Why I Wore Lipstick to My Mastectomy (3 page)

The first thing that I need to do is tell my little brother, Howard, who is in the waiting room. He is not really little, he’s twenty-three, but he was like my baby growing up. I want to lie and protect him from this bad news.

Howard hugs me and tells me that everything will be okay. Howard will later offer to drop out of law school to take care of me. He offers to take night courses so that he can take me to every chemo. I will cry when I hear his kindness, but my parents and I convince him that his life has to go on even if mine is screeching to a halt. Howard walks with me and Tyler the four blocks back to our apartment on 96th Street between Park and Madison. I see a chalkboard outside our favorite neighborhood bistro that says “Today’s Specials.” As I pass that sign, I think of how easy those decisions had been—whether to have soup or salad—and how I stumbled over them. I remember how angry I was at myself because I had forgotten to drop off Tyler’s shirts at the dry cleaners that morning.

When we get back to our apartment, Tyler cries until he starts honking his nose when he blows it.

“Geralyn, please, please don’t leave me. I’m so scared we’re going to break up. People who get cancer, they leave their marriages.”

What? His comment totally floors me. I am the one who should be worried about being left. I am the damaged goods. The nurse at my biopsy already implied how “lucky” I am that I am married (as if I can’t even flirt now).

That night, I decide to make a list of everyone I need to call to say that I have cancer. I don’t want anyone to hear it secondhand. Like secondhand smoke, or clothing, it’s not as good as the original and I realize that there is etiquette even in cancer. I get through the first call to my parents in Philadelphia. My dad keeps saying, “You have cancer? Really?” Then they start to wail. And, as if on cue, the fire alarm goes off. They must have been cooking dinner when I called and now it is burning. My mom says the house is crying. They still live in the same house in Philadelphia where I lived since I was two years old. I make my other brother, Paul, drive out to their house to make sure they are okay. He’s a lawyer in Philly. What am I thinking? When I tell Paul,
he
sounds out of his mind. How could I think that he could take care of anyone? Who is taking care of him?

I keep calling everyone on my list. I even put my old boyfriend, Brian, on the list to call. It’s strange, but I want him to know. I am so scared to call Jen. Her mom just had breast cancer. How can she deal with more breast cancer? My friends are outraged that the doctors in the room were the ones crying. Isn’t that supposed to be my role? Weren’t they supposed to comfort me and be the strong ones? But there was something that I liked about these two men in their white coats of authority suddenly feeling as helpless as I do.

The next morning, at 8:45 on the last Friday in July, instead of heading off to my job as an assistant story editor at ABC News
20/20
I am sitting in the Park Avenue office of a famous breast surgeon. I had a good excuse not to be at work that morning, although I lied to my bosses and told them I had a sore throat. I have been waiting for over half an hour to see her, and I know instead of feeling annoyed by the wait I should feel grateful. She squeezed me into her packed schedule because Tyler called her in a panic when we found out the news last night. Tyler worked for her on the breast service and told me that all of her women patients adore her because she is so tough. He said they loved her warrior mode because they thought she would be that aggressive with the cancer.

Her office is slightly below street level, and there are grates on the windows and not much light. I see the people hurrying by. Children being tugged to camp by their parents, people running to work. It feels right that I am only watching them go about their normal lives now, because nothing about my life will be normal again. Her desk is beautiful steel and glass, and it is gleaming. I notice the reflection of more glass, and pictures of a child. I don’t think I will ever be able to have one now.

The order in her office is offering me a sort of refuge from this chaos. Her impressive diplomas are speaking to me from their gold frames. They are telling me that they will help me, they will cure me. I think about my own diplomas. About how hard I worked my entire life, studying, trying to get A’s, just to get those diplomas to put on my resumé, to get that job. And now sitting in this chair, nothing seems to matter anymore. The diploma, the job, the marriage, the future, all feel like they are about to vaporize with that one word: cancer.

