FIRST, YOU GET PISSED: Chapters 1 -- 5
FIRST, YOU GET PISSED
Mary-Ann Tirone Smith
Author of Girls of Tender Age: A Memoir
Author's note: The story presented in this book is true. However, in some cases, names have been changed to protect the privacy of the individuals involved.
Copyright © 2018 by Mary-Ann Tirone Smith
Jacket design: Courtney Lopes Jacket photograph: Charles E. Bimmler
To Charles Edward, my king of kings, and Saltalamacchia, prince of the realm, with love.
Amanda, Joey, Emmie, and Chris Borst, Jene Maria Smith, Jere Paul Smith, Kim Gonzaga, Duane Trevail, Tadhg Hoey, Marnie Mueller, Karen E. Olsen, Betty Rollin, Joan Schmitz, Barbara Tirone, Marion Morra, Eve Potts, the staff at Beach Library, Fort Myers Beach, Florida, and in memory of Mollie Donovan and Shirley Temple Black
ALSO BY MARY-ANN TIRONE SMITH:
The Honoured Guest
An American Killing
Masters of Illusion: A Novel of the Great Circus Fire
The Port of Missing Men
Lament for a Silver-Eyed Woman
The Book of Phoebe
THE POPPY RICE MYSTERIES
She Smiled Sweetly
She's Not There
Love Her Madly
IN COLLABORATION WITH JERE SMITH
Dirty Water: A Red Sox Mystery
Girls of Tender Age: A Memoir
FIRST YOU GET PISSED
CHAPTERS 1 -- 4.
EVERY YEAR, A POST CARD without the picture arrives in my mailbox. Maybe you get one, too. It comes a week after your mammogram, telling you that everything is right as rain. In my case, the card comes from my OB/GYN, who always scribbles a happy face on it. Sweet. But once, around three or four years ago, a detour: no card. Instead, I get a letter. And rather than a happy face, the key message is: You have dense breasts.
I call my primary care guy and ask him what "dense breasts" means.
He says, "It doesn't mean anything. It's a way for them to cover their tracks in case they missed something."
I do admire Dr. Slattery, my no-holds-barred doc. In the movie, "Love Story," the female lead, Jenny Cavalleri, gets really sick and knows it's bad. She goes to her primary care guy, and after her examination, tells him not to bullshit her. He doesn't, and consequently, we all know how the movie will end, unless you read the book. My boyfriend at the time says, "Get the Kleenex ready."
It isn't necessary that I tell Dr. Slattery not to bullshit me.
I find it a bit of a relief that Dr. Montessi doesn't have to go around drawing unhappy faces when things aren't right as rain. The dense breast letter, in fact, doesn't even come from her; it comes from some lab.
About breasts: You know how glad you are to leave the doctor's office after a mammogram? Delirious with joy because you don't have to go through that again for another 365 days, an entire year before your breasts will, once again, be compressed between two steel plates. I mean, your breasts! They've never done anything to deserve that kind of…uh…discomfort. (Discomfort is a hangnail for crissake, in case anyone in the medical field is reading this. A mammogram hurts).
My own breasts make me feel so good about being a woman; they please my partner while my partner is pleasing me; they allow me to experience a unique intimacy between two humans—between me and my apparently starving newborn. We do what we have to do because, even though our breasts don't deserve pain, they surely don't deserve to succumb to cancer.
So now, this year, this summer, the first week of August, August 6th, I get a another detour, but not a letter, a phone call. Caller ID reads: Yale-New Haven Hospital. I figure it's my daughter, who probably has to use a company phone for some reason. She's a nurse at the Yale-New Haven Infectious Diseases Clinic. I tap green. A woman's voice, not my daughter's: "Hello, I'm Dr. Somebody." Her name doesn't sink in because I experience an immediate loss of breathing ability, thinking that something's happened to Jene. Then, the voice says, "I'm a radiologist at Yale."
"Fuck," I say aloud, though quietly, thinking Jene broke her arm. When upset, I ordinarily say to myself, Shit. But this is a far higher grade of upset. There are times when dropping an F-bomb is therapeutic.
Before I can ask, "What happened?" The radiologist says, "We've seen an anomaly in one of your images. It almost always means nothing, but we still want to do a second mammogram. My nurse will make an appointment for you. I'll connect you."
Maybe she said, goodbye. I wouldn't know because of the panic that takes hold. Jene doesn't have a broken arm; I have an anomalous breast. In my ear, I hear phone connecting noises, while the radiologist's words echo: It almost always means nothing. That is called bullshit. The give-away is almost, a word meant to soften the blow, but of course, has the opposite effect. It's not nothing.
I'm switched over to the nurse. I don't remember the appointment conversation with her, but I put the date in my cell, August 22nd, even though I don't remember doing that either.
A flash of memory: Once, upon my release after a mammogram, while I'm getting dressed, the technician reappears. The johnny-coat, size C (colossal), is around my ankles. She gives me a big smile. "I'm so sorry, Mary-Ann, I need another picture. Something seems awry with your left breast. I'm sure it's because you moved."
I moved? Does one move when one's breast is in a vise?
I get another round of torture . The verdict: "My error. There was nothing there."
I say, "Thank you."
Shit. I already thanked her for torturing me the first time. (If you have my mother for a mother, if you don't say please and thank you, you're a sociopath.)
Now, on this day, a beautiful day, a summer day in August, it's a radiologist who's telling me something is awry, not a technician. It's something!
I have to talk to Charlie is all I know. Charlie is my husband. He's an ex-widower. His late wife died of breast cancer.
I will wait for the right moment to tell Charlie the crummy news, but along those lines, as any shrink will advise—say you have to inform the kids you're getting divorced—there is no right moment. Receiving news of a divorce will make them hate the parent giving them the news even if you segue directly into, "But I've got Southwest tickets to Disney World for April vacation!" That's because the first thing the kids will say is: "Dad's coming, right?" The little nincompoops. Did they not hear me say Dad and I are getting divorced? So we all know the answer to their question, which makes them hate you more, unless you're Jennifer Garner and Ben Affleck.
Come April, they're saying, "Dad would have never stood in this long a line and we'd have missed Space Mountain." We'd miss it because Dad would throw his arms up in the air, storm off, and we have to get out of the line to find him because there are no cell phones then.
