12 August 2009: the visible universe

Five months exactly since I saw the surgeon for the first time. Leaving the tutorial on To the Lighthouse, meeting K. at Barons Court tube station and walking to the hospital and treating him horribly. That infernal wait in the hallway, having left K. in Main Outpatients. Shifting again and again the uncomfortable plastic seat, staring at my polka dot skirt (I’ve not worn it since; it seems a harbinger). Saying I did not want K. to come in when their first question was “Are you alone?” And why were there so many people in the room? The terror of all those eyes.

I feel foolish even still–how she knew. How the pathologists knew my terrible diagnosis–just a checkbox or a word to them, a name on a test tube, an address I’ve left, an improbable birthdate that made me 24. I wonder if it gave them pause. And I ignorant of it all, not even worried, ignorant and aloof and impatient, teaching Virginia Woolf and being horrible to my boyfriend.

They knew then, as they know now. The grading, the damage it’s done. Ignorant with a blue stain on my breast, stitches uncomfortable but no longer painful under my arm. In a few hours, I’ll know too. And I can barely begin to brace myself for the possibility of bad news, that it’s spread to the lymph nodes, because I am too beaten down by everything else to be able to process it.

This morning I picked up Virginia Woolf’s Writer’s Diary, which I’ve returned to periodically, but not for quite some time. There, it was 1927, and she had just completed To the Lighthouse. A strange, accidental circularity. I hope this week can mark an end point to this strange and terrible piece of pirated time, rather than picking up where I’d left off after the last traumatic prodding and pathology.

In the meantime the cosmos continues irrespective of my private tragedy. Physical perspective is always striking–as when my plane began its descent into London, following the snaking Thames, over Tower Bridge, the London Eye, St. Paul’s, Buckingham Palace, all discernible as a postcard. In between such experiences one always forgets, somehow–one’s self, one’s own life, becomes magnified almost to the point of distortion. And then sometimes the hills or clouds or stars or multitudes of people re-position you. You become barely discernible, even to yourself.

We’re in the midst of the annual Perseid meteor shower, our planet passing through debris from the Swift-Tuttle comet. I think of it continually, wonder how people can sit in offices and houses, drudging through little lives not thinking of it–this spectacular reminder of how we are bound by gravity to this planet, circumnavigating the sun. Last night I saw several–a spectacularly clear sky with close-seeming stars–the Greeks’ stars. Identifying what constellations I could (Cassiopeia of course, my marker–and then Ursas major and minor, Cepheus, Draco, Hercules, Pegasus’ body later in the night), I thought of everyone I have ever loved, under them, and of the whole of human history, having shared them. Very cosmical and astounding all of it, even without the occasional meteor; on seeing one I could not help but gasp and squeal. I couldn’t reconcile the incredible, breathtaking outer world of the visible universe with the inner world of tea and television–couldn’t understand, either, how K. could not be as excited as I–how anyone could not.

But I gather the memory inside my private mind, and love it. So next time the anesthetist says “think of somewhere you’d rather be” as he holds the oppressive plastic mask over my face and prepares me for surgery, it will be there–

Tonight’s the “peak” apparently, but in southern and central England it’s expected to be too cloudy to see–

the visible universe obscured, how Blakean.

[Lymph nodes are normal. She asks for a smile.]

7 August 2009: awaiting my own tragedy

Day after biopsy–sitting bandaged in the backyard. An excruciating experience all around–less from the pain of the surgery than the hospital inefficiency, in a corner alone for hours afterward, told I’d see the surgeon–that I must see the surgeon–before leaving. “Before six.” Near seven I’m confronted with a registrar who does nothing, looks at my bandage, asks, “Are you always this pale?” Refuses to answer when I ask how to take care of my stitches, dressings, etc. Says the nurses will explain everything. She goes home. The nurses don’t know. Seven days or one, covered or left exposed? So I am still bandaged, taking painkillers and waiting.

What an absolute mess I must seem–and am, snapping at everyone and crying. Jetlagged still, having managed to sleep half an hour before going to the hospital, my first time under general anesthesia, terrified and alone. And back for the mastectomy, the “real” surgery, in a week. The seemingly impossible process of recovery.

