by Karin Aharon
“To each her own. Lisa is really nice and knows a lot of doctors.” A piece of tomato found its way to my salad and I removed it with disgust.
“I want to find out if I’m qualified for a tissue reconstruction surgery.”
“What’s that?”
“They take fat from your stomach and use it to reconstruct your breasts.” Mia spread some butter on the bread she got with her salad and ate with evident pleasure.
“I didn’t know it was even possible.”
“It’s irrelevant for skinny girls like you, but I have some meat on me.” Mia gently patted her belly, that didn’t look at all fat to me. “Two surgeries for one, that way you don’t have to replace your implants every few years, and all that.”
“That really is a plus.” Maybe I should have ordered the pasta instead of the salad and started growing a gut.
“Have you chosen a surgeon yet?”
“I scheduled a consultation next week with Katzman and Remez. We’ll see.”
“Both are considered amazing. Everything is private, naturally. Will your insurance cover it?”
“I actually don’t have a clue. I didn’t think about it.” I felt silly not even having started looking into it.
“Never mind, as long as you find someone good. The rest will work itself out.” Mia spoke with confidence and it reassured me. “How’s your mother?”
“Not so good. The doctors don’t really know how to treat her cancer.”
Mia’s mom died of breast cancer when she was really young, less than twenty, I think. Although I knew she sympathized with me, I didn’t feel comfortable complaining too much, because after all, I still had a mother.
“They generally don’t know too much. Which is why I decided I can’t rely on their early diagnosis.” Mia said firmly. “I have to go back to the office, let me know after your appointments.”
“Of course, we’ll be in touch.” I tightly hugged her goodbye.
Chapter 53
“Shirley, here’s your file. You can see the doctor now.” Dr. Katzman’s secretary gave me a paper folder and opened the door leading to the exam room. I walked into the room and Michael followed me in. It looked like a private clinic from an American TV show, filled with statues and paintings scattered around. There were also some ‘thank you’ letters and gifts that Dr. Katzman probably received from his patients.
Dr. Katzman sat behind a large wooden desk and we sat in front of him on two leather armchairs. His short greying hair and delicate glasses, disclosed his real age. A wooden box full with silicone implants was placed on the table. You could clearly tell what he mostly did.
Next to the desk, was a door leading to a room that looked like a real doctor’s clinic.
Dr. Katzman opened the file and scanned the form I had filled in. “So, I understand that you’re a carrier and you’re looking to have a preventative surgery.”
“Right,” I tried smiling to conceal how nervous I was. I looked at Michael but he was too busy examining the art across the room.
“It’s not my place to say, but I think you’re doing the right thing.” He put the folder down and leaned back, “I operate almost weekly on two to three carriers having preventative surgery. In the US nearly all carriers have it, we just started having them here.”
“Yes,” for some reason I was at a loss for words.
“Come, I’ll show you what it’s going to look like.” He turned the screen to me and the image was split in two – the before and after. Michael looked at me with embarrassment and kept quiet. Dr. Katzman flipped through the pictures and explained who amputated just one breast and who amputated both, and how the reconstruction happens in either cases. I tried to conceal my shock with an awkward silence and polite nodding.
“Come into the room and take off your top, we’ll see what we’re dealing with.” He stood up and went to the exam room, I followed him. Michael stayed in his chair and his alarmed look showed that he didn’t know where to put himself. He wouldn’t come with me to my checkups, and except for the pregnancy scans, he has never been with me on such intimate exams.
I undressed while Dr. Katzman sat on a chair in front of me and examined me. “You should know there are two options. If we decide to keep the nipples, I make the incision under the breasts. If you choose not to keep them, then I make the incision here, in the middle of the breast and around the nipples.”
“OK,” I was still speechless. The whole thing was too embarrassing for me.
“So, which do you prefer?” he asked after waiting a few moments.
“Oh, I think I won’t keep my nipples.” I could see Michael, in the corner of my eye, sinking into his chair, “I understood it reduces chances of getting sick even further”.
“So they say, but it’s up to you.”
“Do I need to make a decision right now?”
“No, you can let me know later.”
“Good, so I’ll think about it.”
“About the size, I’ll try putting in as much as I can but I don’t want to stretch the skin too much. There’s not a lot of excess skin here and I’ll be removing some with the nipples. You’ll choose the type of implant and I’ll bring a few sizes with me to the operation, and we’ll see which one fits.”
“OK,” I nodded and Dr. Katzman stood up.
“You can look inside that box and feel them,” he said to Michael, as he walked into a storage room, “there are different types of implants, but I recommend a silicone anatomic one. They get the best results.”
Dr. Katzman came back with a camera and signaled that I stand on the red X marked on the floor in the middle of the room, “Come, let’s take some pictures.”
