All You Could Ask For: A Novel (20 page)

I think I should tell you who I am, because it’s important to me that you know that I’m not just a cancer patient. I hope no one takes that the wrong way. I know you’re all cancer patients, too, and I don’t want to minimize that, I really don’t, but that’s not who I am, just as I assume it’s not who you are. I assume you’re all somebody just like me, somebody’s daughter, somebody’s sister, maybe somebody’s wife. Maybe somebody’s boss. I’m some of those, not all of them. I’m not anybody’s boss, or anybody’s wife, and I’m not sure if I’ll ever be either one. I mean, I wasn’t sure last week, before this bomb was dropped on me, and I’m even less sure now.

So who am I? I’m 28 years old. I was raised in Greenwich, Connecticut. I love sports, not so much watching them as playing them. I love to be outdoors, hiking, biking, running. I’m a good athlete. Just three weeks ago I finished the Ironman Triathlon in Kona, Hawaii. It was a 2.4-mile swim, 112 miles on the bike, and then a full marathon; I completed the course in 10 hours, 23 minutes, and 17 seconds. I have never felt healthier, stronger, better in my life. The idea that I might be sick could not have been further from my mind.

I came back to New York with my father two days after the race and began to get my life back together. (It’s a really long story how it had come apart. I won’t get into all the details today, maybe another time. I’ll just say that I married the wrong man. But there’s no need to feel sorry for me. I’ll bet marriage is a wonderful thing if you choose the right person, and maybe I’ll find that out someday, but I’m all right with it if I don’t, I really am. I felt that way before my diagnosis and I feel that way now.)

I was planning to go back to work as a television feature producer and I still am, but I couldn’t get in to see my old boss for a few weeks, so I was just taking a little time off. I rather liked the idea of easing my way back in. I went to visit old friends, ate in some fabulous restaurants, joined a new gym, started looking for an apartment. Everything was really mellow and nice, and after two months in Hawaii it was mostly terrific to be back in the hustle and bustle.

One of the things I needed to do was go up to Greenwich to see my gynecologist. I hadn’t been in over a year, between travel and my ill-fated marriage and a variety of other reasons too, among them being I had grown tired of the lecture the doctor is always giving me. You see, my mother died of ovarian cancer when I was just eleven years old, and my aunt Judith was diagnosed with breast cancer when she was thirty, so my doctor has been pounding into my head that I need to start having mammograms much younger than most women, and even advised I should see a genetics counselor, because my family history puts me in a high-risk category. And I appreciate her concern, I genuinely do, but when you’re young and healthy you’re just not thinking that way.

Except this time I listened.

Part of the reason, ironically, was that I’d been feeling so good. I’d been treating my body so well in every other way: nutrition, exercise, training; consultation with medical doctors just felt like it fit. Plus, as I mentioned, I had a bunch of free time on my hands.

So I went.

My gynecologist made the appointment for me at Manhattan Breast Radiology Center last Tuesday. I couldn’t have been less agitated about any of it. In fact, I felt empowered; it was just one more piece of my overall commitment to health. The entire time my boob was being squeezed flat in the machine I was contemplating becoming a vegan, and beating myself up for disliking the taste of carrot juice.

The exam wasn’t as bad as I feared. The worst part was not being allowed to use lotion or deodorant; I was paranoid I would smell. But the machine itself was fine really; a little uncomfortable, but certainly I’ve been more uncomfortable before. It didn’t feel like it took so long, either, and when it was done I got cleaned up and dressed and sat and waited, surreptitiously sniffing about my armpit the entire time. Then the radiologist came back in the room with a funny look on her face. It’s not a look I’ve ever seen before, but I could read it immediately. She had news for me, and she didn’t want her expression to give it away.

“Samantha,” she began, “we did a mammogram, an ultrasound, and we did some additional views, and here is what we found. You have what are called abnormal calcifications in your left breast. Knowing that you have the family history we spoke of, I think we should do a biopsy.”

“I’m sorry, what?” I said. I’d heard every word, I just didn’t have any idea how to respond. All I could think of was to ask her to repeat herself.

