Breast cancer

Then there is my divorce. So far, my children and I have kept moving on, but here I am immobile and I fear the hurt and abandonment that circle above my bed, waiting to settle their talons and weight on me.

In the morning, a nurse calls her and Billie answers. She sounds like one of my students, a seventh-grade boy who reminded me from the start of a bird: black, lustrous, delicate, skittish. I worked with him carefully, as if one wrong move or word and he’d take flight. Twice a week I’d put my finger out for him to land on and hold my breath to see if he’d stay. Week after week. Before this operation we were into our second year, and he’d found his perch. Billie’s voice is soft, uncertain, tentative, as if it might not hold in the air. But at night it fills the room.

I am silent. My crying sticks in me, just as if they’d put their dressings and gauze and tape to hold my tears in place. The tubes coming out of me do not drain despair and the tubes going in bring healing only for my body — nothing deeper. When I talk on the phone or to a nurse or visitor, I describe the beauty of the flowers sent to me: the pink begonia in its sandalwood basket, the dozen white roses arranged with eucalyptus and heather, the vase from the Brattle Square Florist holding a summer’s garden of lilies, iris, and sunflowers. I don’t talk about how the pain meditation makes me so sick that they have to alternate morphine with Compazine, or how much it hurts just to move in bed, my back cut and filled with tubes. My new breast pulls and aches where my own had been. I don’t think about the surgeries I’ve had in the past although my doctor told me that I held my body rigidly, as if I knew when each cut was coming. My body remembered.

On the second day Billie speaks to me. She says in her whispery voice that barely makes it through the curtain that she is sorry she had the television on all night; the nurse has told her that it kept me awake. The pain is so great, she says, that the only thing that helps is to watch the movies. She sounds matter-of-fact, as if she too has trouble talking about what hurts when the sun is up. I say that if it’s the only thing that helps her, keep the television on. I say that my daughter can bring me earplugs.

She seems grateful. I can hear it in her voice gathering itself up like a bird taking flight. She confesses that the pain squeezes at her until she is almost passing out. I hear how they started with cutting off her toes, a few at a time and then cut off her leg first right above the ankle. She describes how they keep coming back to do more and then this last time they took it right below the knee, and now they say that they don’t know if they have to be going back again. Her words dip down. “I haven’t been home in six months,” she says. I imagine her crumpled down in bed, her body fading with her voice.

I say that I am sorry. That I have lost things, too. I don’t know what home is anymore. My husband is gone. My children are grown and away at school. My body aches, too. Pain settles, perches, nests, reproduces, and I try not to let it go too deeply in.

I want to get up to see Billie now that we’ve talked, but I’m hooked to too many tubes and I don’t even know if my arms will lift me into a sitting position or if my legs still work. Morphine drips into me, making me think I can walk, but I can’t figure out how to rid myself of the catheter and lingering epidural lines.

That night she has the sound all the way off and I am grateful, but when they wake me to take my blood pressure I still hear her crying. I ask the night nurse when I’ll be loose from so much tubing and she says by tomorrow night I’ll be able to get up to use the bathroom and the antibiotic and pain medication drips can roll along with me on their metal stand.

And it is true. By the time Billie starts her crying the next night I have already been up twice and I know exactly how far my legs will carry me. I can get to her.

She starts her wall way down low, and I push the button to raise my bed. Its whirring sound is drowned out by her crying. In this upright position, I can see out the window. Mission Hill bathes in the light of a full moon so bright that the colors of the houses are visible. Sitting, I can smell the sweetness of the roses on my windowsill, and I breathe them in as if they’ll give me strength. I begin to hoist myself up on my right elbow. I, who have loved the strength in my arms from working out, find it hard now to make this simple move, but before I know it I am sitting up and pulling my legs over to dangle from the bed. The I.V.’s in my arm will move with me — in fact, their stand adds support as I edge myself down to the floor and shuffle around the drapes to her bed.

Billie is sitting up. Everything is dark except for her sheets and the layers and layers of moon-white gauze wrapped around the stump of her leg. Her skin is a glossy brown, her hair tied back in a dark bandanna. She has on her own nightgown, a soft navy cotton one. She’s probably sixty; she looks like someone’s grandma. She rocks herself back and forth, holding onto her bandaged leg as if it were a baby she’s cradling. Her moans and tears mix together so that my heart almost breaks now that I can see her. I get myself up on the bed beside her with the help of my pole. She doesn’t seem surprised. I come to her bandaged too and without speaking she keeps rocking.

