Tamoxifen Tonight - Flashes and Flashbacks
Jeanne Holtzman
It's 11:00 P.M. and I wash down a Tamoxifen tablet and begin the
determined preparations for sleep. Before breast cancer, before I found
the lump, before the surgery, and before these pills meant to starve the
tumor, sleep was not an undertaking but an effortless pleasure. Closing
my eyes at night, I would deeply and blissfully slumber until my snooze
alarm persistently nudged me back to myself. Now, Tamoxifen sabotages my
body's thermostat with repeated false alarms, an exaggerated mockery of
menopause.
My husband retires to his bedroom down the hall, our resolute attempts
at sleep having become solitary endeavors. I strip down to my underwear,
being sure to remember to remove my potentially suffocating socks, and
try to recall the weather forecast. Thankfully, tonight will be cold and
breezy, but not below freezing. Perfect conditions to invite the chill
air in through the window next to my bed. I gratefully open the window
wide and wriggle under the cool covers almost naked. The thin outside
air smells exciting, like nights camped in a sleeping bag by the side of
the road, like an adventure. . . . I fall asleep.
At 12:45 A.M. sweat begins to prickle up between my breasts and collect
under my chin, and the nape of my neck becomes muggy. I fling the covers
wide, but not out of reach, and lie spread eagled, all the better to
radiate. The heat churns out of me in pulses, in surges of swelter. I am
a furnace, an oven, a kiln. I can almost see the heat rays rising off
me, like a cartoon of the Sahara desert. I move to the cool side of the
bed. Cold air puffs through the window soothing my breasts and belly
like fat raindrops on parched earth. Unmercifully, the draft stops and I
pull the cold pillow against me. Slowly my body cools to lukewarm, and
finding the covers again, I turn over with hopes of slipping back into
oblivion.
But I have been flushed into alertness, my brain heat-activated. My left
hand drops to my right breast, and I re-live finding the lump. An
ordinary moment, about to watch "The Wonder Boys" with my husband on our
new TV, our 10-year-old daughter sleeping with her girlfriend
downstairs. Then without warning my life shifts. Lying back for viewing
pleasure, with one arm behind my head, I cross the other over my chest,
and my fingers graze the unmistakable lump on the edge of my breast. It
is hard, not benevolently soft like a cyst, and clearly defined. Mobile.
That is good, I guess. But I know that it has not been there for too
long. Not 10 months earlier when my childhood best friend called to tell
me she had breast cancer, and I did my self exam for three days in a
row. Not even a few months earlier, when I searched my breasts again
after curiously dreaming that I had breast cancer. This was a new, hard,
painless lump in a 52-year-old woman. Not a reassuring picture. Sure, it
could be benign, it could be a fibroadenoma. But it could just as easily
be cancer. I feel it a few more times to be sure I haven't imagined it.
I say nothing to my husband. We watch the movie.
My world becomes a torment of suspense. Waiting for appointments,
waiting for tests, waiting for results. I am brittle, on high alert. I
imitate everyday life while my mind is a din of shrieking smoke alarms,
screeching air raid sirens. The taste of turmoil gags me and I lose 6
pounds. All the preliminary results are reassuring, but I am not
reassured. I am expecting malignancy. More appointments, mammograms,
biopsies, apprehensive anticipation, inching my way to a diagnosis.
Until it is removed, I reach for the lump repeatedly, feeling it,
willing it to get smaller, softer, go away.
I go alone to see the surgeon to finally find out if it is breast
cancer. Of course, my husband would come with me if I want him. But I
surprise myself by preferring to be alone. I want to react by myself, to
deal with it by myself, to be one-on-one with the doctor. I don't want
to be distracted by anyone else's feelings. I don't want to cope with
accepting sympathy or support. I wonder if this is perverse. Wouldn't
most people want someone with them, someone who loved them? Am I a freak
to want solitude more than solace? Is my husband cold and uninvolved not
to insist on coming, or is he simply respecting my needs? I go alone and
wait alone, cold in a tiny paper johnny, in a room as small and sparse
as a jail cell.
