Out of the Woods (13 page)

The next morning, I felt much better—it is relatively easy to get over someone you had talked yourself into liking in the first place—but nevertheless I went through the usual cathartic ritual: the purging of the phone numbers and e-mail address from the contacts list, the deletion of the correspondence from the computer. I canceled the Match.com account. Then I wrote two e-mails to Mitch. One was noble, calm, and generous, if just a wee bit guilt trippy; the other was a wicked, mean, vindictive screed that made me laugh when I read it over. I sent the first and kept the second to cheer me up whenever the cancer threatened to overwhelm me.

By then it had been a week since the diagnosis and I had become three people. One was a disinterested observer, watching a colossal train wreck and thinking to herself, Oh dear, those poor people: that was the writer, taking notes. The second was a kind of protean emotional swamp creature who morphed from a frightened field mouse into a gallant (and I wished this wouldn't soon become an all-too-appropriate description) Amazonian warrior, ready to stare down any enemy, back into a trembling bit of fluff in less than a minute.

She in turn yielded to my own personal manifestation of Kali, the Hindu goddess of death and destruction, black with rage, bearing a skull-topped staff and wearing a garland of heads, Kali of the gaping mouth and lolling tongue and fiery red eyes, filling the sky with her roars, devouring her victims, dancing on the corpses of her enemies. I would drive down the highway, the snow swirling white along the blacktop, possessed by a kind of exhilaration—I can't figure out another word for it—at the idea of leaving my old world in ashes. Yes, cut off the breast, renounce sex and love and womanhood and contentment, revel in chaos, rejoice in a wholly impersonal universe, where the whirling snow and the injured body and the thin air of catastrophe were one and the same and equally meaningless. Off with their heads! shrieked the Red Queen. Off with their heads! And then I understood the dark power of the old crones in the legends and the fairy tales, the women who had lost everything but the rage that kept them alive.

 

I
began to tell people my news, each announcement sounding like some ridiculous lie—why on earth would I say such a thing? People reacted as people do, according to their nature. What both touched me and nettled me was the nearly universal need to make it better, to fix it, if only for the moment, to soften the blow. You'll be fine! they all said. You have to be brave! My cousin had it and now she's running marathons! It could be worse!

The reactions brought my relationship with Lee to mind, how at first, when I came to him with bruised feelings, or disappointed hopes or fears for the future, he would set about fixing me, telling me what I should do and how I could overcome whatever obstacle had flummoxed me, with the enthusiasm of an energetic border collie determined to chivvy me back to the herd of the contented and confident. Sometimes, though, all I wanted were four short words and an accompanying tender glance:
you poor sweet baby
. Eventually, we got it down to a formula, as couples do after a while. I would cry or complain, he would start in on the border collie, and I would hold up four fingers.

Oh right! he would say. You poor sweet baby! in so triumphant a tone that I always had to laugh.

My favorite response to my situation, however, came from my friend Lynne, whose blunt Yankee pragmatism had always served to protect the easily aroused sensitivity that lay beneath it. I told her that I would probably need a mastectomy. Well, she said, casting an appraising glance at my seated form, the good news is, your breasts are small. You'll hardly be able to tell the difference.

Others were more overtly comforting. I blurted out the news to Harriet in the parking lot at Runamuck. She thought for a second. My best friend died of breast cancer this year, she said.

I raised an eyebrow. And this is supposed to make me feel better how? I asked.

It's not, Harriet said. But my friend was eighty years old when the breast cancer came back. The first time she had cancer she was sixty. That meant she had twenty good years in between. I think that's pretty good.

I would have hugged her then. Luckily it was out of the question—Harriet was a New Englander born and bred. But I was grateful and, for the first time, optimistic. Harriet had provided a way marker, pointing in the direction I needed to go. It wasn't sympathy I needed, or encouragement. It was a clear eye and a steady hand on the tiller, a realistic sense of what I was up against. A map.

