Woman in the Mirror

I was a young woman in my twenties when I met Chandler Bing, fell in love and found a partner for life.  Toned and tanned, with a mop of brown hair and gorgeous blue eyes, he is a patient man, with a great sense of humor.  He is also an American, and was in his last year of a computing studies course at London University near to where I was a chef apprentice.

He loved England, but after he finished his degree, he returned to New York to take up a position at an American company and I followed him.  One year after I finished my apprenticeship, Chandler & I were married.  I loved our New York life: dear friends, Central Park, the many shops.

Towards the end of 2003 we had been together for almost 10 years and had moved to Boston, where Chandler was to open a new branch of the company.  Like many other women in my family, I had wanted to start a family almost immediately after Chandler and I married.  But this proved an unlikely possibility after I failed to fall pregnant for five years.

“Why me?  I’ve always wanted a baby of my own, why can’t I fulfill my dream?”  I asked my husband.

“It takes two people to make a baby,” he always said,  “If we can’t have a baby in the next two years, I think we should consider adopting a child.”

But that possibility never came.  After visits to fertility specialists and hormone treatments, I found myself pregnant the following year, when I was 34 years old.  The first eight months were an unexpectedly glorious time; friends said that I glowed the way women carrying new life do.  My body was growing a new person.  What I didn’t realize was that during those fruitful months, my body was also growing something else, cells multiplying astronomically, terrifyingly.

I was 13 years old when my mother was told she had breast cancer, 17 when she died.  For that reason, I was usually painstaking about doing regular breast self-examinations, but I had been so happily engrossed in my baby that I hadn’t checked myself in a while.

So it wasn’t until my thirty-third week of pregnancy that I found the lump.  Although it was just a small mound, I made a note to tell my obstetrician, Laurie Goldstein, when I saw her next Monday.

Laurie examined the lump and said “It’s probably a blocked milk duct, Monica.” But se called over her colleague, Stefi Reed, to take a look.  In order to minimize exposure to radiation, mammograms generally aren’t given to pregnant women.  However, both doctors said that, because of my family history, they would refer me for a sonogram if I liked.  I know some women cope with the heritage of a mother’s death from breast cancer by fleeing from the fear.  Others – and I fell into that group – try to keep the fear at bay by being very matter-of-fact about it.  I had decided long ago that if there were any question of my body harboring a malignancy, I would want to have it dealt with as swiftly as possible.

I told my obstetricians that, yes, I would like to see their radiologist friend Andie Bower.  After Andie’s technician took pictures and went to show them to the doctor, I busied myself in study the machine.  And my face in the mirror.

Relatives and friends always said that I looked like my mother.  Sometimes I would think back to what it felt as a teenager when I watched breast cancer kill her.  I remembered her face, the weary, set look it had assumed after she got ill.  As I studied my reflection, I felt her shadow.

I realized a longish time had elapsed and no-one had returned.  My anxiety could no longer be held.  Suddenly it seemed both women were there together.  Andie said she needed to extract some cells for analysis.  Several days later I was just settling down for a coffee break at the restaurant where I worked when the phone rang.  It was Laurie, my obstetrician.

“I know you would want me to be straight with you, Monica,” she said.  “The cells are malignant.”

I was stunned.  I could not speak.  When sound finally did come, I was sobbing.  Laurie said that she would phone Chandler and that we should come to her surgery immediately.

As I left the restaurant, I felt as though the clocks had stopped, as thought I were suspended out of time.  I wondered if I had given the cancer to the baby.  My maternity leave was due to start in just two weeks.  I wondered if I would need maternity leave at all.

********************

Laurie sat us down and told us that she had already talked with her colleagues and had been on the phone to a well-known cancer surgeon, who would see me early that evening.  First, thought, I was to go to Andie’s surgery for a set of mammograms.

Furthermore, since many breast cancers need oestrogen to develop and my pregnant body was a veritable oestrogen factory, the obstetricians agreed that the hormones were most probably making the cancer grow very fast.  The baby had to be taken out very quickly so that I could be operated on.  The best way to proceed was to induce labor.

I knew I had to be logical in order to make the final decisions.  However, at that moment I was so overwhelmed that when I attempted to speak, all I could produce were little strangled sounds.

After 11 years of shared living, Chandler knew what I wanted to say.  He spoke for me.  “The baby isn’t due for another five weeks.  What are the risks?”  Grimly he added, “Could the baby have cancer too?”

Laurie spoke with her usual directness: “No way.  I just doesn’t work like that.”  As to risks of early delivery, she said they would be low.  The baby would be born at 35 weeks and should be fine.

It was already late afternoon when Chandler accompanied me to Andie’s surgery for my mammograms.  As I waited in a small cubicle, an unfamiliar technician walked in.  I felt, as I would so often during the next few days, like a freak.  I was a pregnant woman and I had breast cancer.  I could not believe it.

Tears welled up and washed over my face.  The technician looked at me with a calm, steady gaze.  “It’s all right, honey,” she said.  “You’ve got to hope for the best.  My cousin, Rachel, had two little children when she and her husband were killed in a car crash.  They didn’t have a chance.  You’ve got a chance.  Remember that.”

Chandler and I got to the breast surgeon’s rooms at five.  Ironically I noted how the rooms were in Mount Sinai Hospital, the large teaching hospital where I had already booked a maternity room.

The breast surgeon, Steve Fairall, came out and ushered us in.  Balding, with a thin dark moustache and the paleness of those who habitually overwork, he began quietly and gently.  Andie’s analysis was correct, and he warned the cancer might no not be confined to the areas of the lump.  He picked up a film and pointed to some tiny white flecks. Those, he said, were calcifications and could indicate more malignant cells.  Cancer seen in several parts of the breast is at greater risk of being invasive – meaning that cancer cells might have spread to healthy tissue.

