Surgery

I slept quite well, though woke early. My sister was there. The nurse offered “a little something for my nerves,” a small pill. I left it on the night stand. “I feel fine. I don’t need it.”

“We recommend you take it regardless,” she urged.

“Really, I’m fine. I don’t like to take medicine unless absolutely necessary.” (Ha! Wouldn’t that change!) She shrugged and left it on my nightstand.

Jen and I hung out for a little while. My entire ward was women all there for BC related surgeries, and I liked that thoughtful organization. My roommate was Marin, a mother of three there for her second go-around with BC and on the same surgery schedule. They also avoided putting a fresh patient in a room with someone who was just ahead of them in the surgery process, as not to scare or stress the “new girl”. Jen and I explored the place as if it were a resort and we just liked to hang out there. I wasn’t even nervous. Finally, she and I returned to my room from goodness-knows-where, and the nurse was there with a hospital gown. “It’s time to change.” I just stared at her. “It’s time to go. We need you to put this on for surgery.”

Completely accustomed to being top-naked in front of strangers by now, I took my last chance to show off my small but beautiful rack. Too bad the nurse didn’t have Mardi Gras beads to throw at me. The left one was just going to have to retire without that sophisticated honor.

Off came my top and I put my arms out like a zombie to accept the cotton garment, which opened via a line of snaps in front that ran from my neck to my armpit on either side. (How handy!) Now I was scared. Now I was sad. NOW I wanted that “little something” for my nerves. Why, oh, why didn’t I have a warmer attitude to drugs?!

Tears started to stream down my face. There was no more distraction from why I was there and I admitted my fear. I’d never even been in the hospital before, much less under general anesthesia. Jen asked me if I wished mom were there. I said no, I was glad she didn’t have to watch me do this and I believed it. I laid on the gurney. They took my glasses and the world went fuzzy as well as wet. Jennifer walked beside me as far as they allowed her, holding my hand. I really did not want her to leave me. I felt a little silly, as no one on TV or even anyone I’d seen on gurneys in the hall ever rolled by blubbering. It was not my “bravest” moment. I suppose I didn’t jump up and cling to my sister like a money, so it could’ve been worse.

I got into the prep room and Dr. Awesome came to say a few words to me as I was given the first steps of anesthesia. He comforted me and said he understood that I was scared but the he was doing my surgery and would take very good care of me. His words and presence did help. I stopped crying but my face was all blotchy, swollen and red like it gets if I really cry. (It’s like I’m allergic to tears or something. I’ve been accused of having the measles before. You can imagine that it helps my comfort level about crying in “public”.) Next they wheeled me into the very cold OR. The assistants were struggling with English, so I proudly got a little Dutch practice as I helped them get me positioned correctly. I looked over and saw Dr. Awesome in the corner, back turned, looking at my chart, seemingly taking a private moment to prepare himself. And then blissful ignorance…

Some hours later, a nurse would wake me up once or twice, seemingly just to get me to respond. I remember being unhappy that they woke me. I was still under the blanket of heavy sedation, but I could tell I hurt and I wanted to sleep through every minute of discomfort possible. Finally, they came to wake me for real, with my sister and Del in tow. They looked down on me lovingly and I asked, “Hey…so who won the game?”. This was June 28th and the soccer World Cup was on. Now, I like me some WC, but even I am impressed with myself for that.

They visited for a little while and I was glad to have them, but mostly I just wanted to sleep. The rest of the day was a blur of discomfort and fatigue. I was tired and I hurt, and I couldn’t move, that’s all I knew. They had taken 12 lymph nodes, I would find out, which seemed to cause the worst of the pain. For this first day they had doubled a sheet over with my arm in the fold and the length of the sheet running under me, so that I could not move my arm accidentally (or on purpose for that matter). Nurses came in here and there and pressed on my chest, nearest the armpit. That hurt a lot though I was too out of it to care strongly about much of anything. Apparently I had some blood pooling just there and they stuffed some extra material in to increase the pressure and force the fluid to drain. Suddenly I thought a bed pan was the most wonderful invention ever, so grateful I was not have to face walking and moving. At the moment that seemed an enormous task. I just wanted to lie there and sleep for the next month, to wake up feeling all better. Unfortunately, they didn’t go for that idea.

