On the Other Side

"See here?" [The radiologist] squinted, wrinkling his nose as if that would help him focus. "Just beneath the curve of the areola? Microcalcifications, more than ten of them, in a cluster." I saw them, too, chalk white against the graphite gray of the normal tissue: white squiggles like tiny worms, freeze-framed and suspended in time.

Usually, doctors and nurses gain authority not only by their titles but also by the expectations patients hold of them. Patients think we're in charge, the privileged ones with the sacrosanct information. But when caregivers become patients, we, too, are reduced to the essence of our bodies: the bitten nails, the stretch marks, the festering blemish.

All I wanted was a doctor who would know what was wrong and which treatment would cure me, and nurses who would keep me safe and free from pain. Like any other patient, I wanted to go through the bad time, the sick time, and emerge unscathed. "Certainly," I agreed. "Of course I want it biopsied."

I spent the days before the breast biopsy planning how I would cope if the diagnosis were cancer. I wanted to be an example to my children, my husband, and my patients. Somehow, I imagine, I would be made transcendent and special by my illness. Other women with cancer would welcome me as the newest member of a dread society. We would know what no one else could, and we would recognize one another on the street by the stunned look in our eyes. I would see everything differently, I thought, cherishing each day and not wasting a moment. That's what I pretended. Inside, I was paralyzed.

Two nurses who'd had breast cancer, … in the clinic … tried to cheer me up. … I asked them everything – about the biopsy, the surgery, the radiation, the chemotherapy. I wanted to know what it was like for them. Not knowing and not naming seemed to give breast cancer a power it didn't deserve. I said "malignant" and "chemo" and "tumor" as often as I could, in case those words might soon apply to me. If I knew everything, even the worst, it wouldn't be as bad and I wouldn't be so afraid.

When I arrived in the one-day surgical unit, the nurse told me to get undressed …. With the removal of each item of my clothing – my faded blue T-shirt, my jeans, my tan sandals, my watch, my bra and underpants – I became more and more a patient. The more naked I became, the more difficult it was for me to locate the "I" who was also a mother and a nurse, a writer and a wife.

We talked some more about our families, about the problems in their department.

I wished they wouldn't talk about work. I wished they would treat me like a patient and not like a coworker. If I were a patient, I could say that I felt faint, that I was frightened, that the pain in my breast felt like a white-hot burn. As a coworker, I had to be jovial. Complicit and gossipy.

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… it's not easy to be a female patient. Because most of our reproductive organs are internal, even routine examinations and procedures in the field of women's health are uncommonly invasive, reminding us of our vulnerability. To investigate much of the female body, we must dilate, probe, reach deep. In addition, almost every female organ represents not only the real but the symbolic – breasts, which serve for both lactation and pleasure; the vagina, which allows birth and yet becomes, both in literature and in jokes, the forbidden passageway; the uterus, which nests our babies yet is named our enemy when no longer needed – and so manipulation of these areas reverberates emotionally as well as physically.

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Dr. Patino called me on a Friday afternoon, one day after surgery. He said, "I'm very pleased to tell you that the biopsy is negative."

"Right," I said. Then, "Thank you. Thank you so much."

After I hung up, I waited to feel a deep sense of relief. I had been spared. I wanted tears to come to my eyes, I wanted to laugh or call up my family and tell them, I wanted to go for a walk and praise every beautiful thing along the way. But instead I stood in the middle of the kitchen and a quiet, eerie calm settled over me, as if a cloud had drifted in front of the sun, stopping the light flowing in through the windows. I had been riding a high crest of tension and uncertainty, holding my breath. Then, just as a wave crashes against the sand and gently disperses, the tension was gone. I had been spared, and for that I was wildly grateful. But a lesser sensation, a kind of fearful apprehension, had quickly moved in.

I was left … with many uncertainties. Because I'd had these microcalcifications, would I develop more? And there was that other question, the one I asked myself only in the middle of the night: Was this the beginning of the aging process, that series of small, unannounced alterations to which we all have to adjust?

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