â she asked, looking at a chart, and I corrected her, âNo, itâs Dr. Beaumont, Rene Beaumont.â She showed me the form with the wrong name on it, and I noticed that the name of the radiologist was wrong, too, because Iâd just met the buxom woman with the long nose and I donât 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 didnât matter, nor words, when both were everything to me.
Iâm 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 itâs 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. Iâm 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 gynecologistâs 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 Iâd beenâhowever routine that was and intermittent. She introduced me to a word other than âmass.â
âSo itâs not a cyst,â I said, and she said, âThe thing about it is that itâs 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.â 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.
âWould that this too, too solid flesh would melt, thaw, and resolve itself into a dew.â Literary references immediately entered my mind. I felt like reciting Hamletâs words, but checked myself! Alice Jamesâ 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 âan island of difference.â (I heard this line even though nothing about a potential breast c-diagnosis made me feel âdistinct.â Itâs 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, Iâm hopelessly alone. With metaphors, Iâm like, Iâm 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 Iâd 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. Iâd 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. âGo with that!â I told myself. Hmmm. Itâs 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 biopsyâno one had ever described to me the parts of this procedureâIâd hoped to gaze at the ocean mural painted by a student from the Rhode Island School of Design onto one of the hospitalâs ceiling panels. But the gurney got pulled around, turning the image upside down. The steps of a core biopsy go like this, and, remember, youâre 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 sheâll 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 âbreak up,â and she has to take more.
I told myself I was of âstrong peasant stock,â 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. âThis is nothing!â I told myself, and when the doctor and technician beheld my calmââYou didnât even flinch!â they saidâI lied a little: I told them I had practiced Tai Chi.
They sent me home with a prescription: âGo out and buy six bags of frozen peas,â Maya, the technician, said, âand keep them tucked inside a tight fitting bra for the next twenty-four hours. Thatâs going to be the best thing you can do for yourself.â 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 didnât 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 âragged,â âpointed,â âpeaked,â âstarlike,â âspiculated,â or âfinger-likeâ? Does a tumorâs 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 starâwell, a star is simply beyond reach, but I appreciated it for its fanciful dimensions. As though the sheriffâs badge I wore as a kid embedded itself, as though the fairy whoâd 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 mothâs wing, the moth caught inside your chest, the tumorâs changing form, its batting. âRaggedâ suggests unkempt. âStar-likeâ invokes the heavens. âFingersâ 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 thereâs 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, âYou look like your mother!â, âYou look like your father!,â one brave, wise soul looks you in the eye and says, âYou look like nobody but yourself.â
Words do matter. What if instead of saying, âI have breast cancer,â I said I had EPMâEnvironmental Pollutant Marker or, if you prefer, Environmental Pollutant Mangler? Or PPPâPlastic Polymer Perverter? Iâm not âsufferingâ from anything just yet: PPP in its earliest stages is symptomless. In fact, Iâve never felt better in my life. Iâve only been duped, despoiled by global capitalism and imperialism, in which case, Iâm a benighted victim of GCI syndrome, just like you, and I was such a âproductive citizen,â too.
Names are key. The answering machine can be a devilish device once the news is out.
Message #1: âHi you guys, itâs Lori White. I just got the news of Jeannieâs diagnosis from Laura in an e-mail, and I just want to give you such positive thoughts. Having beat this myself, thereâs so much to be hopeful about, Jeannie, and I really want to talk to you. I hope youâll call me tonight.⊠Tomorrow Iâm participating in a triathalon. Iâm in great shape, and Iâm going to show the world I can run a triathalon with one breast! I hope youâll call me!â
Message #2: âUh, Jeannie, Mary, Iâm so sorry. I just re-read Lauraâs message and I see itâs Mary who has cancer. Mary, Iâm so sorry. To be honest, I was a little bit in shock when I read the news and I wasnât thinking clearly. So, Mary, I hope youâll give me a call because I really want to talk to you about this, ok?â
You canât 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 youâll have to keep them on track and stay clear for them.
Mary: âHi Lewis, itâs Mary. I know you got the message that it is cancer âŠâ
Lewis: âOh my God, Mare, I canât believe it, do you really have stage 5 cancer then?â
I had explained to this beloved friend, face to face in my garden, that the radiologistâs code for my tumor was 5, or âhighly suggestive of malignancy,â but stage 5 cancer? I had to explain to him that if I had sta...