Steve said he would wait several days after I gave birth, to let my body recover, and would then do a surgical biopsy on the breast.  The biopsy results would help determine if I needed a lumpectomy, in which only the limited areas or tissue and perhaps some lymph nodes would be removed, or a mastectomy, which would take the whole breast.

He asked about my pregnancy.  I told him that we had difficulty conceiving and how I had taken hormones to move things along.

Then he asked about my mother.

I had felt her shadow again while I was sitting in his surgery.  Yet I knew so little about the woman who had been my mother and, until it was too late, even less about her cancer.  Our parents kept the nature of the illness from us for as long as they could.

Years afterwards I was to learn that when she found a lump she was sent by our family doctor to a specialist, who told her that he suspected breast cancer.  I remember that day because our parents returned, and my brother and I were shooed outside the house while our father and mother were inside together.  We could hear our mother crying.

She could not accept the specialist’s diagnosis and went for a second opinion to a different surgeon, a famous doctor in Chicago.  He told my mother that her lump was not malignant, that it was merely fluid that needed to be drained periodically.  For more than a year my mother visited this man’s surgery for treatment.  But he was wrong, and one day, much later, he told her he was sorry.

When Chandler and I left Steve’s surgery, it was after seven.  We had spent more than five hours with doctors that single day and were mentally exhausted from having to concentrate on what they were telling us.

After we returned home, we sat quietly in our dining room.  All of the ordinary objects, the familiar bits and pieces of our life together, seemed to be part of another world.

********************

Chandler and I talked about how much there was to do.  Suddenly in 72 hours I was scheduled to go to the hospital and have our baby.  We had very little prepared.

Beyond that, what we dreaded most were the telephone calls.  We would have to let people know.  How would I tell the news to my brother, Ross?  Worse, how would I tell the news to my father?  I feared stirring the cauldron of memories that might spill over into one of his depressions, the legacy of those dreadful years.

After my mother’s cancer really took hold, my father could not handler the mental and emotional strain – my mother had always been his best friend and business confidante as well as his wife.

My father’ grief was barely supportable, added to which his sign-making business was in financial trouble.  His working day stretched longer and longer into the night.  He had a breakdown and had to leave home for a while.

Since my elder brother, Ross was away at university, I was left to take care of myself.  All the while our mother was slowly disintegrating in our parents’ bedroom, not speaking, seemingly unable to recognize us.  Each day she seemed to shrink smaller and smaller into the vast whiteness of the bed.

And there was Chandler’s family.  They, too, knew the trauma of breast cancer intimately.  Jackson, Chandler’s elder brother, had lost his first wife, Kim, to the disease when she was only 34 years old.

We made phone calls until ate into the night.  It was difficult because I am a very private person.  Our mother had drummed into our heads: “Don’t tell people your problems.”  But now wasn’t the time for discretion.

Chandler’s brother was the first one I called.  “Hi Mon,” he answered.  “How are things with the baby?”

I fought the constriction in my throat.  “The baby is fine, but the mother isn’t.  look I didn’t want you to worry, but I found a lump ten days ago.  The doctors said today that it’s breast cancer.  I’m going into hospital on Sunday.”

I had wondered if he would cry, but instead his response was a momentary silence, like that silence so many years ago when I picked up the phone and was told that my mother had just died.  I tried to keep my voice from cracking as I went through what had happened, what was about to happen.

“Mon, what can I do?”

“Please, don’t come yet,” I said.

“One thing you can do now is phone Kellie and tell her.  That would help a lot.  Tell her that I’ll speak to her tomorrow.” Chandler added, on the extension.  Kellie, Chandler’s younger sister, lived in Italy.  I put the receiver down and let the brothers talk for a while.

We phoned Ross next.  Now I felt sorely in need of my brother’s emotional support.  Even so far away in Spain, his support far outweighed any I could have gotten from anyone else, even Chandler.  There was a link we shared that even a husband couldn’t break.

Chandler and I were going to ask a very particular favor of Rachel, my sister-in-law.  Rachel had been my best friend in high school and I was overjoyed when she married Ross, who had been infatuated with her for what seemed like forever.  We wanted to ask her to come to New York to help us out.

“Oh Mon,” Rachel said when I told her the news, “I know you’ll be strong.  And Chandler loves you so.  You must hold on to that.  I’ll see what I can do about coming.  I’ll try.  We’ll all be praying for you.”

That night I decided to make the call I had been dreading the most.  I phoned my father.

“What?  What are you saying?”  was how he responded to the news.  My father in his old age had become deaf in one ear.  I could just see him, an old man, short and slightly stooped, with still-powerful arms and hands, white wavy hair, a pencil-thin moustache, blinking his eyes slowly, behind his large spectacles.  Blinking in disbelief.

“No, no, no.  How could this happen?” he said.  “Who are these doctors?  Are you sure about them?  You know what happened to your mother.  Maybe they could be wrong.”

“Dad, these are good doctors,” I answered.  “There’s no question.  The only question is what they will have to do, how much they will have to take.”

“My God, what a life, what a life.  Why? Your mother, now you.  You know I love you.”

“Of course I know that and I love you too.”

After I hung up I waked into our bedroom and bent to pluck from the bundle a slim bundle that had moved with me from place to place.  I had taken it from New York many years before.  Carefully, I unfastened the large portrait photo that held the collection of smaller black-and-whites between its covers.

