Breast Lump

I sit on my deck making my dinner by peeling the foil off of Hershey's Kisses thinking two thoughts. The first thought is that someday, I'll write the Hershey's people to thank them for pulling me through so many crises. The second thought is that it isn't cancer yet. It's still just a lump.

On the mammogram, they found something odd so they covered my breast with freezing jelly and showed me a fuzzy TV screen of what looked like the layers of Jupiter with a huge black dot in it. The technician kept frowning and redoing the Ultra Sound with different kinds of Jell-O.

I tell a few friends - fellow journalists, mostly. Professional gossips. Within 24 hours, I take about 30 phone calls. Apparently, someone has put out a news release.

A woman at work who loves catastrophes insists on setting me up with cancer survivors. I'm not ready. An uber-extrovert wants to buy me a drink, surround me with people. I will do nothing of the sort. I don't have the energy to keep up with others. Besides, I now drink nothing but Odwalla Superfood in a belated effort to take care of myself.

On the subway, by mistake, I hit the open door button while the train is in motion. The authoritative voice of the transit agency comes over the intercom: "State your name and emergency."

"Jan Johnson," I say. "I may have cancer."

My primary care physician is on vacation so it takes a week to get an appointment. When I finally get in, she recommends that I wait three months and take another mammogram.

Sorry, but I'm not wired that way. I am genetically incapable of waiting three months to find out if I have cancer.

She says my next option involves a surgeon and she writes down her recommendation. I call - and discover she's recommended a cosmetic surgeon. Trouble is, I don't view cosmetic surgeons as doctors. I put them in the same category as hairdressers. (No offense to hairdressers.)

The cosmetic surgeon's office puts me on hold. I listen as a continuous loop plays a taped advertisement for collagen injections. "You can get them on your lunch hour!" chirps the taped voice. I find out that I have to wait a month for an initial consultation for a breast cancer biopsy, but I can come in on my lunch hour for collagen. "You can't even get medical care in this country without somebody trying to sell you something," I moan to my friend Lacy. "The reason why I can't get in is probably because they're stacked up with collagen injections."

Lacy - the daughter of a doctor and a breast cancer survivor - makes me ask for another referral. I cancel my far-off appointment with the collagen peddler and begin anew - ultimately seeing a doctor who recommends surgery.

"You weren't watching TV last night were you?" he asks as he pushes and prods.

"No."

"Good. There was a show on breast cancer that would scare people to death."

I tell him there's nothing on TV as scary as a dot on your own ultrasound.

"It's best this way," says my friend Val, a nurse. She prefers complete removal of tumors over needle biopsies because a needle inserted into a cancerous growth and then pulled out could release a single cancer cell that could seed cancer into my bloodstream and give me a much more widespread problem than breast cancer. Then she advises me to get on the Internet to learn everything I can. "No matter how good the surgeon is," she says, "the person who cares the most about your health is you."

"How are you feeling?"

"Great," Val says. "The baby's kicking all the time."

I apparently morph into the world's most alluring woman. Men who wouldn't give me a second glance when I felt all healthy and whole now call me three times a day.

"What's the protocol on this?" I wonder. "Isn't there some kind of full disclosure implied when you start liking somebody. Shouldn't you tell them up front that you might have a serious disease? Or a missing breast? A bad scar?"

"A scar is the last of your worries," laughs the colleague who loves catastrophes. I have a dream that she touches me and blood comes out of my nipple.

"You don't need to start that kind of relationship now," says Lacy.

Why not? Smoke 'em while you got 'em.

Lacy brings me a gift. It's a beautifully wrapped basket of chocolate and dildos.

My father calls me every morning at about 6:01. "Are you awake?" He tells me where my mother is. Fairbanks. Denali. The Yukon.

My mom, the worrier, was about to board a series of planes, boats and trains with other senior citizens when I had that baseline mammogram. I could see no reason to tell her before she left. There was nothing she could do, except stay home and worry.

When she returns, my parents will fight as usual about how many days in a row one can eat the same casserole and whether he absolutely has to wear a tie, but while she's gone he's a lovesick mooncalf. In the past five decades, they've been apart for only a few recent vacations. Now his emphysema prevents him from taking trips. She loves to travel.

"Are you awake?"

It's 6:02. I tell him about the upcoming surgery, which now is only a day away.

Other callers love to enumerate long lists of friends and acquaintances dead of breast cancer. I quit answering the phone so I don't have to listen to terrible tales of simple surgeries gone bad, never-healing wounds, butchery.

When my cat got into a fight with the neighborhood tom, she needed stitches. She came home from the vet's and immediately crawled into the closet. Anybody who came near her emerged bleeding. I try to learn from her good example and draw my own forces close.

I eat vegetables. Drink Odwalla Superfood. I decide to finish my second novel. Read to school kids. Volunteer at Habitat for Humanity.

