He wheeled backward on his stool, opened a drawer and pulled out a crescent-shaped expander. I liked him immediately. He seemed practical, matter-of-fact in the wake of my cancer, the way I hoped in my best moments to be. He explained the surgery would involve placing two of these filled with saline in my chest to begin stretching the skin and muscle to shape mounds that would eventually house the implants.

After being diagnosed with early-stage breast cancer at age 43, I viewed my choice to have a mastectomy and then reconstruct my breasts as a privilege. My grandmother died of metastasized cancer in her 40s. My mom had a lumpectomy and radiation following her diagnosis of cancer in her 40s. I realized many women with more advanced breast cancer didn’t have a choice of treatment options. Still, I wondered about the function my new breasts would serve. I no longer needed them for any practical purpose, such as breast-feeding. I would no longer derive the same sexual satisfaction from them, since they would be numb and my nipples were gone. Would they be purely cosmetic, as the title on my doctor’s business card implied? If so, what was the right size for me?

A couple of weeks earlier, right after I’d had my post-mastectomy drainage tubes removed, I’d visited Mary Catherine’s, a boutique in Seattle that specialized in mastectomy wear, to try on prostheses and bras.

A woman in her 50s in polyester pants, pink lipstick and bright white bouffant hair that flipped up in a curl once it passed her shoulders asked if she could assist me. I wondered if she was a breast cancer survivor herself. She led me to one of the changing rooms. I winced when a twinge of pain spiked across my chest as she helped me slip my shirt and camisole off. She asked me what size I’d like to try on. “Let’s start with a C,” I said.

As I waited, I glanced in the mirror and saw the two strips of surgical tape that remained over the horizontal incisions on my chest, and the tan lines from my pre-surgery trip to Hawaii that started at my shoulders and led to nowhere. The tan was fading, and my skin was beginning to peel off in little white flecks.

She brought in the first bra and a couple of boxes with different types of prostheses. “Most insurance covers the standard silicone – see how heavy that is. If you want to pay extra, you can get this new, whipped silicone, which is in the same shape, but much lighter and more comfortable to wear. Since you’ll only be using yours for a couple of months, though, you probably just want to go with the standard.”

I nodded in agreement and she showed me how to fold the heavier prosthesis like a taco to fit it into the pocket in the bra. She gently slid the bra straps over my arms and up on my shoulders, and hooked it together in back, and I slipped my shirt on over it. They were too pointy and cone-like – more like what women wore in the 1950s. Next, please.

The next set I tried on felt more comfortable – I liked the way I looked in the mirror.

“Why don’t I try on a D just for the heck of it?” I asked the shop lady.

D felt too big on me – I thought it made me look wider in my chest than I would naturally be. I settled on the second prosthesis I had tried that was a full C cup – one or two cup sizes bigger than I’d been just before the mastectomy – and about the size I’d been in college, pre-kids.

As I thought about my ideal size in the dressing room, I tried to separate my own preference from the expectations of society, media and men. Wasn’t the purpose of reconstruction to replicate what you had lost? I knew what middle-aged women’s breasts were supposed to look like. I remembered sitting on my knees on shag carpet on sun-drenched afternoons thumbing through a stack of my parents’ National Geographic magazines. The image of flaccid, elongated tissue with a surprising turned-up nipple on the end stayed with me. After using my breasts to nourish my infant son for a year, I hadn’t expected them to pop back up to their pre-baby bounty. The replacements the surgeon could give me would not look natural in any real sense. They would be fuller and rounder than middle-aged women’s breasts, regardless of the size I chose.

Now I sat, bare-topped and scarred, glancing over the plastic surgeon’s shoulder at creamy brown walls holding strictly aligned, framed black-and-white photographs depicting nature’s perfection: sailboats thrusting through currents and mountain ranges piercing cloudless skies.

I asked, “Why is there this myth that mastectomy is such an emotionally devastating surgery?”

“Because it’s mutilating,” he replied. “It’s more like removing a hand than an appendix.”