There they were, my parents smiling at me, the younger couple, one fair, one dark, both with laughing eyes.  It was 1963.  That beginning produced my brother and me.  As I stared at my parents’ youthful faces, at all the possibilities for all that could have been, might have been, I felt an enormous sadness and an immensity of love.

********************

Three days later, at six o’clock on Sunday evening, we went to Mount Sinai Hospital for the birth of our baby.

My husband turned to me in the taxi.  “We’re going to have to take it in stages,” he said.  “We’ll break down if we try to face it all at once.  After the baby is born, we’ll deal with the biopsy, the surgery, the pathologist’s report and whatever else you’ll need.  That’s the only way we’ll get through the coming weeks.”

I sat on the battered back seat of the taxi, almost inert with exhaustion.  I held Chandler’s hand and tried to accept his words as a child does, to believe in their power to determine how things would be.

At the hospital, we took the lift to the birthing floor.  We walked up to the partitioned nurses’ station.  I identified myself to the duty nurse.

“I’m sorry we don’t have you on the list of inductions.”

I listened as Chandler kept insisting quietly,  “There must be a not or something about my wife.  Please look again.”

Several people were milling around.  One of them, a young blonde woman, a doctor, spoke sharply, dismissively:  “Don’t you understand?  You’ve come on the wrong night.  Why does she have to be induced anyway?”

My husband rarely raises his voice, but now all the anger at what was happening to us exploded from him.  “We’re he because my wife has cancer,” he shouted.  “She’s being induced because she has cancer.”

Although this was a hospital, the word cancer was not heard on this floor.  I covered my eyes and sobbed.  Everyone froze like the statues in a children’s game.

The first person to move again was the doctor, who turned and walked away without a word.  The nurse in charge of registrations began to search frantically among the papers under the counter.

“Yes, here it is.” She said.  She walked around the desk to us.  I felt her arm encircle my shoulders.  “I’m so sorry, Mrs Bing.  Please come with me.  Please forgive us.”

She led us to Birthing Room 3, and then left the two of us alone.  Chandler squeezed my hand and I leaned my head on his shoulder as we silently tried to calm down.  He kissed my head and stroked my hair, the way you might try to calm a child.  Two young nurses came to take my blood pressure and examine me.

Chandler stayed with me until they finished.  “I’ll see you in the morning, darling.  Don’t worry.” We embraced and he kissed me on the forehead.  And then he was gone.

As I lay in the birthing room, I could feel my baby moving.  Although like most first-time mothers I had been fearful about the labor, I felt curiously numb about it now.  Like a detached spectator, I merely wondered when the pain would begin.

The next morning, Monday, I was hooked up intravenously to the drug Pitocin to get my contractions started.  All that day Chandler and I could hear the trolleys taking women to the maternity ward after their babies had been delivered.  Yet little seemed to be happening to me.

On the following morning doctors increased the level of Pitocin.  The labor was dragging on slowly.  By the afternoon I had been on drugs for over 40 hours.

Late on Tuesday afternoon, everything seemed to occur at once.  Laurie appeared in her green gown, having just delivered another baby.  Chandler was there hovering over me, and a nurse fluttered between the bed and the high-tech monitors.

Laurie told me to push.  I felt so tired after almost two-and-a-half days.  “I can see the baby’s head,” Chandler shouted.  And then I heard an infant wail, and I saw tears streaming down my husband’s face.

“You have a boy, it’s a little boy,” Laurie yelled.  And that is how, at ten minutes to midnight on Tuesday, October 1, 50 hours after my labor had started, Matthew Benjamin Bing was born.

********************

Laurie placed our son in my arms, and I heard his little cries.  He brought with his that night the simplest, most powerful of gifts.  He gave us hope and bound us back to life.

Laurie laughed with joy and relief.  “He’s a long one.  And he weighs almost three kilos, a good weight, even though he looks so thin.  He didn’t have a chance to put on any fat, but he’s fine.”

The next day, just before lunch, they wheeled Matt in, and Chandler and I took turns holding him.  He was do delicate, so fragile.  I felt awkward, afraid I would do something wrong, but cradled in my arms he slowly, sleepily, took a little milk from the bottle.

That Thursday night, sleep did not come easily.  I was going to have a biopsy for breast cancer the following day.  It would determine how much of my body would have to be cut away, and the doctors would have a much better idea of how long Ben might have a mother.

All too soon it was time for me to be discharged from one part of the hospital to enter another for my biopsy.  I asked Chandler to bring a Hawaiian-style maternity sundress, white and blue flowers on a yellow background.  I had worn in all summer, the new life of our baby flowering beneath the flowers of the dress.

I put on the dress, but when I glanced at myself in the mirror, I felt overcome by sadness at a kind of innocence lost.

Chandler and I looked in on Matt in the nursery for one more time, and began the long walk through the meandering corridors to radiology.

Waiting with Chandler in the reception area of Steve Fairall’s surgery, I could feel my body shake.  I thought of how it had been for my mother and consoled myself that at least the biopsy experience would be better for me.

They did biopsy differently in my mother’s day.  Her doctor decided that what was called an excisional biopsy should be done.  All was arranged for an August day in 1963.  The tissue surrounding a large, blood-filled cyst was rushed to pathology.  It was found to be cancerous, and the surgeon decided to take off the breast there and then.

In those days they called it the “one step” procedure – performing the biopsy under general anesthesia, rushing the tissue for analysis, removing the breast while the patient waited, insensible.  The operation was called the “Halsted radical mastectomy.”  It took the breast, lymph nodes, both chest muscles.  The upper part of the woman’s body was no longer convex.  It wasn’t even flat.  It was almost concave.  So much easier, doing it that way, all at once.

When my mother opened her eyes and saw, through the anesthetic haze, their eyes, she lifted her left arm and felt – nothing.  Nothing but bandages and dressings.  She started to scream.

