by Debra Jarvis
“He is going to get better,” she said.
I didn’t tell her that his nurse grabbed me in the hall to tell me that his blood pressure was dropping, and he was having kidney failure and wouldn’t make it another twenty-four hours.
There was nothing to say to her. I couldn’t suggest prayer, or ask her if she would like me to read scripture to her. So I simply sat with my arm around her.
The attending physician came in, and I could tell he was waiting for me to leave before he spoke to her when Michiko said, “You can talk in front of Debra. She is a friend.” I was touched and felt my throat tighten.
He tried, as did the nurse and resident after him, to make her understand that Haruki was dying. “He has multiple organ failure. That means his vital organs are shutting down, and there is nothing we can do to stop it.”
“Give him a more powerful drug.”
“There isn’t a more powerful drug. We can’t give him any more Lasix—it’s not working. He is not responding to anything.”
“Please do everything.”
The attending was quiet for a while and then reached out and took her hand. “We’ll do what we can, Mrs. Ito.”
I knew their thirty-fifth wedding anniversary was coming up. In fact, it was on the day of my surgery. So I asked her, “Michiko, are you trying to keep Haruki alive until your anniversary?”
“No, I am just waiting for him to wake up.”
I let a lot of silence settle around us before I asked, “Michiko, what do you believe happens when you die?”
“I don’t know. Nothing.”
She did not have faith in anything beyond herself, anything that could comfort her now or later. No sense of a bigger picture. And where were their friends?
“Are your friends coming?”
She sighed and wiped her eyes.“We have told no one. Haruki did not want anyone to know.” Her mascara was smeared, her perfect bob a mess. She took both my hands in hers. “You must understand that in our culture we do not tell people outside of the family our problems. It was difficult for us to tell you things. And now, I want a miracle. But from where, Debra? I don’t believe in miracles.” Then she got up and went over to the bed. She bent over Haruki, crying and tenderly speaking to him in Japanese while the ventilator swished and moaned.
“When he dies it will be as if your arm is cut off,” I said.
“No. It is my heart. My heart will be cut out.”
When I got home that night I said to Wes, “If anything happens on the table and I end up on a ventilator and the prognosis is bad, give me three days.That’s it. If I can’t figure out how to come back in three days, I’m not supposed to come back.”
Haruki died the next day, and I never told Michiko about my surgery.
Looking the Part
During my pre-op appointment, I was told that the thing to do was to get a mastectomy camisole. So the day before my surgery, I swung into Nordstrom. My eyes instantly went to the dresses, the shoes, and the cosmetics. But that was not what I was there for. My mission: find the camisole. I made my way to the lingerie department. Would they be hanging on a rack?
The first things I saw were all the lacey teddies and the sexy bras with matching panties. I love that stuff. That is when I felt my throat close up and a burning sensation in my eyes. I fingered a red satin push-up bra while I blinked back my tears. I wanted to go back in time, before the biopsy, before the mammogram. I wanted to be able to place my little breasts in that red push-up bra, and go to a party. That’s it—I wanted a party, not a mastectomy. I finally pulled myself together and approached the salesgirl who I judged to be around thirteen.
Please understand that I never pay retail. So when she told me the camisole was fifty dollars I nearly choked.
“I don’t suppose they ever go on sale, do they?”
Her eyes got really wide, and she handed me the box and said, “This is the smallest size we have.”
It was white and made of the softest cotton knit I’ve ever touched. It had soft feminine lace around the neckline and a sort of peplum at the bottom. Everything about it screamed, “No sex! Can’t you see I’ve just had surgery?”
But there were two really cool things about it: (1) the neck was wide enough so that you could step into it, and (2) there were two pockets in the front on each side.These were for your drains. Hideous, but true, I’d have a drain coming out of my surgery site. Usually you’d pin the drain onto your pants, and then when you needed to pee, you’d forget about the bulb and pull down your pants and yank on your drain. Or, you could pin it to your shirt, but then you’d have that clammy rubber bulb touching your skin. (In the hospital they pinned it inside my gown, and it felt like some creepy little hand trying to cop a feel.)
The camisole even came with a fake boob. It looked enormous to me, but the salesgirl explained that you removed the stuffing until it matched your other breast. I knew I was getting a saline implant at the time of my mastectomy, so I didn’t bother with getting the prosthesis down to size. I was afraid I’d be sitting there all day tearing out stuffing.
The step-in camisole reminded me that I wouldn’t want to be reaching over my head and putting on and taking off clothes. I was wandering through the mall, wondering what to wear with my new camisole when I found myself in the sportswear section of JCPenney. And there, on sale, were these really light, soft warm-up suits—drawstring pants and zip-up jacket. That meant no yanking down waistbands or reaching over my head! And these suits were soft enough to sleep in but were made for the daytime.
Yes, Grasshopper, seek and ye shall find on sale.
I immediately bought two, one aqua blue and one black for those dress-up occasions like dinner in the kitchen versus dinner in bed.
The last store I visited on my pre-op shopping trip was the Body Shop. I’m not sure why I was drawn there because the irony of the store name was not lost on me, but the minute I walked in, I knew why.
Sitting there looking up at me with huge golden-brown eyes was a beautiful ginger-colored dog with sticky-uppy ears. He was on a leash, and his mistress was yakking with the salesgirl and didn’t even notice me squat down and pet him. He snuggled right up to me and kissed my face all over. And then it was as if this faucet that I had kept tightly closed burst open. I started crying with silent hiccupping sobs. He kept licking my face, licking all the tears that were rolling down my cheeks. When he was satisfied that the flow was slowing down, he turned over on his back, and I scratched his belly. This got the attention of his owner who looked down and exclaimed, “Oh, gosh! He never does that for anyone. He must think you’re special.”
