By Lana Ayers
Two nights ago, I heard the frogs singing. It’s mid-January on the Oregon coast. Yesterday morning, the thermometer just below sixty degrees, air smelling of mown grass, I stood outside waiting for my ride in clear sunshine. The fuchsias are already abloom, the camellias about to be. My skin tingled in the bright light. My mouth tasted of acid. I felt as if I was choking, couldn’t get enough oxygen.
Looking up into the egg-blue sky, I spotted two turkey vultures gliding graceful circles over my egg-blue house, enormous wingspans, wingtips like serrated knife blades. My stomach did somersaults. Vultures homing in on my home. A bad omen. Yesterday. Of all days.
The day I dread every six months.
The day I go for my biannual breast exam.
A month after I turned forty-nine, I felt a hard spot in my right breast while doing a self-exam in the shower. My mother had breast cancer, so I wasn’t taking any chances. I immediately phoned my doctor and a mammogram was scheduled a week later.
On that day, after a thirty-five-minute wait, I was led to a cold exam room with fluorescents that buzzed like angry bees. The air smelled of alcohol and wet paint. One of the walls was partially demolished, covered in yellow caution tape. My mouth was dry. I couldn’t swallow the lump at the back of my throat.
The technician took about twenty pictures of each breast. I had no idea if that was normal. She told me I had dense breasts. They’ve always felt kind of wobbly to me. Dense as in dumb? No. More like impenetrable to x-rays. Unfathomable.
In the seven years since that first time, I have been told that I have dense breasts, cystic breasts, fibrocystic breasts, doughy breasts, busy breasts, and a few other terms I’ve forgotten. Busy doing what? Tea-cupping, the radiologist with genuine pearls said. Brewing up lots of little cyst creatures. And all those wily creatures could be camouflaging cancer cells.
Since age forty-nine, I have been on a cycle of mammograms and ultrasounds, followed six months later by ultrasounds in both breasts and an MRI. I am always offered the option to do a biopsy or two. Or twenty. And I always say, If it’s an option, not a necessity, then no thank you.
Every year, twice a year, for the last six years, I go to find out if I have cancer yet.
And the key word is yet.
I know this because my former army-surgeon gynecologist—who had removed both my ovaries because one was encased in a benign, orange-sized tumor, and despite my begging her to save the other—insisted I have genetic testing.
Prior to the DNA testing, I was referred to a genetic counselor who looked somewhat like an Amish nun, with a severe bun and a white-collared, black button-down dress to her ankles. She made a chart of all my relatives who contracted cancer.
Grandmother’s sister at age twenty died of breast cancer back in Poland.
My Aunt Millie died of ovarian cancer at age sixty, after an eight-year battle that left her skeletal and hobbling.
Cousin Susan, Millie’s daughter, succumbed to ovarian cancer at fifty-six, after losing all her teeth to the chemotherapy.
Mother at age sixty-five, diagnosed with stage III B cancer in her left breast, survived the mastectomy combined with chemo and radiation, for seven years, before dying from a stroke.
My father died of lung cancer metastasized to his brain a couple of months after an experimental radiation cure eradicated his cognitive skills and robbed him of his personality.
My older brother ended up with leukemia from exposure to burning jet fuel on 9/11 at the World Trade Center, where he just happened to be that day for the first time in his life of growing up and living in New York. Was it good luck, since he was a trained Red Cross volunteer, and stayed to help with the rescue efforts? It took eight years for the leukemia to show itself, and eighteen months for him to die. The last time I saw him, he was bald, and his fogged eyes reminded me of hard-boiled eggs.
And no, it doesn’t help lessen my devastation to hear he was a hero. Though the full-dress uniform Red Cross funeral was as breathtaking as
Before the genetic counselor drew up my malicious chart, I’d failed to notice that cancer was what everyone in my diverse, quarrelsome nuclear family had in common. Everyone but me. So far, anyway.
Based on family history, the counselor said, the likelihood of me getting breast cancer was well above fifty percent, likely in the mid-sixties.
