Healing With Words

"You can't keep misery from coming, but you don't have to give it a chair to sit on."

- Proverb

The following week Simon and I flew to Dallas. .We checked into the Dallas hospital's hotel room and the following day, my alarm clock shook us from bed at nine o'clock. It was the morning of my biopsy.

The waiting room for the women's health center was decorated with needlepoint chairs and rugs, nestled in a wood-paneled room. The receptionist sitting in this cherry-wood encased receiving area welcomed me, and handed me a clipboard with a stack of blank forms. I sat down beside half a dozen other anxious-looking women and their partners. My eyes shifted side-to-side, wondering what all those women were doing there. Are they in a worse predicament than myself?

Within moments a nurse called out my name. After flipping through my papers and making small talk about the weather, she directed me to the changing room-four barren cubicles containing clothes hooks and a small mirror. Outside these rooms was a cozy sitting area with magazines; the women waiting here were old enough to be my mother. What am I doing here? Aren't I too young to have breast cancer? I felt incredibly out of place.

When I left my cubicle, a middle-aged nurse came to direct me to the biopsy room. I desperately looked for a window into her thoughts. Does she know what is going on inside me? What about my prognosis? Her face offered no answers. Something about her smile did echo concern, but I did not know if her sentiments were directed toward me or toward all the women who stepped through the clinic's doors. Maybe her face mirrors my fear? As we entered the biopsy room palpitations chilled my chest. Tears fell upon my powdered cheek.

"Are you okay?" she inquired, closing the door and putting her arm on my shoulder.

"I'll be okay. I'm just nervous."

"That's normal. You're in good hands. Dr. Phil is the absolute best."

"Yes, I know. I came all the way from Orlando."

She nodded. "I need to take some chest measurements before we begin," she said, glancing at my breasts.

After untying the strings of the hospital gown, I looked down at my breasts too. The stretch marks were impossible to hide, a gentle reminder of having nursed three babies (coupled with sixty pounds of weight gain each time.) My areolas were fairly large and stretched out of shape. In one of the books piled on my bedside table, I had read (ironically, as it turns out) that breast-feeding is the best insurance against breast cancer.

My breasts had served me well. They were a sharp contrast to my 17-year-old daughter's perky ones, but they had nursed three beautiful children and brought me endless erotic pleasure. For me they were the perfect size for my five-foot-four small frame-tottering between and A and B cup-size. It never appealed to me to have them enlarged and I never made a fuss about them. They were there and once a month became a little more tender, but I never worried about that; it was expected, short-term, and part of being a woman. I sometimes wore camisoles instead of bras. Maybe the lack of support contributed to their droopiness.

"Okay, look straight ahead," the nurse said, while marking up my right breast with a pen.

There was a knock on the door and then it opened slightly. As Dr. Phil squeezed through the crack, I quickly closed my gown. He extended his arm, and a warm smile formed on his lips. He cupped both my hands into his. "What a pleasure it is to meet you," he said. "So you're good friends with Ellen?"

"Yes, and she recommended you very highly."

"How nice! We'll take good care of you here. So we're doing a needle biopsy on you today. Have you ever had one?"

"I haven't." A few years earlier when I had a cyst removed in the same breast, they did not do a biopsy first because it was so small and they were fairly certain it was benign.

"No problem. It goes fairly quickly, but the trick is you must remain completely still, and that's sometimes difficult for a long period of time. You don't have any back problems, do you?"

"None that I know of."

"Good, because you'll have to lie on your stomach for a little over an hour, and it could strain your lower back. Your breast will hang in an opening on the table and we will take the biopsies through that opening. "

He picked up on the uncertainty in my face.

"Don't worry, we'll anesthetize the part of your breast we're working on. But you might feel a little tingle now and then. Okay?"

He sat down in a swivel chair and faced my mammograms hanging on a lit screen.

"I suppose," I said. What other choice do I have? I reminded myself that he was one of the pioneers in performing this type of procedure.

"It looks as if you have some scattered calcifications," he said, turning back to me. "So we might have to take a few aspirations, just to make sure."

I parsed every word, listened to every intonation in his voice, and raked his face for any revealing expressions. Although he had a warm demeanor, in his eyes I sensed a reserved concern.

"Okay, let's start," he said. "I don't think you want to be in here any longer than you need to."

With my gown opened in the front, I stood on the stool beside the stretcher-like bed and gently put myself face down. I turned my head towards the wall. I really did not want to see what the doctor was doing. I tried lying as still as possible, and the long periods of silence were broken by Dr. Phil recounting each step of the procedure. Part of me wanted to hear all the details, yet another part of me did not. Some of his commentary froze me in the present and impeded my desire to daydream about more pleasant things in my life. Dr. Phil numbed my skin so I did not feel him taking any of the biopsies. I tried to repeat a mantra I had learned years ago during a meditation class.

Dr. Phil frequently asked if I was okay. I told him that I was fine. I think he was asking about my physical status and if I was comfortable. It was not the time to talk about how afraid I was to get the biopsy reports.

When he wasn't speaking to me I zoned out to recap my past and present and dream about my future. My life became a movie reel, and something inside me said that the film was running out.

"We're just about finished," he finally announced. "Why don't you get up into the chair so we can talk?"

As promised, the entire procedure had lasted about an hour. The nurse helped me up, and thankfully she cupped her arm under my armpit, as the room spun around me. She noticed the color leave my face and offered me orange juice.

As I sipped through a straw, Dr. Phil said, "I'm sure you want to know the findings. I cannot say they're good."

I motioned the cup down and the nurse took it from my shaking hand. I folded my cold and clammy hands on my lap. Because my husband was in the waiting room and not beside me paying attention, something he does so well, I had to carefully listen to Dr. Phil's words. The only way I could focus was to make believe he was talking about someone else-someone I did not really care about. The moment was too surreal for words.

"I took about twenty small biopsies. You have something called ductal hyperplasia, which means there are too many cells in your mammary ducts. This happens over the years and can be perfectly normal. But, sometimes the cells begin to look strange and we call this intraductal hyperplasia with atypia. If the cells keep multiplying in the duct and the number becomes very abundant, then it's called DCIS, or ductal carcinoma in situ. My suspicion is that's what you have."

"Now what?" I asked.

"At this point, I'd recommend a surgical biopsy which means that it would be done in the operating room and we would take a larger piece of breast tissue for analysis. Most often if the cells remain in the duct, DCIS may be reversed through hormonal treatments. The danger arises when the cancer cells break out of the ducts. When this occurs the diagnosis becomes invasive cancer, and surgery, possibly a mastectomy might be recommended. But, let's go one step at a time," he wisely concluded, seeing the horror sweep across my face.

After some silence, my eyes flooded with tears. My throat felt paralyzed. The questions did not roll off my tongue.

While seated on the edge of the examination table, Dr. Phil astutely put his arm around me. "For the surgical biopsy, I can recommend someone here. Or maybe you know someone in Orlando; it's your choice."

I tried taking a deep breath, but the air would not enter my lungs. Did he clamp off part of my lung while he was doing the biopsy? All I wanted to do was curl up on the examination table and remain there for the rest of the day. How could I face the world and the bombardment of phone calls from concerned...