One afternoon there was a knock at the door. I looked out the window—no car in the driveway. That meant only one person, and yes, it was Tom, my next-door neighbor, already in the mudroom, calling my name. I braced for battle. I didn't care what harebrained flatlander thing I'd done this time, I didn't want to hear about it and was prepared to tell him that I had just about enough on my plate, thank you very much, without another ear beating, as my grandmother would have called it, from him. I was channeling that formidable woman when Tom appeared in the kitchen, holding a delicate blue bowl, a snow-white cloth napkin, and a mason jar full of something that smelled delicious.

My wife made it for you, he said. I had met Catharine, or Cat as she was called, on one of her visits to Woodstock. She didn't come often: the Vermont house was Tom's retreat, where he could play his music and have time to himself. She was a warm woman with an incandescent smile and a down-to-earth wit. It's her Portuguese kale soup, Tom explained. It's really good for you, and you need to eat healthy. I'm sorry about the, about the—he could barely bring himself to say the word.

Cancer? I said. I thanked him for the soup.

If there was anything he could do, he said, anything at all, just call—he would walk the dog or bring in the firewood, anything.

That was when I knew things were really, really bad. I was so touched by his kindness that my eyes began to fill, but Tom knew how to avoid a scene. “Look at it this way,” he said. “At least you won't have to worry about dating anymore.”

 

A
lexander Swistel was a dapper man, inclined toward bow ties and a suavity that he wore with proper Ivy League insouciance. Well, he said after glancing at my left breast, which the biopsy had left looking like it had gone five rounds with a washing machine. You certainly didn't give me much to work with.

You're the first man who ever complained, I said.

Given the size of the tumor, Swistel said, he would not operate right away. He suggested I have chemotherapy first in the hopes of shrinking the thing and thereby salvaging the chance of a lumpectomy. I left his office mildly encouraged.

Bonnie Reichman, the oncologist Swistel recommended, took a different tack. Part of it was a difference in personalities: Dr. Swistel discussed treatment options with a reassuring offhandedness, as if we were discussing the game plan for next week's office party, but then he could afford to: he did most of his work while his patient was unconscious. Which is not to belittle his reputation—he has been a pioneer in painstaking surgical methods that preserve as much of a patient's normal appearance as possible; others in the field describe him as an artist. But Dr. Reichman shepherded her patients through the nerve-racking, debilitating hairpin turns of a treatment that can last every day for years. She was the one who had to tell a woman her future, when there was no future left.

Yes, she said, chemo might shrink the tumor. It might not. More likely I would have six rounds of chemo, surgery, probably mastectomy, radiation, and possibly more chemo. In addition there would be a year of targeted therapy delivered intravenously. And after that, five years of hormone therapy, which could turn bones to glass, increase weight and weaken the heart, and set the stage for other cancers. Or not. I was one of the lucky ones, she said without any irony: the cancer had been caught at a relatively early stage, I was otherwise healthy, and there was no sign of metastasis.

I knew she was right, but I walked out stunned and, I'm afraid, in tears. The next few days were taken up with the usual cancer treadmill—a raft of tests to make sure my physical self could survive the treatment, and then a round of shopping for hats and a wig, to make sure my ego would. The wigs all looked like roadkill; it was impossible to imagine wearing any of them. Then I drove back to Vermont, with what looked like a dead muskrat in my suitcase, and a small mountain of pamphlets about everything from what to eat during chemotherapy to how to pencil in eyebrows when I had none. Coming down the driveway I stopped and sat in the car and listened to the wind in the trees for a long, long time. Everything looked the same. And nothing was.

 

I
n 1971, a lightning-struck airplane fell into the Peruvian jungle. One of the passengers was a seventeen-year-old girl. Disobeying all of the standard advice for being stranded in such a place, she did not stay put and wait for rescue, as the other surviving passengers did. Instead, she started walking, still wearing her white confirmation dress and a pair of high heels.