Because of my family’s history of cancer, since my 20s I’d imagined what course I would take if I received the dreaded diagnosis one day. I knew early on that I would choose to have my breasts removed, and didn’t view the possibility as any more difficult than the issues my friends would deal with in their midlife. By the time we hit our 40s, we’ve all known pain – it’s been layered on us like so many coats of paint. Who’s to say which heartbreak is the greatest – losing a child or never having a romantic relationship? Surviving cancer or having a mentally ill son? All painful life events gouge deep furrows and cause emotions to bleed out of us – shock, sorrow and dismay. Through these tragedies, we are constantly rediscovering ourselves, peeling off the personas we’ve created to fit in socially and reaching for the unaltered seed of self within us. We’ll never completely know our raw core – never completely be able to separate the white of external influences from the yolk of our true selves. But we can ask the questions, keep on with the quest.

Why did I want new breasts and a larger cup size? For reasons of vanity. For my husband’s sexual pleasure (since he’d be able to feel them and I wouldn’t). And so I could deal with the emotional pain of removing my breasts privately by “passing” in society’s eyes. My new breasts would be more than cosmetic. They served a practical purpose. They would help me conceal the worst of this injury even from myself.

The wink-wink effect will always surround anything to do with such a fascinating, beautiful and powerfully erotic body part. But wasn’t Breast Cancer Month sufficiently appalling when it jumped the shark into a big branding opportunity, a chance to doll up merchandise in pink and make a buck? Does it really now additionally have to be skanky? Not to mention tacky?

Think I’m exaggerating? Already this month, a high school cheerleading team in Arizona landed in hot water for printing T-shirts that read, “Feel for lumps. Save your bumps.” Lingerie company Journelle is meanwhile encouraging women to “Save the tatas.” Hipstamatic has released a limited edition We Heart Boobies Goodpak to benefit vaguely defined “breast cancer charities.” In Canada, roller derby queens have sold off casts of their breasts in the name of “boobies” care. There’s even a boobies bus.

I understand. Breasts are awesome, whereas cancer is terrifying. The desire to tame a disease, to wrangle it with cuteness and a side of sex, is perhaps a natural response. If by doing so, money goes to research and women remember to get their health screenings, that’s not a bad thing. But I’m just warning you, this is how something like Kris Carr happens, folks. Cancer is so totally bangable! In, like, an adorable, Zooey Deschanel-like, girl-next-door way!

Tatas? Feel your boobies? Seriously? What are we, 12? It’s somehow at once both lecherous and infantilizing. And as a friend recently eye-rolled, “Is there anybody who isn’t ‘aware’ of breast cancer by now?” At this point, it’s damn near impossible not to feel a sharp pang of sympathy for the many diseases that ravage less sexually arousing body parts. There are no leering campaigns for leukemia. You can’t build a double-entendre empire around non-Hodgkin lymphoma. And I’m saying this as someone fortunate enough to have cancer of the skin, which conveniently lends itself to all kinds of nudity-related “awareness.”

With each passing October, the cult of Breast Cancer Awareness feels exponentially less like empowerment for women — of every size and age and level of allurement — and more like one big autumnal grope-fest. The incentive of a long and healthy life is plenty sexy enough for a whole lot of us. You can be firmly in the “I don’t like cancer” camp and still call shenanigans on straight-up exploitation. And you can believe in the value of eradicating disease without baby talk, without condescension, and without, even, the enticement of giving somebody a boner.

She gladly accepted it.  I was exuberant to let it go, like excess weight falling off my body, making me feel lithe, agile and aloft.

Within days it showed up on my doorstep with a note. “Sorry, it didn’t fit.”

I held it cautiously like a snake I might pick up with a long, sturdy stick to keep it far from me until it could be tossed back into the woods where it belonged.

I could donate it to the American Cancer Society or just stuff it in the trash can, for that matter.  I don’t have to keep it, but old wives’ tales run through my head like, “If you get rid of it, you’ll need it.” Or, “If you keep it, you’ll never need it again.”

So I keep it, granting it some kind of cancer-fighting power that will protect me from ever having to be caught up in the maelstrom of a cancer war again.  

I tried to give it away at least three times but it kept coming back with comments about it being too small.  Stupid small head anyway, I thought as I marched upstairs to store it for the last time.

I climbed on the stool, reached for the designated floral hat box on the top shelf of my closet, and stuffed it back in there for permanent keeping. Maybe the fact that it kept coming back to me was another sign that I needed to keep it. Whatever works, right? Storing a wig in my closet is a small price to pay for being cancer-free.