I call my surgeon's office. I mention what I've read, issues raised by friends, Val's concern about seeding cancer cells. I ask how long I'll be black and blue, how big the scar will be, when I will be able again carry a 25-pound bag of cat food up the steps. The nurse answers but ends each sentence with the word "okay?" as if I'm going to hang up and let her go back to Something Important. Finally, she lays it on the line. "I think," she says, "you should quit talking to your friends."

The morning of the surgery, Lacy picks me up. She makes me leave my biographies of Joan of Arc, Crazy Horse, and that Thomas Mann tuberculosis novel on the nightstand. Lacy is firm. "You don't bring to a hospital any book where you know the hero dies."

The night before going to the hospital, I hiked up a steep butte. This morning, I put on a gown labeled "hospital property" and a cotton bathrobe with stripes like those prisoners used to wear before human rights organizations declared them too dehumanizing. An orderly puts my feet into disposable slippers. He wheels me to x-ray.

The hospital has turned me into an invalid. The passivity is seductive. There's a pleasure to giving in, giving up, letting others do for you. But at Ultrasound, I regain my Self.

I ask if the needle that injects the breast with blue dye will penetrate the tumor itself. The nurse who kept saying "okay?" assures me it will not. "Oh yes, it will," says the radiologist in charge of the blue dye. He looks over his glasses and tells me not to worry. He assures me it could not possibly seed cancer cells into my bloodstream. "I've never heard of that," he says.

But I don't believe him and I don't trust him. All healing is faith healing and I have no faith in him - or quite frankly - the surgeon, the hospital, the medical system in general. I inquire about options.

"Well, we could dye the area around the tumor and take out the whole area. It would mean removing more breast tissue."

It doesn't sound like anoption. It sounds like a threat. I ask for five minutes alone to think about it.

Negotiations with God go into a final round. But lying on a hospital bed, naked but for a hospital property gown makes me realize I don't have much to trade.

The doctor and technician return.

"Do what you have to do." I hand my life over to the Unknown Radiologist and consider who will take my cats when I'm gone.

More Jell-O. Jupiter and the dot appear on the TV screen.

"Looks like a cyst to me," mutters the technician. She shakes my foot.

The radiologist ignores her and inserts a three-inch needle into my left breast, just outside the nipple aureole. I watch the screen.

"More interior," says the tech.

The radiologist pulls the needle out and jabs again.

"Aspirate," the tech says. And on screen, I watch the black dot implode, like a vacuum-tube TV shutting off.

The tech pronounces victory. "It's gone!"

"It was a cyst," the radiologist says, as if he's announcing something. I grab the syringe and study its contents - a greenish/brown fluid the same color and consistency of Odwalla Superfood.

I discard the striped robe and gown on the hospital bed. The short-stay nurse talks at my back as I race for the elevator. She's telling me about painkillers. I don't listen. All I can feel is relief.

My friend Theresa picks me up and immediately hands me a bag of homemade cookies. At home, I call about 70 people with the good news. The phone rings all day and late into the night. Another friend gets through early the next morning. "What are you doing?"

"Eating cookies for breakfast."

"What happened to negotiations with God? Where are the vegetables?"

"I signed the chocolate clause under duress. Besides, if God wanted me to give up chocolate, He wouldn't have sent the cookies."

When we hang up, it's almost 8 a.m. and I realize that I haven't heard yet from the lovesick mooncalf. I call him.

"Are you awake?"

He wants me to tell him the story. Not just once, but again. His favorite part is "It's gone!" He can't hear it enough because he doesn't hear it very often. At his age, he's attending weekly funerals. So he loves to hear about the vanishing dot on Jupiter.

But enough about me. I switch the topic. "So, what's on Mom's itinerary today? Sitka? Ketchikan?"

He sighs. "On the boat. She's finally coming home. Boat docks in Seattle on Saturday."

Now that I'm not going to be recovering from surgery, I decide to go to Seattle to meet Mom and the fellow cruisers. Finally, with the tumor vanquished, I can think about somebody besides me, me, me.

This decision perks up the Lovesick Mooncalf. "When you see your mom, tell her I'm sitting right here by the phone."

A follow-up mammogram detects "nothing of interest" in my breast tissue. This is true. Nobody is taking any interest in my breasts. No suitors, but I'm not fielding 30 calls a day either. It's blissfully peaceful.

My most frequent callers are my parents, who ring me up so that they can fight in my presence. The primary area of discord now is how to celebrate their 50th wedding anniversary in June.

The biggest difference between now and then is that I might be marginally more "awake." I keep my hospital wristband on a candle atop my desk to remind myself that no matter how lousy a day I might have at work, it's better than being in the hospital.

The colleague who loves catastrophes has left the company. Val has given birth a healthy baby girl.


© Jan Johnson

Jan Johnson has been a journalist in television, radio and newspapers. Currently, she works part-time in corporate communications and writes fiction full-time in Portland, Ore.

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