For now, all I know is, I just have to spit it out. I realize that as I'm brushing my teeth that night, spitting out toothpaste. Charlie is in bed. I'm brushing away for a good, long time. Earlier, he welcomes me home from my mammogram with my mothers' favorite cocktail—a Sidecar. Google it. Know that it requires a beer chaser if you're my mother. I'm acting as if it's just any old day, and I need to take advantage of a least a little denial. Denial is one of the best things that God created. Charlie and I have a lovely dinner. The man cooks. The man is a good cook. Mussels in white wine and garlic, and bread he had to go ten miles from home to get. Nice sauvignon blanc. All lovely, but I don't taste a damn thing.
So, I'm brushing my teeth, while chanting silently to myself in rhythm with the brushing: There is no right moment, there is no right moment, there is no right moment. Can you brush your teeth all night? Denial only takes you so far. I have to stop. I press the button on my electric toothbrush, put it back into its stand, screw the top onto the toothpaste, and look at myself in the mirror. My usual flossing and a rinse of Listerine will have to wait. I tell my face in the mirror, "Get it over with."
As soon as I come into the bedroom, our dog, Salty, gets out of my spot and goes to the foot of the bed. He performs this ritual every night. Great in winter since his 58-pound self leaves me a big warm spot. Salty remains at the foot of the bed until he's sure we're asleep. Then, cautiously, stretches out, plants his head on half my pillow, and is immediately and blissfully unconscious.
Every night, I sleep between man and beast.
I stand there looking at Salty at the end of the bed. He doesn't know why. He raises his head. I pat it. I climb into bed and nestle into Charlie's chest, a magnificent chest, I have to say—broad, hard muscles, gently hairy, and especially sexy nipples. Yum. Neither of us has put on a pair of pajamas since we co-mingled, not counting a Meet and Greet session, re eHarmony's rules. We are diehard cuddlers what with being naked. We very often entwine our naked selves together like two kittens and pretty much make love without even thinking twice. But tonight….
I say, "Sweetheart?"
"I have to have another mammogram. They saw what they call an anomaly but that it almost always means nothing. I'm sorry." I immediately think of Nancy Reagan, who told the President she was going to have a mastectomy and that she was sorry. At the time, I thought she was apologizing because he would have a wife with only one breast, but now I realize she was saying she was sorry because they had to face something unbearable, especially her.
Charlie's breathing stops just like mine did when I hear the almost always thing. He knows from almost always. I wait. When he can speak, he calmly asks, "Have you felt a lump?"
"Me, neither." Considering the way his first marriage ended, he's obviously on guard.
Then he says, "Is it Starlight or Starbright?"
Once, when looking at my breasts after bestowing them with his sweet caresses and warm kisses, Charlie says, "I love you, Starlight, and you too, Starbright. You're so gorgeous." Charlie gives my breasts names! Lol. (Lol is exactly what I do at the time. Note: When I first saw lol in an email, I thought it meant little old lady as in the Beach Boys hit, "The Little Old Lady from Pasadena.")
Tonight, laughter of any kind, lol, or otherwise, isn't in the cards. I say, "The radiologist didn't tell me which breast. Maybe she did, but I must have blanked it out."
Since Charlie has passed through his initial terror mode and into a mode of being there for me, he props himself up on his elbow and says in his fabulously deep voice, "You're going to be all right even if there is something. It's very soon. I mean, you still can't feel anything."
He pulls me into his strong arms, and says, "I love you." He has such a deep, fabulous voice.
When I first meet Charlie, I say to my friend the writer, Sarah Clayton, "He has this really deep voice," and she says, "A deep voice goes a long way."
Then we're nuzzling, then kissing, then touching each other all over, making love. It's our best way to communicate as Charlie has a fairly serious hearing loss from the time he's fourteen. He doesn't get medical attention for chronic ear infections until they become mastoid infections. (His widowed mother is "on the dole." That's what welfare is called back in the day.) So let me tell you this: I would rather have a man who can't hear me than one who won't listen to me.
Anyway, Charlie makes love to me in an especially soothing way. While he's loving me, I'm thinking of this one night when Charlie is finished making out with Starlight and Starbright and he says to me, "Your breasts give me peace, Mary-Ann. Serenity." Then he gets a little weepy. He's a very emotional guy, him and his deep voice.
I say at the time, "All I know is that that you are really making my toes tingle, cutie."
He stops being weepy and gets turned on instead.
Now, tonight, I interrupt him, "Charlie?"
"How come you named my breasts?"
Without even trying, I am changing the subject.
He says, "What?"
I forget to put my lips up to his good ear. Well, not good, but better than the other one. I repeat the question.
He says, "It was because of the story you told me about your aunt."
"The one with the jars."
Is changing the subject part of the denial phenomenon? Maybe. Anyway, with the subject changed, Charlie and I go about still enjoying that most wonderful stage in a relationship— autobiographical reverie. All new lovers enter this state until they either find out there's nothing all that interesting about each other (usually right away), or stay lovers forever continually exchanging missed-out pieces of their lives that render them more and more in love.
When I'm little, Auntie Mary says to my mother, "My stars are itchy."
My mother says, "So scratch them."
Auntie Mary reaches into her bodice and follows her sister's instructions. The thing is, I think Auntie Mary is saying jars, not stars. I never heard the word breasts before. It is several years before I learn that human jars are actually called breasts. I just figure breasts are a certain brand of jar, which makes perfect sense because they look somewhat like jars. I tell that to Charlie.
He says to me, "Rather than call your breasts Jar A, and Jar B, I think I'll go with Starlight and Starbright," and proceeds to make wishes on my breasts in keeping with the rest of the nursery rhyme. Among the wishes: that I won't leave him, that I'll love him forever, that I will marry him, and that the Red Sox will win the World Series. All come true.
On this awry night, remaining wrapped up in one another, Charlie and I both pretend to fall asleep, until we finally and blessedly, somehow, do.
And only then does our Salty dog move up the bed.
AUGUST 22nd ARRIVES, and I am where I don't want to be—the imaging center at Yale. Charlie is ushered into a special waiting room for family or friends of women having advanced placement mammograms. Salty is enjoying the action at doggie day care. The breast-crushing machine is revved up, only this time the two steel plates are a quarter the size of the usual ones, appropriately, more the size of a sandwich. These are geared to descend upon the breast anomaly, specifically.
