How quickly the horrifying becomes mundane.
Our little team—I, my husband Pete, and our dear friend and note-taker Sarah—met yesterday at the Memorial Sloan-Kettering Evelyn H. Lauder Breast Center on East 66th Street.
Just as at NYU five days ago, Sloan-Kettering has a concierge, gorgeous leather and upholstery, a private check-in area that makes you realize how luscious paneling can make cubicles bearable, Just as at NYU, there’s a leather cube in the elevator for patients who feel too ill to stand. Just as at NYU, everyone is smart and kind and smiling and achingly positive. The receptionist on the fourth floor apologizes not once, but twice, because we got misdirected upon arrival. (Hospitals always want you to work out the finances first. Thank goodness for the gold-plated health insurance plan that is attached to my husband’s job.) Just as at NYU, there is a coffee and drink station in the waiting area. Just as at NYU, the waiting room is filled with women who look nervous, or ill, women who don’t want to meet your gaze, and nurses and staff who try to make it all bearable. Just as at NYU, my husband comments on how this breast cancer world is a world of women. He feels like a rogue who has broken into the harem. Nurses, clerks, PAs, doctors—they’re all women. The only men in sight are husbands. Just as at NYU, Pete, Sarah and I laugh a bit too much. It’s probably a defense. It’s also easier to laugh when the doctors have told you there’s every reason for hope.
Of course, there are differences: The lush color scheme at Sloan-Kettering tends to fawn rather than to the greens of NYU. The lobby is smaller. I guess that’s because the whole building is dedicated to breast cancer rather than being an integrated center for all cancers. You go upstairs right away rather than staying in the lobby. I fill out a much longer questionnaire. As I check, no, no, no, I am grateful for all the misery that is not mine. We don’t wait as long this time. I’m not finished with the forms when a pretty, young assistant comes over and tells me it’s time for the doctor’s nurse to interview me. The nurse seems as smart and as authorative as most doctors. As she interviews me, I begin to think that my breast cancer is pretty plain vanilla. They lead me to an exam room before the doctor consult, rather than after.
The hospital gown in the exam room is seersucker and actually attractive, more like a hotel robe than the usual open-in-the-front horror. Sloane-Kettering doesn’t miss a trick. I barely have time to tie the tie and start scanning The New York Times headlines on my iPhone before the doctor comes in.
She is, like the NYU doctor, obviously brilliant. She is, like the NYU doctor, kind. She clearly understands how terrifying breast cancer is. She calmly examines my breasts while I sit up with my hands on my head. She reassures me that the two bumps I found in the shower this morning are just hematomas, clotted blood, from where the biopsy needles shot in two weeks ago. She asks me to get dressed and meet in her office.
I feel like our little team is getting into a groove. We make sure to say “hi,” from the UC-San Francisco surgeon who will do my operation and who did her residency under this doctor. We ask better questions this time. I love how this Sloane-Kettering doctor is a little more cerebral in her approach. She’s warm, and patient. How many times must she have explained breast cancer to freaked out families and friends? She explains more of the science. She basically reaffirms what the NYU doc told us last week: that it’s very, very early, and that I’m mostly likely going to be OK. I don’t remember much more than that. I’ll have to wait for Sarah’s notes.
Here are the three big things I do remember:
1) She showed me my films pre-biopsy and post-biopsy. She pointed out that there were very few calcium specks visible in the after-biopsy image. The test may have removed a big chunk of the cancer.
2) Cancers are classified not only by where they’ve spread (the Stage 1, 2 etc. with which we laypeople are most familiar). They are also classified by “doubling rate,” that is, how fast the cells double in number. Lung cancer, the cancer that killed my father, has a very fast doubling rate. Plain vanilla breast cancer—the kind that reacts to estrogen, the kind that I have—has a relatively slow doubling rate. It takes six months for the cells to double in mass. “Because of that, this is not an emergency,” the doctor says. “This is not a case where you have to have it out immediately.” I wonder a bit why this is not the first thing I was told by my internist, but never mind. The tension knot has mostly disappeared from my chest.
3) I am an excellent candidate for lumpectomy. Of course this depends on the MRI today, the genetic testing, the results of any more biopsies indicated by the MRI, what the surgeons find when they go in, but it’s nice to be a good candidate.
I’ve said a lot of brave things lately about how breasts aren’t worth dying for, and how I’m not so insecure that losing my breasts will destroy my sense of sense of self and my sexuality. At 12, I was annoyed when the breast buds appeared. No more going shirtless like the tomboy I was. The endless annoyance of bras, lace, how yucky. My mother suddenly getting all concerned about my modesty. But I have had breasts for 35 years now, and as I was walking down Court Street in Brooklyn a couple days ago, I suddenly wondered what it would be like not to feel my breasts swaying slightly in my bra. The doc tells me that if you have a double mastectomy, your chest feels numb because the mastectomy removes all the nerves under the skin. “For most people,” she explains, “The numbness becomes normal after a while. But you won’t feel it if someone hits you in the chest.”
I guess that could be a plus if I take up rugby or boxing. You’ve got to find the upside to the new normality.