Hospital Check-in

The afternoon before surgery, my sister accompanied me in. I felt fine, I was ready to get it done. We were told that the doctor wouldn’t be free for a few hours, so we should go have lunch and return. We joked that I needed a beer, and the nurse informed us that would be no problem. “Really?” we asked incredulously. “Well, if you ever needed a drink, now’s the time, right? I’m not saying go crazy, but one couldn’t hurt.” Well, where do we go then?, we wondered. “Oh, they sell beer in the cafeteria,” the she offered. Man, I love Europe.

After lunch the nurse sat us down in my room. Still, I felt casual. She took some information and answered any questions. She was very attentive and kind. I would spend the night in the hospital and they would take me in to surgery as soon as the ER was free in the morning. Hopefully 9am, but you never know. When she mentioned the time when my sister would have to leave, I was a little less fine. The lump came to my throat. Eveything was cool as long as I was not alone, so it seemed. As usual for the hospital, the kindness of the nurse made me want to emote even more. She said it was no problem for her to stay past visiting hours.

Eventually the radiologist came in to see me. He sat down on the bed next to where I was sitting and said, “so, you’ve had some trauma to the spine.”

It was actually a question. I shook my head. “No.”

He looked at me seriously. “You must’ve fractured your spine.” No way. I could think of nothing. He pressed. “You had an accident…”

“No…Never.”

A fracture was our only hope. I was getting worried. Wouldn’t I know if I had fractured my back?! He reached around and gently touched the damanged spot. “There.” He did not touch the spot that had been hurting for days. Instead, he touched several inches down, and as soon as he did, I knew what it was. Understanding burst open in my head. “Oh, that.”

Long story short, I had taken a fall at work back in February. I felt something was wrong. I tried to work but could not even roll my suitcase with one hand. My company sent me to the airport doctor. For weeks they gave me muscle relaxers and insisted it was a soft tissue strain. I went back several times complaining of continued pain and asked for further examination, but they never did and x-ray, and never investigated further. Even today, 18 months after the fall I can tell when you touch that spot. Not only had I not known that I’d fractured the vertebrae, but their negligence had led to this scare. But boy where we happy. Especially when Dr. Rads breathed a sigh of relief. “Good,” he said, “because if there was still any possiblity is was cancer, we would have to cancel your surgery.”

Later that night Del showed up after work. Handsome in his suit, he was also carrying a small handled bag. It was a present for me before surgery – the watch that I had been eyeing with my sister earlier that very day. Surprisingly, when they finally left, I accepted the sleeping pill the nurses suggested I take and went right to sleep.

On Fighting and Crying

Ok, in light of all the past week’s happenings, it time for a reconnaissance. (And as anyone who goes through this knows, military terms are precisely the most appropriate, because all this now becomes a battle of the cells, the Goodies vs. the Badies.)

The spinal scare put everything into perspective. (And there is always “perspective” to be had. Remember, no matter how bad off you are, there is almost always someone who has it worse.) So here’s the situation: My boob is now officially trying to kill me. It’s that simple. I know there are some good soldiers left in there, but sometimes you’ve got to make sacrifices. They’ve been infiltrated by the Badies and they just can’t be weeded out. Left breast, I loved you most, and this is the thanks I get. Off you go then. “Y’a dead ta me!” Ptuh. (*spits on ground*)

While I am not happy about going to the hospital, my attitude now is, “Get ‘er Done!”

While I’ve given the gory details of every difficult moment, don’t let that misconstrue the tone of life on these days. I still went out for drinks and generally enjoyed the visit of my sister. Watching both parts of Kill Bill seemed terribly appropriate and inspirational! I’ve developed an M.O. for the emotional ride and it goes like this: if you feel sad, sit down and just let it out for 5 minutes. You blubber all you want. Give yourself a break.

My sister taught me after mom died that mourning is hard work but it has to be done. It’s not fun, but being tough all the time is just not real. The emotional work also has to be done or it will come back and bite you on the ass later. With breast cancer, it didn’t even occur to me (aside from the spinal scare) that I wouldn’t ultimately “win”, at least for the time being. But there are still things to mourn. I’d be lying if I said there weren’t. As positive as you are, it just plain sucks to be doing this. But when your cry time is up, pull yourself together, put it back on the shelf where it belongs, and get back to life. And it works surprisingly well.

How will a simple x-ray detect cancer?