The technician arranges Starbright onto the bottom plate and has me hold the bar that is alongside the machinery. She dashes over to a console, presses a button, and the upper plate descends. When Starbright is flattened and hurting, she returns to my side and lowers the upper plate manually, twisting a short rod with a vinyl cover, sort of like a gearshift. I'm gripping the bar with all my might.
"Can you take another turn?"
Tears are springing to my eyes. She dashes around to her control panel, calling out to me, "I'll be really fast." I'm still hanging onto the bar for dear life, bearing the singular pain, when she calls out again:
"Three seconds, two seconds, one second, done!"
Starbright is released.
She rushes over to me. "You okay?"
"I'm really sorry."
I can tell she is. I say, "I appreciate your running."
She's not finished with Starbright naturally. I forget all about the dreaded side view, but it doesn't hurt worse than the usual side-view mammogram, don't ask me why. It doesn't take as long, either. I only know it's over. The technician tells me I can get dressed.
I do. As I'm grabbing my bag to leave, she says, "The doctor will be out shortly."
I say, "What doctor?"
"The radiologist. The one who called you. She's looking at the images."
I sit down on a little bench for one.
The jury is out, and my brain is churning. Maybe I'll have to wait a really long time, all day, I don't care, because when the jury goes out and is back before you have time to blow your nose, forget it, you're guilty. Five seconds later, the door next to the door that is the escape hatch opens. I am doomed. Again, because of who my mother is, I stand when a person enters a room.
In walks a tall, slim, very pretty girl in lab wear, who looks to be in the neighborhood of twelve years old. She smiles and puts her hand out. So do I. I'm trying to smile but don't know if I'm successful. We shake.
She says, "Please sit down, Mrs. Smith."
Mrs. Smith is my late mother-in-law's name.
She next says, "I'm Doctor…." She tells me her name, and it goes in one ear and out the other just like before on the phone. My brain has made an executive decision: If you don't know her name you'll think you're dreaming this whole damned fucking thing.
I sit. This is no dream. This is the opposite.
She steps over to a chair and pulls it over to face my bench. She's Asian. But this is Yale. You might as well be in Beijing. She places the chair directly opposite me, sits down, and looks deep into my eyes and asks, "Do you mind if I call you Mary-Ann?"
I say, "I'd rather you do." I do not ask, Do you mind if I have no idea what your first name is, or last name either, and I don't want to know?
She says, "I'm the doctor who spoke to you on the phone."
We are not even a foot apart, face to face. I feel my saliva drying up so I try to brace myself. I don't want to faint and fall off the chair and have a concussion, although I'd surely rather have a concussion than whatever the thing is she's going to tell me I have, though I know what it is but can't accept it.
She leans in closer. I see she has what is called back in the day a "lazy eye." Maybe, like Charlie, her mother had no money for medical care. (My friend, the writer Katharine Weber, doesn't get appropriate medical care when she tells her parents she can't see out of one eye, even though her parents have a ton of money. They just won't believe her. They think she wants to wear a certain style of glasses popular at the time.)
I gaze into the radiologist's face. She must be one of those brilliant Asian kids whose tiger mother sees to it that she graduates from high school at nine.
She says in a chummy way, "Ya know, Mary-Ann…see…like, here's the thing." She sighs. "We have loads and loads and loads of ducts." Maybe she is twelve. Did she say, Ducks? Maybe she is nine and skipped elementary school altogether.
Leaning in ever closer, "I mean, like, we have…" then, her voice goes up a couple of decibels. "…a zillion ducts!"
Oh. Ducts. This does not sound good.
"We have bile ducts! We have lymph ducts! We have intrahepatic ducts.…" She gives me several more examples of ducts I've never heard of, finishing with one I have, "…and we have mammary ducts!"
This is getting more ominous by the minute. My brain is playing a comfort song. Julie Andrews is singing to me: The hills are alive with the sound of music, with—
The radiologist interrupts. "Now, Mary-Ann, let me tell you about the problem with ducts" Then she says forcefully, "They are full of…junk!"
Good God, I thought she was going to say they were full of shit.
I don't say, Get to the point, because I don't want to know the point. Instead, I say, "My mother never let a day go by without telling me to get rid of all my junk."
A couple more decibels: "OMG! My mother, too!"
What does one say to that, to that person, at this time, in this place I'm in? Nothing. Besides, she's on a roll, doesn't leave me a second to respond to what our mothers have in common.
"So, here's why our ducts are full of junk!" (Good. She's still not getting to the point.) "Because when our cells die, they're replaced with new cells. But the old cells leave deposits behind. Deposits!"
Turns out our ducts are full of shit.
"And one such deposit is called a…" (drum roll) "…calcification!" She takes a big breath and keeps going. "BUT! We have calcifications throughout our bodies, not just in our ducts." (She's still emphasizing ducts but has toned down the volume.) "You can have calcifications anywhere, like…like…in your larynx. Calcifications in hard tissue such as the larynx, however, are not worrisome. They just sit there."
Here it comes, because who doesn't know that breast tissue is soft? She's now speaking to the point, dropping the use of like as an adverb. I have no problem with the likes since it's the equivalent of um. I think um is worse.
"So…" (She still starts off sentences with the conjunction so, which I do all the time, even though language purists will rant)… "last year, Mary-Ann, I saw a few teeny-tiny calcifications in one of your mammary ducts in the left breast. Calcifications found in mammary ducts can sometimes be the deposits of mutated cells. Sometimes the deposits—the calcifications—will form a pattern. I saw no pattern last year and neither did my colleagues."
Is that good or bad? She starts her next sentence with, However. Bad.
"However, when the next year rolls around, when the patient—you— has another mammogram, most of the time the calcifications are gone, but sometimes they're not, and sometimes they have even increased in number."
She pauses, waiting to see if I can take what's coming. Oh, but I can't. I have no choice, though. I say, "My calcifications have increased, haven't they?"
"Yes." She reaches over and touches my wrist. "When you were here last week, I immediately took a look at that particular duct where I'd seen those few calcifications a year ago. Not only have their numbers increased, they've increased significantly, and the calcifications have formed a pattern."
I'm not surprised she's going to say something terrible like that, but at least her voice is growing significantly softer. She is calmer, and no longer in need of like. I ask, "A pattern. A pattern like a china pattern?"