I rub her back in unison with her rocking so that we’re both moving together and she tells me that the pain doesn’t seem to stop. All these operations. I feel her pain and it opens me up as much as the surgeon’s knife and this time what comes out are my feelings. I can’t stand it either, all these surgeries. My chest begins to heave; we keep moving together as if we’re all one motion, her rocking leg, my rubbing arm, our sobbing throats. She says that she’s losing her home because she can’t work and I suddenly feel my house empty. It’s just another divorced couple’s house on the market, but I cry for all the fires in the fireplace and family dinners at the table that will be too big for anyplace I will ever live again.

She cries for the pain and I rock along with her. I tell her that I’ve never known such burning and pulling at my flesh. She’ll never be the same, she says, and I know what she means and then we don’t talk. My sobbing grows and overtakes hers. Billie rocks years of tears out of me just as surely as if she were cradling me in her arms instead of her leg. We do this for the next two nights, as illicit as lovers forbidden to meet. I give her touch that soothes her and she takes me to a place in the darkness, alongside her grief where I too can cry.

But in the morning, at the residents’ early rounds, I am brave and strong and take it all with courage. People like me to behave that way. I like it, too. I thought that’s the way it had to be until I found Billie and the nights and finally a way to let go of sorrow and rage and hurt that kept me raw and empty inside.

During the day the clusters of residents and doctors and nurses tend to our bodies, but at night Billie and I tend to our souls.

1997 — Cancer Says

I lie in bed once again at the time of the winter solstice. It is the darkest day of the year. I stare at the candles on my grandmother’s wicker table that became my altar when I first had cancer. I used to burn a fat blue candle with a drifting smell of lavender, a white taper in a silver candlestick, and a votive in a gilded, star-cut container with light flickering out, as if to a night sky. I have not lit them since my surgery. Over the altar hangs a Matisse sketch of a nude with full breasts, thick heavy nipples. Further up on the wall is a New Mexico cross, two sticks fastened at their center with garlic doves and dried red peppers.

In the darkness I hear “Silent Night” from the stereo downstairs. My son and a friend from college are stringing lights on the tree. We always used multicolored bulbs, but the boys went out a few hours ago and bought five strands of tiny, starlike white lights. When he was small I taught my son that stars were for wishing. He now says in his stage of questioning God that while others pray, he looks for a star. I know he is afraid. Tomorrow or the next day we’ll have the pathology report. His friend downstairs lost his mother to breast cancer; as he watches me, I wonder how much he thinks of his mother. How much does my son think of his friend’s mother, buried six years?

This is my second mastectomy, my seventh and eighth surgery. Seventh, the mastectomy itself, eighth the reconstruction, one following the other with a half-hour break to change “teams” as if my body were a playing field.

This is the first time I have really understood I have cancer. With the original surgery five years ago, denial’s seed pushed up and produced a sheltering tree so vast that when I looked to the sky I could see only bits of lacy blue. I felt little threat to my life. Instead I focused mostly on the plight of women with breast cancer. I saw us as sisters: bruised, cut, stitched, and marred. Then when the suspicious mammogram, the confirmed malignancy, the surgery and subsequent radiation occurred again a year later, I sat under the shade of the tree and looked around, talking about the other patients but saying little about myself. With the third surgery two years later, they took my breast altogether. That surgery knocked me down. It was winter and through the bare sinewy branches I saw a stormcloud sky. Gunmetal. Fast moving. A sky full of tears. Today, I’m laid out flat recovering from another surgery — another breast. The tree above me is still bare; the winter sky is dull, unmoving, a ceaseless gray with no puffs of clouds or streaks of sunlight. I am totally exposed to whatever it might do: snow, sleet, blow a northeaster hard for days.

A week ago, after I woke up from the surgery, I wondered if it was my breast they had taken. Had they removed my heart? Stitched my mouth shut? I had nothing to say. I knew the routine of recovery: the drain sites with their plastic tubes and suction cup containers, the lengthy knifing across my back marking the taking of the latissimus dorsi to make a breast. I knew how long before I’d be able to walk, that morphine made me sick but that I could tolerate doses of synthetic heroin. I remembered the casings they put on my legs to prevent clots, the plastic filling up with air every few minutes and then deflating like a slow breath taken in, held, and let out. I knew to order puddings and tea with extra milk. I knew what to do, but I no longer knew what to say.

