Authors: Lauren Slater
She said, “Give it a couple of months.”
I said okay, but I knew I wouldn’t wait that long. I was done with waiting.
My husband was tentative. “I really like your breasts,” he said, but he knew I didn’t like them. He’d seen me lift the ledge of them up on a hot day. He’d seen me sweat out countless biopsies too. He said, “Without your breasts you’ll look weird.” I said, “With my breasts I look weird.”
I convinced my surgeon that a mastectomy was truly what I wanted to do. In the week or so before the procedure, a kind of elation filled me. Here I was, diagnosed with a dangerous condition, and I was high, high on the cold, clear winter air and the fashion possibilities in front of me and the freedom: no more screenings, my breast-cancer risk plummeting. A mastectomied woman can still get breast cancer, but studies show that she has only a 5 to 10 percent chance, and that’s a lot lower than you. Or you. Or me, who, with all my combined risk factors, had a whopping 90 to 100 percent lifetime chance (my surgeon finally came up with some stats), good god. Why wouldn’t I cut off my breasts? Why doesn’t everyone? I sometimes wonder this.
I visited a plastic surgeon who told me to take off my shirt. “Well,” he said, “you are large. We’ll make you a B,” and then he showed me the breast that would go in me, a jellyfish-like saline-filled sac, almost pornographically pert.
As the days drew closer, my elation turned almost manic. Dr. Poires, my surgeon, said, “I’d like you to see a therapist. A woman should grieve before she loses her breasts.”
Is this true? Did I have grief I was covering up? I went home and stood naked in front of my mirror. I eyed my mammary glands for a long, long time. Through the pale skin I could see the roaming of veins, green veins, running from my throat, snarling in my chest, and fingering their way into my pale, pale breasts. I could see how the seam of the breast was connected to the chest wall, beneath which hammered the heart. When I breathed, my breasts rose up on the lobes of my lungs; breath and breast. Heart and breast. Flesh and breast. What I saw, standing there, was that the breast is an integral part of the body, its intricate ecosystem, which, when severed, would cause pain. I didn’t doubt my decision then, but I had a long moment of feeling bad for my body, and bad for my breasts, which I was abandoning in cold blood, a piece of me, killed off.
I went into the surgery with my head held high, a tight scoop-necked shirt from the Gap packed into my bag, what I would wear on the way home. There was a damsel fly in the surgical waiting room, one of those leggy primitive insects, and I thought that was strange, a bug in the hospital, but I wasn’t scared. I wouldn’t take it as a sign.
I was shown to a cubicle, where I undressed and lay on a stretcher. The man in the cubicle across from me appeared to have no legs and only one arm. He was pretty much torso topped with brain. I couldn’t stop staring at him. He saw me staring and waved.
The anesthesiologist came around. He told me his name was Dr. Drown. This is when I started to feel definitely scared, but I also thought it was funny. Dr. Drown had a teal-green surgery cap and a mask over his mouth, so I could not completely see him or assess him. Dr. Poires, the breast surgeon, came in; she looked funny in her scrubs and masked mouth, like a criminal. They wheeled me down the long hall.
Dr. Drown put me out; he flicked a neural switch and I was down, drowned, and then I bubbled up to consciousness again, nine hours later, in a room I had never seen. I knew immediately that my breasts were gone. My chest felt terrifyingly light, like it was filled with only cotton, and then there was a long, slow, curving pain that took its time with me.
I was baked on drugs, still swimming in the liquid-glass of anesthesia, but my mind was strangely, awfully clear. I could feel the sawed incisions, the enormity of the amputation, and how hard it was to breathe. “Breathe, breathe,” a recovery room nurse kept yelling to me, and a machine above me was beeping out some warning, and I didn’t want to breathe; I wanted just to sink, and I thought I was possibly dying, sometimes people do die from surgery, and right then and there, just after the operation, I regretted my decision.
I wanted my breasts back.
I wanted my body back: my breath, my ability to move, my blood pressure, which was something like 50 over 40, a common but problematic response to anesthesia. “
Breathe, Lauren
,” the nurses commanded, and I tried to recall what percentage of people do pass on, from complications. Did I have a complication, or was everything okay? “Am I okay, am I okay?” I kept saying, and they kept saying, “You’re okay,” and then the machine would beep and they’d shout, “Breathe!” so it was a mixed message.