"Uh…no. More like a cluster, actually. The calcifications have formed a cluster. A little independent galaxy of their own."
I tune her out, though not deliberately. My brain needs a rest. My brain is stuck at galaxy. My children and I so love galaxies, along with constellations and meteor showers, and human-made satellites, and everything else in the sky. Once, the three of us and their cousin Melanie lay on our backs in a field behind the neighborhood elementary school watching the Perseid meteors showering across the Milky Way. We try counting the number of meteors in each shower. We don't get far because Melanie throws up. Lying on your back and watching meteors zipping overhead can actually make you car sick if you are so prone. Then, another time, at four o'clock in the morning, my son pats my shoulder. I wake up and he whispers in my ear, "Mom. The aurora borealis. Hurry."
I creep out of bed and follow him out to the deck. The Connecticut sky is bursting with Technicolor striations. My son, whose name is Jere, will grow up to ask his beloved girlfriend to marry him and how would she feel about having the ceremony during the upcoming Delta Aquarids? These are lesser known meteor showers, in case you don't know. His girlfriend thinks it's a capital idea. (I am so very glad he found his Kim who became our Kim during last year's Delta Aquarids.)
The radiologist notices how I'm drifting to a better place and lets me have my moment of peace. Then she has to interrupt. I'm not her only patient after all.
I say, "Go ahead."
She tells me what I need to hear about the galaxy in Starbright's mammary duct, and I have to pay attention so I can tell Charlie the exact words. Right now, he is waiting and waiting, out in that higher-level waiting room, wishing for a shot of Macallan 12. I am wishing the same.
So, here is what I need to know. She races through it and uses the C-word for the first time. She has to do it at some point, doesn't she?
"This anomaly can indicate a cancer but the good…really good…news is that the higher resolution, limited angle mammogram you just had showed that no cells have made their way through the duct wall. If they had, they would definitely be cancer cells. But I could see none."
I now feel my first emotion after a week of my nerves shot. A ping of anger suddenly fills up the very core of my being. I picture a bunch of scrawny-assed cancer cells joining forces to smash through the wall of my mammary duct with a battering ram so they can chow down on my dense breast. I am pissed.
I say to the radiologist, "The fucking little bastards."
The radiologist says, "Yeah."
Then, her elbow on her knee, her chin resting on her hand, she says, "A biopsy is kind of the final word as to whether or not what I'm seeing is a lesion."
"A lesion is cancer."
She really cannot stand saying the word cancer. I am thinking that when this poor woman must tell a patient that cancerous cells have burst through her mammary duct, that she sees lesions, it breaks her heart. All I know is, I can't stand saying the word cancer, either. And now I have to prepare for that word applying to me.
I take her hand. She squeezes it and then leans back into the chair. She says, "Let me describe the biopsy procedure for you."
Very Dear Reader, if you have never had a breast biopsy described to you, hang on to your hat. Smoke a joint. It's medicinal in this case. Like me, I'm sure you just figure that someone sticks a needle into your breast and sucks a couple of cells out of the duct junk to be examined by the boys in the lab. When I'm a kid, I love "Hawaii Five-O," who doesn't? In every episode, Jack Lord can be counted on to say two things to James MacArthur: "Book `em, Danno," and "Send this to the boys in the lab," the latter when he's holding up a possibly blood-stained screwdriver.
And so, if you don't have a joint immediately available, go pour yourself a shot of Macallan 12, or if you don't drink, have a cup of coffee.
THE BREAST biopsy. Ready?
The radiologist starts with, "You'll be on your stomach on a table with a hole in it. Then—"
I interrupt. "I'm getting a massage, first? That'll help."
"Uh…no. The hole is where your breast will hang out so we can do a much more intense mammogram previous to—"
"Starbright will hang through a hole?"
I explain about Charlie's names for my breasts. She stares at me, sort of. The lazy eye is presently leveled toward the wall over my shoulder. Then I repeat my question: "You're saying my breast will hang through a hole?"
"And where are you? Underneath the table on one of those things your mechanic rolls around on when he's under your car?"
"Not exactly…" she gets a rather huffy expression on her face, but right away reverts to her previous kindly demeanor. She has trained herself not to take offense with her patients. She says, "It's a stool. But it won't be me who's rolling around. Another radiologist will be on the stool, and a nurse and technician will scoot under the table as need be."
"They'll each have their own stool?"
What did I think? They'd be down on their hands and knees?
I think for a moment. "Are you saying you won't be doing the biopsy?"
"What I do is analyze images."
I visualize three strangers crammed under a table with Starbright in the middle of them. I wonder how they get at the breast of a woman with cute little perky breasts. At Branford Harbor, where we have a boat, there is a captain who names her cruiser, Sea Cup, which is the size of her bra. I'm a Sea Cup, myself. (When I tell the captain that, she gives me a knuckle-bump.)
Alas, I must force myself to concentrate on the business at hand, but I want very badly to blink like I dream of Jeannie does and vaporize. I can't. I listen as the radiologist continues the narrative.
"First, the doctor will numb the breast... he'll numb Starbright, actually." She smiles at me. "Starbright won't feel anything at all."
We are very glad to hear that. I like this woman.
"And next, he'll make a quarter-inch incision—"
"Incision?" She pulls back from me. I must have shouted the word. I shout it again. "Incision?"
"A needle requires an incision? How the hell big is it?"
"It's not a needle."
"It's not? What is it?"
"It's a spring-loaded, large-core transducer. Essentially, a—"
She clears her throat so that she can talk fast, preventing me from interrupting her again. "A transducer is essentially a metal tube filled with very fine needles except they have barbed ends…" I am thinking, but do not say aloud, Jesus Christ Almighty "…and these barbs will hook several strands of tissue within the duct. Then the transducer will draw them out of the duct and into its tube. After that, the transducer is taken out. Then we send the specimens to the lab to see if the cells in the duct are cancer cells."
I really do hate the word cancer. If you change the second c to a k, you've got canker. I get canker sores when I'm a kid. Now I have cancer. (I say it. Cancer. If only to myself.) Maybe if you get canker sores as a kid, you're predisposed to cancer. I bet if the radiologist said, "…we send the specimens to the boys in the lab…" I wouldn't be doing that monkey-brain thinking. I'd laugh.