Jen and I went to the hospital and had the spinal x-rays. She is a smartypants and explained to me how an x-ray would work for such a situation. When a bone experiences trauma, the body, of course, reacts to repair it. Cancer on the spine would register as a trauma. The resulting repair activity on the bone would leave a trace in the form of calcium deposits. The x-ray would show such an area; that’s what they were looking for.

The x-rays took but a minute, but it would be hours before the final word came in. Jen and I decided to make a nice afternoon of it in Leuven, so we went for a lengthy lunch in the beautiful town square. Believe it or not, we had a great day and managed to forget all about calling for the results. We called just as we stepped on the train home, catching the office only minutes before it closed. It appeared not to be cancer, but we’d talk details the next day. Whoopee!

That night as I am preparing for my last night of sleep as the “pre-me”, I swallow my pride about being the first to say it, and I offer the sappy words to my bf. (You know, those three.) It just feels too silly to not to say it at this point, if for no other reason than to let him know that I recognize what his level of commitment means, even if it’s not been said. And to acknowledge that accepting said commitment from him and sharing such an intimate experience means the same from me. Certainly I don’t expect to die under anesthesia. That’d be crazy. But you never know. I wasn’t into tempting fate just now.

The Scariest Day of my Life

It was his assistant who called. She said, “we need you to come back in for a spinal x-ray today. We have found a spot on your spine.”

I don’t remember the rest of the conversation, but it was brief. I put down the phone and told Jen the news. I was due to go into the hospital the next day for my surgery. I didn’t really want to spend my last day there as well, but the caller had made it clear this was something “very important”. Truly, I have never been so scared in all my life. I had thought that mastectomy and chemo were bad, but even then I had been looking at recovery. This was something else.

Cancer on the spine is baaaad news. I called Del and told him. I remember standing in the kitchen, by back to my sister, leaning on the countertop with my elbows, white flip phone pressed to my ear, the weather hot and sticky, the room quiet. He excused himself from the phone rather quickly. This is the only time I have ever heard him struggle to keep his composure. I mostly remember the feeling of panic; a feeling of wishing to have back the previously terrible-seeming news from the other day. I didn’t know any hard facts about cancer on the spine, but I did know that that meant my cancer was metastatic (spread to other organs) and that that automatically upgrades my cancer to Stage IV. In one moment my cancer had gone from highly curable to “advanced”. For the first time I had a real fear of dying. Absolute terror thudded in my chest. And I had thought my inherent feeling of security was knocked out before…

Thank God for Del once again. Jennifer and I had been getting ready to go to an internet cafe. We needed facts; we couldn’t have our suppositions getting the better of us . (Del’s place had no internet as of yet.) Before we got out the door he called back and, in perhaps the smartest thing he has ever said to me, he adamantly advised against going online. (The implication of what he’d found there was doubly frightening.) I argued with him a bit about needing information. He stood his ground and insisted that I call the doctor directly instead. The internet, we had all discussed, was full of all sorts of information, much of it incorrect, sensational, or at the very least, claimed with some personal agenda behind it. “You really need to know exactly what they’re talking about. Do not go fishing for facts that may or may not actually pertain to you. Ask him what this means. That’s his job.”

In another show of what appears to be a pattern of my heroics of the time, I once again had Jennifer call for me. She got through directly to Dr. Awesome and I heard “uh huh…uh huh…oh!” Her posture crumpled in the act of releasing a held breath and 1,000,000 pounds of pressure psi. Her hand fluttered to her chest. “Whew!…(a nervous half-giggle)…thank you!…Ok… Ok…oh, Thank you!…Ok. Bye bye.” I was on top of her with anticipation.

“He thinks it’s just arthritis,” she got out before taking a moment to swallow deeply and still her heart. We processed and savored that for a few seconds before continuing. “There is a spot on one of your vertebrae. But because all of the blood and bone tests were negative, he thinks it must be a random spot of arthritis. They need to check to be sure though. He says you don’t have to come in for an x-ray if you don’t want to, but he fears you won’t sleep tonight if you don’t.”