Breast surgery was done this way until the late 1970s when a few pushy, questioning women began to challenge the doctors and demanded that the biopsy and the surgery be done separately.  They also began to question the need for the terribly disfiguring operation.

By the early 1970s, the medical philosophy had begun to change, and the “two step” procedure gradually became the norm.  not only that, but the Halsted radical gave way to the “modified mastectomy,” which left the woman flat, father than just ribs and skin.  I was receiver of all this.

A nurse came into the waiting area and called my name.  Chandler and I looked at each other, wide-eyed.  He nodded his head and squeezed my hand.  I followed the nurse through the doorway.  Now I was on my own.

Dressed in a hospital gown, I walked into the operating theatre where Steve was waiting.  “Hi Monica.  Why don’t you climb up on the table and we’ll get going.”

I felt the needle with the anesthetic enter my breast, followed by a burning sensation, then numbness.  Steve began to cut down through the skin, through fat, through tissue, separating layer after layer of flesh, probing down towards the cancer itself.  It was taking so long.

Finally, Steve glanced directly at my eyes and said, “We’re sending the tissue over to pathology for frozen sectioning right away.  We might even hear something before you leave.”

When he had finished, I got dressed and walked out to the waiting room.  Chandler was there.  I could see how full my husband’s eyes had become.  There were other people in the room, too, and I couldn’t speak.  We sat there in silence, holding hands, until a woman called my name.  We followed her to Steve’s surgery.

He looked exhausted, his face a grey-white mask.  The shreds of foolish hope disintegrated completely.  Steve began to speak.  “I’ve heard from pathology.  It looks invasive.  Monica, Chandler, I’m so sorry.  We’ll have to schedule the mastectomy.”

********************

Back home, Chandler brought me tea on a tray, tuned a radio to a classical-music station, and then set out to return to the hospital to pick up our son.  I listened to the music and picked up a news magazine, but it was useless to try to read.  The painkiller I had taken made the words swim before my eyes.  I began to flick through a women’s magazine instead, filled with glossy pictures of beautiful faces, beautiful clothes, beautiful bodies.  It was hard to look at the lingerie adds, but it was also hard not to dwell on them.  I flicked through again and came upon an add.  It proclaimed:  “You don’t have to be your mother.”

Suddenly, the letters swam before my eyes.  The tears poured down my cheeks and I allowed myself to cry very hard.

During the past few days, I had seen other mothers dress, pack up and leave the maternity floor, cradling their precious parcels in their arms, proud fathers at their sides.  There was no such homecoming for us.  I would be here only a few days before going away again, and God only knew what kind of shape I’d be in when I returned.

I felt outraged by the uncertainty hanging over our lives, over my baby’s life.  But I had to pull myself together.  I had to be there for him.

Eventually I heard the key turn in the lock downstairs, and a few moments later my husband placed our son in my lap.  I sat there holding him until he was fast asleep.

That Sunday Chandler’s family came to see me before surgery and to celebrate the birth of my baby.  I was afraid of what they would say or do, but somehow they understood exactly.  They hugged me and Chandler in turn, and smiled at the baby.

We have many photographs of that day.  One in particular flashes into my mind.  We are all together in the den.  My father-in-law is sitting on the sofa next to his wife.  I am seated in the rocking chair next to him and Jackson is hovering above me.  The expression on his face is full of warmth, but the smile is crooked, just a bit on edge.  Kellie is on the right, broad grin, big blue eyes, leaning on Chandler, who has put the camera on automatic.  He hates being photographed and this occasion is no different.  But nevertheless, he tries his best to look good.

There is, of course, Matt – lovely, sweet Matt – fast asleep on my lap.

After lunch, while Ben was asleep, my Dad called.  Ross was with him, on the extension and he listened quietly while our father talked about our mum.  “You kids meant the world to her.  She didn’t seem to mind not working while she brought you two up.  That was her decision and she stuck by it.  She was happy at home with you two, until it all fell apart.  I think she dreaded getting cancer, what with her mother and everything.”

I snapped to attention.  “Dad, what are you talking about?”

“Well, you know, don’t you?  I thought I told you.  Your grandmother Althea died of cancer too.  Lung cancer.  But that was the odd thing.  She never smoked a day in her life.”

I remembered something I had come across during my crash reading course in cancer literature.  “Dad, in those days what was diagnosed in the lung sometimes started in the breast.  For all we know, it could have been breast cancer.”

********************

That Wednesday, I got word from my obstetrician that I needed to find another surgeon.  Steve Fairall’s secretary called to say he was seriously ill with a viral infection, and she didn’t know when he would be able to operate again.

I put the phone down and burst into tears.  Chandler, who was listening on the other line, was crying too.  We had clung to Steve’s warmth, to his caring.  Suddenly we were cut adrift.

It was out lowest point since the diagnosis.  Given all the hormones that were pumping through my body, the timing of the surgery was critical.  We had to get things moving right away.

After what seemed like ages, the phone rang again.  “Cally Highfield has agree to see you at Sloan-Kettering at four today,” my obstetrician’s surgery told me.

I got ready to go to Memorial Sloan-Kettering Cancer Center.  First I fed Matt, and as I placed him on my shoulder to burp him, I couldn’t help but notice what a delicate little creature he was, so warm and clinging.  I loved the smell of him, the sweet new baby smell.

The nurse we had hired to care for him took him from me, and Chandler accompanied me to the hospital.

Dr Cally Highfield immediately impressed me.  Se had red hair, sharp features, milk-white skin, and was wearing a flowery dress beneath her doctor’s coat.  There was a no-nonsense air about her.