I work around the damn monkeys who have set up a trampoline in my cerebral cortex. I ask her, "How will the other doctor get it out?"
"He'll pull it out."
"How many what?"
"How many specimens will be in it?"
"Oh. Four or five."
Whew. I'm thinking she'll say eight hundred. I ask, "Will the incision require stitches?"
Naturally. I'm hoping for the same number of stitches as the specimens, or fewer. Imagine the number of stitches you need if you're breast is riddled with cancer. I cannot imagine. I ask again, "How many?"
"Two…maybe three. Then we'll leave a marker behind—a tiny wire—so that if you do need to have surgery to remove the duct, the breast surgeon will know exactly where to go."
I say, "The transducer guy won't be doing the surgery?"
"He's not a breast surgeon."
"There are surgeons who only do breasts?"
"Yes, but if you choose, you may have any surgeon you like, including one who does not specialize in breasts."
Ping of anger. "What do I look like, Doc, some kind of idiot?"
She says, "Hah! No, Mary-Ann. You don't. What I mean is, if you have had a surgeon in the past you can talk to him or her about all this. You might decide that surgeon will be more appropriate." She puts her hand on my knee. She smiles. "But if not, you will have the best breast surgeon in the country. We are so fortunate she is right here at Yale. Diane Quigley. I will see to it that your surgeon will be Diane Quigley."
I will never forget Diane Quigley's name.
But I am not ready yet for that particular discussion. I need to finish this one. "About the marker? The wire?"
"How big is it?"
"It's the size of an eyelash. It will serve to guide the surgeon."
I try not to picture a doctor with a scalpel in each hand rummaging around inside my breast looking for an eyelash. The radiologist knows what I am thinking. She says, "The end of the marker will stick out of your skin and there'll be a Band-Aid over it."
Can you believe this? I can't, but it's all true. Right at that moment, I do not want to know anything else about an eyelash sticking out of Starbright. I am finding myself overwhelmed with a need to backpedal. I have to ask an extremely specific question centered on statistics. Statistics is truth. I don't like surprises. So, here is my pressing question for the radiologist: "What are the odds that the calcifications are cancer?"
She doesn't skip a beat. "Twenty-five percent."
"Is that based on your own experience?"
"No. That's based on statistics." She gazes into my eyes with one of hers trying to look elsewhere.
I know exactly what she means by No combined with the unbalanced gaze. In her experience, the odds that the calcifications are cancer, based on what she is seeing in my mammographic images of Starbright, are one hundred percent. The gaze reflects the fact that she's not comfortable lying.
She thinks I will cry. Maybe I look like I will break down. She asks, "Would you like a Kleenex?"
Forty years ago, the New York Channel 4 newscaster Betty Rollin titles a book she writes, First, You Cry. It starts with her learning she has breast cancer and how much the diagnosis screws up her life that is already screwed up because her husband is a philanderer, and it's about how no one wants to talk about such an embarrassing subject as breasts. In perfect timing with what is going on with me, the book is re-issued, a new edition. I read the first edition way back when because it gets such good reviews, not so much because breast cancer is the culprit, but because it's about life in general when you meet up with a monkey wrench. Life is full of monkey wrenches, isn't it? Betty Rollins's book is both moving and exhilarating. I remind myself to go to Madison on the way home, a nearby town that has the best bookstore in the country, "R.J. Julia." No one knows what R.J. stands for, or who Julia is. I will buy the new edition even though I still have the original. I want to support Betty and maybe she added new stuff.
Mainly, though, knowledge is power. My mother drills that into my head.
To my radiologist, I say, "No, thank you. I don't need a Kleenex. I need you to tell me what to expect."
She takes my hands in both of hers. "Please, please understand, Mary-Ann, that if there are cancerous cells in your mammary duct, we have caught the cancer early enough to cure it."
I am now apparently hallucinating. The doctor is telling me the cancer that is more than likely inside Starbright is curable.
She says, "Did you hear me?"
I say, "Yes. What do you mean by cure it? There is no cure for cancer. You die from cancer."
Here is how my mother describes her golf partner's stomach cancer surgery: They opened him up…loaded with cancer! Loaded! Sewed him right back up again. Left the damn cancer where it was. They'd've needed a shovel to get it out. Dead in a month.
Most ironically, my mother is diagnosed with stomach cancer shortly thereafter. They open her up—loaded with cancer. I picture a load of cancer looking like oatmeal. They take out ninety percent of my mother's stomach, treat her with a short course of chemotherapy, and she's back on the links in no time but dead in a year. That's all the time chemotherapy can give her, but right up until her last month, it's a good year of doing what she loves doing—playing golf, replacing golf with cut-throat card games when there's snow on the fairways, getting her hair done once a week, hanging out with her sister, my Auntie Margaret, doing crossword puzzles, knitting sweaters, and watching Pat Sajak and Vanna White every day, no matter what. The last month? There can be no dignity in death, same way it is with childbirth.
I tried my best, Ma.
The radiologist is speaking, still holding my hands, yet more warmly. I try hard to pay attention. She says, "If the cluster of cells is a lesion—something we won't know till we have a pathology report—then we have found a cancer before it can be felt or even seen by the human eye. If there are cancer cells in the duct, your surgeon will excise the duct, and the cancer will never come back. Never. It can't come back. The duct will be gone, and the cancer along with it. Again, I saw no invasive cells outside the duct."
I believe her the first time she tells me that, and I still believe her. I probably have a duct full of cancer but at least it's not a stomachful. I say what I'm next thinking. "But calcifications might show up in another duct next year, right?"
"No. First, the lesion will be disappeared by Dr. Quigley." She snaps her fingers. "Gone! And your post-operative treatment will prevent any new cancer cells from developing in…Starbright."
I find that impossible to believe. "Post-operative treatment is chemotherapy, right?"
"Not likely in your case since the lesion is minuscule. Dr. Quigley, and your oncologist, and your radiologist will discuss radiation with you. Also, any drug treatment to follow."
"You're my radiologist."
"I do not give radiation treatment. I–"
"Sorry, I forgot." I pause a moment to drum up some courage. "But what are the chances that what I have is a more advanced cancer than what you…" how should I say this? "…than what the images are telling you? What are the chances you missed something?"