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The news comes that I have slipped through cancer’s narrowing noose once again. I do not have invasive cancer, and for days I am lifted out of my mourning. I come downstairs and sit by the tree; the lights burn through my melancholy. Each ornament is full of meaning — the ones my children made long ago from pine cones, yearly cross-stitched Christmas sentiments from an aunt, the hand-blown glass balls friends have given me each year. I ask my son to turn “The Messiah” to full volume to fill the house. When I was growing up, my father used to sing it every year with a chorus. I close my eyes and hear his bass part, the one he rehearsed in the bathroom each morning while he shaved. The smell of molasses and sugar drifts through the house. My daughter is home now, and she bakes gingerbread men the way I used to and frosts them with white pants, green shoes, yellow hair. They have cinnamon drops for eyes, so that they look like clowns. We laugh. We all rejoice.

A few days after Christmas, though, I don’t get out of bed. I don’t raise the shades. I lie there until the visiting nurse comes to change my dressing. Once she’s gone, I’m back under the covers. I’m so still inside I wonder if I’m alive. My spirit, I realize, is as scarred as my body. Have I gone through all of this finally to give up?

At the end of the week, the silence that has wrapped itself around me is pushed away by loud voices. They’re my own. Screams I’d stuffed back not with a fist but with a smile; not with a gag but with my own refusal to pay attention. Pain drones right through the center of the wails. It shapes itself from the hours waiting for pathology reports. The first time, when I hadn’t heard for eight days, I dressed to go to work. I called the doctor’s office when I had my Coat on. The nurse said the results had just come through and the doctor needed to talk to me. “Don’t go to work,” she said, and I sat by the phone for the next hour. When I think of waiting and bad news now, I see myself in that navy wool coat sitting alone by the phone waiting to be told I had cancer. Pain shapes itself from the repeated slicing of my palest flesh; from the mammograms in those rooms where other women glided in and out, exchanging the “johnny” for their own clothes as I sat, pulling the cotton gown close around my body, and they called me in again, first for another view and then a magnification and the cheerful technician who eventually couldn’t even look at me and became grimly silent herself except to say, “Move in closer … Lift your right arm … Hold your breath.”

I think now it’s as if I’ve been holding my breath for five years. I gasp in mouthfuls.

My scream carries through the house. My keening climbs the attic stairs, settles into the depths of the basement, sweeps through the rooms. This pain penetrates the walls so that when I’ve moved, this house will remember not only my beautiful children as they grew from toddlers to young adults, but it will have recorded what I finally felt.

An explosion has occurred in me, and fury snakes into the air. I want to rip out all the I.V.s I’ve had since 1993; I want to snatch the scalpels from the surgeons’ hands and plunge them into the earth where they’ll cut no more. I would return my muscles to my back and take a club to the radiation machines maneuvering into place to kill my cells. If I could, I’d try to find my lovely pink nipples in the midst of my discarded flesh and then drug all the doctors with an anesthesia as strong as mine — let them be gone from this earth for eight-hour stretches.

But the doctors were as kind as anyone could have hoped, I’m not mad at them. It’s not God either, for I do not believe God punishes. It’s loss I throw my rage at. It rolls along, gathering new parts of my life. It circles me, waiting for the kill, for I am now so vulnerable. My breasts cut from me. My husband’s desertion and divorce, my children grown, my house to be sold. I scream to scatter loss. I swing my arms out in the air, throw back my head and yell to stop, please, please to stop.

As the days pass, I feel calmer, and oddly, I return to where I began five years before — feeling the pain of millions of women with breast cancer. I think of my friend Susan, whose spine crumbled after cancer spread to her bones and the woman who had her first child aborted at three months when they discovered her breast full of tumors. I ask for healing. For me. For them.

Cancer takes your life and changes it, transforms it forever, and sometimes, as it does for me today, gives it back. Cancer then says to take up your broken self once again and, if you are able, fashion something even better than what you had before — “before my visits began,” cancer says.

Compilation and introduction copyright © 1999 by Hilda Raz