Now I am getting angry. There is nothing I can do to change the results. This is not about studying, working hard, getting the right answer, charming the right person, or nailing the interview. I spent so much of my life worrying. I thought of myself as a Chicken Little of sorts. Yes, the sky is always falling down, but not really—until now. I am a chronic worrier. A catastrophizer, actually. If that word existed, it is because someone knows me. I fret and agonize about everything and nothing at all. Maybe my worrying is a lame way of controlling my world; maybe a lifetime of silly worrying could somehow have prepared me for a real catastrophe?

When the surgeon enters the room she barely looks at me. It is my pathology report that matters here. I have been reduced to a cell type. A bad one. No small talk about what I do or how she knows Tyler. God, I would do anything for chitchat, please, please, let’s at least talk about the weather? She is fishing for my mammogram. She holds a film up to the light and looks distressed. Almost as if I had snuck into a parking spot she had been eyeing or caused her to break a perfectly manicured nail. Annoyed, that is the emotion I sense. She picks up my file and that is when she finally looks at me.

“Oh my god, do you have bad luck! You are only twenty-seven? This is unbelievable.”

I start to cry. No, sob. A doctor has just told me that I have bad luck? She seems bothered.

“Please pull yourself together,” she is pleading now. “We have a lot to talk about.”

All I can think about is that I want my mommy. She is in the waiting room. She took the train up first thing this morning from Philadelphia to be with me at this appointment; she will come with me to every doctor’s appointment. I think that she insists on being here now because she was so busy working full-time with three kids when I was little.

“You need to have a double mastectomy. Meet me in the examining room.”

She tries telling me a joke in the examining room. Something lame like, “Pink is your color,” when she sees me in the examining gown. It is too late for any laughing now.

I want to tell her who I was yesterday, before I knew I had cancer. I want to compare notes on the last great sushi restaurant we ate at or the last pair of fabulous black strappy high heels we bought. Anything to show we still have something in common. I want her to understand that this is not my fault.

I cry so hard that she decides to have a social worker call my house later that day to check up on me, because clearly this is not part of her job—she is just the doctor. I can’t stop crying. It’s the first time I have cried since hearing the news. And I am crying because I think she has told me that I am incurable. That I am a walking death sentence. That she has only read about cases like mine in her medical school textbooks. I never heard of a doctor telling a patient she had bad luck. My first doctor cried, my second doctor told me I had bad luck. I am screwed.

I kind of felt like I was cheating on my boyfriend when Dr. B insisted that I get a second opinion. Would I like the other doctor more? Were there any rules about pissing off the first doctor with what the second doctor said? Dr. B recommended a lumpectomy, but this second doctor wants me to have a double mastectomy. She sees how much this news panicks me and she offers to give me the phone number of a woman in the Hamptons who recently had a double mastectomy. All I can think about is, “What kind of bathing suit is she wearing now?” Since the second doctor has such a different opinion from the first, I decide I need a third-opinion doctor.

My doctor husband still can’t stop crying. He must think I am going to die. He must be thinking about the twenty-eight-year-old woman he took care of on his breast rotation who was dying. He watched her die of breast cancer. I am about to turn twenty-eight in a few weeks. He is spending all his time in the medical library, pulling every study on breast cancer, reading his medical textbooks every night. He won the golden scalpel award in med school, but nothing could prepare him for this. He has taken a few days off to come with me to my doctor appointments, but then he needs to go back to the hospital, to his patients. But being in a hospital when your wife has cancer is not so easy. He is sent home from the hospital his first day back because his hands cannot stop shaking while he was scrubbing in for surgery.

I continue to see doctors. Nine strangers feel me up. Since we have already gone to second base, there are things about me that I want them to know: I wear black almost every day. I am a Leo. I wear sunglasses even on cloudy days. I am an incurable slob. “Desperado” was my favorite song even before this happened to me.

But they all keep looking at me in the same way. No eye contact. I make jokes, I wear beautiful suits and lots of perfume and lipstick to catch their attention. I am being too obvious. Tyler even tells me on the way to one consult that I look like a prostitute. I know he is terrified to see the way the other doctors are looking at me. I know he is so sweet to his patients, but maybe even he has looked at a patient this way—just right through them. I am just trying to get their attention. I want them to look at
me
and realize I am not the cancer. I am not the malignancy.

But something has happened:
I
don’t exist anymore.