In what is surely the most dramatic moment of my life, we stared at each other silently for a moment with big grins on our faces. What came next can only be described as emotional diarrhea. We roared with laughter at the release of stress. Heeee heee hooo hooo haaaa haaaa. (Urm…Yes, that’s what I sound like when I laugh.) We positively howled. And somewhere in the middle that laughter turned into sobs. I am embarrassed at revealing such an intimate moment, but I said I’d be honest here. We were clutched in a tight hug by the time we finished. Then we pointed at each other and giggled again at our outpouring of theatrics. We were a right old couple of Spanish TV novela starlets!

My previous “worse then expected” diagnosis was looking like an awfully good deal about now, and I was eager to have it back. While indescribably relieved, I was not home free. A random spot of arthritis seemed strange at the age of 30, especially to manifest itself on my spine the very week I was being diagnosed with cancer. Such an easy resolution seemed too good to be true at this point. So off to Leuven we would go.

Wonderful Men and Well-Meaning Friends

On the hard day of receiving the results, I was not able to call my bf until the train ride home. Of course I wasn’t going to get into it on the cell phone, him at work and me in public. I just told him “it is not what we’d hoped,” and that we’d speak that night. While it was not the first thing on my mind, I had mulled over the implications on my brand-new relationship and made a decision.

When he got home, Jen and I told him the news. It was no surprise to any of us when I suggested he and I go in the other room to talk. We settled comfortably on the bed and I explained to him that three months into a relationship was a little soon to ask someone for the kind of commitment that would be required of him. Immediately he interrupted in a worried voice. “I don’t want you to break up with me.”

To be honest, I had a feeling he was not going to bolt. He seemed like a stubborn and committed guy. But I dared not expect that. I was happy to have his words above, yet still I dared not cling to them right away. I proceeded to present my suggestion that we call a hiatus to us and, “once I’m back on my feet, we can decide if we want to try again. I will harbor no ill feelings whatsoever.” He said doing that would make him a “coward.” I repeated that it’s not like we’d been together for a year. Three months doesn’t obligate one to make any personal sacrifice if you ask me.

“I want you to move in,” he blurted. Again, rational me was keeping control over (happy, relieved) emotional me. I encouraged him to take some time to think about this decision. “You have never taken care of an ill person; I have. Trust me when I say that you have no idea how difficult it is. Please think carefully about this.” Stubborn thing that he is, he would hear none of it. I was moving out of my shared, hot, 4th floor walk-up apartment and into his beautiful place. I chose to keep paying on my place for a while, just to be safe and to provide a bed for the continuous trans-Atlantic visitors I was sure to have. He and I had never even said we loved each other.

In what I thought was nothing more than a passing occurrence, Jen and I went to my apartment to access the internet, and after 45 minutes on the laptop I developed a sudden, sharp pain in my upper spine. Just below the neck I had what felt like the most severe of cricks. I assumed it was from bending over the computer, though it had not gone away by that evening or even the next day when we joined friends for a few beers at the outdoor haven for expats, Place de Luxembourg (or “Place DeLuxe” just outside the European Parliament building). Standing at a table drinking, a wince led me to divulge the pain to my dear friend P. Helpful as she is, and unfortunately knowledgeable about cancer, she advised that I should call my oncologist. “You might think it’s nothing, but that’s what happened to [personal information] and that’s how we found that it had gone into his spine. Make sure you bring it to their attention.” I reminded her that the tests had shown nothing. She pointed out that he had had tests too.
This was my first taste of how life would be from now on: nothing was “just a little pain” anymore. I would learn to listen to my body with a suspicious mind. What she said concerned me but I was hesitant to “bother” my oncologist.

Imagine my surprise when he called me about a “suspicious spot” on my still aching spine two days later.

Last weekend of duel-breastdom and decent showers

I’m posting a lot right now, but a lot was going on at this time last year:

My sister Jen was very smart in presenting the news to my family, in that she avoided saying that it was worse than we expected and instead focused on the fact that the news was to be considered “good”. That is, that it had not spread anywhere else. That was one a point one couldn’t argue with (not in my family, who really had a concept that it could be worse).

