“Yes, he did.” She tried to maintain the calm that Sam had given her the night before, but it was more difficult with a stranger. She felt threatened by him, and everything he represented. “But I'm a trial attorney, and I start a trial tomorrow. I really can't do anything for the next week or ten days. I was hoping to come and see you after that.”
“That would be a very foolish decision,” he said bluntly, denying everything Sam had said to her, or perhaps confirming it. Maybe he was just protecting himself from malpractice, she told herself. This way, he had warned her. “Why don't you come and see me today, and then we'll know where we stand. And if we need to, we can set the biopsy up for a week from next Monday. Would that suit you?”
“I …yes … it would …but …I'm very busy today. My trial starts tomorrow.” She had already told him that, but she was feeling desperate again, and very frightened.
“Two o'clock this afternoon?” He was relentless, and she found herself incapable of arguing with him. She nodded her head silently at first, and then agreed to come to his office at two p.m. Fortunately, his office wasn't far from hers. “Would you like to bring a friend?” The question surprised her.
“Why would I do that?” Was he planning to hurt her, or render her somehow unable to take care of herself? Why would she take a friend to meet a doctor?
“I find that women very often get confused when confronted with difficult situations and large amounts of information.”
“Are you serious?” If it weren't so shocking, she would have laughed. “I'm a trial lawyer. I deal with difficult situations every day, and probably more ‘information' than you deal with in a year.” She was not amused by his comment.
“The information you deal with normally is not about your own health. Even physicians find facing malignancies of their own difficult and upsetting.”
“We don't know that I have a malignancy yet, do we?”
“You're quite right, we don't. Will I see you at two o'clock?” She wanted to say no, but she knew that she shouldn't.
“I'll see you then,” she said, and hung up, furious with him. Part of her reaction was the hormones and part of it was that he was the potential bearer of bad news and she feared him deeply. And as soon as she hung up, she called one of her paralegals in, and gave her an unusual project. She gave her all three names Dr. Anderson had given her, and told her to find out about their reputations. “I want to know everything about them, any dirt, any good stuff, what do other doctors think. I'm not sure who you should call, but call everyone, Sloan-Kettering, Columbia Presbyterian, the medical schools where they teach. Call everyone you have to. And please don't tell anyone you're doing this for me. Is that clear?”
“Yes, Mrs. Parker,” the paralegal said meekly, but she was the most industrious worker assigned to Alex and she knew she would get her the information.
And two hours later, she already had the scoop on Peter Herman. Alex was about to leave when the girl came hurrying in and told Alex that he had a reputation of being cold to his patients, but he was the best there was surgically, and there was something to be said for that. One of the hospitals she'd called, and the most illustrious, said he was extremely conservative but one of the best breast surgeons in the country. And the early reports on the other two were that they were almost as good, but not quite, and even more unpleasant to their patients than Peter Herman. Both of them were supposedly prima donnas. And Herman supposedly liked dealing with doctors and not patients, which was probably why John Anderson liked him.
“At least he knows what he's doing, even if he's no Prince Charming,” Alex commented as she thanked her paralegal, and asked her to continue to follow up on the others. And as she took a cab to his office, she wondered what he would say to her about the gray mass on the mammogram. She had had a range of views now, Sam's optimistic one, and John Anderson's far more ominous one, which Sam said was probably nonsense. She liked Sam's view of it a lot better.
But unfortunately, Peter Herman did not share. Sam's assessment of the situation. He told her that the shadowy area they saw was clearly a tumor deep in her breast in an area, and of a shape that almost always indicated a malignancy. Naturally, they couldn't be sure until they did the biopsy, but in his experience what they were going to find would be a tumor, and not a good one. After that, it would depend on the stage it was in, the degree to which it had infiltrated, whether it was hormone receptor negative or positive, and if there was metastasis. He was cold and matter-of-fact, and he painted anything but a pretty picture.
“What will all of that mean?”
“I won't know till we get in there. At best, a lumpectomy. If not, you may want to follow a more extreme course, which would mean a modified radical mastectomy. It's the one sure way of being certain that you've eliminated the disease, depending on the stage of the tumor, of course, and the extent of the involvement.” He showed her a chart that meant absolutely nothing to her, which had letters and numbers on it and covered a variety of contingencies, all of them completely confusing.
“Is a mastectomy the only way to wipe out the disease?” she said in a strangled voice, realizing that he'd been right. She was completely confused, and felt utterly stupid. She was no longer the trial lawyer, she was merely the woman.
“Not necessarily,” he answered her, “we may want to add radiation or chemotherapy. Again, this will depend on other factors at the time, and the extent of the involvement.” Radiation or chemotherapy? And a modified radical mastectomy? Why didn't they just kill her? It wasn't that she was so enamored with her breasts, but the idea of being completely disfigured and desperately ill from chemo or radiation made her want to vomit just thinking about it. Where was Sam now with his cheerful prognosis, and warnings about surgeons fearing malpractice? She couldn't even remember it now. What Herman said was so much more real, and so utterly terrifying, she could hardly think straight.
“What exactly would the procedure be?”
“We'll schedule you for a biopsy. I would prefer to do it under general anesthesia since the mass is so deep in your breast. And after that, you'll have to make the decision.”
“I will?”
“Presumably. You're going to have to make some informed choices. There are a number of options in this area of medicine. You'll have to make some of the decisions, they don't all rest with me here.”
“Why not? You're the doctor.”
“Because there are choices to be made, involving more or less risk, and more or less discomfort. It's your body and your life, in the final analysis, and you must make the decisions too. But with early detections such as these, I almost always suggest a mastectomy. It's a great deal wiser and surer. You can always have reconstructive surgery within a few months to restore the appearance of the breast, if you wish to.”
He made it sound like having a fender put back on a car, and not a breast on her body. And she didn't know it, but his preference for mastectomies as the surer cure was what had earned him his conservative reputation.
“Would you do the biopsy and the mastectomy on the same day?”
“Normally not. But if you prefer it that way, we can. You seem to be a very busy woman, and it would save you time, if you're prepared to entrust me with that decision. We can work that out beforehand, in the event of certain findings. We would have to plan that carefully.” Of course, she thought of Sam, to avoid a lawsuit. And then she thought of something else.
“What if I turn out to be pregnant in the next few weeks?”
“Is that possible?” He seemed surprised, and she felt faintly insulted. Did he think she was too old to have babies, just tumors?
“I've been taking Serophene and trying to get pregnant.”
“Then I would think you'd want to abort, if you were, and proceed with treatment. You can't afford to let something like this go for eight or nine months. Your husband and family need you, Mrs. Parker, more than they need another baby.” It was all so coldblooded and so simple, like the razor-sharp edge of a scalpel. She still couldn't believe what she was hearing. “I'd like to suggest that we schedule your biopsy for a week from next Monday and you come in to see me before that to discuss the options.”