From Both Sides
by Ellen Weisberg
Table of Contents|
parts: 1, 2, 3, 4
A biopsy was scheduled, a whopping ten days from my mammogram and ultrasound Dance of the Macabre with Dr. Twinkle In His Eye. Until that day came, I made sure to continue moving along as usual, keeping my nose to the proverbial grindstone, and respecting any and all prearranged meetings with colleagues. Any desire I may have had to curl up in a tiny ball at the edge of my bed and stare blankly for hours on end at cracks in the wall or wayward flying insects would have to be tempered by the reality that time was not going to stand still for me.
My first meeting was in the tiny, paper-strewn office of a colleague at the cancer center where I worked, a hematologist-oncologist and long-term collaborator. He had been a co-advisor and author on a number of published papers over the years and, at the time of our meeting, he had just finished conducting a clinical trial that was bringing a leukemia drug I had identified in a screen very close to FDA approval.
Several years earlier, he had also been instrumental in helping me get a second opinion on scans of my mother’s lungs that showed possible metastasis of her breast cancer to their periphery. I never would have predicted back then that I’d be seeking yet more support from him years later, for myself.
“So how are you?” he asked.
Little did he know what a loaded question that would be, and how much it would delay us from discussing the new data I’d generated. I told him that I was going through something a little unnerving, that abnormal tissue was detected in my right breast and I was scheduled for a biopsy in ten days.
“I can help you set up an appointment here if you want,” he said. He was referring to our beloved Dana-Farber Cancer Institute.
I smiled and thanked him but shook my head. At that point, I wanted to keep fully alive and kicking the possibility of the mass being benign. Making an appointment at the cancer hospital where I worked felt like too much, too soon, and I opted instead to sweat out the week and a half and keep my humble appointment at the quiet and unassuming northern-Massachusetts based Harvard Vanguard.
Despite my really not wanting the conversation to get yet more personal, the pros and cons of the size and density of my breasts were raised, as was the fact that I was an Ashkenazi Jew, with a higher prevalence of the BRCA breast cancer gene in that population. The darkness of the conversation was brightened by the reality of the statistics, with up to eighty percent of growths in the breasts turning out to be non-malignant. Right?
I worked over the next ten days, and I played. I celebrated the fiftieth birthday of a friend of mine, a musician, who was singing at a restaurant in a nearby town. I had a photo taken with a mutual friend of ours, in front of a large window that bordered the outside sidewalk. There was a glare that was making it difficult to get the picture taken without the two of us looking washed out. I found the light to be symbolic, as I was trying very hard to be there, but in reality I was only there to an extent.
* * *
On the day of the procedure, which was an ultrasound-guided biopsy, I was nervous, nervous to the point that my whole body was physically shaking. I didn’t understand where all the vibration was coming from and what subconscious fears and worries were going on to cause all that crazy ruckus inside of me.
I had no idea if the biopsy would be painful or painless, if it would tickle or sting, if it would send me into a deep, dark depression or make me deliriously show-tune singing happy. What I did know was that pieces of this strange growth in my breast were going to be removed and analyzed, and the result was either going to be something or nothing. And I supposed that knowledge was enough to make me tremble uncontrollably.
A nurse standing near my bed, who saw all of my weird ticks and convulsions, asked if I was cold and needed a blanket. I tried explaining that I really didn’t think I was feeling chilled, but rather that I just wasn’t good with medical techniques. I also genuinely and sincerely wished I could be just about anywhere else than in that room with her waiting for a portion of my body to be excised and examined, but I didn’t tell her that.
My biggest concern was whether or not the doctor doing the biopsy would have a better sense of humor than Dr. Twinkle In His Eye. As he was preparing instruments for the procedure, he asked me what I did for a living. My nervous shaking became nervous chattering as I blabbed on about how I did cancer research and how we were working on drugs that affect that intracellular machinery to promote selective and targeted degradation of cancer-causing proteins. Blah, blah, teeth chattering, blah.
Pleasantries were exchanged, but this time with no sudden startling revelations that made me feel sucker-punched. I was told that any results I’d be getting from this round of testing would come on a different day and not from any member of this medical team.
I learned that the radiologist, like me, was also Jewish, and I quipped about him being a “member of the tribe.” There was some laughter, and a few more inane back and forth comments that were helping to calm my nerves.
I threw a few names at him of people I worked with, and he humored me by agreeing the names rang a bell. I was on a roll. This had been really starting to work to distract me from the nauseating thought of what was yet to come. I continued to try to come up with physicians or researchers that I knew in my heart he had probably never heard of, when he abruptly changed the subject to the task at hand.
“So we can’t talk shop anymore?” I asked, making sure to sound dejected.
“No, sorry,” he said. “We need to get started.”
The last thing I wanted to do was disrupt his concentration, should it be commensurate with failed attempts and the need to repeat digging into me to get what he needed. I quickly sobered up by thinking gloomy thoughts, which at that moment, unfortunately, really wasn’t all that difficult to do.
“Do you want to watch the screen?” he asked. What he meant was, did I want to watch weird images that would have to be explained to me on the screen of the ultrasound while they chipped away at my insides.
Do you want to watch me projectile vomit? I thought. I politely said, “No” and turned my head almost as far as Linda Blair’s head turned in The Exorcist, which had not so surprisingly come to mind.