I felt my face turning red, but I tried to remain calm, as if I took nude photos next to my husband on a daily basis. Michael was busy with the implant box and I thought maybe I should have charged Dr. Katzman rather than paid him. All that was left for me was to hope my pictures didn’t find their way to his presentation or into the dossier at the waiting lounge.
“Get dressed and let’s talk.” He put the camera back in its place and stepped into the office.
“So,” he said as I sat in front of him (fully clothed this time), “I operate at the Tel Aviv Private Medical Center. This surgery is comprised of two parts – amputation and reconstruction. I’m in charge of the reconstruction. On your way out, my secretary will give you a list of surgeons who amputate and with whom I prefer working. I can also work with other surgeons, but those on the list are those who I trust and know their work. It’s your choice to make. Also, you should either find an anesthesiologist, or use the one at the hospital. That’s also up to you. If you decide to move forward with me, then you can call my secretary and she’ll schedule the operation. She will also give you a list of tests you should have with you. I work with all insurance companies. If you need help handling their bureaucracy, my secretary will help you. That’s it, more or less. Do you have any questions?”
“No,” I looked at Michael who shook his head.
“Good, stay in touch.” He stood up and we shook hands with formality.
His secretary explained everything again as she handed us a pile of papers and of course, a receipt for the consultation.
“That was awkward,” Michael said when the elevator door closed.
“It was, but that’s how it is, I guess,” I casually said, though still worrying about those photographs.
“What next?” Michael held the door open and we stepped outside into the sticky Tel Aviv air.
“We’ll go see the other doctor and decide who we want to go forward with. Do you have it written down? It’s next week.”
“I think so.”
“What do you think about Dr. Katzman?”
“I wouldn’t meet him for coffee, but he looks professional. The surgery sounds complicated, doesn’t it?�
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“Perhaps, but it doesn’t matter. If that’s what we need to do, we’ll do it. Worst case scenario, your new wife would have to replace me sooner.”
“No problem, I just need to let her know in advance, so she can get ready.” This time Michael went with it.
“You’ll get a notice, don’t worry,” I said and we kept walking towards the parking lot. “Don’t you mind the silicone? It won’t be the same, you know?”
“I don’t mind. I’d still love you with silicone.” Michael pressed me closer to him and we walked, hugging.
I kept thinking about all the stories I read on the Foundation’s website, about men who really struggled with their wife’s surgery. Sometimes, it caused a serious marital crisis. I let it go, although I didn’t think Michael really understood what this surgery meant. I was losing a big part of my femininity. I hoped Dr. Katzman was really as good as he thought himself to be.
Chapter 54
My second task, other than booking Natalie for the next two months, was finding someone who would stay the night with me at the hospital. Everyone said that I would need help at night. Mostly during the first night. So I decided to ask Sarah, my only single friend.
“So,” I said to her on one of our short conversations, “I need your help.” I closed the office door for some privacy. Anna had just left for a hearing at court which made this a good time for having such conversations.
“Of course, honey, anything you need. You name it.” I could ask Sarah for anything, if she couldn’t do it, she would always let me know.
“I need help after the surgery. Someone to stay the night with me at the hospital. I would rather Michael stay with the kids. Would you stay with me?”
“Sure, no problem. Text me the date and I’ll save it.” I could finally put Sarah’s unique and flexible sleeping skills to use.
“Thank you, Sarah, so much, you’re a real life-saver,” I said, and I really meant it. “I’ll feel better knowing Michael is with them at night.”
“Don’t worry, honey. I’ll take good care of you. You won’t want to go back to him.” She laughed and I imagined her curls bouncing around as she spoke.
“I just hope that he would want me back after the surgery…”
“Of course he will. He’s crazy about you. And you’ll still be gorgeous with your new boobs.” I hoped Sarah had closed her office door so that Nathan wouldn’t hear our conversation. I hated having these conversations at work, but it was impossible having them later, “is everything ready for the surgery?”
“Not really, but I’m working on it.” I peeked at the operation to-do list I had written down in the little notebook I would take everywhere with me.
“What else do you have left?”
“I met Dr. Shavit, a surgeon some girls from the Foundation had recommended, and I took the documents from him for the insurance. I just need my insurance company to approve the surgery. They referred me to their own Onco-geneticist. The surgeon asked me to have another MRI to confirm everything was fine, and that the surgery was indeed preventative, so I made an appointment for that too.”
“All these procedures sound like such a pain. Good thing you’re a lawyer and know what to do. I had to help my mother with these things a few years ago, because she couldn’t handle it on her own. Are you getting any work done?”
“Between that and all of mom’s issues, hardly. Even when I’m at the office I can barely focus. In any case, there’s still plenty of time, until mid-August.” I looked at the papers piled up on my desk, there was hardly any place left for my tea.
“That’s a long time from now, will you get the results by then?”
“The surgery is after the holidays. There’s no pressure, just a lot of bureaucracy. The only thing I’m nervous about is hoping it won’t be too late.” These bureaucracies felt like having a second job.