Despite the anesthesia, I was in great pain. And right there in the recovery room, I got a bit more acquainted with death. I saw my baby girl, not as she was, a five-year-old, but as she’d been when she was born, her lids creamy and clamped closed.
Then my blood pressure stabilized enough so that they could bring me to my room. It was midnight; the surgery had started at two that afternoon. My husband was in the room, and in the dark he held my hand. I could just make out the crimson skulls of flowers, and behind them, in the glass square, flecks of stars with no names. I said to my husband, “Don’t leave me here,” but at some point he did, he was just too tired, and so I stayed alone, and I listened to my heart, clomping like a heavy hoof, I could hear it. Without my breasts, I was that much closer to my bones, my body.
Mastectomy is not a makeover. I was mistaken in thinking it would be. No. Mastectomy is a brutal operation where your breasts are ripped out at the roots, where you wake up in significant pain, where, when you finally see the hatchet job, you want to gag. My chest was bulldozed, like a refugee camp, a lot of blood and rubble.
I stayed in the hospital for four days. So did my breasts, the ones that had been removed, they were ten stories below me, smeared on some slide, being read for cancer. Dr. Poires told me, on my third hospital day, that the left breast had been okay but that the right was full of misshapen cells, and later, when I saw an oncologist, the oncologist said, “The line between what you had and cancer is arbitrary. Two pathologists read your slides and one saw carcinoma.”
When I heard this, I was truly glad I’d removed my breasts, but I wasn’t elated anymore. It is
not
a makeover, and it is
not
a guarantee. The recovery is difficult. I couldn’t lift a coffee cup, or my baby, for months. I had drains inserted, and for two full weeks a zinfandel-colored pus collected in the plastic bulbs, which I had to empty every hour or so. The anesthesia, which I was under for so many, many hours, seemed to seep into my bones like radium, and that, combined with a steady dose of pain pills, made me dumb and eventually very depressed.
I write today, a little more than one year after the procedure. It has been a June of fantastic weather, river-blue skies, a profusion of roses, the scent of sheared lawn from the man and the mower next door. June is a fine month, a hammock month, and I have been doing that, lying back. I am finally feeling better now, although it’s taken me a long, long time. I can lift my child with effort. I can scrub the floor, even though that hurts. I can sleep without the pain pills. And yesterday I went shopping, for the first time, buying the little shirts and Lycra I had said I so wanted, and still do, but with much, much more sobriety.
I don’t know that I won’t get breast cancer, or that the cancer one pathologist said I had will not return. As I said, mastectomy reduces but by no means removes the chance. What I do know, though, is that I won’t be living my life in a mammography studio or an MRI machine, or waiting for billions of biopsies to come back, because, while I have some tissue, it’s not even enough to biopsy, really, and it’s not nearly enough for a mammogram. As for the body-image issue, I do like my body better, in clothes anyway, with my pert B-cups—but I don’t want to overstate it. Implants are not pretty when you see them “in the flesh.” They are obviously fake, nippleless mounds, with dark-pink shiny scars and puckers on them. Sometimes I miss my old big breasts; I wonder what became of them, if they were thrown into the trash bin at the back of the hospital, if they somehow sense my betrayal.
I say I’m sorry.
I say it to my real breasts, my true breasts, that I betrayed even as they betrayed me, and I say it to the body left behind, for it has had an intricate part of its ecosystem just carved out, and I say it to all other women who must tussle with a difficult choice between mutilation and temporary peace of mind, and I say it to my daughter—I’m sorry—because when she sees me naked now, she looks away.
This is the truth, and she’s so young.
“What happened to you?” she says.
Next door to us, Corinna, our lovely neighbor, has had her second baby. Corinna’s body is intact. My daughter and I go to visit the baby, and not long after, the baby starts to squall, and Corinna lifts her shirt and brings the infant to her chest. My daughter, who knows nothing of etiquette, stares at Corinna’s giving nipple, she just stares and stares, at the breast, the baby, the white markings of milk on its tiny mouth.
Later on at home, my daughter turns to me. “Let’s pretend I’m a baby,” she says.