She asked me about my medical history.  I had to do it all over again: I pushed myself and told her about finding the lump, about the sequence of events since then.  Then I told her about my mother.  “You know,” she said, “some women in your situation, with a strong family history and cancer already identified in one breast, decide to have both of them off.”

Chandler and I were speechless.

“You’re lucky you found it when you did,” she went on.  “If you hadn’t and you had the baby as planned a month from now and were breast feeding, you might not have noticed the lump at all.  You could be dying within a year.”

None of the doctors had spoken to me so grimly before.  None of them had talked about having the other breast shopped off.  I had walked into the room thinking that nothing else could shock me, and yet here I was, felling jolted out of my skin.

Dr Highfield wasn’t prissy or fussy the way some doctors are.  She didn’t ask Chandler to leave the room; she didn’t even move him to the other side of the curtain.  I was glad that he was there.

Dr Highfield examined me and when she finished she announced, “I operate on Fridays and Tuesdays.  I can fit you in either the day after tomorrow or next Tuesday.  You can either decide now or tell my secretary.”

We told her we’d phone her first thing the next morning.

When we left the hospital, I took in great gulps of air.  “Boy, how could she talk about taking off the other breast?  I think tomorrow morning I should phone Steve Fairall’s surgery to make sure there isn’t any news.  I don’t think I can face changing surgeons.”

“Hod on, sweetie,” Chandler said.  “I agree she was blunt, but I’m sure she’s a good surgeon.”

When we got home, we slumped down in  the living room to finish the discussion about the surgery.  I had gotten so used to Steve Fairall, but I knew Chandler was right.

“Phone your obstetricians if that will make you feel better,” Chandler suggested.  I decided to heed his advice.

Stefi took the call.  “Look, Monica, Cally Highfield’s got a really good reputation.  I wouldn’t have any doubts.  Go with her.”

And so I did.  Dr Highfield would be my surgeon, and my breast would be removed on Tuesday, only five days away.

********************

Around this time we got some welcome news.  My sister-in-law Rachel would be able to come from England to stay with us during my surgery and for several weeks afterwards.

Until Rach arrived, I had to ask myself, how would Chandler manage to hold up?  He tried not to show his fear, but occasionally I could see him blinking back the terror that was passing behind his eyes.

I depended on him absolutely, unquestioningly, as we both knew.  But Chandler carried such heavy emotional cargo, shouldering his own shock, grief and fear as well as some f mine.  Chandler knew that my father, in the end, hadn’t been able to cope with it at all.  My husband was frightened that he, too, would break under the strain.  As before, all we could say to each other was that we had to take it one stage at a time.  We repeated that over and over.  We would get through until Rach came; then there would be some relief.

Neither Chandler now I slept much the night before my surgery.  We crept in to look at our son over and over again, until finally Chandler said, “We should at least lie down.”

We went into our bedroom.  He held out his arms and kissed me gently. We lay there exhausted, with no words left, finally dozing off around two in the morning.

The alarm rang at 5:15.  Chandler fed Matt.  I bent to scoop up my son, savoring one last hold of him before handing him to his nurse.  With Chandler at my side, I went down the stair, out through the door and into the waiting car.

At Sloan-Kettering the paperwork was finished swiftly, and Chandler & I were led to a holding area.  A nurse took my blood pressure and briefly examined me as she prepared me for surgery.  “You’d better take your glasses off, Mrs Bing,” she said, “and give them to your husband.  Oh, give him your wedding ring too.”

“My wedding ring?  Can’t you tape it on?  That’s what they’ve done in other operations.”

“They won’t operate if you’re wearing any jewelry.”

I looked at the thin gold band.  It had always been a little too big for my finger and had become slightly deformed over the years.  Now it felt as if another part of me were being stripped away.

I handed the ring to Chandler.  “It’s OK darling.  I’ll bring it back as soon as the operation is over.”  I could hear the tightness in his voice.  I looked at the big, plain clock on the wall: 7:30.

“They’ll be coming for you soon,” the nurse announced.  “I’m afraid your husband will have to go.”

Chandler put his arms round me and clasped me tightly to his chest.  “I love you.” he whispered, kissing my forehead softly.

I smiled a watery smile in reply and he was off.

“Hi, we’re all here now and everything’s ready.”  Cally Highfield was speaking through a large, clear plastic mask covering her face.  Even in my pre-operative state I was sufficiently coherent to think how peculiar she looked wearing such a thing.

The anesthetist inserted the IV into my hand.  People were bustling all round my body.  I could hear Dr Highfield directing everything.  And then they were no longer there.

I sensed I was in a much bigger room, with softer lights and muffled sound: dull moans, the shuffle of feet.  “I have come though the operation, I have come through the operation,” the words telegraphed repeatedly, wonderingly, through my brain.

Later, in my hospital room, full consciousness returned.  I was aware of a great stiffness on my left side and so, carefully, in order not to disturb the IV, I reached for the phone with my right hand and cradled it between my shoulder and head.

A silly thought had preyed upon my mind before the operation.  Would I remember my own phone number coming out of the anesthetic?

But my fingers remembered the sequence, and then I heard my husband’s voice on the line.  Before I knew what I was saying, the words tumbled out.  “I’m alive, I’m alive Chandler.  Will you come now?”

And he did.  When he walked in the room, Chandler slipped the wedding ring back on my finger and then held my hand.

********************

I decided to attend the hospital’s group therapy session for breast cancer patients.  Seated in the therapy room were women of all ages, all sizes, all types.  A few already knew what stages their cancers had reached, but most, like me, were still waiting for the pathology report and knowledge of their fates.