“You have a cluster of abnormal calcifications in your left breast. I can explain to you in as much detail as you like what that means—”

“You don’t have to do that,” I said. “I know what it means.” I didn’t. I had no idea what it meant, I just really didn’t want to have it explained to me. “Should I go get a second opinion?” I asked.

“Really, this isn’t an opinion,” she told me. “If you want someone else to look at your films before we do the biopsy, we can arrange that, but there isn’t any question about what we are seeing. I don’t want any of this to seem scary for you. It is likely that there is nothing at all to be concerned about, but considering your family history there is no doubt in my mind we should perform a biopsy.”

“When do we do that?” I asked. I rubbed my hands together. My palms felt cold and clammy.

“Let me make a quick phone call,” she said. “If I can get the insurance approval, we do it right now.”

And she did. She numbed the upper area of my breast with a shot, then dug a needle in and removed some tissue. It hurt, a lot. Even with the Lidocaine. And she told me we would know the results in forty-eight hours. That was on Tuesday, in the afternoon. I don’t think I slept at all Tuesday night, or Wednesday night either. I skipped the gym both days. I didn’t answer my phone, or respond to a single text or e-mail. Time moved achingly slowly. Whereas before I had been energetic and hopeful, I was suddenly lethargic and sad. Then the phone rang, nearly six o’clock Thursday evening. I didn’t recognize the number, so I answered it.

“Hello, Sammy.”

It was my gynecologist. Only people who have known me since I was little, as she has—I grew up with her son—call me that. I haven’t used the nickname in ten years. I don’t mind the name but her tone bothered me. She sounded like she was trying really hard not to alarm me, which alarmed me a lot more than if she’d just come out and said it.

“What did the tests show?” I asked.

“I think you should come in tomorrow morning and we’ll talk about it.”

That was when I went from lethargic to frantic. My hands were shaking. I held the phone away from my head and watched it quiver in my fingers.

“You have to tell me now,” I said, the phone still away from my mouth, “I can’t wait until tomorrow morning.”

I clicked the phone onto speaker and placed it on the floor, then I lay down flat on my tummy to hear what she had to say.

“Samantha, there are abnormal cells, they are cancer cells,” she said, her voice tinny and hollow. “We should talk about it in person, but you’re going to need to see a breast surgeon.”

I could feel my heart beating against the wood floor.

“They are malignant cells, but they are noninvasive cells, which in regular English means they do not look like the kind of cells that will spread, but it needs to be taken care of. When we sit down to talk, I will give you the name of a breast surgeon.”

I sat up, cross-legged, and shouted toward the phone.

“What do you mean a breast surgeon? Like a boob job?”

“Not at all,” she said, and as I listened I started to breathe deeply, in and out, in and out, just like at the beginning of a yoga class. “In the old days there were surgeons who would do everything, one afternoon they might do two gall bladders, fix a hernia, and then do a breast surgery. But now they have people who do only breast surgery. I will send you to one.”

I was starting to get it. I think I knew the answer before I asked the next question.

“Are you saying I am going to have to have my breast removed?”

There was a long silence in the space between my knees and the phone. I filled it as best I could with my breathing. I was in no hurry to hear the answer.

“That isn’t going to be a decision I make,” she eventually said. “That will be a decision you’ll make in consultation with the surgeon. But, candidly, I would tell you I think that is going to be a possibility, yes.”

I did not say anything. I did not think anything. I breathed in and I breathed out.

“As you know, Sammy, you have this family history,” she continued, “and this history means you are at a disproportionately high risk for breast cancer. So, while you might consider just doing a lumpectomy, taking out only the affected area, I think it is certain the surgeon will talk to you about taking off your breast, and I would say that in my opinion that would be a very reasonable option.”

I put my hands on my breasts, cupped them, squeezed them. They’re small, always have been, but they’re firm and proud. I haven’t thought about them much, really, since I was a girl. I like them, I suppose, but I don’t think I
love
them and I surely know I don’t
need
them.