I know this is insane, but old wives’ tales or not, I’m keeping that wig forever because getting rid of it makes me feel as naked, vulnerable and afraid as the day I looked into the mirror and saw a bald woman reflected in the glass, and realized it was me.

Still, I wanted something besides photographs to remember my parents by. I found it in my mother’s messy bureau — a white sweat shirt, washed, worn, stained, with a tacky picture of a teddy bear under the words “I Am Loved.” She had worn it frequently after her mastectomy noting how soft it was; she wore it after chemo when her skin had felt itchy and flushed. After she died, it became my father’s official suit of mourning. He puttered around the house in it, sipped his beer and worked on the backyard roses. It was his way of holding on, which he could only manage for a few more years.

So when the time came for me to choose an item on the day I left, I took the sweat shirt to New York. Later I moved it from our small subsidized apartment to our larger rent-controlled one, and finally to our brownstone where there is more than enough space. Now, it’s folded on a shelf next to Sephora shopping bags, designer scarves, above my daughter Isabelle’s artwork.

Two months ago, when I was diagnosed with breast cancer, I took the sweat shirt down and considered trying it on — just to see how it felt after the surgery. I placed it against my chest, regarded myself in the mirror. It wasn’t just a reminder of Mom; it was a vestige of a time past when women like my mother weren’t even offered the option of reconstruction.

I put the sweat shirt back in the drawer. Me, I am happy in my snug jog bra and a V-neck T-shirt, grateful I had only a small incision and a guarantee of long-term survival. But, if I ever need the shirt, I’ll know where to find it.  

I’d pressed my oncologist for surgery during a winter break from work. She’d replied, “But if you have the full course of chemo before surgery and radiation your chances of living five years increase to 37 percent.” Those were grim odds.

That Christmas, I kept looking at my kids and running into my bedroom to cry: I wouldn’t see the little one past the age of 10, I might not even see the older daughter graduate high school. I went a little crazy after that.

So my online presence was a direct result of illness. My primary goal was to leave a record of who I was. I didn’t want my kids to rely on my family and ex-husband for their memories of me. I wanted them to have a permanent record of my impressions of childhood, joys and travails in adulthood. I wanted them to know my thoughts on literature and politics, my assignments for the writing classes I teach, my plain old whining bitchiness at times.

Have I disclosed too much? Well, I have disclosed a lot. And this has been a problem for me in my professional life, as it must be for the two other women named Dr. Dorinda Fox. (To them I can only say: sorry.) But if a bus hits me tomorrow, then my kids know who their mom was. 

They know what made her cry. They know what made her laugh. They know who was important in her life. They know why she was driven to run off to Ireland by herself, to not give a damn about keeping the house clean, and how she rebuilt a life.

And a funny thing happened on the way to the archive. Just when I thought I was safe and on to a new chapter in my life and not alone … I learned I was not part of the lucky 37 percent. 

The cancer had returned with a vengeance, and I needed a radical mastectomy requiring a long, painful reconstruction. Now it is very unlikely the cancer will return, because it has no place to go. (My breasts are not breasts, they just play them on TV.)

And my body was totally resculpted. My stomach is now my chest. When I wore a clingy jersey dress for work the other day a few students asked why I was dressed as Jessica Rabbit. Life is weird. I am almost 50. See me roar.

But I am here. All of me. Along the way I learned to tell my own stories and to resist mentioning others unless the reference was positive. I learned that many times even a positive reference is not appreciated. Now I ask permission.

When teaching I tell students I am serious about keeping the personal and political out of the classroom because I write about that elsewhere. I have to because in the days of Google they will find me and most likely ask, “WTF?”

However, when meeting a new friend or health professional I direct them to my blog and tell them to let me know if they have any questions. Most don’t. Informational overload is already available. If they are still around after reading, then we’ve skipped months of get-to-know-you conversations and can spend time on more enjoyable pursuits. If they so choose, these people know why I was naked and terrifying a public official on the day Reagan was first elected as president and why I think Jake DeSantis was a whiny banker representing the absolute worst of Wall Street entitlement.

They know how fiercely I love my children and how I regret at times failing them. They know how hard I fought to be here writing and to live my life and not the life others would choose for me.

I was a woman who was terrified of just about everything before I went online. I still have fears. I just don’t let them cage me in. There isn’t anything to hide anymore. Google it. It is there as it was meant to be.

I love you, Tyler. I love you, Molly. Read all about it.