The social worker told us she had invited a guest.  She went out of the room for a moment, and came back with a slim, spry, white-haired woman in tow.  “This is one of the volunteers who come here sometimes.  I’ll let her tell you about herself.”

The volunteer had aged gracefully and didn’t try to hide her years.  “I’m here because I’ve had breast cancer, like all of you,” she said.  “I had a mastectomy 36 years ago and haven’t had a reoccurrence since.  I’m proof that there is life after cancer.”

She smiled, waiting for her words to sink in.  We all smiled back.  Everyone of us wanted to be that woman.

“Now is there anything you’d like to ask?”

people began speaking about their fears – of passing the disease on to their daughters, of how this would change their relationship with their husbands or future boyfriends, of chemotherapy, of never again feeling that they could trust their bodies.

Then the discussion turned to whether or not we should tell other people what had happened to us.

A brunette woman jumped in.  “I just wanted to get out of here and back to my normal life.  I’m not going to tell anybody at work – my boss knows, but nobody else.  And I’m not going to tell most of my friends.  It’s nobody else’s business.”

Another woman looked at her uncomprehendingly.  “But you have to tell people about it,” she said.  “We have to be open.  How else will there be more pressure put on the government, more money for research?  More and more women are getting breast cancer, and not enough is being done.”

The brunette woman’s face tensed, her voice tightened.  “This is my body, my business.  It’s not for public consumption.”

As I left the discussion group, I wondered what I would do.  I myself had only told a few people.  But the woman was right; breast cancer was nothing to be ashamed of, and yet for far too many women, shame was close to what they had felt.  Certainly my mother had felt it.

Arriving back at my room, I found that who should be in the next bed, but that same woman.  We got talking and I found out that she and I had much in common.  Her name was Phoebe Buffay and she also lived in Boston, just a few blocks from where Chandler and I lived.

Phoebe’s mother had had breast cancer and though she hadn’t died from it, she had later committed suicide.  Just like my father, Phoebe’s mother hadn’t been able to cope with the strain.

We talked long into the night and before we slept, we exchanged phone numbers and promised to keep in touch.

The next day things improved when my husband’s smiling face appeared round the door.  “I’ve brought somebody with me!”

Behind him, I saw an angel from across the sea, my sister-in-law Rachel, one of my favorite people in the world.  She came up to the bed and put her arms round my back.

“Hello, mother of that wonderful boy,” she said in her old familiar voice.  We hugged for a long time.  I felt so grateful that she had come.  I noticed Chandler’s face was a little less tense.

Finally, my husband turned to me.  “Have you heard any word on when the pathology report will come?  We ought to be heading back so Rach can take care of Matt but I won’t leave if you’d like me to wait.”

I did not want him to go, but I knew he would come back as soon as I heard.  “You go on,” I told him.  “I’ll phone you.”

As I waited for the pathologist’s verdict, I recalled what my mother’s pathologist had told her after her second operation, when they removed her ovaries.  The doctors had found more cancer in her lungs, liver and bones.  By then she had grown thinner and begun to stoop.  She stopped changing from her dressing gown into day clothes, then stopped leaving her bedroom at all.

My father hired a nurse the day after he came home and found her on the floor, dazed, barely conscious, unable to speak.  Then came the day when the nurse told our father she couldn’t manage any longer on her own.  Our mother had to go to the hospital.

I never visited her.  Everyone thought it best if Ross & I stayed home.  By the end, she had shrunk so much that they had to put her in a kind of crib.  She was there for four weeks before she died.

I did not want to die of breast cancer.  I did not want to take my leave in the horrible, lingering, painful way.  I knew everything about my future hinged on what I would hear later today.

It was nearly five that afternoon when Cally Highfield walked into the room.  “Well, I’ve heard from pathology,” she said.  “It’s all noninvasive – ‘in situ’ is what we call it.  You are really lucky.  Let’s see if we can get you home on Saturday.”  She stood across from me, smiling.  I felt as if I had been given back my life.

********************

Chandler came to the hospital immediately after I phoned.  We sat in the room knowing we could plan a life together.  Then I turned to him, trying to mask my shyness.  “Well, it looks as though you will be living with a single-breasted woman for some time to come.  Do you want to see what I look like now, or do you want to wait?”

Chandler smiled gently.  “Of course I’ll look at the incision now.  I didn’t want to ask in case you weren’t ready.”

Earlier, shortly after my operation, a young and very caring nurse asked me, “I’ll be giving you a clean dressing.  Have you looked at the incision yet?  Do you want to see it?”

I felt the fear course through me.  “Yes, I guess I’d better get it over with,” I told her.  She removed the dressings gently until there was only the gauze.  “OK?”  She looked at me for a second.  I nodded, and she carefully removed the final layer.

It had not been nearly as bad as I had feared.  I saw a long thin line extending to my armpit, crisscrossed with bandaging.  Dr Highfield had done a good job.  So neat, no lumps, no breast.  To show Chandler, I unbuttoned my gown and removed the gauze.

“It’s not so bad,” said Chandler.  He bent over and kissed me on the forehead and held me.

More good news came the next day.  After examining me thoroughly and taking my family history, the oncologist, Dr Amy Grey said I would not need chemo or radiation.

“What did you say?” I asked her.

She smiled.  “For the type of cancer you’ve had, a mastectomy can be sufficient because it takes away tissue that is at risk of becoming cancerous.”

“But there isn’t any risk that it might have spread?”  Chandler interjected.

“Yes, of course, there is always a risk that a cell or two or three have escaped.  But in medicine we have to work with probability.  The probability is that the cancer was contained.  We would not want to put you through chemo for the one- to two-percent chance it was not.”

