He took the needle out and said, “You know, I would really be a lot happier if I could aspirate that.”
“What’s that mean?” Joan asked.
“If I could have gotten a little fluid out, we’d know a lot better,” he said. “Then we could inject a little fluid in and it would dissipate. That doesn’t seem to be the case, however. Why don’t you get dressed and we’ll talk.”
She was alone again. She took off the johnny, slipped into her bra. Her hands shook as she hooked the catch behind her. Her hands shook worse as she buttoned her blouse. So he couldn’t aspirate it. He couldn’t aspirate it. We’re going to talk. She went into Barry’s office and sat. He was grim-faced. She was good at body language and she knew it was not good. He was grim.
“I know you’re worried,” he said. “That you are worried that this is an ovarian cyst. Ovarian? Oh God, I don’t mean ovarian I mean mammarian cyst.”
Joan said, “Jesus, Doctor, you’re in worse shape than I am.”
He laughed and his face went grim again. “The next step for you is a mammogram.”
Joan said. “Okay.” Okay. Mammogram. “I’m beginning to get scared of this, Doctor. Mammogram to me means I should start thinking about this as a malignant tumor.”
“There’s simply no way of knowing,” he said. “Until we do further tests. The next test is a mammogram. You’ll go over to Union Hospital and have a picture taken. A mammogram will give a much better idea. I think you should be thinking in terms of a biopsy, which is the only certain way to know what the lump is. And I would be happier if I could aspirate it. That’s all I know now. And the next step is a mammogram.”
She said, “Okay. If I need surgery, who would you recommend?”
He said, “Dr. Eliopoulos.”
She nodded.
He said, “Are you going to be all right?”
She said, “Yup, I’m going to be all right. I haven’t told my husband yet and I wonder if now is the time.”
Barry said only what he could say. “It’s up to you.”
“I can’t miss work,” she said. “I can’t miss work. I have to go on working.” In three years she had not missed a class at Endicott College. She was puritanical about it.
“We’ll schedule it in the afternoon,” Barry said. “We’ll try for tomorrow, but it’s more likely to be Wednesday.”
“But Wednesday my husband is speaking and I need to be there. I don’t want to screw it up with a mammogram. He doesn’t even know about this yet. And tomorrow afternoon I have to supervise a student who’s taking over the classroom for the first time. It’s important to her that I be there.”
“And,” Barry said, “we’ll have to have the mammogram. We will tell the girl that we’ll take the first appointment they have, and we’ll work around that.”
Joan said, “Okay. If this does lead to mastectomy how long will it be before I can work? What’s the recovery time?”
“The surgery is not terrible. Say, ten days in the hospital. And most women are back on their feet in six weeks, four to six weeks.”
They looked at each other for a moment, then Dr. Barry gave Joan’s hand a small pat. “We’ll hope for the best,” he said. “And take one step at a time.”
Chapter 4
She didn’t drive straight home. She drove around town. There’s no way now to say there’s nothing to worry about. Barry didn’t come even close to saying this is nothing to worry about. He hadn’t said that this is not breast cancer. He didn’t even come close to saying that. I’m scared. I’m scared shit. In the Center on the common the white meetinghouse looked much as it must have looked in the eighteenth century when it was built. The spring night was silent and unoccupied around it. No cars, no kids on the wall, no lights, except the empty arc of streetlights on the aimless asphalt. She drove home and didn’t tell Ace and went to bed. As long as he doesn’t know and no one knows hut me I can pretend. When I’m with him or with others I can pretend it’s not true and all the people who are talking to me as if it weren’t true will make it seem as though it isn’t so. She slept. Every few hours she woke and remembered and fell asleep. During the waking periods she alternated between telling herself it wasn’t cancer and beginning to deal with the possibility that it was.
At four-thirty Tuesday morning she lay on her back in bed and thought of Betty Ford and Happy Rockefeller. All right. I remember them. It happened to them. And I remember saying to Jude and John that it all happened awfully fast. Betty Ford. Did they railroad her into a radical mastectomy because she was the President’s wife and they didn’t want to take chances with her life? Why didn’t they give her an opportunity? Why wasn’t there a chance to explore chemotherapy and radiology? Did some male chauvinist pig surgeon push her into a mastectomy because it was easier, safer for him, instead of trying the riskier newer approaches and thereby save the breast? I will not be railroaded. I am going to be very thorough and research this very well and, maybe, if it’s breast cancer I can hang onto this breast. I will move on this slowly. And if it is cancer, say it is cancer, I will not be pushed. I’m not going to lose this breast because it’s the quickest way, or the easiest for someone else. I’m not going to say, ‘Yes Massah Doctor, whatever you say.’ I’m going to make sure what I’m doing.
The dog, sleeping against the wall, half under one of the floor-length drapes as he always did, made a kind of lip-smacking sound and sighed and shifted his position. She got up. The bathroom door was ajar and the bathroom light was on. In the light from the bathroom she could see the dog now, lying on his side, the drape partially covering his head, his muzzle sticking out. He looked like Mammy Yokum. Ace on his side of the bed was motionless, his back to her, sleeping on his side. She went into the bathroom and looked at herself in the mirror. She took off her pajama top and looked at her breasts. She tried to flatten out the left breast by pressing down on it with her hand. What does it look like? Grotesque. Gross. Unbelievable. A one-breasted woman. I can’t believe it. Even flat, with boobs like mine you can’t tell what it looks like and mine are easy to flatten. But you can’t really tell. They had paneled the bathroom in pine with a reddish stain and hung a big copper carriage lamp over the mirror. Where does the incision go? Does it go up the shoulder? Down the hack? Around the side? Under the armpit and around and meet the original scar? What do they do? Is it up? Down? Is it across? Christ, it’s too awful. It’s too much. I can’t think about this. But I have to. I have to be prepared. If this happens to me I’ve got to be ready. Goddamn it, I will be ready. I will handle this.
She put her pajama top back on and buttoned it. Her hands were steady. She went back to bed, stepping over the dog to do it and pulled up the covers and turned on her side and went back to sleep.
Tuesday, April 15
Work organized her morning. She taught her classes, focusing on the development of the young child and on the students, and handling it as well as she always did. She loved to teach, loved the students, and the sense of interacting lives that she found there. And the students gave it back. They were all girls and there was a sense of female community among them, teacher and student, of shared concern and shared awakening. Most of the administrators she thought suffered from near-terminal anality. But she loved the girls.
Her class ended at one-fifteen and she drove home and ate lunch, sitting on an antique blue stool at the chop-block counter in her kitchen. She had a half hour before she had to go and supervise the person whose take-over day it was.