The Instant When Everything is Perfect (2 page)

But he is blushing, too, and even though she can’t see her own face, Mia thinks that they both must be the same, rosy red.

Sally shuffles on the table, her gown crackling, and she flashes her dark mean eyes at him.

“My appointment was supposed to be at 3.30.”

Dr. Groszmann stops looking at Mia, and his face becomes even redder. “I’m sorry. We’re a little backed up today.”

Mia thinks to say, “A rush on reconstruction?” But she doesn’t because she can’t find her voice. She looks at her red Giraudon shoes.

“Mrs. Tillier.” He looks at the chart and holds out his hand. Sally’s eyes widen and she looks up at him and shakes his hand. In that second, Mia can see how scared she is. Mia is scared, too.

Since her mother called, Mia hasn’t wanted to think of what cancer means, what it has always meant to Mia, ever since she was nine and her father died.

How can her mother really be sitting here with cancer? Can it be possible that her mother might die from it? Even though her mother is prickly and very different than Mia, Sally is constant, the voice Mia hears in her head despite herself. She’s the first person Mia calls when something good or bad happens.

“Well, yes,” Sally says, pulling her hand back, adjusting her gown. “Who else would I be?”

Dr. Groszmann turns to Mia, his face paler now, his mouth in a slight smile. His skin is smooth except for a trio of wrinkles at the corner of each eye. She wonders why he doesn’t slip into a colleague’s office and get shot full of Botox during his break. Wouldn’t anyone working in a plastic surgery office be tormented by the tyranny of perfection?

She can feel her stretch marks under her sweater. Her thighs spread onto the chair, both prime candidates for liposuction.

“I’m Mia Alden. Her daughter.”

“The pathologist? It’s here on the chart that the slides went to a daughter.” He seems excited, just like all the left-brained people are when they hear the call of their own. Like Mia’s whole family at Thanksgiving or Christmas talking about beta-blockers or nanotechnology.

Mia shakes her head. “No, not the pathologist. I’m just a writer. I’m not on the chart.”

Dr. Groszmann—it only says R. Groszmann on his white lab coat—blushes again and holds out his hand to her. His hands are red and slightly dry looking, almost painfully so—probably from washing before and after surgery—but strong and soft. Mia lets go quickly.

“Nice to meet you.”

“Thanks.” Mia sits back in her chair, and R. Groszmann sits on his stool, opening the chart again and then looking at Sally.

“So you are going to have a bi-lateral mastectomy?” He asks the question. It isn’t a question at all but fact. Sally stares at him.

“There’s only cancer in one breast.”

Sally shakes her head. “I’m not coming back here in five years and going through this again. Doctor Jacobs said she herself might do the same thing in my position.”

The doctor crosses his legs. “I understand. So have you given any thought about what you’d like to do in terms of reconstruction?”

Mia can’t help it. She touches one of her breasts. She likes her breasts. At this point in her life, Sally’s breasts have turned into little more than two nipples with a pad of flesh underneath them, barely an A cup. Maybe a double A. For many years, Mia wanted her mother’s breasts—or her sisters’, really. Both Dahlia and Katherine have perky little breasts, the nipples just at the rise before the downward turn. Teenaged breasts. Katherine, of course, hasn’t been pregnant or nursed a child, so some of her uplift is from lack of use. But Dahlia returned to her pre-pregnancy shape within weeks of weaning both the boys. And neither she nor Sally has the crosshatch of silvery stretch marks that Mia does.

But Mia would miss her breasts, the way material hugs them, the way they are always there when she looks down. She can still see her boys on her left nipple, the one she weaned them both from. It wasn’t on purpose. She just must have started their last suck on the right, and then put them on the left, their toddler mouths latching on for that final time.

She looks down now and can see first Lucien and then Harper, eyes closed, tongues tasting the last milk.