Pause. Then, "I don't miss anything." Pause. Then, "But I have to tell you that sometimes, a protuberance—a tiny bit of a cell—will penetrate the duct wall. So tiny it will not be visible on the mammogram image. The pathologist will see it, though, once the duct is excised. Then you'll be scheduled for a second surgery—but through the same incision. Dr. Quigley will take out a margin that incorporates any tiny bits of a cancer cell that might have worked their way through the duct wall."
Is this a horror film, or what?
I ask her, "What are the chances of that?
Another twenty-five percent. I might believe the statistic if she said, Twenty-two and seven-eighths percent.
She officially has no more time for me; she leans back out of my face, and says, "Let's go ahead and make that appointment for a biopsy, shall we?"
She has other patients, after all. I am suddenly feeling exhausted. I can't ask her if there is anything else she should tell me because I'm shut down. But not to worry. There are other people I will be able to question: this Dr. Quigley person, an oncologist, and a radiologist—one who actually does the radiating.
But it turns out the image-reading radiologist has one last thing to tell me: "During the biopsy, in addition to the little marker, they'll leave a chip in your breast so that in future mammograms we'll be able to zero in on the exact area of the excised duct. The chances of that will be as close to zero as you can get."
Believe it or not, I say, "The vet put a chip in my dog's ear so they can find him if he ever gets lost or stolen."
She is so glad to smile again. Broad grin. "Same idea, sort of. What's your dog's name?"
I tell her his real name in case she's a baseball fan. "Saltalamacchia." (Jarrod Saltalamacchia starts his too few years catching for the Red Sox the summer Salty is born. They both have the exact same curly hair as well as extraordinary catching prowess.)
The radiologist, what with the expression she makes, is clearly not into baseball. So I say, "But we call him Salty."
She asks, "What is he?"
"Cool, he doesn't shed. I have a beagle. We had to buy a new, really powerful vacuum cleaner a week after we got him. He's two."
I say, "Salty is two! What's your beagle's name?"
"His name is Greensleeves. Guess what we call him?"
Now we both laugh, believe it or not. I know I can't believe I'm laughing, but I am. She says, "So, I'll have Dr. Quigley's assistant call you. Her name is Beth. She'll make the appointment for the biopsy, and another with Dr. Quigley once they have the pathology report. At that appointment, she'll discuss the pathology with you and take it from there.
I wish she'd left out the take it from there part. Laughing or otherwise, I'm in no condition to think about crossing a further bridge. She stands. So do I. She hugs me. I hug her back.
The hug softens the pain of what I am now thinking: I have to tell Charlie.
I GO INTO THE waiting room and Charlie is sitting there all alone, looking into a magazine he's not reading. He doesn't hear me come in because he basically can't hear anything as soft as sneakered footsteps even with the industrial-strength hearing aids he wears. Then he senses me. He's up and his arms are around me. After a moment or two, we sit down together.
I tell him everything except the one-hundred percent odds part I detected in the radiologist's expression. I start with, "The doctor says that the mammogram found these strange cells in a mammary duct." I skip the galaxy part too. "So, I have to have a biopsy to see if they're cancer cells. She told me they found them early enough that if they do turn out to be cancer cells, the duct will be removed and I will be cured."
(Did you note the euphemism, removed?)
Charlie responds the same way I do when I hear that. "Did you say cured?"
"Yes. A breast surgeon will take out the duct. The radiologist says she is not seeing any cells outside the duct. When the duct is gone, the cancer cells will be, too." Then I add, "If there even are cancer cells."
It is not the time to mention the possibility of cancer cell protuberances having successfully penetrated the duct wall, wiggling the rest of their sorry-ass selves out of there and onto a path of destruction, engulfing everything. (Did you see "The Blob?" The original movie, a 50s horror film, about a small, round, half-solid, half-liquid ball that just happens to be in a meteor, a meteor landing on earth, when scientists who note such things are out to lunch. It crashes in a wooded area of rural Pennsylvania and cracks open upon impact, and the little ball rolls out of the woods until it reaches a street, whereupon it catches up to and devours one hapless soul after another, none of whom can outrun it. Do I need to explain that the little ball gets bigger and bigger as it digests half the people in the town?
"The Blob" is one of my all-time favorite, super-camp flicks, so I seem to have memorized the theme song, which now comes cha-cha-ing through my head: It creeps and leaps, and glides and slides across the floor, right through the door, etc.… Beware of the blob!
I right now google to see if I got the song right. (Also, right now, I am hating the concept of metaphor, as in, the blob is some kind of tumor.) But you will never guess who composed "The Blob." BURT BACHARACH! I'm only glad he found his way to San José. And I can only hope that he doesn't own the rights to the song, but if so, that he won't charge me a lot to include one-and-a-half lines of his lyrics in this book.
And getting back to Charlie, why would I talk about the possibility of a second surgery now? I can put it off because I might not ever need to have that conversation. But the way Charlie holds my gaze to his, I know he needs more. I change my mind and give him the story of the possible second step with the caveat that the chances are slim. Then I describe the margin-thing and while I do, I am actually visualizing the scene in the "The Blob" as described in the above lyrics segment. It oozes through the space all around doors until its weight alone forces the doors off their hinges, and then the rest of the Blob, now enormous and blood-red after having eaten all the cancer cells—I mean the people out on the street—rolls on through.
If I may, in Phoenixville, Pennsylvania, where the movie was filmed, the townsfolk reenact the absolutely unforgettable Colonial Theatre scene once a year during "Blob Fest." I would tell you about that scene but I hate spoiler alerts. (Get the original Blob from NetFlix.) All tourists to "Blob Fest" are invited to take part, to go into the Colonial and have a seat. The participants pack the Colonial and on cue, come flying out, running and screaming while the Blob….
You really have to see the movie. All I know is, if I'm at a point where I should start thinking Bucket List, "Blob Fest" is in the #1 position, where I do believe it will stay, ahead of Graceland even.
Though I'm able to move my mind to other things, yet another form of denial, Charlie interrupts. He starts to cry just like Betty Rollin, but she cried in despair, while he is crying in relief because, like me, he at least has the radiologist's optimism going for him. We hold each other, and I know that even though I'm facing the possibility of bad news, he is also facing maybe losing another wife to breast cancer. I'm feeling such sympathy for Charlie because he is a good man. When you feel love and affection for someone, even if it is mixed in with devastation, the desire to spit nails can be temporarily nudged off to the side of your brain by a flashback to "The Blob."
