Well, here we are again, friends, talking about tumors and doctors’ appointments not five months after I’d declared the end of the sad cancer blog. I’d wanted to blog instead about walking that half-marathon in December, but it would seem I really know how to get out of strenuous activities.  Alas, I will walk another half marathon at a later date, and crossing that finish line will be all the sweeter.  But for now, I’ll tell you a little story about boobs.

doll

Yesterday, I cancer-punched nurse Margaret.  (Cancer punch: verb — to blindside innocent party with unprompted news of one’s cancer, often, but not necessarily, at the least appropriate moment.)  It seemed clear when Joe and I showed up at the oncologist’s office for our first meeting since the biopsy that everyone was very gingerly preparing us for the bad news of the biopsy results.  My oncologist has a strict “no test results over the phone” policy, so, as far as they knew, we were in the dark. As far as they knew. I’ll tell you a secret. I always ask that test results be sent to my surgeon as well because he calls me as soon as he gets them. I’m like the Danny Ocean of oncology patients. Always a step ahead.

Danny Ocean

And Nurse Margaret looked pained as she settled into her swivel seat at the computer in the examining room.

“Margaret,” I said, “It’s okay.  Dr. Fischer already told us about the biopsy results being negative.”

Margaret’s posture crumpled.

Bam“I thought something was up!” she said.  “I never look at test results because I’m no good at hiding it when patients walk in.  Damn it.”  After a long sigh, with her fingers arched over the computer keys, she continued, “Well, let me ask you my questions,” sounding thoroughly deflated, “Are you still taking your Tamoxifen?”

Tamoxifen is the hormone regulating drug some patients are given as a breast cancer preventative.

“Nope.  I stopped taking it two days ago,” I told her.

“And why’s that?”

“Because I’m mad at Tamoxifen. It’s like, ‘You had one job, Tamoxifen!”

“No shit,” she said.

If I haven’t told you about Nurse Margaret before, she ‘s great. She once gunned down a ten foot rattlesnake on her ranch and posed with it dangling from her grip for pictures. She claims vegetarian food makes her tongue swell.  When she first gave me the after hours nurse phone number and I called it the same day, she answered, “Oh, you think you can just call me whenever you want?”  And after she input all of my updated information, she stood and said, “I’m telling on you,” as she let the door fall shut behind her.

“About the Tamoxifen?” I called after her.

“About you talking to Dr. Fischer!” she answered from the other side of the door.

But the oncologist didn’t come in with a scolding.  She came in with the contorted head tilt of the completely perplexed.  “You shouldn’t be sitting here right now,” she said.  Surprisingly not on her list of explanations:

Her best guess?  A few stubborn cells somehow got left behind during the lumpectomy and were then resistant to radiation.  I’m imagining these cells hanging out silently chain-smoking in white.

guilty remnants

This was echoed by the plastic surgeon I met two hours later, the one who compared the DIEP flap reconstruction process to Big Mac layers and told me to start inhaling donuts to gain weight before the surgery, AKA My Favorite Plastic Surgeon.  “You should have met with me back then,” he lamented.  “I would have made you do the mastectomy.”

Ugly truths time.  And I want to be clear about how moronic my reasons had been that first time so if you are in the same predicament you won’t repeat my mistakes. The fact that I thought Guardians of the Galaxy gave me cancer again is proof in itself that I should not be trusted with major decisions.  More evidence:  I decided a mastectomy would have taken me away from work too long. The surgeries required for someone just off chemo sounded numerous and extensive … based on what I found on the internet. The terms “DIEP flap” and “nipple reconstruction” sounded like something from Saw.  I liked my boobs (emphasis on past tense — I’m over them).  To paraphrase Shakira, they might be small and humble and not to be confused with mountains, but they’re mine.  The worst reason?  I decided, without talking to Joe about it at all, that Joe would see me as deformed and our marriage would be kaput.  Chemo had already made me feel monstrous enough.  I know.  I told you they were ugly truths.

There’s a scene in Dallas Buyer’s Club in which Matthew McConaughey’s character takes his doctor, played by Jennifer Garner, to dinner.  He wears his best cowboy hat, brings her a framed painting of flowers, clearly has romantic aspirations the viewer knows aren’t likely to materialize.  He’s an emaciated, terminal HIV patient with possibly only months to live. As he sits across from her, settles in, he says something like, “Nice dinner. Pretty lady. I almost feel human again.”

That line crushed me.  That’s the secret fear of the toll of hard fights, of the toll of serious illness — that we’ll be rendered inhuman, unlovable, desexualized.

But, to quote Dr. Malcolm, “Life finds a way.”  And in my case, life found a way to make me do what I should have done the first time around. Full mastectomy with reconstruction.

“Like, yesterday,” the oncologist said.

She tells me I’m such a strange case that a board of breast cancer specialists will be convening to go over my records.  After the surgery, the removed tissues will be “genome profiled” to try to isolate and define the mutation in my DNA. They will grow the tumor in the lab for research purposes, to study the behavior of these cells, to test the types of cancer treatments they respond best to.  “They’ll transplant little pieces of the tumor into mice,” the oncologist explained.  (My sister Michelle called this “The Cindy Project” when I told her.) And when the oncologist left the room, I turned to Joe and said, “Aw!  I want one of my little mice when they’re done with it!”

Then Joe pulled the same wide-eyed, ironed-flat expression he gets when our kids ask if he’s Santa.

My posture crumpled.

Kapow

“Oh.  Oh!”

“It’ll be like the monkey in Project X,” he said.

We were both sitting there morosely doing the “Virgil, apple” sign when Nurse Margaret came back in with my flu shot.  Now I’m feeling a little conflicted about “The Cindy Project” …..

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