Ford likes them too, sucking and kissing them when they make love. One amazing night he began sucking them when she was asleep, and she woke to an orgasm from his pulling, tugging lips alone. When she’s awake, though, she is sometimes annoyed at his suckling, wondering why it’s men who have this solace all their lives, women weaned from comfort before they can even remember it.

“I’m not going to be talked out of having them both come off.”

“I—“ he starts.

“Both off. And then I want some nice breasts. I want to look okay in a t-shirt.”

Sally has always laughed about her breasts, saying they were barely there. Now and then, she turned to Mia at a picnic or dinner party and whispered, “I’m not even wearing a bra. Imagine that.”

Now, Mia thinks, she’ll have to take her mother to the lingerie department at Nordstrom to buy some bras. Maybe some with a little under wire and lace.

Dr. Groszmann smiles, writes something in the chart, reads a little more. “Have you seen the reconstruction movie?”

Sally waves her arms. “Of course they were out of everything down at Health Services. They said they’d call, but they never did.”

Dr. Groszmann nods, his eyes flicking to Mia and then back to Sally.

“Let me go over your options,” he says. Mia leans in, wanting to know the options, too. Dr. Groszmann sits back and looks at Sally. He is very good-looking but a bit thin. A runner. A workaholic. Too thin for her, of course. It’s possible she weighs more than he does. What does she weigh now? 150? She doesn’t get on the scale these days. In fact, the last time she got on the scale was in the week before Harper was born—more than sixteen years ago--and she tipped the scales at 197. He weighed 10 pounds, twelve ounces, but still. 197.

Dr. Groszmann weighs what? Maybe 160. Probably less. He would get lost in her bones and flesh, pulled down into her vortex. He’d be sucked into her and made invisible. They’d have to send the search and rescue hounds, she thinks, almost laughing. She puts a finger to her lip and avoids the doctor’s gaze.

“There’s immediate reconstruction, which would commence the moment the mastectomy was over.”

Sally nods, the immediacy attractive to her. Mia watches her mother’s lips, sees them twitch in an almost smile at the word. Immediate. Like everything should be. Tears should be over immediately. Grief? Gone. Worry? Vanquished in a second. Move, move, move. You don’t know if you want the dress, the boyfriend, the college, the job? Well, forget it.

“Delayed reconstruction can take place weeks, months, if not years after the mastectomy,” Dr. Groszmann continues, detailing the potential drawbacks to both the immediate and the delayed. And as she listens, Mia realizes she’s lived in the drawbacks. Too soon, too late. Too fast, not quick enough. She’s been like Sally and then too much like herself, stuck in the fear of moving at all.

“You’re telling me the skin could die?” Sally asks. “The skin could die?”

“It’s a rare complication, but yes.” Dr. Groszmann looks at Mia. “The skin gets its nourishment from the chest wall. If there is an expander between them, sometimes the skin can react. And if this reaction necessitates treatment, that could put off the chemotherapy. And if you are going to need radiation—which I think is unlikely—I won’t be able to do an immediate reconstruction at all.”

“So what do you recommend?” Mia asks, knowing she is supposed to be asking questions. That’s her official role here, the witness, the advocate.

Dr. Groszmann looks at her, his eyes tired but very blue. He pushes his long brown hair (nicely tied in a ponytail) away from his forehead. In that second, Mia blushes again. He sees her, and his skin pulses rose.

She looks at her red shoes.

“Your mother,” he begins, and then turns to Sally. “You seem to be a very practical person. What I’m hearing from you is that your lifestyle is more important to you than time spent in recovery. You like to walk in your neighborhood. You want to travel. To be with your grandchildren. Reconstruction on top of a mastectomy will necessitate a longer recovery. And we haven’t even talked about the stages or types of reconstruction. My recommendation based on hearing what you’ve said to me and to your surgeon is a delayed reconstruction. After your treatment for breast cancer. When you have time.”

Sally leans forward, listening closely. Mia tries to pay attention, too, focusing on the doctor’s face, listening to his words. She’s here to pay attention, to ask smart questions, to help her mother make the right choices, but what she really wants to do is ask the doctor questions such as, “Are you married? Would it bother you that I am?”

