FIRST, YOU GET PISSED: A Memoir
by Mary-Ann Tirone Smith
The memoir will be posted, one chapter a week, every Sunday, on this page.
If you're getting a late start, you can READ CHAPTERS 1 - 10 by clicking "PREVIOUS CHAPTERS" on the red menu bar above.
SOMETIMES I ENJOY a misadventure, but not when it comes to an appointment with the woman who will be treating me for cancer, if I have cancer. There is no need to tell you how miserable it is to have to wait for so much time to elapse to find out the news that, perhaps, you're about to die.
Date of misadventure: August 24th, sixteen days since the constellation is noted to me by the radiologist with no name. Charlie and I drive into the "Air Rights Garage" at Yale-New Haven Hospital and head upward toward the 4th floor, as instructed, where the Smilow Cancer Hospital is situated. If you ever have to go to the Smilow Cancer Hospital, and I hope you don't, I promise you that you will experience the exact same misadventure I do. At least you'll be prepared. But isn't it funny that the garage is named for the fact that the hospital has to buy air rights over their own parking lot from the city of New Haven to build a five-floor parking facility? Clearly they become so pissed they name it the "Air Rights Garage." They could have named it after the Mayor. They could have named it after the first famous Yalie: "The Nathan Hale Garage." Or maybe just, "The Spite Garage." At least the guy who foot that bill wasn't the owner of Chef Boyardee, as with baseball stadiums.
We follow the Smilow signs, driving round and round, whereupon we see a pair of huge glass doors emblazoned with the word: SMILOW. What's with these people who want to have buildings named after them with signage the size of the Hollywood one? Do they say things like, "You want my money to build a mini-hospital inside a famous one to treat people with cancer? Fine. I'll send you a check. But I want my name on the front door, and the letters had better be at least six feet high." Do they think that makes them presidential material? Lol.
Charlie takes a parking ticket from a machine that has SMILOW splashed across its front. The machine then speaks: "Welcome to Smilow." Good God. We park, get out, and walk to the glass doors which spread open before we reach the threshold so that the letters SMI are on your left, LOW on your right. We enter, though I am wishing I were anywhere else on the planet.
Inside, we are immediately confronted with a vast bright space. We are enclosed in glass walls, sun streaming in from all sides and above—glass ceiling, too. Perhaps the design is meant to cheer people up who have cancer, or who might have cancer. Wrong.
Also, there is an open stairway in the middle, the widest indoor stairway I've ever seen, plus elevator doors in the one small piece of wall not made of glass. The only object in this entire…uh…foyer? Lobby? Lanai?...whatever… is a giant desk with a smartly uniformed security guard sitting in the chair behind it.
We approach him. He seems nervous. He asks, "May I help you?"
I actually have to say these words: "Can you tell me how to get to the Breast Center?"
I have no idea that it is the guard's first day on the job and, as we all know, when a man hears the word "breast," he cannot think straight. The fellow looks at me, and I do believe he wants to say, "I wish I knew, baby," but his training leader is rushing toward us from out of somewhere, not unlike when the people who return to Earth in "Close Encounters of the Third Kind" come out of a flying saucer bathed in so much light, you can't see them at first.
He says to me, "Sorry, ma'am, Beaumont is new. May I help you?"
I take a deep breath because I'm feeling faint. "I have to go to the Breast Center."
He gives me directions: "Go behind you to the elevator bank. Press 1. When the doors open–"
He is interrupted by the appearance of a woman with a tag hanging around her neck that reads, GUIDE. She very gently places the palm of her hand between my shoulder blades, smiles, and asks me, "You haven't been here before?"
"You're seeing a doctor then?"
My stomach is turning over in addition to my feeling faint. "Yes. Dr. Quigley."
The guide smiles some more. "I'll take you right to her office. You won't have to sit and wait at the Breast Center waiting room."
The guides know from experience that if they don't head patients off at the pass, those patients—already in major stress-out—will have to listen to Beaumont's boss go through a 25-step list of directions and halfway through they'll start crying, or in my case, ask, "Have you got a fucking print-out?"
Charlie hears just bits and pieces of the above because we are in a place where sound dissipates into the endless vastness of space instead of heading straight into his hearing aids. He is more grateful for the guide than I am.