The girl in the next bed was laughing, joking with the hospital staff. She was in to have a fibroid cyst removed. “As long as no one cuts my nipple off,” she says to the nurse, smiling. And I think–this is wrong, a grave mistake, shouldn’t it be me there? Instead the urgency of my situation is amplified. Five months ago, it is now almost, waiting for the diagnosis which was almost certainly, they assured me, fibroadenoma. Then cancer. The giant leap for womankind. Now this radioactive, surgical biopsy, more serious, but somehow less horrible than the first because it wasn’t a surprise, an invasion of that magnitude. Now waiting to find out not whether I have the horrible disease, but how horribly I have it. Grading. I always got good grades. And despite my perpetual pessimism about most things, I have a strange optimism about biopsies. Which is dangerous of course, because look what happened before.

So the doctor I met with in Pittsburgh says he’d be “surprised” if it had spread to the lymph nodes. But then, that’s exactly what they said here, only to find it was cancer. Surprise! After “I’m sure it’s nothing.” Sure. That roomful of people, looking at each other, nodding in unison to confirm how surprised they were. Me, stupid, faint, childish in my polka dot skirt and Mary Janes. What does their surprise mean to me? Should I feel honored? At their optimism, if that’s what it was. Dr. S. saying, “we’re hopeful.” As if hope were a treatment, a cure. As if it were anything.

It was raining then too, the day of my diagnosis. I was clutching my blue raincoat in the hospital hallway. Raining the day I began chemo, when I climbed into the loft bed of my little flat and vomited. And a downpour yesterday; we drove to London, dangerously, in it, and it began again fourteen hours later in time for us to leave. K. ran to the car while I stood outside the hospital, holding nothing and sobbing. “Are you okay?” someone said. And I nodded, because what do you say to a stranger?

“How old are you?” the nurse asked yesterday. “Twenty-four? You’re a baby.”

Of course I am. I have never felt younger or more helpless, never. And my body has never felt older, more decrepit and disgusting.

The bandage is not so bad, it’s everything else. My hair of course, getting patchy, falling out steadily, the pathetic covering I regrew over the past few months littering the pillows. Lost hair, gained weight. They made me strip off my nail polish yesterday and I got a look at my cracked yellowed nails. All to complement the fake, nippleless, Franken-stitched breast they’ll make me. I feel sorry for K. I wonder how he can stand it. Maybe he can’t.

At home, I flipped through my high school journals, and was not as embarrassed at that self as I imagined, but amazed at my intensity. Perspicacious pessimism–and actually prophetic in it, or at least realistic. I wrote at seventeen: “I am awaiting my own tragedy.”

Everyone has one, surely, coming up, sooner or later, I supposed. To varying degrees, maybe. But I’ve always been waiting for it. Or maybe  pessimism causes cancer, that holed-up negative energy. Maybe. Either way–awaiting my tragedy? Here it be.

18 June 2009: the worst possible outcome

I had prepared myself for the worst possible news but still not quite expected it–mastectomy, or a waiting list for one at least. A terrible uncertainty, weeks or months of waiting for worse news. For the moment, waititing to see the Oz-like Dr. S. on Monday, who cancelled last week’s chemo without a word to the surgeon, then upom speaking with her apparently agreed to sanction one or two more sessions of Taxotere while I wait for the mastectomy. I over overloaded with information from the surgeon that I’d expected I should have known before choosing to begin chemo–for instance, that a lumpectomy was never actually a viable option, with a 50% chance of local recurrence in a lifetime. Also, that they cannot know whether the cancer has spread to my lymph nodes until surgery. So I must wait for an appointment for a sentinel node biopsy–which isn’t even necessarily accurate–and an additional week for its results. And I cannot even begin to allow myself to imagine the worst possible outcome for that, even at the disastrous course I’ve already set.

Alternating disbelief and bitterness. I cannot concentrate on anything–anger and self-pity and ugliness. Unable to plan for, focus on, commit to anything–not with all this doubt and fear and ignorance and uncertainty surrounding me. If I felt I were recovering–but will I ever feel I am recovering, or constantly fear its ugly, dreadful presence in me?