“What do you mean?”
“I hope nothing develops while I wait for the surgery. And then, instead of a surgery, I’ll have chemo.” I closed the notebook and put it in my bag so it wouldn’t get lost on my table.
“God forbid, why would you say that?” Sarah’s superstitious side took over. “Stop talking nonsense. Everything’s going to be fine.”
“I hope,” I said. I hope it won’t be too late.
Chapter 55
“You can take the kids into the water in the meantime. I’ll just put away the food and come.” Michael reluctantly took them to the pool, and I packed the leftover vegetables and hard-boiled eggs in boxes.
There weren’t a lot of people at the pool, because bathing season had just begun. I placed the boxes in the cooler and slathered some sunscreen on myself. I hardly heard the phone ringing in my closed purse.
“Hey Gabi, what’s up?” Michael called after Ariel who ran towards me. I signaled him it was OK. I was planning on telling Gabi I would call him back later, but he spoke before I could say anything.
“Listen, mom just fell, and she’s in a lot of pain, but she won’t go to the hospital.”
“Do you want me to come?” Ariel was wet and clung on to me as she tried pulling me towards the water.
“I would love it if you could. When can you come?”
“Give me an hour and I’ll be there.”
“OK, come as fast as you can.” Gabi sounded extremely nervous.
“OK, I’ll see you soon.”
I waved at Michael to come over and he came out of the water with Romy in one hand and Adam in the other.
“Mom fell and I have to go to her right now,” I said as I handed out towels to everyone and helped Romy wear her sandals.
“OK, did anything happen to her?”
“I don’t know. Gabi said she’s in pain.”
“What happened to Cathy?” Adam asked.
“She fell and I need to go and help her,” I said as I looked for Ariel’s second sandal.
“But I want to stay in the pool.” Ariel started running to the pool but Michael chased and caught her.
“We can’t, we need to go home.” Michael tickled her to soften the blow, “I’ll give you ice cream at home, what do you think?”
“Yes! Ice cream!” Adam and Ariel shouted excitedly and agreed to wear their sandals.
We rushed to the car and when we got home, I went in with them to change clothes and then left quickly. With every second that passed my nerves were about to get the better of me. Michael sat the kids down and handed them ice cream cones to compensate them for our change of plans. I rushed out of the house, and grabbed a sweater, just in case we find ourselves at the ER. It’s always cold at the ER.
When I got to their place, Gabi opened the door. Today, I didn’t waste time on niceties and ran straight to mom’s room. “Mom, how are you?” I yelled from the hallway.
“I’m fine,” mom was in bed, covered with a thin blanket. She had an agonized expression on her face as she shamelessly lied.
“You’re not fine. Where does it hurt?”
Mom paused for a few seconds, as if she was contemplating whether she should tell me, and only then replied, “actually, my head hurts a little.”
“From the fall?” I asked and sat next to her on the bed.
“Probably,” Gabi walked into the room, “she fell on the door frame. I was right next to her and I couldn’t catch her. I think she hit her head.”
“What made you fall?”
“I don’t know, I just came out of the bathroom and lost control of my legs.”
I looked at Gabi and then at mom again. The pain showed on her face, even though she wouldn’t admit.
“Maybe we should go to the ER?”
“What for? Waste another day? On a Saturday?” Mom twitched her face with pain. “In any case, there are only interns today at the hospital, and they don’t know anything.” Gabi left the room, and I could hea
r from the kitchen sounds of pots banging and drawers opening and closing.
“Maybe we should call and ask an on-call nurse?”
“As you wish. In the meantime, could you please get me a glass of water? I want to take something for the pain.”
I went to the kitchen and saw Gabi standing and staring outside the window. He was leaning against the counter and I noticed he was wearing the silly red-spotted apron on which I had sown the word ‘mom’ ages ago. That ridiculous apron made me smile, even though what I actually wanted to do, was to cry.
“She wants to take a painkiller,” I told him as I poured her a glass of water.
“Something isn’t right with her. She’s in a lot of pain. She just fell for no reason. I couldn’t catch her on time.” He kept looking outside.
“If that’s the case then you need someone here all the time. She can’t be on her own anymore.”
“I guess…” Gabi said quietly as he left the kitchen and went back to mom with her water.
I called the medical helpline and within a few minutes a nurse named Rona picked up. After having a back and forth conversation on the matter, she convinced mom to go to the hospital ER. She wouldn’t listen to us, but she did listen to Rona. It was mom who actually taught me that trick. She would do the same to me, but she used grandma, who would basically repeat what mom said, without making me angry. I tried thinking who I could do that trick with, when I’ll need to convince my own kids. But the ambulance came and I didn’t have too much time to dwell on it.
Gabi insisted that they take her to the Tel Aviv Medical Center, because that was where she was treated. They finally agreed. I drove with mom and Gabi drove in his car behind us.