She leads us into one of the elevators, and we head down four floors in reverse of the direction our car took. We come out and walk—I'd say, a mile—past a large fountain with granite bench seating all around where no one is sitting since whose ass wants to sit on granite? The fountain is surrounded by a food court, and there are two gift shops. The tables and chairs and the gift shops are full of people. Since I'm pathologically curious, I wonder why there are two gift shops. Alas, I will find out but not now.
Then we arrive at another bank of elevators hiding in an alcove. We go back up again, this time to some other floor, not the 4th, the floor where we started.The guide leans in to us and says conspiratorially, "I'm going to suggest they put lights in the floor like on an airplane, pink obviously for the breast center."
Obviously. I say, "I've yet to see a hospital designed with a patient in mind."
She says, "This one wasn't."
We take some twists and turns past a large crowd gathered up at a cell hot spot and arrive at Dr. Quigley's office, where the guide immediately leaves me, calling out, "Good luck, dear," as she races back to her designated position. Who knows what Beaumont might be up to?
Dr. Quigley's PA, Justine, greets Charlie and me with a quite wonderful smile and sweet handshake. She puts us in a tiny cubicle stuffed with three hard chairs, a small table, a stand with a computer on it, plus a rolling chair in front of the computer. She tells us to sit down on two of the three hard chairs. Then the doc comes in. We stand up again. Diane Quigley.
Yet another kindly smile but a very strong handshake. I introduce Charlie, she shakes his hand, too, and I tell her my daughter is a nurse in community health and will be running over here any minute.
She says, "Good."
Diane Quigley has shiny, black, curly hair and wears, big, black glasses, and dangling earrings that are maps of the African continent in bronze. She has style, the kind of style that is not only cool but also says: This is my style and if you don't like it, tough.
She gestures for us to sit down again.
A young woman in a white lab coat comes in. We are introduced: Marina. She smiles, shakes our hands, and then takes the chair in front of the computer. Her back is to us. She will not turn around until we get up to leave. I will learn that whenever and wherever I have any sort of appointment at Smilow—doesn't matter with who—Marina will be there. All Smilow Breast Center doctors do not look at computer screens and take notes on the keyboard while talking to me or asking me questions. Doctors today, excluding Dr. Slattery and Dr. Montessi, never so much as look into your eyes. They stare into a computer screen instead. They have no idea, as have doctors of yore, that if your eyes are bloodshot, yellowed, crossed, rolled back into your head, etc. that it just might tell them something about the patient's condition. They are no longer steered toward obvious diagnoses by the sight of you because they're trying to figure out how to navigate the computer to order blood work.
The doctors at Smilow each have a Marina who taps away at the keyboard getting down all the stuff the doctor and patient say, all the stuff the doctor needs in order to remember who the hell the you are and what your problem is.
Dr. Quigley sits down and opens a folder while Marina places her hand on the mouse, ready to rumble.
"Let's look at your medical records here," she says. She flips through the pages within, stops, and looks up at me. Marina scrolls through my medical records online, also stops, but doesn't look at me. She says to Dr. Quigley, "Number 17."
Dr. Quigley says, "Thanks." Then she says to me, "Tell me about this…you had a fibrous tumor removed from your underarm…uh…ten years ago?"
I say, "That long?" Wow.
She waits. Here is what I say only in a nutshell: When I got pregnant, I got swellings in my armpits. My obstetrician told me it was errant breast tissue. In a pregnant woman, that tissue will swell along with her breasts in preparation for producing milk. (Can you stand it?)
My obstetrician also tells me not to worry; the swellings will most likely go away. What he doesn't say is that I have only a fifty-fifty chance of that happening. So, in my left armpit, the swelling goes away, but not in my right. I have to have surgery to disappear a lemon-sized benign mass of hardened breast tissue.
Now, Dr. Quigley peruses the file for maybe thirty seconds more, finds nothing else interesting, and says, "I'll meet you in the examining room and I'll include a good look at both armpits. Justine will take you."
I say, "Don't you just look at mammograms?"
She raises an eyebrow. Silly me.