I was exhausted from the day, but I woke up often during the night and very early the next morning. Crying always comes a little easier in the company of sleep deprivation so I took advantage of a little private morning blubber. Jen was still asleep. Unable to lounge comfortably in bed – one of my favorite things to do in the entire world – I was wide awake and had to get up straight away. My friend Johanna called and I took a stab at telling someone the news. I got a little choked up, so even though she could barely understand me (and surely hardly believed what she thought she heard) she got that it was bad. She had never seen me upset over anything. Actually it felt good to tell someone. Vocalizing something is part of making it “real” I find. It sort of ties together the mental and physical aspect of how something is affecting you (My fellow anthropologists will dig that one!) and that was needed. After, it was time to take the bull by the horns. I felt it was a good time to tackle a little of the information the breast nurse had given me, and to generally start educating myself about this cellular freak out of a disease.

Most memorably, one brochure contained the personal stories of many different women. According to my journal: They both touched me personally and didn’t. Everyone was different. I was trying to maintain my objective, professional distance. Then one lady’s story said oh-so-nonchalantly “even though Mary Moo has had other physical discomforts to deal with, like Multiple Sclerosis and…” I don’t even remember the rest. (nevermind the fact that there was MORE tragedy in that sentence.)

I realized that one of the only “good” things about all this was my subconscious feeling of security that, given this, surely my number for terrible life things was up. (As a family, this was already over the line of what you would expect/is fair…from anyone not belonging to an unrecognized minority, not chronically suffering from any more financial challenges than most folks, and just not being born into a less than First World country…) But reading that this woman got cancer AND MS? That’s just fucked up. And they called it a ‘physical discomfort’?! They dropped it like it was an quiet fart and no one would notice how rotten it really is.

But I knew. And when I read that a chill went down my spine. Well, it would have were that not a bit dramatic for my taste. So, a figurative chill went down my spine. But an almost unnoticeable (almost) shade of darkness tinted my vision of the world. Literally and Figuratively.

To clue some of you in a bit, MS is what had my mother struggling for 20 years and bed-ridden for 10 more until she passed. I’m rather pissed to realize that technically I still have to worry about that too! Grrr….

My sister asked if I had broken the news to my best friend Wendy in NYC. I said no and that I didn’t want to call her. I didn’t want to admit it, but I was feeling a bit sore at her because I hadn’t heard one peep from her since this whole “maybe cancer” thing start several weeks ago! (My mention of her in a recent post was a little out-of-sequence.) I’d be damned if I was going to go to her to give her the news. If she wanted to know she could damn well call. Jen suspected that Wendy was simply scared to call because she was afraid of the answer. So I agreed to call her, but telling Wendy was like telling a sister and sassy as my attitude had been, as soon as I heard her voice I could not talk through the lump in my throat. Wendy probably thought it was a heavy breather until I handed the phone to Jen, who gracefully took over.

Sure enough, Wendy had been procrastinating. (Doesn’t please me, but I do understand.) She and Jen chatted a while, until I was involved enough in the conversation for Jen to be serving as an intercom. Past my weak moment, I grabbed the phone and said “Hi, my friend…”. Again, I heard her voice and I had to thrust the phone back at my sis. What a silly wuss I am! No way would I have gotten through the family calls without freaking them out!

My life was suddenly about several categories of stress: medical, financial, bureaucratic. In interest if length I won’t start all the details here, but the situation was that my Belgian residency and health insurance had lapsed on the 1st of the year. (Hence, the reason I had gotten the mammogram the year before! How’s the for a tasty dish of cruel irony?) My American insurance was of doubtful use. So, on top of everything else, I had to figure out what to do there. My last weekend relaxing started off with me making bucketfuls of calls to the US to start the process for having my coverage apply to my surgery. Fat load of good that would do. But I’ll get to that.

Meanwhile, I did have one last weekend of duel breastdom and normal shower-taking. I wouldn’t see either of things for a long time…

The Moments After

As soon as we were done I bolted out of the office and made my way to the bathroom. While my sister exchanged closing comments with the doctors, I wanted a minute alone to get myself together. I had just washed my hands and dammed up the leak of tears when my sister came in and found me. She hugged me and I backed off. “I don’t want to cry now.” She said something very smart then: “I think you should do it now. You might not be able to later.” She was very right about this and I immediately knew it. So I balled my eyes out for 5 minutes, and it felt good. Then I proceeded to pull myself together again. Jennifer told me that the doctors had instructed us to stay so I could “talk to the ‘breast nurse'”. My wet face was distracted by a snort of laughter. “The what?!”