She began to shuffle her papers together in preparation for leaving.  “But there is one thing that I think you should do,” she said.  “You had two kinds of cancer cells: ductal carcinoma in situ and lobular carcinoma in situ.  The second kinds, LCIS, shows a tendency to get cancer in the other breast.  LCIS, added to a family history like yours, says to me that you may want to consider taking the other breast off.”

I was an automaton when she extended her hand.  I shook it and then she was gone, and Chandler and I left completely stunned.  In course of three weeks, I had been told I had cancer, given birth to my baby five weeks early after two-and-a-half days of labor, and had a mastectomy.  Now they were telling me that I should come back and have the same surgery all over again.

I felt like I could not catch hold of all that was galloping through my brain.  On that night, when I had heard what so many women passing through this hospital long to hear – that I would not need radiation, not need chemotherapy – I should have felt wonderful, triumphant.  Instead I felt fearful and panicky.

Other surgery aside, I was supposedly cured, and yet I felt terrified, cut adrift.  They weren’t going to give me anything for those cells that might have escaped.  I would have to live with the fear of them everyday.  My mother once listened to a doctor who told her nothing needed to be done.  She had died five years later.

When he heard the suggestion, Chandler’s face looked grim, mirroring my own.  It was so unexpected.  “Look, Mon, you’ll have to talk to Dr Highfield about it next week.  We’ll get other opinions.  You should see another oncologist at least.”  By then it was 11 o’clock and he had to go home.  After he left, I tumbled exhausted into bed.

The next morning it was time for me to leave the hospital, to return to my home, to my baby.  When  we got inside the apartment, Chandler sat me down on the small sofa and went to the kitchen to put on the kettle.  I could hear Rach’s soft footsteps coming to joining us in the sitting room.

As soon as I saw her, I could not help it; the tears began to flow.  But Rachel, who was a mother herself and who had known me half my life, knew exactly what to say and do.

“It’s all right Mon.  let it all out.  It’s just been too much.  But you’ll be all right.  You caught it early.  And you’ve got the best reason to carry on, sleeping upstairs.  He really is the dearest little chap, and he needs you.”

I perked as soon as I saw my son.  We all had a light dinner together, Matt snuggled in his portable cradle, the center of attention on the table in front of us.

********************

Every morning Chandler brought a cup of tea and some toast for each of us while Rachel fed Matt.  Gradually the three of us got into this routine.  I felt so spoiled: I had never had breakfast in bed except when I was sick, and sickness like that, in all our time together, had never lasted more than a few days.

Each day after breakfast I did a series of stretching and strengthening exercises.  For the final exercise, I stood up, pencil in hand, and crawled my fingers up the cupboard door, marking how high my left arms could reach compared to the right.  At first I couldn’t believe how much lower the left always seemed.  Soon I was able to crawl a fraction higher each day, or at least match the mark made the day before.

I tried not to worry too much about it, but at those times I couldn’t help wondering if I would ever be able to straighten my arm again.

Sadly, there came the time when Rachel had to return home.  The day she was to leave, we chatted and even managed to joke, but when it came time for her to go to the airport, we held each other.

October gave way to November, which gave way to December.  Gradually my strength began to return.  Doing all those exercises had finally paid off.

One of my first big tests of stamina came in November when I was to go to a prosthesis maker and be fitted for a special bra and insert.  That night, as I walked into the bedroom, I glimpsed the box containing my purchase sitting on the chair.  As I picked it up, sadness poured out of me.  I sat on the edge of the bed, holding the prosthesis.

Chandler came in and found me like that.  “It’s alright darling,” he said, his own voice catching a little.

“This thing reminds me of what I really must look like,” I told him.

He held me.  “You look like you, Mon.  You are an incredibly attractive woman.  I don’t want anybody else.”

I held tightly to him, and when I looked up, I could see the face of the man I fell in love with 12 years before.  It was still there underneath the care-worn lines that had deepened so much during these past few weeks.

Later, for the first time since my diagnosis, we made love.  The dreaded unknown were still there, but that night the two of us crossed another bridge.  And we crossed it again, together.

Towards the end of January I slowly became aware of a restlessness within me.  The habits of 12 years of working are not easily erased.  Chandler and I both realized that the part of me that used to work was calling me back.

As the date of my return to work approached, I grew more and more anxious about seeing all my colleagues.  When asked about my sudden leave-taking, my boss had spoken vaguely of “complications.”

But I knew that some of my work-mates must have wondered why I suddenly disappeared weeks before my maternity leave was to begin, why I had not brought the baby in to visit, and why I had been silent all this time.  What would I say to them?

Some of my close friends thought I should not tell anyone else about the cancer: “People won’t treat you normally – we all have such a fear of cancer.  Anyway, it might not be good for your career.”

Then I remembered that group discussion at Sloan-Kettering about whether to keep the cancer a secret, or tell the world about it.  I had come down on the side of the latter. But now I felt my self-confidence slip.

I dressed very carefully for work that first day.  At a meeting that afternoon, the owner of the restaurant, smiling in my direction, extended and official welcome back.  With his words, I knew my moment of decision – to either speak, or remain silent – had come.

I heard my voice quavering, “Well, my return to the restaurant has been a little more momentous that I expected.” There was uneven laughter.  “But let me tell you, it’s been a strange four months for me as well.  I know many of you wondered why I seemed to have fallen off the face of the earth in September, why I’ve not been back all this time.  Well, I didn’t just have a baby, I had cancer as well.”

The words were out and I felt a tremendous relief, even as I saw the momentary incredulity of the men and women seated all round me.  Although I knew it would be painful to have to repeat the story to colleagues and business acquaintances, I was glad I had spoken.