She wonders what is wrong with her. She wonders if she’s insane. Here she is fighting the urge to flirt with her mother’s plastic surgeon. Her poor mother is sitting on this funky table, her left breast filled with moderately differentiated infiltrating and
in situ
ductal carcinoma. Breast cancer that has spread and breast cancer that is waiting to spread.

“Fine,” Sally says, her voice flat. “I’ll have a delayed reconstruction. But I want to know everything. Everything about it. And don’t tell me to watch the damn movie. The woman down in Health Services seems to be functioning on half a brain cell.”

Dr. R. Groszmann smiles again and almost winks at Mia. Mia feels the heat in her body and shifts on her chair. He leans back against the cabinet filled with gowns and boxes of tissue and cotton balls and latex gloves, and begins talking.

After he is done telling Sally everything, Dr. Groszmann asks her to take off her robe. He pulls a measuring tape from a drawer in the cabinet and scoots closer to the examination table. All of this, the position he takes in front of her mother’s bent knees, the way his face is directly in front of Sally’s breasts, seems too intimate. Sally’s long lovely back is arched, her head turned toward the window, her breasts as perky as they’ve ever been, nipples erect.

Mia is uncomfortable suddenly, sad, though she knows that she shouldn’t be. Her mother would be the last to want someone else’s hands on her body. Sally doesn’t need a man to tell her she is beautiful, but just seeing the evidence of a life untouched this way makes Mia want to jump out of her chair and run out of the room. Her left leg starts to twitch, the plastic back of the chair digs in her back. She doesn’t understand how her mother can live in this beautiful body and not long to be touched, to show it off, to enjoy the connection with someone else. Maybe Sally pretends to not care that for thirty-three years she’s been alone, but it makes Mia want to throw herself down and weep.

In another universe, Dr. Groszmann brings his lips to Sally’s nipple and sucks, pressing his face and forehead into her chest. In that same universe, Sally smiles, pulls him close, and somehow, they manage to fold this table into a place they could lie on. In this universe, Mia is not in the room, just as she was never in the room when Sally pulled her father close. In the thirty-three years since David died, Sally has—as far as Mia knows and, of course, she might be wrong—never sat in front of a man like this, her breasts pushed out, her nipples tingling, her head bent away in supplication. Even though this is an exam, an important one, Sally’s willing body makes Mia want to cry, to call out for the doctor to notice how beautiful her mother is, Sally’s skin pale and unmarked and lovely. She wants to tell Dr. Groszmann to worship her, to lower the table, to make love to Sally right now, but, of course, Mia doesn’t. She looks at the floor, not wanting to see her mother’s swan beauty, her untouched flesh, her imperious smile.

Dr. Groszmann makes comments to Sally, but Mia adjusts her gaze, noticing the pigeons outside the window, the building opposite, the grey sky hovering over the dry hills.



Out in the hall, Sally stands next to Dr. Groszmann’s medical assistant, arranging for future appointments. She is supposed to watch the movie and then come back to tell the doctor her firm decision. Sally needs to decide soon because her cancer surgery is in two weeks, and if she changes her mind and wants an immediate reconstruction, there will be further measurements.

Mia leans against the wall, moving out of the way when a clerk pushes a basket full of charts past her. She looks down at the charts, the folders held together with colored tape, the names written with dark black pen. So many sick people, all reduced to words. Soon, her mother will turn into a chart like this.

“She’s a great candidate for reconstruction.”

Mia gasps, looks up. Dr. Groszmann stands next to her, a chart in his hand, another patient, another cancerous breast.

“Oh, that’s good news. Good news is nice.” Mia breathes deeply, trying to hold the wall of blood urging itself up her chest again.

“Yes,” he says, pushing his hair back, a habit, Mia can see, because there’s not a strand out of place. He looks at her, and then cocks his head toward the hallway. “Well, see you next week.”