The breast nurse. Ah, I seemed to remember the doc’s mentioning it now. “I don’t want to talk to her now,” I stated. “I just wanna go home. Can’t I do it another day?” Everything felt very overwhelming and I wanted to distance myself a little bit and then re-approach slowly, when I was prepared, circling and poking it first, prepared for whatever ways it might further lunge out to bite me. (Was it dead and unable to do further harm or was it just lying there, pretending to be out of venom?) The doctors seemed to feel it was very important for me to talk to her today. They said she would “teach [me] how to live without a breast for a while,” whatever the hell that meant. Seriously, what did it mean?! Jen and I had plenty of time to mull that one over, as the nurse wasn’t available for something like an hour. Meanwhile, we sat in some chairs in the hall outside her office, drinking Coke Jen had sweetly gone to buy me and giggling about what qualified one to earn the title of “breast nurse”.

Why did I need someone to tell me how to live without a breast? Do they do something that I wasn’t aware of this whole time? Did I need them to…I dunno…taste salty foods? Sense cold? I didn’t get it. But it was actually a little fun as we made ourselves giggle over the ridiculous things this mysterious expert might have to say.

The breast nurse turned out to be a sort of counselor who discussed the implications of having a mastectomy. She gave me booklets and showed me photos of what I could expect it to look like. I didn’t really want to read/look yet, but she pushed a little and when I did see the photos, my reaction was, “Huh. That’s not so bad.” I absorbed most of what she said with my business attitude on, until she wanted to discuss prostheses. She wanted to show me some samples that she had in a box. That was too much and I refused, my eyes suddenly leaking again. On the whole, I wasn’t horrified about the idea of losing a breast; I was horrified at what that said about my cancer, the general extent of my treatment. I didn’t want to concentrate on the losing of the breast right now. I certainly didn’t want to focus on details or attitudes that did make losing a breast seem like a big deal. I wanted to embrace my thinking that, “it’s just a breast and you don’t need it. It’s no big deal. It’s a lump of fat. Just cut it off and move on.” No need to dwell. Concentrating on how to “fix” losing the breast or “camelflage” that you were missing one felt like making a fuss over it. Made it feel very important. I had bigger things to deal with and I refused any attempt to make this part bigger than it had to be. That was my thinking.

I didn’t explain all this to the breast nurse. I let her do her job mostly. In a rare happenstance, she wasn’t very confident in English, so Jen and I encouraged her to give her spiel in Dutch and we’d stop her when we had questions. At one point I made a comment involving the word “boob”. Jen and I laughed. The nurse just looked at us with confusion. Like a four year old, she very carefully and seriously pronounced, “b – o – o – b. Boob?…What is…’boob’?” We howled. After explaining to her, she blushed a little, “oh. Boob. We don’t learn such words here.” I assured her it was a handy word for her profession. For over an hour I listened, and overall I was grateful to have her to speak to. She not only answered any and all questions about the surgery, but she was there in capacity as a therapist if I needed. I appreciated the fact that the hospital was attentive to the psychological and emotional needs of its patients as well as the physiological. She had her weaknesses in being a comforter. In one moment Jennifer and I were cooing together, she rubbing my head and saying quietly that she would remain in Belgium thorough my surgery and all six (!) days of my hospital stay, and that she would visit every day. “You know, come in and whisper a little English in you ear.” The nurse butted in, “Oh, there will be no need. The nurses will all speak English.” Jen and I exchanged a look that said, “Damn, this woman can be obtuse!”

When we finally returned home, I was exhausted, but I couldn’t sleep. I sincerely could not break the news to my father and middle sis. We’d had a very rough couple of years as a family, and I couldn’t bear to be the source of more sadness and worry. I also didn’t have the emotional energy to put on my optimistic, worry-free persona in order to ease their concern. So I asked Jen if she would make the calls for me. I didn’t even want to be in the room. I told her to tell them I was napping, and I shut myself in the bedroom to read while she took care of business. A small part of me wishes I had had those discussions now, I’m not sure why. Mostly, it doesn’t matter.

Today it Came Crashing Down (biopsy results)

After my biopsy my sister stayed on for a bit and we had a nice visit, the terrible reson for her being there little acknowledged, but making us feel close nonetheless. (There was the moment that I coaxed her into feeling the heavy bastard of a lump. I never thought I’d put my sister’s hand on my boob, but I figured she needed to know exactly what one felt like because it’s pretty particular.) She left and then my oldest sister replaced her, to accompany me in receiving the results. This didn’t seem necessary, although it was not unwelcome. Tentatively she would leave the weekend after.