“Let me ask you,” I said, still cross-legged, still shouting toward the phone, “if I have the surgery and they take off my breast, would that be the end of it? Would that mean it was gone and I’m totally out of the woods?”

“The answer is not as simple as yes or no. I don’t want to make this complicated for you, but doctors can be like lawyers sometimes, we don’t like to speak in absolutes . . .” Her voice trailed off.

I opened my eyes, picked up the phone, turned it off speaker, spoke directly to her. “Dr. Leslie, I have known you since I was a little kid. You knew my mom, you’ve known me my whole life. I played spin the bottle with your son Elliot when I was in sixth grade and he was chewing grape-flavored bubble gum when he kissed me. What I’m asking you to do, even if it’s not what you’re supposed to do, is tell me the real truth the way you would tell a friend, not a patient, because I am scared to death right now and the only thing that will make me feel better is knowing the whole story, whether it’s good news or bad.”

She paused a second. “You know, Elliot is a doctor now,” she said. “He’s a resident at New York Presbyterian on Broadway. I’m sure he’d love to catch up with you sometime. Hold on, let me close my door.” It sounded like she set the phone down, then I heard some rustling, then she was back, breathing a little heavily, speaking a little more softly. “Okay, here’s the deal. We are dealing with a couple of ‘ifs’ here, so I can’t promise you anything. But if you do have only a noninvasive cancer, which means the kind that does not have a propensity to spread, and that’s
all
they find when they do the mastectomy, then, in essence, you are cured. We never like to speak in absolutes, and that isn’t just to cover our ass but it’s because sometimes things happen that we don’t expect to happen, things that shouldn’t happen. But the answer you are looking for is YES, if all they find is what I think they are going to find, then YES, in any way that really matters you are cured after they remove the breast.”

So that made my decision for me, right there, on the floor, the phone in my hand, her voice still registering in my ears but not in my brain. I had heard everything I needed to hear. There would be other questions but there would be time for those later, right then I knew what I wanted. I wanted to see the surgeon as soon as possible. I’d have gone that evening if I could have.

And I knew who I was, who I am, maybe more clearly than I ever have before.

I am too strong to let this stop me.

I am too healthy to be defeated by anything or anyone.

I am too resolved to be afraid.

And I am alive. I will never take that for granted again.

I don’t care about my breasts, and I don’t need any man who does. Any man I ultimately lose because of this will not have been worthy of me to begin with.

I am going to have this surgery and then I am going to resume my life with no hesitation. The key to life is having a plan, having a destination and then charting a course to reach it, and so I have. I can see the path and I can already see the end of it, I can see
me
at the end of it, and I love where I am and who I am when I get there.

I would consider it a privilege to have any of you who read this accompany me on my journey, and in turn I will walk with you as well, any of you, all of you, on yours. I await your reply. In the meantime, I am going to be absolutely fine. I have never been more certain of anything in my life.

Brooke B.

BreastCancerForum.org

Greenwich, Conn

Date joined: 9/30/2011

I remember the sweet sixteens so well.

It’s a stage you go through as a girl, at least where I come from. Some of the girls use their sixteenth birthdays as coming-out parties, debutante balls. I started to be invited to those parties around the time I was twelve. They were so glamorous, it was like being invited to the Oscars every weekend. I had to have a different dress for each event, which meant there were times when I needed two or three in a month, and that lasted about four years.

The next stage was when all my friends started to marry. That was another regular cycle, beginning when I was twenty-two. Scott and I must have attended thirty weddings and I was a bridesmaid in at least half of them. It became a ritual, choosing the bridesmaids’ dresses, complaining about the colors behind the bride’s back, organizing showers in strip clubs and tea salons. Hair and makeup and hosiery and tears; that lasted three years.

The next stage came very quickly after that. That one was babies. Jill Armel was the first of my group to become a mom. We were so young at the time, and clueless; four of us went to visit her in the hospital just hours after she gave birth. I’ll never forget what she looked like, exhausted and pale. She had been in labor for eleven hours. I asked her cheerfully: “How are you, sweetheart?” And she grumpily replied: “I haven’t peed in two days.” That woke me up a little.