“What do you mean, it could be a number of things?” She was suddenly totally confused by what he was saying. It was as though all of a sudden she couldn't hear him. Why was there a mass deep inside her breast? What was it and how did it get there?
“There are several possibilities, but a mass of this size, at this depth, in this particular area, is never a good thing, Alex. We think you have a tumor.”
“Oh Jesus.” No wonder he didn't want to tell her on the phone, and insisted that Liz interrupt her. “What does that mean? What happens now?” Her voice was thin and her face pale, and for a moment she thought she might faint, but she forced herself not to.
“You need a biopsy, as quickly as possible. Within the next week ideally.”
“I'm going into trial in two days. I can't until after the trial is over.” It was as though she hoped it would go away by then, but they both knew it wouldn't.
“You can't do that.”
“I can't let my client down. Are you telling me a few days will make that much difference?” She was horrified. What was he saying to her? That she was dying? The thought and the terror of it made her tremble.
“A few days won't necessarily make that much difference,” he admitted cautiously, “but you can't afford to drag your heels on this. You need to choose a surgeon and get the biopsy done as soon as possible, and then you'll have to see what he recommends, based on the pathologist's findings.” Oh God. It was all so complicated and frightening, and so ugly.
“Can't you do the biopsy?” She sounded suddenly desperate and very frightened. She felt as vulnerable as she had feared she would when she went to the mammography lab and began to panic. And now, the worst had happened, or almost. It was happening. It was rolling out in front of her like a terrifying movie.
“I don't do biopsies. You need a surgeon.” He picked up a piece of paper from his desk then, and she noticed that she had already been there for half an hour, but suddenly her whole life had changed, and she wasn't ready to leave yet. “I wrote down the names of a few very good people, a woman and two men. You should talk to them, and see who you like best. They're all excellent surgeons.” Surgeons!
“I don't have time for this.” She started to cry in spite of herself, it was all so horrifying, and she felt uncharacteristically overwhelmed and astonishingly helpless. She was torn between anger and terror. “I don't have time to go shopping for a doctor. I have a trial, I can't suddenly back out of it. I have responsibilities.” She sounded hysterical even to her own ears, but she couldn't help it. And then she looked up at him in genuine terror. “Do you think it's malignant?”
“Possibly.” He wanted to be honest with her. On the film, it didn't look good. “It could very well be. Or it could be fooling us into thinking it is. We won't know till you get the biopsy, but it's important that you do that quickly, so you can decide on a plan of action.”
“What does that mean?”
“It means that if the biopsy is positive, you'll have to make some decisions about the course of treatment. Your surgeon will advise you, of course, but some of the decisions will have to be yours.”
“You mean like whether or not to take my breast off?” She looked appalled and her voice was shrill as she asked him.
“Let's not get ahead of ourselves here. We don't know anything yet, do we?” He was trying to be gentle with her, but it was making it worse. She wanted to face it now, she wanted him to swear to her it wouldn't be malignant. But he couldn't do that.
“We know I have a mass deep in my breast, and you're worried about it. That could mean I'll lose a breast, couldn't it?” She had him on the witness stand and she was relentless.
“Yes, it could,” he said quietly. He was deeply sorry for her. He had always liked her, and this was a terrible blow for any woman.
“And then what? That's it? The breast is off, no more problems?”
“Possibly, but not necessarily. It's not as simple as all that. I wish it were, but it isn't. It will depend on the type of tumor you have, the extent of its malignancy, if there is any, and the nature of the involvement. It will depend on whether or not your lymph nodes are involved, how many, and whether or not it has spread to other parts of your body. Alex, there are no simple answers. You may need extensive surgery, you may need a lumpectomy, you could need a course of chemotherapy, or radiation. I just don't know. I can't tell you anything until you have a biopsy. And I don't care how busy you are, make time to talk to these surgeons. You have to.”
“How soon?”
“Do your trial if you have to, if it's really only a week or two, but plan to have the biopsy in two weeks, no matter what. And we'll take it from there after you do that.”
“Who do you like best on this list?” She handed it back to him, and he glanced at it, and then handed it back to her quietly.
“They're all excellent, but I like Peter Herman. He's a very good man, and a nice one. He cares about more than just surgery and biopsies. He's a human being, for a surgeon.”
“Fine,” she nodded, still looking stunned. “I'll call him tomorrow.”
“Why not this afternoon?” He was pushing her, but he wanted to, he didn't want her to use her work as an excuse, or get caught up in denial.
“I'll call him later.” And then she had a sobering thought, as she glanced at him again. She felt as though she had a ten-thousand-pound weight on her shoulders. “What if I got pregnant this weekend? What if I'm pregnant and have a malignant tumor?”
“We'll cross that bridge when we come to it. You'll know if you're pregnant around the same time you have the biopsy.”
“What if I have cancer and I'm pregnant?” Her voice was nervous and strident. What if she had gotten pregnant and she had to sacrifice her baby?
“We'll have to establish priorities, you're the most important.”
“Oh God.” She dropped her face in her hands, and then looked up at him again a moment later. “Do you think the hormones I'm taking have anything to do with this?” The thought of it terrified her even more. What if she had killed herself trying to get pregnant?
“I honestly don't think so. Call Peter Herman. See him as soon as possible, talk to him, and let's do the biopsy as soon as you can, within reason.” It seemed a reasonable course of action. And now she had to go home and tell Sam there was a mass on her mammogram. She still couldn't believe it. But it was there. She could see it on the film, and in the expression in John Anderson's eyes. He looked devastated, as she stood up and looked at him. She had been with him for almost an hour.
“I'm so sorry, Alex. If there's anything I can do right now, don't hesitate to call me. Tell me which surgeon you settle on, and I'll take it from there.”
“I'll start with Peter Herman.”
He handed her the films from the mammogram, so she could show them to whichever surgeon she chose. Just the word “surgeon” seemed ominous, and as she walked out into the October air, she felt as though she'd just been hit with a two-by-four to her stomach. She couldn't believe what she'd heard, or what had happened.
She picked up her arm and hailed a cab, trying not to remember everything she'd ever heard about mastectomies and lumpectomies, and women who could no longer raise their arms, and other women who had died of cancer. Everything he had said to her was suddenly jumbled in her head, and as she rode back to the office, she didn't even cry. She just sat and stared straight ahead, unable to believe what he had told her.
And when she got back to her office, the whole team was sitting there, Liz and Brock, the law clerk, and the two paralegals. They were waiting for her, and Liz had ordered her turkey sandwich on whole wheat bread, but she just couldn't eat it. She stood and stared at them, and Brock noticed that her face was deadly white, but no one said anything. They went straight to work, and went right through to six o'clock. It was only after that, when they were summing up, after everyone had left, that Brock even dared to ask her.