This sister has a habit of obsessing over small and sometimes random details in the face of some other drama. In the days when my mother was bedridden, Jen might come home and spend 4 days arranging all the paper clips in the house according to weight and size or devising a plan to brush the dog’s teeth. To some extent I thought she was doing the same thing by saying she really needed to come to my meeting so I could have another set of ears, someone to take notes. Not that this doesn’t sound useful, but I thought she was overdoing the necessity of it a bit. After all, we already knew what they were going to say. Right?

When we arrived and got seated in the office, Dr. Awesome was accompanied by another doctor, the man who would be my radiologist. (I’d call him Dr. Awesome if the name weren’t taken. He was also great.) My sister was immediately as taken with my doctors as I was. They confirmed that the biopsy showed cancer. They also confirmed that the tests to identify any spread of the cancer all came back negative. While this was expected, I breathed a sigh of relief, not knowing until that moment how realistic and scary that possibility had been. We weren’t prepared for the other news though.

That was, that the tumor was relatively big and that a lumpectomy would not suffice….

(Let me just pause there so you can appreciate the fact that the world stopped for a moment.)

Because of the tumor’s location right in the center, the nipple could not be saved. Considering that it would be gone, plus the fact that (let’s be honest:) my breast was not sufficiently bigger than the tumor, a mastectomy would be the chosen procedure. Next Wednesday. (gulp!) I wanted to argue and negotiate this in my mind. Less than a week away. That was pretty concrete and eminent.

My cancer was labeled as Stage II. This was both because of the size of the tumor and the fact that they had detected an infected lymph node. Thus, they would be removing nodes in my surgery. As I sat there digesting, Dr. Awesome and Dr. Rads discussed the taking of my lymph nodes. Dr. Rads asked if the node had been biopsied. Dr. Awesome said it was so obvious that it had been unnecessary to do so. (Remember the node the lab technicians took notice of during my biopsy?) Dr. Rads asserted that still, maybe we ought to take the one node and check it out before removing the rest. Dr. Awesome said, “That is what they would do in America. They are very big on sentinal node biopsies. We prefer to treat the cancer as aggressively as possible. This saves her going back to take them later.” Some people think it was not right of them to have this discussion in front of me. I am glad they did however, as I witnessed how the decision was made. At this point, I really had no concept of what the loss of lymph nodes would mean and didn’t care about taking them, so I never even considered arguing. I was a little distracted by the whole breast thing…

Dr. Awesome continued on to say that not only would I get radiation, but I would be receiving chemotherapy as well. (Again, did you feel the world stop on its axis just then or is it just me?) Because of my young age and the infected node, there was no waffling on this decision. I was going to get chemo. Looking back I don’t even know how I continued to breathe right at this moment. Chemo was probably one of the scariest things in the world that I could think of. (Though I had never acknowledged it as a “great fear” because it was so unlikely. I’m scared of wrestling alligators too, but there’s not point in putting that of my life’s list of things to steer clear of.) This news was the destruction of all the walls I had carefully constructed to keep myself feeling safe and “lucky”. This was the collapse of the feeling I had carried around my whole life that I would always end up on my feet, that things would work out better for me in the end than I had even foreseen. (“Extraordinary Machine” is a favorite little theme song of mine.) This was part of my private personality they were messing with. They might as well have been talking about a lobotomy.

I attempted to put on my “emotions later; let’s tackle the problem” suit, but it only lasted so long. By the end of the conversation tears were leaking out of my eyes at an alarming rate. The only comparable moment of devastation is when my mother died. The doctors seemed legitimately touched and saddened about my news. I had an image of them going home to their families at night, brooding over dinner, their wives asking what was wrong and them slamming their fists down on the table cursing, “dammit! It’s just that I’ve got this one girl…she’s so young and sweet…”. (I figure, if you’re going to fantasize that you know anything about your doctor, tortured personal investment is a good story to have.) Their kindness and concern made me more emotional, as did the fact that they seemed to expect the tears as part of the important business of the meeting. At one moment I gave in to my sister’s arm around me. But I found it impossible to let her touch me and maintain any degree of emotional suspension, so I snapped back upright to face the business of the discussion. I carefully avoided her eyes as she sat next to me for the same reason.