I whisper into his hearing aid, "Kiss me."
He does. He sniffs to stop the tears. Then he says, "I'm sorry, baby."
I say, "I'll be getting a call from someone today. To make an appointment for a biopsy. So we better get going."
He repeats himself. "I'm sorry, baby." His eyes fill with tears again.
"I know, sweetie."
Driving home, I do what moms and dads do no matter what else is happening in their lives, even cancer. I think about our children.
Charlie's son Jay is getting married in three weeks. When Jay and I meet, when we make eye contact for the first time, we like each other instantly. Maybe since we're both artists and know the same struggles. He's a musician. His band is "The Pop Rocks." Did you like the 80s sound? Did you hate the 80s sound? Did you know there was an 80s sound? Doesn't matter. It's a smashing band, all of them good, even the girl singer. Google them and see when they're playing in a town near you, and dance, and/or sing along to "Another One Bites the Dust," and "Girls Just Want to Have Fu-un."
So, I have been so excited about my approaching role—Stepmom-of-the-Groom (and determined to do his real mother proud)—and now this has to happen. I'm going to have to tell Jay and Melissa, his bride-to-be, about my mammogram.
The first written mention of the word melissa is in an ancient piece of Greek writing. Melissa, in Greek, means honeybee. This name so fits her: she is lighter than air, and she pollinates everyone who knows her with her kindly grace. From the minute Jay and Melissa are engaged, it's pretty clear a fairy tale wedding is on the horizon.
My son Jere's wedding takes place on an island a few months ago. Just he and his Kim. They hop on the Narraganset Bay ferry in Rhode Island where they live, and have their private and personal ceremony on the most beautiful spot on earth, or at least, surely, on the Atlantic, Block Island. I don't get to be Mother-of-the-Groom who walks down an aisle, but Jay, as it turns out, becomes back-up.
Jere and Kim's wedding is another version of a fairy tale. After the ceremony, they will have a wedding reception for two—them. Instead of people, their guests will be the millions of stars of the Delta Aquarids, falling all around them. But, totally unexpectedly, they do end up with a witness, who turns out to be a star in his own right. They are no sooner off the ferry when they see the comedian Steven Wright walking down the street. They are huge fans. (So am I.) Kim nudges Jere, who thinks, This is it, and without giving himself time to chicken out, goes right up to Steven, telling him how he and his girlfriend are so crazy about him, giving him significant details as to that craziness, and that they are getting married in a few hours, and will he be their witness. They have no witness. Steven Wright spots Kim kind of hanging back. He smiles at her. She smiles back. I don't know which is more dazzling about Kim—her so-genuine smile, her huge, green Bette Davis eyes, her one-day-burgundy, one-day-chartreuse hair, or the 2004 Red Sox World Series Championship logo tattooed at the base of her spine just above the bikini line. (Steven is wearing his 1980's-era Red Sox hat when they spot him. Jere's own Red Sox hat is of the same era.)
Melissa is golden like honey, Kim as Technicolor as the aurora borealis.
So, Steven Wright looks to Jere again and says, "Sometimes I have to think about things." All the same, he puts Jere's number into his cell, doesn't say, Don't call me, I'll call you, and Jere gives him the time and location of the wedding: eight o'clock that night on the sand at the foot of the Mohegan Bluffs.
Back at their hotel, right when they're watching him on YouTube, a text message from Steven appears on the screen: I'll be there.
A Block Island hotel is the kind of place where you can jump up and down screaming with joy, and no one bats an eyelash.
Five minutes before the ceremony is to start, Jere and Kim watch their witness climb down the treacherous wood stairway, zig-zagging the face of the bluffs to the beach 206 feet below, where they are standing with an acquaintance who has a certificate to marry people in the state of Rhode Island. Steven Wright is juggling his wedding gift. It's a kite. He tells Jere and Kim, "It's not meant to be flown. It's a symbol of your love taking off," and then he witnesses them take their vows and signs their marriage certificate.
Are you verklempt, or what?
So with all this wonderful dual wedding stuff, I really have a lot to be happy about, even though I know my fury will rise again. For now, wanting to believe I'll be cured if I have cancer, though doubting it, I am still a thrilled mom/stepmom. In case you've ever wondered if a thrill can be experienced even when a person is devastated and in terror besides, the answer is yes.
Circling back, this night of the second mammogram, Charlie holds a conversation with Starlight. While he gives Starbright's soon-not-to-be identical-twin a massage, he tells Starlight that we will work together to get Starbright through this. To have someone in a conversation with your right breast is very funny. So then, we all make love and when we are melting into sleep, Salty sneaks into his usual position. On this night, though, he tucks his head into my left armpit and snuggles up to Starbright. All those stories about how a dog can sense a lot of stuff with his baseball-size brain are true. I do what I normally do—turn from Salty and snuggle closer to Charlie's back away from dog-breathing, but tonight, I first have to extricate my arm from under Salty's head. I whisper to him, "You're a good boy. I love you." And he is content to sleep up against my own back.
Then I cry just a little bit. Finally, this is what makes me cry. Dog-love.
Not long afterward, Charlie stirs with the assurance that I am asleep. I am, but I wake up when he creeps out from under the blanket because even with a king size TempurPedic you can feel the other person get out of bed. He circles our giant bed that we are still paying for and gets in on the other side of our dog, who is doing his best to protect me from whatever it is he senses. Or maybe Salty knows exactly what's going on. Just because a dog doesn't speak your language doesn't mean he doesn't understand it.
Like me, Charlie realizes we now have a fourth partner, in addition to Starlight, who will help Starbright survive—our Salty dog. Charlie gets into bed on the other side of Salty, puts his arm around both of us, and we fall asleep on a three-foot-wide edge of a thousand-square-foot TempurPedic.
THAT NIGHT, BEFORE I go to bed, I'm a little perturbed that I didn't get the biopsy appointment call. I take a Benadryl and sleep like a rock. I awake to the smell of potatoes frying in onions and paprika. Smoked paprika. Have you ever tried it? Try it.
I open my eyes. Charlie is not in bed. Neither is Salty. Charlie is in the kitchen and Salty has no doubt woken to the sweet sound of a package of bacon being unwrapped. I can smell the bacon frying, too.