“Okay,” I say.
“Ga ga,” she says, and then she comes over and lifts my shirt.
“What are you doing?” I say, I practically shout, but she says, “I’m a baby, you have to feed me,” and then, my god, she puts her mouth where my nipple once was and pretends. She just pretends. I want to cry. I hold her close. I am so sad she doesn’t have me as a full-bodied woman, but I’m so glad I have a better chance of lasting until the time when her own breasts fill.
My blood is in a blender. It’s just about the only bit of brightness in this drab office of a life insurance company that, before it’ll bet on my body, feels the need to sample its various fluids—specifically urine in a tiny pleated cup and, now, my blood in some sort of centrifuge the phlebotomist switches on. It circles, at first slowly, then picking up speed until it’s whipping my life-source so thoroughly that, at last, the lipids separate from the fresh red liquid and rise to the top—that’s cholesterol I’m seeing, a custardy yellow substance that reminds me of the pudding my mother used to make. Damn my mother! It’s her cakes and tarts and tortes that have put me in this position, which is precisely . . . what? I’m a forty-seven-year-old fatso with a penchant for Belgian waffles. In truth, though, it’s neither my mother nor those waffles that are responsible for my body’s breakdown. Isn’t this terminology odd?
Breakdown
. My body is having a breakdown, for sure, yet instead of atomizing into pieces and parts, I’m doing just the opposite. I’m acquiring a perverse sort of solidity that belies the real crux of the matter. For sure, no breeze will blow me over, but that doesn’t mean I’m strong. My breakdown is a kind of hyperplasic excess that renders me easily winded and, nearly worse, has exiled me to the X section of clothing stores, where I now must buy clothes in a 1X or even 2X size. Once I was five feet (I’m still five feet) and weighed one hundred pounds. What has happened here?
“Do you think they’ll insure me?” I ask the phlebotomist as we look at my spinning blood and at the lipids lining its surface.
“I see this with lots of folks,” the kind phlebotomist says to me, but I’m not reassured. I am now a member—along with “lots of folks”—of the American obesity club, a club I’d do almost anything to leave, the damn badge stuck to my excess skin with an adhesive that is out of this world.
This is not a story about life insurance and how hard it is to get when your cholesterol, like mine, is 405 and your triglycerides are over 800. In fact, I got the life insurance, but that didn’t change my predicament. Every night I take a palmful of pills, all of them psychotropics. Way back when, in my lean, clean twenties, I needed only one pill to keep my mind aloft, but the brain is a sneaky, needy organ and even though psychiatry denies it, the brain becomes tolerant to the chemical you drink down, more often than not necessitating what is called in certain learned circles “polypharmacy” and in less learned circles, “the cocktail.” My cocktail at this point consists of Effexor, 300 mgs; Wellbutrin, 300 mgs; Vyvanse, 90 mgs; Suboxone, 4 mgs; Klonopin, 1 mg; and, last but not least, the fattening drug called Zyprexa, its zippy little name not to be confused with its stuffy side effects.
All, or almost all, psychotropics cause some weight gain, but Zyprexa is in a class by itself. It was prescribed for me last year during a horrific depression. I saw black hats roll across roads and heard everywhere I went the crying of a child I could never find. At night the darkness was intense, all consuming, like liquid coal I tried to move through.
I’d always known, at least for as long as I’ve had my psychology degree, that severe depression can have psychotic features, but knowing is one thing and experience so entirely something else that you are humbled, thinking you had ever understood. During the summertime season, well before I’d ever heard of Zyprexa, the depression’s psychotic features worsened, in part because I could not stand the contrast between my blackness and all that beauty, everywhere around me but utterly inaccessible. From the window of the kitchen I could see my garden, full of bee balm and mint, loosestrife and arctic daisies, big wheels of white with florid amber navels packed with pollen. My garden bloomed profusely that summer, calling to it butterflies and bees and birds with yellow vests. And yet all this beauty seemed somehow menacing to me. The flowers—some had the heads of serpents, others flamed in the high heat, which caused the air to warble, as though the whole world were wavering. If I stared at my garden long enough it would dissolve into thousands of Pissarro points that then lost their shapes and dripped downward.