However, if I possessed either of the inherited gene mutations of BRCA1 or BRCA2, my likelihood of breast cancer rose to more than ninety percent.
Guess what? Not only do I carry both of the BRCA genes, but five additional genes that are now being strongly aligned with breast cancer as well.
Amish bun said that takes my breast cancer probability up to ninety-nine-point-nine. And because of the density, or busy-ness of my breasts, it’s likely the cancer won’t even be detected until it’s stage four. “Given your age and family history,” she said, “in five to seven years you will be diagnosed with breast cancer. That’s as near certainty as we can come.”
A certain death sentence.
My former-army-surgeon gynecologist was just a little too gleeful at this news. “Prophylactic double mastectomy is the most prudent course of action in your case,” she said, her smile as wide as an army saber is long.
I crossed my arms over my chest. “But these are my breasts,” I said.
“At your age,” my doc said, “they’re purely ornamental.”
Ornamental? Was she mental? “I’m as attached to them as they are to me,” I said.
A little background—and let’s not mince words here. I wasn’t a chubby child, or robust, or pleasingly plump. I was fat. My entire childhood. Fat. And short. And had an afro and dark skin. In an all-white neighborhood. How many strikes is that?
I never really grew out of my dark skin or curly hair or shortness. Or fat, for that matter, despite trying every diet on the planet, numerous exercise regimens, and even a few medical interventions.
I hit puberty when I was eleven and bosoms blossomed on my chest, seemingly overnight. Maybe the boob fairy brought them? Or a goddess who believed I deserved a break. By age twelve, my training bra was a C-cup. And the cups kept going up from there.
Boys started to look at me differently. The same ones who called me names before. Instead of mockery, there was lust in their leering now. I went from being Fatso to Boobalicious.And anything is better than Fatso.
Truly, my entire teenage and adult life, my breasts have been the most attractive thing about me. They drew men to me. Sure, women have always said I have pretty eyes. But men weren’t looking above my neck.
Giving up my breasts feels like giving up my femaleness, my attractiveness to the opposite sex, to my husband who didn’t make eye contact once during our first date.
I realize I’m being stupid. Vain. After all, I’m well past middle-age and no one’s looking at me that way any longer. Not as a sexual being.
So, now four years into my seven-year death sentence, I’m feeling much more willing to let the girls go. Off with these melons, I think.
There’s just one problem. Anesthesia.
You see, anesthesia and me, we’re also mortal enemies. At age thirteen, not long after I blossomed, my impacted wisdom teeth almost ended my life. Well not the teeth, but the oral surgery to remove them. The surgeon was unable to revive me. I was pronounced dead. For a few seconds anyway. But the summoned ambulance arrived in time, and the heroic efforts of EMTs brought me back to breathing.
Naturally, after dying, I’ve been skittish about anesthesia. And dental work. Though I thought I was safe with Novocain. Until a single injection caused nerve damage and facial paralysis. Gifted me a crooked smile. Since then, I bear the dentist drill unnumbed.
Terrified when I learned I needed my ovary excised, which required I undergo anesthesia again, my doctor promised to have the procedure done in under forty-five minutes. Apparently, each hour under anesthesia geometrically increases the possibility of post-surgery complications. And the risk of death.
My army doc was true to her word. She had both my egg-makers extracted in just under forty minutes. Still, it took twice as long for me to come around from the anesthesia than is typical. The recovery nurse wouldn’t say if heroic efforts were made, but she kept pressing her cross necklace to her lips. I remained blurry-headed and bloated-tongued for over a week afterward. I was unable to speak without stuttering.
A prophylactic bi-lateral mastectomy is a four-hour procedure. Minimum. All those messy blood vessels to fuss with. And that is without reconstruction, or the possible follow-up surgeries to gut out missed tissue. Four hours of gas replacing the oxygen in my blood and brain. I might never wake up again from that.
In a recent consult, a highly respected anesthesiologist said, “We’d be very careful with someone with your history, but there are no guarantees. And we would rule out the possibility of reconstruction. Unnecessary additional surgeries.”