They told me lots. Gave me some introduction to the radiation and chemo I’d be having. Mostly I remember “blah blah blah” and us asking about the possibility of my getting the surgery in the US. Dr. Awesome said, “We’ve already discussed that I support whatever you want to do. But at this point, if you cannot promise me that you will be able to arrange a surgery date within the next two weeks, do not go. This is growing fast. You want this out as soon as possible.” While I sort of knew that I would stick with the current arrangement, I was just too overwhelmed to fully agree to anything in the moment. I promised I would give him a firm answer within 24 hours.

The days between biopsy and final results…

Tomorrow is the anniversary of getting my biopsy results. Meanwhile:

• To this point I haven’t cried at all. I’m really so relieved that I’m not headed for chemo. I’m going to have a rough couple of months and then I’ll be “good as new”.

• I haven’t really acknowledged the fact that once you have cancer, you kind of always have it. Anyone who knows anything about cancer understands what a complicated and unspecific statement that is. My boyfriend made a comment about “always” having cancer, and I didn’t like that very much. For the moment I brushed that aside. For the time being, I was still going on the “then I’ll be good as new” sentiment above. I wasn’t really ready to digest anything bigger. Considering how little I knew about cancer at this point, it’s kind of funny that I conveniently became even MORE ignorant about it (as in: “What do you mean ‘I will always have it’? You mean they don’t just give me the treatment and then I’m ‘cured’?).

• I’ve got friends trying in all sorts of ways to help me with my decisions about what to do and where to do it. It’s a complicated issue for me. I want to be home. I’d like to be with my family, but my dad is in NC where I grew up. That’s it. I have one sister in New Mexico and one in Georgia. My best friend is in NYC. No matter where I go in the US, I only have one “family” person to support me in any given city. Everyone else will have to travel to see me anyhow. So in that sense, what’s the difference between being here in Europe or in the US? And of course, my bf Del was here in Brussels. I didn’t want to leave him when I didn’t even know for sure how long it would require us to be apart. In fact, more of my friends were concentrated here in Brussels than anywhere else. But the complications of getting serious medical treatment in a foreign country? It was mind boggling.

• Every time I thought I had made up my mind, someone or something made me lean the other way. I was really confident in my oncologist here, and my family and I had no idea how to arrange for me to see the right people at a hospital at home in good time. My dear friend Wendy has a sister that works at a hospital in NYC who said she could get me in there. I went crazy with stress trying to scan my medical records to her for the doc’s to look at over the weekend, etc etc. It just didn’t work out and in the end I had to take a deep breath and let it go. I realized that the real stress was in not having a decision. I needed to just trust my instincts and pick something, against all external pressures. Everyone seemed to have an idea I felt obligated to follow-up on or be interested in (not just to properly acknowledge them but because what if they were right and had the best answer?). I felt so much better when I let all that go.  In the end, when I told Wendy that I wasn’t going to pursue the NYC option, she informed me that her sister’s colleagues had asked her where I was, and when she replied “Belgium”, the NYC doctors actually advised that I stay where I was. “Belgium’s a great place to be medically speaking, particularly for breast cancer.” As much as I had made my mind up, that sure was a relief to hear. (Because, really, it wasn’t “made up” of course. I was just trying to stop oscillating for the sake of my sanity.)

You see, there is a sort of pressure when trying to make such an important decision, and it doesn’t only involve yourself, silly as that is. In the beginning, everybody that you are really close to seems to “own” your cancer just a bit.  (At least it felt that way.) This was where the pressure to accept and acknowledge everyone’s opinions came from. It took a while to assert in my own mind that it was mine all mine and I could do whatever I wanted and I didn’t have to explain to anyone what or why. Everyone trying to help by giving opinions and suggestions, and that’s what you want. But unfortunately, those opinions and suggestions don’t all agree with each other and none is usually more informed than another. And there is the feeling that you have to defend whatever you decide as the “right” decision to all the people that are investing themselves trying to help. So there was such a feeling that I was “off the hook” when the NYC doctors gave the nod to the idea of staying here. What people (and even you yourself) don’t quite understand until you’re in the situation is, you don’t WANT options just at this moment. What you want is your doctor to say “this is what you need to do.” So far, that hadn’t happened.