Nine excruciatingly painful and loud snipping sensations later, I was lamenting that I hadn’t asked for more anesthetic. I felt more than what I’d hoped I’d be feeling as they took their samples of whatever this as-of-yet unnamed thing was inside of me. But since it was more of an achiness than a sharp, stabbing pain, I decided not to be a big whiny crybaby and take it like a man. A man that — considering what I was going through — I secretly wished I was. I would learn only later that numbing the crap out of oneself was key to a painless biopsy.
What actually was more unsettling than the procedure itself was this ice-cold pack they slapped on the area that was biopsied. They told me to hold it in place for a while but, as it was only literally adding insult to injury, I only pretended to hold it against me for any length of time.
I was escorted by a nurse to another room to have the epitome of oxymorons they described as a “gentle mammography” done so that they could get an image of a chip they had placed inside of the growth. The same technician who had done the original mammography was waiting for me. She had been the one that tried to calm my nerves by attempting to convince me that the growth looked to her like it was just a cyst. I wondered what she was thinking as I entered the room after being biopsied, with her gaze slightly averted, a sad but possibly pitying smile on her face.
Despite all the pressure I’d put on the biopsied area with ice, there was a lot of bleeding, which the mammography technician didn’t seem to be expecting, as she hastily ran out of the room to fetch gauze. There was a box of tissues on the counter next to where I was sitting. I just pulled one out and dabbed at the blood, not giving much thought at the time to the potential significance of it. Tumors encapsulate themselves in blood vessels.
The technician returned with a fistful of gauze, but by then I was proudly surveying the successful job the Kleenex and my thumb had done. She had tried positioning me to get an image of the clip, but it was to no avail. It was too deep to be easily seen by mammography. As the ultrasound had detected the clip earlier, it was decided that the additional imaging by mammography was unnecessary.
I was relieved of further senseless irradiation and discomfort and sent home. I rested for a couple of hours in bed, a partially melted ice pack in place. I had work I needed to do in the lab, and I drove there to get it done. I found myself wincing every so often while I pipetted leukemia cells into tiny wells in a microtiter plate, thinking about what I’d been through. The snapping sound. The pain. The ice. The bleeding.
* * *
Three days later, my husband and I went to the scheduled office appointment to get the results of the biopsy. I was once again weighed with my boots and all of my clothes on and my blood pressure was checked and was — yet again — high. As we waited in an office for my primary care physician that someone had randomly designated to me and whom I’d never met before, I can’t say that I felt overly worried or concerned. In retrospect, that was undoubtedly a mistake.
I had found more often than not over the years that a dollop of pessimism sprinkled with a pinch of hysteria helped ward off bad things. It’s almost as though this kind of thinking strips the Powers That Be of the ability to shock and rattle, and they just give up, since there’s no fun in it anymore. My whole life, I’d been semi-jokingly referred to by friends as a complete neurotic, but what they didn’t realize was how being a neurotic was my modus operandi for survival.
I sat in a chair next to my husband, assuming what I had was indeed one of those hormonally-induced, benign fibroadenomas I’d read about, which could range anywhere between the size of a pea and a golf ball. A golf ball! I couldn’t even imagine having something that huge inside of me that’s just a big lump of nothing that isn’t going to go anywhere. And what I had seemed roughly to be about the size of a small marble.
To fuel my wishful thinking even more was the fact that I was premenopausal at the time of the mammography and ultrasound. Bang! Obviously there were oodles of hormones up to no good and flying devilishly around inside of me, giving me these weird feverish sensations in the chest area every month and making odd things happen and strange growths pop up out of nowhere.
Add to the mix the fact that I’d turned 50 earlier in the year, the age at which folks are strongly encouraged to have polyps checked in the back end and women are slated to start going through menopause if it hasn’t happened already. Of course I was destined to experience this plethora of oddities, and I was convinced that what I had was just this goofy, harmless mass of misplaced flesh that arose from my body’s biological clock having ticked as much as it was ever going to.
The primary care physician walked in and shook my hand and my husband’s. She didn’t look particularly happy, which my husband pointed out later as having been the moment that he “knew.” The words “Your biopsy came back positive for invasive ductal carcinoma” came from the primary care physician’s taut lips. She did not pause for breath before following up with: “Would you like me to write you a prescription for Ativan?”
It had become obvious to me at that moment that the Grim Reaper had returned in a more feminine and expectedly humorless form. And if I had been raised in a rainforest by monkeys and had known absolutely nothing about cancer, her offer of a lorazepam script would have told me in no uncertain terms that what I had was something really, really bad.
I have to drive by the Harvard Vanguard building every day as part of my commute to and from work. The building always summons a memory of my husband, standing outside it and facing me after we were given the diagnosis. I suppose it’s natural when the question of one’s mortality is touched on for the philosopher residing deep within to be wooed out of hiding. I found myself suddenly reflecting on how good or bad life had been or how good or bad I had been, and if things could have been better or different or if things needed to start being better or different.
“Would you be happier without me?” I asked.
A pause, the “You’re being ridiculous” facial expression, and “Of course not. What are you talking about?”
“You love me?”
A hug, a kiss, the wind blowing through our hair on that cool March day.
* * *
Copyright © 2019 by Ellen Weisberg