When I walked through my front door that evening, practically the first thing I did was carry Matt upstairs to the rocking chair, and together we sat.  I began to sing, “Froggy went a courtin’,” one of the childhood songs that had mysteriously found its way into a front compartment of my mind.  Eyes deep blue, like my own, smiled up at me.

 

It happened one morning near the very end of June.  It was three days before we were due to set off on a holiday when I noticed the thin, dark line of what looked like dried blood at the center of my right breast.

I walked out of the bathroom and into the bedroom to show Chandler.

“I’ve just noticed something funny on my breast.  Why don’t you take a look?” is what I said to him.  His face turned gray.  We stared at each other, realizing how far we had come.  I hadn’t felt this intense since the previous October.

Chandler examined the line.  “Yes, I see what you mean.  Could it have been the baby, accidentally scratching or pinching you?”

“Well, Matt does sometimes pinch.” I tried to grab onto some explanation.  Maybe it was the baby.  But my words rang hollow.

I hadn’t yet reached my one-year anniversary, and I knew the first year after diagnosis is the most uncertain.  The second year is only slightly less worrisome.  It is only after five years without a recurrence of cancer that people begin to breathe more easily, or so I’ve been told.

I finished dressing.  The clock crept past eight.  Amy, Cally Highfield’s secretary, would have just started work.  I picked up the phone and dialed the number I knew by heart.

It turned out that Dr Highfield was away on holiday.  The unflappable Amy made an appointment for me later that afternoon with the surgeon who was covering for Dr Highfield, Dr Patrick Borgen.

 I felt the adrenaline rise as I was shown into a familiar examining room at Sloan-Kettering.  Soon, a youngish, fair-haired man walked in, carrying my file.  I heard myself laugh nervously.  “I feel a bit ridiculous creating a fuss over what’s probably a normal secretion.”

The doctor smiled off my embarrassment and began to examine me closely.  He didn’t say anything, but went to a cupboard, extracted a bottle of liquid, some cotton, some swabs.  He gently, repeatedly, wiped away the blood.

He looked closely again and then said, “Well, you can get dress.  I’ll be back in a moment.”

It was a long moment, but when he returned, he smiled.  “You did the right thing in coming here,” he said.  “I think everything’s OK – I was able to wipe away the stuff without any trouble, and I don’t see anything underneath.  Have a good holiday and forget about it.”

My fingers were shaking as I inserted the coin into the pay phone in the lobby.

“We are going to have a really good holiday,” is what I told Chandler.  And we did, in a cottage by the sea.  Best of all, nothing reappeared on my breast, no telltale signs or marks of doom.

But somehow, I could not shake of that moment of pure terror when I first saw the blood.  In early October, when I went to Dr Highfield for my one-year anniversary checkup, I told her that I was thinking of going ahead with the removal of the other breast.

“I want to know what the risk factors are,” I said.  “How you think I stand.”

“Weell – “ her Midwestern accent made its appearance.  “The chance of a recurrence from the original cancer, as I’ve told you, is pretty small.  But given you’ve had cancer in one breast, you’ve got a strong family history, you’ve taken hormones and you had LCIS, I’d say there’s a 50 – 60 percent chance that you could eventually develop cancer in the other breast.”

For a moment I could not take it in.  I somehow had never reckoned on odds quite that high.  “And if I were to have the surgery, what would be the odds then?”  I asked her.

“Oh, I’d say only about one in a hundred that you could develop something from the original cancer.  That’s the best odds we can give.”

I had heard the plain facts, stark and straightforward.  Dr Highfield gave no opinion, no recommendation.  I would have to make my own decision.

I thought of my mother, I thought of Matt, whose first birthday we had just celebrated.  I would do anything to see the boy I brought into this world grow up.

Chandler and I had talked about this, especially since our pre-holiday scare.  But the thought of taking away healthy flesh, chopping off clean tissue, was even more barbaric and horrific than removing a breast in which cancer lodged.

And yet I already knew what I would do.  I had know it, in fact, even before coming.  Chandler did too.

“Cally,” I said,  “I’d like to schedule the operation.”

The deed was done early December that year.

The physical and psychological effects were different the second time round.  A woman with one breast can stand in front of a mirror and at careful angles the image reflected will have the illusion of wholeness.  After my second stay at Sloan-Kettering, the mirror no longer held such illusions.  And yet the emotion I felt was overwhelming relief.  I’m convinced it was the right decision.  I have no regrets.

A short time after my first operation, we made a family trip to New York.  During our visit we stopped by the cemetery where my mother is buried.  We drove slowly through the entrance, Matt asleep beside me in the car seat.  I easily found the bronze plaque embedded in the earth.  “Beloved wife and mother, Judith Elizabeth Geller”  Time seemed to come to a halt.  Chandler stood beside me and we held each other.

As I stood above my mother’s grave with my husband at my side, some lines that form part of a Jewish memorial service came back to me.  They ask the question: “If some messenger were to come to us with the offer that death should be overthrown, but with that one inseparable condition that birth should also cease…that never again would there be a child, or youth, or first love, never again new persons with new hopes…could the answer be in doubt?”

So many years later the answer was finally clear to me.  I looked across to my baby, my mother’s grandson, sleeping quietly in the car.

At that moment I realized that not only did she give me life, as I was blessed to give life to my son; her life taught me a lesson.  I truly believe it’s because I learned so much from the tragedy that befell her that I am still alive today.

I bent down, plucked a few blades of grass and scattered them over the grave, as, when I was still a small child, my mother had taught me to do over my grandmother’s grave.

Then I stood up.  Chandler and I locked hands, walked back to the car, back to our son.

 

THE END