My breast-appreciative husband is an optimist. He says, “The genetic counselor told you the chance you’d get cancer is ninety-nine-point-nine percent. Maybe you’re that tenth of a percent that won’t.”
But luck doesn’t run in my clan. With my brother happening to visit the World Trade Center the only time in his forty-five years on earth on September eleventh. With the one instance my dog ever got loose, and his being run over and killed by a car. With my grandfather’s winning lottery ticket being stolen when my grandparents’ apartment was robbed.
No. Luck isn’t encoded in my DNA.
So, what do I do? Roll the dice on surgery that might end my life prematurely? Or cause permanent brain damage? Or some horrible paralysis?
Plus, there isn’t enough evidence to show a preventative double mastectomy actually does save or lengthen lives. Not enough women have undergone the procedure for there to be statistically reliable data. And doctors don’t remove every inch of breast tissue, which also extends to your abdomen and into your chest cavity. Nor do they remove all the lymph nodes that rise into your underarms. Lots of breast cancers are birthed in those very cells.
So, do I just keep biding my time, continuing with this every six-month ritual? The anxiety as the dates roll closer, nearly crippling, with migraines, heart palpitations, and digestive disturbances. Not to mention the hair loss. Patches that never come back. But oh, that’s merely my vanity again.
The typical winter wet weather of the Oregon coast has returned. But not my calm. Not even after being told yesterday by the radiologist, “We’ll see you again in six months.” No urgent biopsy required.
The rain usually restores me to sanity. But as that five-to seven-year genetic clock ticks down, it gets harder to breathe. My heavy breasts feel weightier than ever against my chest.
No person knows how long they’ll live. A bus could flatten me tomorrow.
Still, I feel like I’ve been given six months to live.
A little less than six months before I’m obliged to schedule another appointment for the time bombs that are my breasts, it’s becoming more and more difficult to stop worrying obsessively in between.
Though in a way, I can see a death sentence is a blessing. It forces you focus on the things in life that really matter. Allows you to let go of all the dross. Or a lot of it, anyway.
I’ve been given another six-month reprieve. And I guess, I just must do my best to live with zest. Be grateful. Hope for the best.
But hope is hard. I’ve never had a talent for it. Maybe I have been luckier than most and don’t even know it. After all, I was the child my mother—determined to quit at two offspring—gave birth to because she miscarried the pregnancy before me. A baby girl.
Sometimes, I imagine my sister who ceased to be at three months, all grown up, blue-eyed to my brown, straight-haired to my afro, thin and tall and flat-chested. I picture her twirling in a fuchsia dress in the sunlight of an unseasonably sunny, winter day, carefree and healthy.
Often, I wish my sister could be here instead of me. Because I don’t feel I have earned the corporeal sacrifice she made so that I would exist. As James Wright declares in his famous poem “Lying in a Hammock at William Duffy’s Farm in Pine Island, Minnesota” as soon as he spies a hawk flying overhead, “I have wasted my life.”
And I have. Wasted so much of my life on inconsequential nonsense and insignificant pursuits. Life is the greatest gift. As far as we know, there are no returns.
So, if ever there was a time to stop wasting time, for me, that’s now.
I need to read lots more books, write countless poems, stroll in the rain as often as possible. I want to eat ice cream, even though dairy is bad for me, because the fact of ice cream is the closest I come to believing in the existence of god. I need to laugh with friends more. I want to cuddle with my cats and hug my dogs. I want to make love to my husband. And I must learn to breathe deeply.
I want to live.
At least six months. Or more. Or less. Whatever grace I am allotted.
Those twin turkey vultures who circled my house the other day, they better go seek some other prey. Something other than my busy breasts.
Lana Ayers, night owl, coffee enthusiast, stargazer, has authored nine poetry collections and a time-travel novel. She manages three poetry presses and works as a manuscript consultant. Lana lives on the Oregon coast where she enjoys the near constant plunk of rain on the roof and the sea’s steady whoosh. Visit her online at LanaAyers.com.