My Mamma Mia

“My Mamma Mia”

“You will need a mastectomy”, the barely middle-aged breast surgeon with strawberry blonde hair, Dr. G., is saying. She looks too charming and nice to perform such a violent action. Her hair is pulled back in a pony tail, her cheeks are round and joyful, her toe nails are each painted a different color, and she wears strappy sandals that showcase her healthy legs. How incongruous for her to use the dreaded word: Mastectomy. Unfathomable. I am shriveling. Shrinking. She couldn’t mean me. I didn’t do anything wrong.

I feel attacked and threatened. How can I live without my breast? This is worse than when I was told I had cancer. Cancer is a word, a noun, and mastectomy involves an action. Cancer was an abstraction. I knew that cancer could happen to anyone and yes, even to me. Or: Why not me? I was in my therapist Naomi’s office and being brave when I voiced that thought. The news that I had cancer was numbing and took time to swallow. However now I am in the hands of Dr. G. and she believes that I will need a mastectomy. She mistakes my beaded necklace with the musical note quavers as a charm, for a Chai, as she examines my naked breasts. She is friendly. And I have no lumps. I am encouraged. Then why a mastectomy? Dr. G. explains with medical terminology. I do not comprehend. If only I had worn the gold necklace I possess, the one with a real Chai, this would not be happening. Dr. G. is branding me with the word mastectomy and it is chewing up my insides. I am diminished with fright. I remain standing in Dr. G’s office, afraid to sit down. I would like to pretend that I did not hear her say it. The word. Mastectomy. And mean me. She plans to amputate my breast and leave me flat like a pancake. Dr. G. has to be wrong.

I am a healthy woman. Dr. G. doesn’t know me. I have undergone mammograms every year for the two decades, plus one for this year, since I turned forty. Just as prescribed. There was nothing ever even slightly alarming before. Just the letter in the mail saying that I am in good shape. I had come to expect that letter. And now Dr. G. is telling me that I will need a mastectomy? That is so extreme - so radical - and final. How can I go from A to Zero in one morning?

Dr. G. is pleasant. Not too hot and not too cold. She is matter of fact about my diagnosis. She is calm. Mellow. And focused. We could be talking about hairstyles, hers long, mine short. So maybe I am mistaken. Or maybe she is. After all the broccoli I’ve eaten how can this be my verdict? I consume more green leafy vegetables than most of my friends and they are all cancer free. My favorite dish, after all, is spinach pie. I also enjoy tofu, tempeh, grains and nuts, and multi-colored fruits. I choose egg whites over eggs with yolks and have for many years. I restrict my cheese intake and I drink almond milk. I do my own cooking. What went wrong?

Dr. G. recommends that I schedule the surgery. I have invasive ductal cancer with well to moderate moderations and several smaller cancers. Some of my lymph nodes will have to be removed, and my arm may swell up permanently. My system cannot absorb any more information. I am going to get another opinion.

Actually Dr. G. was my second opinion. I cannot say though that the first doctor I consulted gave me an opinion. After examining me Dr. T. reached for a pointer and with a flourish indicated a spot on the film image of my breast on a monitor.

“It’s just a piece of meat,” he instructed me and smiled generously to convince me that he was right. He had a wide smile and large teeth. The better to convince me that it was okay to cut off a chunk of my breast? Was I Little Red Hiding Hood? Or was he the Big Bad Wolf?

Dr. T. made his intention clear and outlined his plan to perform a lumpectomy. He did not recommend having a biopsy done first.

“They don’t always get the right spot. So even if they say you don’t have cancer they could be wrong. They work in the dark.”

Was he joking?

“What if the doctor is a pool shark?” I wanted to know, imagining my breast spread out on a pool table. Dr. T. chuckled. He thought I was joking. I wasn’t. And he wasn’t either. Puzzled about the business of biopsies and lumpectomies I wondered out loud, “maybe I should go to Sloan.”

“They bury people there too,” was Dr. T.’s all too swift reply. I didn’t know being buried was an option just because I had an irregular mammogram for the first time in my life. I did not contest him but I did contact the American Medical Association about the “butcher surgeon” as soon as possible. I also alerted the gynecologist who referred me to Dr. T. I complained to her about the awful thing

Dr. T. had said.

“What did you expect him to say?” Dr. L., the gynecologist I had been going to for over fifteen years, admonished me. “Why bring up Sloan?”