A couple of times a week, Charlie will wake up and say, "I need eggs." That's after he has one of those climaxes where he makes the noise of a herd of wild boar. I keep telling him we're going to get a knock on the door from the East Haven animal protection lady asking if we're harboring wildlife.
Now, on this morning, he figures both of us need eggs, nothing to do with replenishing his sperm supply, but rather to replenish our spirits that are so crappily diminished. So here he comes into the bedroom with two Greyhounds. I sit up. In case you don't know, a Greyhound is grapefruit juice and vodka, preferably fresh grapefruit juice and preferably Grey Goose. We had our first Greyhound at Pepe's, the oldest restaurant in Key West, where the grill guy—a descendent of Pepe—makes a highly noted breakfast. I have to say, though, after a Pepe's Greyhound, you don't know what the hell you're eating. Or care. You only know it's really good. Charlie once tells me that one morning at breakfast at Pepe's I'm blathering on to everyone within earshot that Pepe's oatmeal is better than even the oatmeal you get at the Dorchester Hotel across the street from Hyde Park. Charlie whispers to me, "It's Cream of Wheat. They must have run out of oatmeal."
After a Greyhound—oatmeal, Cream of Wheat…whatever—you'll love it.
Now, Charlie sits down on the bed, hands me my glass, and we clink. No toast, just the clink. What are we supposed to say? Here's to Starbright having a long life? We have a sip, and I realize that Charlie managed to run out to Stop & Shop and buy actual grapefruits, a whole bag, I'm sure, since he doesn't know how to buy fewer than six of anything.
I say, "Mahalo, Charlie." We learned to say mahalo instead of thank you in Hawaii. I always say mahalo after those aforementioned orgasms, which also means, I love you, also appropriate.
Charlie says, "Aloha," which in addition to the above, also means you're welcome. We clink again.
At our second sip of our Greyhounds, Salty appears in the doorway with a look on his face that says, "Where the hell's my bacon?" Then he trots back to the kitchen where he will return to his post, guarding the bacon until Charlie attends to it again instead of me.
Charlie gives me a smooch. "Five minutes, Okay?"
I roll over for my five minutes. I'm depressed. So I try to think about the beautiful dress in the shop in Branford waiting for me to model for Melissa. But I am unable to concentrate on a happy thought.
I sit up when I hear Charlie dishing everything out and telling Salty, "Go get the Mommy." (We refer to ourselves as The Mommy and The Daddy when speaking to Salty.) Salty gallops into the bedroom, jumps on the bed, and barks at me—Get up, get up! The bacon's done!
I throw off the covers, and he runs back to the kitchen in case the bacon is escaping. That cheers me a tiny bit. He's a handsome dog, our doodle. He's apricot. That's his color according to his breeder. She also says, "This puppy is happy in his own skin." We don't know what that means. It's my first dog and Charlie's second. He only had his first dog for a few weeks before it fell off the third floor porch in the tenement in Bridgeport, CT, where Charlie lived. Charlie is convinced the landlord threw the dog down the stairs. This is the kind of thought that takes over when you're depressed.
I put on Charlie's white terrycloth bathrobe instead of mine. I need a great big, soft and cozy one. It doesn't warm me up. I drag myself out to the kitchen.
We sit down to our breakfast. I have no appetite. I am overtaken by the grief I feel for myself. Suddenly, I might as well be a banana peel tossed out a car window onto the side of the road. How will I eat Charlie's bountiful breakfast spread out before me? I'm getting more depressed with each second. Then I notice the little bowl of blueberries to the side of the butter, even though we aren't having cereal. The blueberries hit a nerve made really sensitive by my depression. I don't feel a ping of anger. Oh, no. Instead, this blast of fury fills me to the brim.
Charlie feels it. "What's the matter, honey?"
I'm staring at the bowl of blueberries. I look up at him. I bang my fist on the table. Dishes rattle and glasses wobble. Salty jumps.
I shout: "HOW THE FUCK CAN I HAVE FUCKING BREAST CANCER? ME? ME! I DON'T SMOKE. I EAT RIGHT. I EXERCISE. MY MOTHER DIDN'T HAVE BREAST CANCER, SHE HAD STOMACH CANCER! I BREAST-FED TWO BABIES FOR TWENTY YEARS EACH, AND EVERY GODDAMN FUCKING MORNING I COVER MY GODDAMN FUCKING CEREAL WITH GODDAMN FUCKING BLUEBERRIES! THEY DIDN'T FUCKING WORK!"
I am crying hysterically just the way Betty Rollin does when she learns she has breast cancer.
Charlie is stricken, frozen in place, coffee mug mid-air, knowing what a terrible mistake he made putting out the blueberries.
When I am a child, my mother never complains. Instead, she says, "I blame the government!"
This is long before it is de rigueur to blame the government. I need Charlie to know right this minute that I'm just pissed at the calcifications in Starbright's duct, and absolutely in no way am I angry with him for the blueberries. So I raise my head from my arms folded on the table in front of me, sit back up, take his hand, look into his eyes, and say, "I blame the government."
His eyes close for a moment. I brush his cheek with my other hand. Then he opens his eyes again. Damp eyes. He breaks into a smile. Did I mention he has dimples? He knows I forgive him for trying to cure the cancer we both know I have with blueberries. We don't need a biopsy to tell us.
He puts his mug down. It's a souvenir from the duck boat tour we took in Boston. Our goofy picture is on the goofy mug. We are standing in front of the goofy duck boat. We are different people then than we are now. I am instantly depressed again because I know I am going to categorize every event as "before cancer" and "after cancer" from here on in: Duck boat tour, before; Jay and Melissa's wedding, after.
Salty barks. When he's distressed, he has this loud, sharp bark that sends piercing notes into poor Charlie's hearing aids. He's distressed about my shouting, but he's also distressed since neither The Mommy nor The Daddy is passing him pieces of bacon. He's been waiting at least ten minutes or ten years; he doesn't know the difference.
Charlie gives him an entire strip of bacon. Salty is so happy he runs off to eat it in his favorite spot—in the middle of our Turkish rug that cost a shitload of money.
Charlie says to me, "I love you, Wonder Woman." He calls me that sometimes.
I tell him I love him, too, and more tears spill over and down my cheeks. I say, "I blame the luck of the draw."
He says he's sorry again.
"It's a crap shoot, isn't it?"