Justine appears on cue, and right with her, here comes my daughter, out of breath, having arrived in her blue scrubs on a run from Yale-New Haven's community health clinics quite a ways away, requiring that she dodge heavy traffic, mostly trucks and ambulances. It's her lunch break, not that nurses have lunch, or any breaks at all. While she hugs me and then Charlie, Dr. Quigley looks her up and down. I introduce them to each other. I cannot help but note that Dr. Quigley and my daughter are two beautiful women. Dr. Quigley says to Jene, "I'm so pleased to meet you. You do good work. Have a seat. I am about to examine your mom, and we'll be back shortly. Dad will be able to fill you in on anything you need to know, but you didn't miss much."
Jene collapses into a chair. She doesn't say, Charlie's my stepdad; she's too tired. Dr. Quigley turns to the door, and Justine and I follow her. I don't want to follow her. I want to go have coffee somewhere with Charlie and Jene. When Salty doesn't want to go where he's being led, he stops. He won't move despite pleas, threats, treats, and pulling on his leash. Oh, to have that luxury.
In the examining room, Justine gives me the usual directions. I take off my T-shirt and bra, and put on a johnny coat. Justine puts some stuff into her computer while she asks me questions, never looking up once. Nurses don't get other nurses like Marina to help them. Then Dr. Quigley comes in with Marina trailing behind, her arms full of the folders with my medical records and I don't know what else. Justine leaves. Marina sits down at the computer, while I learn what "a good look at both armpits" means.
Dr. Quigley pokes her fingers so far into my right armpit in order to feel around that I actually shout out a yelp.
She says, "Sorry," and continues without letting up while I try not to make noise and just bear the pain. She does the other armpit and then says, "There are no lumps in the breast tissue under your arms. Good."
Yeah. Way good. I don't ask what a mastectomy of the armpit requires. I try not to imagine it.
She has me lie down on the examining table and basically treats my breasts like bread dough. She kneads them for some time.
She says, "Not feeling a thing. Good."
Yeah. Way good again.
"I'll see you in my office."
She's gone, so is Marina, and I get dressed. Justine returns to lead me back to the office, where another chair has been squished in. Dr. Quigley is already there, Marina at the computer. She says to Charlie, Jene, and me, "If the suspicious cells in your duct do turn out to be cancerous, they likely have not infiltrated the surrounding tissue, but we won't know for sure until we have the pathology report after your biopsy."
I ask, "What are the odds that they've infiltrated?"
"Twenty percent. If, in fact, they are cancer cells."
"What are the odds that they are?"
"Based on my experience, the odds are very high."
Dr. Quigley's demeanor does not say to me in any way that she is lying. So her saying very high instead of 100% gives me hope. And so does her saying if they are cancer cells.
So I say, "Thanks, Doc."
She says to me, "You're welcome. Beth made your appointment for the biopsy, correct?"
She says to Marina's back, "What's the date?"
The reason she asks Marina instead of me is because she knows that a newly diagnosed cancer patient—even a possible cancer patient—can't be trusted to remember anything. But if there's one date everyone remembers it's 9/11. I'm glad I don't have to say it. Marina gets around having to say it. She says what I said to the Morra girls, "Wednesday."
Dr. Quigley flashes me her lovely smile again. There is compassion all over her face. She says, "Marina will give you your pre-op instructions—they are simple and straightforward."
She stands up. She takes Jene, Charlie, and me into her gaze, all of us together. (The ability to do this is the sign of a good teacher. I hope she's also a professor at Yale. I later learn she is. Good.) "I'll see you again when we have a pathology report. Hang in there."
Handshakes all around and she is gone. Marina hands me a sheet of paper and is kind enough to watch where I put it. Then she says, "Remember, the paper is in that little side pocket right there." She points to the side of my tote bag.
I wonder how many millions of phone calls she's taken with requests for another copy of pre-op instructions because the patient can't find the original.
Jene, of course, has to go. She hugs Charlie and me and says, "Call ya tonight, Mom."
To her back, I say, "Okay, sweetie." She's on the run.
I read the pre-op instructions aloud to Charlie on the way home after he clicks the setting on his hearing aids that reduces road noise. The only instruction of note, besides that I should get to my appointment fifteen minutes early, is not to take aspirin, Advil, or anything else but Tylenol from here on in. That won't be too difficult. I take aspirin if I have a headache (rare), Advil if I have an achy muscle (rarer), but I never take Tylenol because it doesn't do anything for the above.