Through the closed door I hear the voices and casual laughter of
ordinary people having an ordinary day at work. I hear my doctor speak
loudly and decisively, "Stop taking the calcium. DO NOT take the
calcium. Don't take that yellow pill. Tell me what I just said." I hear
muffled footsteps passing back and forth beyond the closed door, while I
silently sit and wait. Finally, the door swings open and the surgeon
steps briskly into the room. "Bad news, Jeanne, it's cancer," and the
waiting, the stomach churning waiting for the diagnosis is over. I have
breast cancer. Surrounding the sinking dread is relief. I finally know.
In a way, I am vindicated. I wasn't wrong to worry. I speak one word in
response. "Shit".
Now, 6 months later, it's one in the morning and I am doing a self
breast exam, wishing for sleep, worrying about the cancer coming back.
Will it recur? How long will I live to mother my daughter? Can I hope
for 5, 10, 15 years, get her to her mid twenties, maybe even married? I
don't want to abandon her as a child, a teenager. Who will help her
learn about boys, makeup, life? And what is this pain in my hip, my
neck, what about this change in my bowels? I try to rein my thoughts in,
relax, slip back . . . . I fall asleep.
I open my eyes again at 2:56, and know that this is going to be a bad
one. I am not hot yet, but feel the heebie-jeebies coming on. I kick the
covers off in anticipation. My skin is getting tighter and tighter,
shrinking so it can't possibly cover my body. I am close to bursting,
jumping out of my skin. Soon my flesh will exude through my skin like
garlic through a press. Electricity is surging, pulsing through the
surface of my legs and feet, crackling on and off like a flashing neon
sign. My skin is on speed. Now, when the heat finally begins, it is
almost a relief to feel soggy. To pump out the heat, sweat it out, and
cool down. But again, my thoughts are ignited. And after pausing briefly
on the mundane - what should I wear to work tomorrow? Did my daughter
study for her spelling test- the cancer rumination resumes: I was
diagnosed with cancer, but the surgeon, direct and uncompromisingly
professional, assured me that this was an uncommon and very favorable
type of cancer. Low grade, well differentiated. She told me it would not
kill me. My oncologist told me I would not need chemo, the most savored
words ever said to me in my life. My radiation oncologist did not
encourage radiation for this favorable tumor. There was only a 5% risk
this would come back and kill me, she said. She told me I was lucky.
Lucky! I am having a hard time feeling lucky. Wasn't I pretty unlucky to
get cancer in the first place? I am not feeling sufficiently
appreciative and thankful and I am afraid this means that I am a bad
person, and that I will be punished for this lack of humility, probably
with a recurrence. Of course, I was lucky to get a favorable tumor. So,
I am a failure at feeling lucky. How else should I feel? I have been
waiting to feel deeply changed, to feel what I have read and reread from
cancer victims, or must I say "survivors"? To have each moment become
precious, realize what's important in life, discover life's true meaning
and beauty. I keep waiting to not feel impatient, frustrated or
irritated, but grateful and blissful for just achieving life. I wait for
exaltation, but it doesn't come. Why don't I feel transformed? Was my
brush with death too glancing? Just enough to leave me in a state of
perpetual agitation and uncertainty, but not enough to achieve grace?
Perhaps the contrast wasn't big enough. I wasn't sufficiently shocked
and disbelieving when I was told I had cancer, but grimly expectant of
it, like the return of a bad nickel. Or is it possible that I already
had my priorities somewhat in order, so the shaking of my mortality
didn't cause any serious realignments? In any case, I have failed to
reach this higher level. Again, I agonize over whether I am too proud
and defiant in the face of cancer and death . . . . I fall back asleep.
At 6:45 A.M., the familiar and soothing voices of NPR newscasters,
briefly silenced by the snooze button, coax me back into the world. I
sit up, close the window, and trudge off to the bathroom to shower away
the night. Reaching for my toothbrush, I see and swallow another 10 mg
of Tamoxifen. I am ready for another day. Another unlucky/lucky,
uncertain, unenlightened, hot flashing, but irreplaceable, day in my
life.
© Jeanne Holtzman
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