I’ve become a lab report. I want to remember a time when I could sit in the room and the doctors didn’t look through me as if I had already died. I want them to know that I got to dance with Elvis Costello on stage during a concert, that I say “I’m sorry” too much, that I always change my mind, so how can I make this decision?

It keeps getting worse. I need to pick chemotherapy drugs, because my tumor was over one centimeter. I even need to choose how I will get them—high-dose IV, or pills and IV. I am offered clinical trials. I am not qualified to be making these decisions. The stakes are so high that I can’t make the wrong choice.

I keep going to see famous doctors at famous hospitals: these are the Chanel, Gucci, and Prada of cancer. The doctors at one designer hospital are so famous that I am kept waiting for five hours in the waiting room. The doctors try to convince me that I need to do a clinical trial—that they created, of course—for my chemo. I can get more powerful drugs with a clinical trial, but when I ask them to walk me through the pros and cons, they seem annoyed. There are some pretty large cons: possible heart failure and early menopause. The pro: less than half a percent greater chance of a cure.

“Why should I do this clinical trial?”

“To benefit womankind,” one of them says, as if I should be in a heroic mood, because I might die anyway?

“My daughter will benefit womankind
after
she survives this disease,” my mother snaps back.

What one of the doctors tells me next stuns me: “It’s very strange, but all of my patients diagnosed with breast cancer get very good luck. Amazing things will happen to you.”

I never knew that so many doctors actually believed in “luck,” and that there is no consensus about whether I have bad luck or good luck and what I should do. I thought this was all about facts.

Whether I have good luck or bad luck, meeting so many doctors makes me realize that I am sick of being looked through and I need to devise a plan. They responded when I challenged them. They were angry, almost amused that my mother questioned their authority—that I asked them about the pros and cons. I decide that I am at a huge disadvantage. I can’t speak about my cancer cell types (yes, there is more than one type of cancer cell) and I don’t know the medical literature. I realize that I need to start showing these doctors who is really in control of her destiny.

My friend Jen’s mom, Jane, is a breast cancer survivor and she gave me two books on breast cancer when I was first diagnosed, with an inscription:
Knowledge is power!
I am unable to even open them. Jane is a ballbuster attorney, and she arranges my next consult with her own doctor and comes with me. She asks a lot of questions about my tumor and my prognosis. She is blunt and funny and suddenly we are all laughing. She is working the doctor’s office like she must work the courtroom, with some objections, but always polite. I am watching. I take notes. She gets me to ask for a copy of my pathology report. I see very scary words like
extensive intraductal carcinoma
and
poorly differentiated
—words that I would not want on my report card, and that are now describing me. Technical words about “clean” margins and estrogen receptor status being “negative.” I need to figure it all out.

Jane inspires me to keep seeing doctors and to keep asking tough questions, because they are all telling me that it is my decision. My decision? I didn’t go to med school. I didn’t complete a surgical residency. This is ridiculous.

My training to be a reporter at the Columbia School of Journalism, and all the research I have done on stories at my new job at
20/20
didn’t even come close to this story. My life is riding on this story.

I start taking notes in a reporter’s notebook like the ones I use at my job at ABC News. My file becomes my secret weapon. I spend hours in the Mount Sinai medical library. I pull every article I can about breast cancer and young women. I memorize the words in my pathology report:
lobular
(sounds like a type of pasta),
intraductal
(nice to meet you cancer).

But it is still so confusing deciding whether to have a mastectomy or a lumpectomy. All the male doctors are telling me that I can have a lumpectomy, which means I can keep my breast. Basically, they would only remove a small section of tissue around where my tumor was to make sure there are “clean margins,” meaning no more cancer cells. But I would then need radiation afterwards to zap any remaining cancer cells left. As part of the lumpectomy pitch, there are code words about leaving me “unchanged.” They are quoting a long-term study out of Italy that sounds like a brand of Italian designer shoes. The study found that women lived just as long whether they had a mastectomy or lumpectomy. But when I pull the study on Medline, I discover that I don’t even qualify for it because my tumor had an “extensive intraductal component.” When I tell this to a doctor his eyebrows go up and I can tell it is working.