Naturally, Charlie says, "Good thing vodka isn't on the list." He's talking about our Sunday morning greyhounds.
NEXT SUNDAY, JULY 1, CHAPTER 11.
A BIOGRAPHICAL ESSAY
I was born and raised in Hartford, Connecticut and have lived in Connecticut until I served as a Peace Corps volunteer in Cameroon. There, I lived in Buea, a town situated on a series of ledges five thousand feet up the side of Mt. Cameroon, an active volcano, its peak nearly 14,000 feet above the equatorial sea. Having aspired to be a beach bum, I am happy to say I now live a half-block from the Gulf of Mexico in the town of Fort Myers Beach, a barrier island that takes the brunt of any hurricane leveled at the city of Fort Myers. Most fortunately, I have a water-loving family and a labradoodle named Saltalamacchia, also a water-lover. Salty is my first dog.
My grandparents on my father's side emigrated from the Italian Piedmont, and on my mother's, Quebec. My fondest childhood memories are of sweltering summers blue-crabbing with my French-speaking grandfather from 5 a.m. until 5 p.m., my grandfather wearing a worn three-piece suit and cap, and me, my underpants. When I told my Italian grandfather that I would be going to Cameroon as a Peace Corps volunteer he told me there were very good grapes grown in Africa.
My brother was autistic, a savant, who would not allow singing, laughing, sneezing, electronic sound (including television, radio and anything that produced music), and the flushing of the toilet except when he was asleep and he never seemed to be asleep. He had a library of over two thousand books all on WWII. As his adjutant, I attained a vast pool of knowledge on such things as identifying fighter bombers from their silhouettes and why we dropped the atomic bomb. "To win the war," Tyler told me. "But it didn't work so we dropped another one. Victory at last."
The relationship with my brother was one of three influences on my writing; the second, my father's bedtime poetry and prose following the Our Father and Hail Mary: "My name is Ozymandias, King of Kings. Look upon my works ye mighty and despair!" The third influence was the shelf of classic children's literature my mother kept stocked with such gems as The Swiss Family Robinson, Bambi, Tom the Water-Boy, Silver Pennies, King Arthur and the Round Table, The Child's Odyssey. Somehow, The Bedside Esquire (1936) found its way to the shelf and I read the extraordinary short fiction within, including Hemingway's "The Snows of Kilimanjaro," Gallico's Keeping "Cool in Conneaut," Salinger's "For "Esmé with Love and Squalor," Hecht's "Snowfall in Childhood," and my favorite, "Latins Make Lousy Lovers," by Anonymous who turned out to be Helen Lawrenson, the only woman with a piece in the collection. (Sheesh.) There was also an excerpt from the novel, Christ in Concrete, by Pietro Di Donato, that so bowled me over I decided I would be a writer, too, just like all the writers who wrote fiction for Esquire Magazine in 1936.
After Peace Corps service, I taught, worked as a librarian and got my first freelance writing job with Reader's Digest. The Digest editor assigned me sports and games for How to Do Just about Anything, a book which sold 50 million copies world-wide. Reader's Digest made a vast fortune on that book alone, while the writers earned $25 to $75 dollars per article. I learned economy of language writing such pieces as "How to Play Tennis" in fifty words.
In 2010, I was awarded the Diana Bennett Fellowship at the Black Mountain Institute at UNLV, where I wrote my most recent novel, The Honoured Guest: Anne Alger Craven, Witness to Sumter, in Her Words.
My work has been reprinted in several foreign languages. I have taught fiction and memoir writing at many venues including the Mark Twain House in Hartford, CT, and on the Aran Islands through the National University of Ireland, Galway, and online via this website.
Presently, I spend time in Fall River, MA, where I went on a tour of the Lizzie Borden house. By the time the tour had ended, I knew who killed Lizzie's parents and it surely wasn't Lizzie. The competition, however, is stiff. Since I started writing this novel, another novel with an entirely different take on the crime was published. And there is a film presently in the works, again, with another take altogether. I'll keep up my work on my own version, which, I'm convinced, is the real one.