Eleven days later, having made her way through some of the densest jungle on earth, she arrived at an empty hut on the banks of a river, and collapsed. She was starving, dehydrated, and covered in leeches and worms erupting from eggs laid under her skin. She was found by three hunters who had happened by and took her back to civilization.

The other surviving passengers had stayed where they were, awaiting rescue, which is exactly what any survival guide would have advised. Besides, they were convinced they would never make it out of the jungle alive. And none of them did. The girl had taken one look at the jungle canopy and decided no plane would ever see them, which in fact was the case.

The difference came down to personality in the end. The teenager, like most of her adolescent tribe, wasn't big on patience and probably shared their inflated notions of her own immortality. The others followed the rules that maturity had taught them. There was no wrong choice. It was a crapshoot—the outcome of any disaster is a crapshoot—all you can control are the decisions you make, what eccentric combination of logic, intuition, personality, and pragmatism leads you to a kind of hope.

In the pink-ribbony dream world of breast cancer, the jungle canopy is composed of information. The Internet is thick with it, the reliable and the utterly specious, the frightening and the inspiring. The books are plentiful as well, but it's the words
I looked up breast cancer on the Web and
. . . that drive the cancer specialists crazy. Dr. Reichman gave me the name of one site she considered reliable, and urged me to stick to that. Of course I ignored her. I bought nearly every book I could find, from the encyclopedias of doom to the unctuous purveyors of treacly optimism. I spent hundreds of hours on the net, unable to stop myself, reading everything I could find.

The obvious disconnect between the grim statistics, the unequivocal fact that there was no cure for this disease, and the pie-eyed optimism of the Web sites drove me nuts. The pink ribbon brigades never met a side effect they couldn't minimize and yet insisted on reminding you that your life would never, ever be the same. I felt condescended to and intensely frustrated, and all the encouraging words made me more afraid—was the unadorned reality of breast cancer really that scary?

I tried to prepare myself for whatever it was the cheerleaders weren't telling me. I googled images of bald women and graphic pictures of mastectomies and breast reconstructions—the good, the bad, and the grotesque. I read blogs by the brave and the terrified, discussion boards on topics ranging from hair loss to horror stories of insensitive husbands, evil insurance companies, and side effects of Gothic dimensions. I read arcane scientific journals that I tried to translate from languages I didn't even speak.

Cancer porn is what Catherine Lord called this sick fascination with every detail and every disaster story in
The Summer of Her Baldness,
my favorite breast cancer memoir. It's a perfect description; the stuff is lurid, often amateurish, and utterly hypnotic.

There are as many ways of coping with breast cancer as there are patients, and there is no preferred method as far as survival goes. Total denial seems to work as well as the diligent industry of those who spend hours imagining golden armies of healthy cells battling evil malignant ones. Some women watch their diets. Others live on chocolate milk shakes.

But I was convinced that if I just kept reading I would eventually find the thing that was missing, the piece of information that would give me the traction I was lacking.

My need for information was the legacy no doubt of too many years as a journalist, the sense that there was never such a thing as too many facts. Somewhere out there was the one statistic or piece of research that would provide a landmark by which to steer a course. Without it, I cartwheeled between shock and denial and depression.

I found it finally on a Web site called, simply enough, Cancer Monthly. In the section devoted to breast cancer I read:

Nearly half of all patients who are treated for apparently localized breast cancer develop metastatic disease. And half of all initial cancer recurrences occur more than five years after initial therapy. Although a very small number of these patients can enjoy long remissions when treated with combinations of systemic and local therapy, most eventually succumb to their cancer.

There it was: the elephant in the room, the thing everyone danced around and no one wanted to talk about. Is it true? I asked Dr. Reichman. She gave me the standard answer to questions concerning mortality rates. Would it make any difference if it was?

It's a good question, because the answer is nearly always no—the patient is going to do whatever she can to get better and live longer, and recognizing that fact can help quell the anxiety at least a little.

That was my answer as well. But I still needed to know.