I just kept scratching his belly and said,“Oh, no, I think he just knew I needed some dog energy today.”
I didn’t want her to see me crying. I wanted to say, “I want to wear those cute lacey push-up bras, but I had to buy a grandma garment because tomorrow they’re taking off my breast and my dog died three years ago, and where is she now that I really need her? And I guess I’m a little more scared than I thought since I’m squatting here in the Body Shop of all places, and your dog is making me feel safe and loved and telling me that everything is going to be okay, and it’s these little acts of kindness, these subtle, small, surprising signs of love, that make me cry.” But I thought saying all that might freak her out.
Instead, I bent down and kissed him on his forehead, on that smooth part just between and above his brows.Then I quietly got up and walked out.The woman holding the leash never noticed.
I cried my way out of the mall and out to my car, now and then raising my hand to my face so I could smell the dog’s scent still on my hands. Did I think I would get through this without ever crying? Sure I was familiar with breast cancer, but I wasn’t familiar with my breast cancer.
It was no big deal and it was a big deal. It was both/and, not either/or. It was messy and mushy and mixed up. Lighten up and take it seriously.
I was exhausted by the time I got home, but I laid out my clothes and
inspected them. I always do this with new clothes: lay them out and imagine with what and where I will wear them. No big puzzle—I’d wear them to and from the hospital and at home recuperating. The only problem I could see with these ensembles is that the pants were at least four inches too long.
Now, let me stop here and say that as soon as my friends and neighbors heard I had cancer, almost everyone of them said, “Let me know if there is anything I can do.” People truly want to do something because they love you and feel so helpless.
I’ve heard countless patients tell me how they turned down offers of dinner, babysitting, rides, lawn mowing, house cleaning, and free theatre tickets. They would say this proudly as if turning down their friends and family was some godly act of profound virtue.
If I know they are Christians, I’ll bring up the story of Peter going ape-shit because Jesus wants to wash the disciples’ feet. I know there are all kinds of symbolic meanings to that passage, but on one level, what I hear Jesus saying to Peter is, “Get over your pride and self-sufficiency.”
When patients say, “Oh, no, I don’t want to bother anyone.”
I ask, “Can you see how letting your friends help you is also a gift to them?”
So I called up my next-door neighbor who is wicked good on the serger. She came over right away. “Mary,” I said,“could you please hem these two pair of pants for me?”
“Sure,” she said. “I’ll get them to you by the weekend.”
“No, I need them for my mastectomy tomorrow.”
She didn’t miss a beat. “No problem.”
I was pretty proud of myself because I have my own serger and technically could have done it myself. But psychically, I didn’t have room for one more thing.
Running Away and Pushing Up
Was I nervous before my surgery? Not really—I was too busy. I wasn’t due at the hospital until four o’clock that afternoon. I was well aware that I wouldn’t be jogging anytime soon after surgery, so Wes and I decided to go on a five-mile run. It felt quite surreal. We both knew that this was the last time we would ever run like this together. Not the last time we would run together, just the last time like this—whole and without regard for my right breast—because it would be gone.
It was a gorgeous day, Cinco de Mayo, May 5, my grandmother’s birthday. She would have been ninety-three had she not died the year before. She had never had a mammogram in her life. Yeah, the mother and grandmother of two women with breast cancer. Go figure.
After the run, we stretched, and I did fifteen full push-ups. I’d never done that many before, and so far, have not again.Then I did a yoga headstand. And a handstand. I did cartwheels on the lawn in the backyard. I hung from a tree branch. I held a backbend for two full minutes.
“Are you auditioning for Cirque du Soleil?” Wes asked.
“No,” I grunted while clasping my hands behind my back and attempting to lift them over my head. “I’m doing all the things I know I won’t be doing for a while.”
He just nodded, came over, and kissed me on my sweaty neck.
A Clean Breast of Things
I’ve talked to women who have done elaborate rituals before their mastectomies: wrote songs and poems about their breasts, took photos of them, lit candles. For many women their breasts are a huge part of their identity. Mine were neither huge nor an important part of my identity.
Here is what I did just before surgery: I looked down at the right one, which by this time was quite bruised and upset looking. I got in the shower, took the Hibiclens, and washed my breast, armpit, and chest area as instructed.
I dried myself with a clean towel as instructed. I then turned to Wes and said, “Last look! Show closes at four o’clock!”
He said something like, “Honey, that breast has got some badness in it and it’s better that you take it off.” It wasn’t that he was afraid to say,“cancer,” it was just that we were sick of hearing the word.
“Yes,” I said, “I believe that’s biblical: If thy breast offends thee cut it off.”
So we were both in pretty good moods on the way to the hospital. My mood changed once I got into that skanky hospital gown, and they wouldn’t let me wear any underpants. Then a nurse walked me down this long hall past a bunch of construction workers. Construction workers!
Did I mention I wasn’t wearing any underpants? Construction workers have panty radar. So I knew they knew I was panty-less; that I was in the midst of a panty famine; that I was overdrawn at the panty bank; that I was sans culotte; that I was pantieopenic; that I was thong-less in Seattle. It was at this point that I realized exactly how nervous I was.
I wanted drugs. Specifically I wanted what in the olden days were called “tranquilizers,” but now they’re all uptown about it and call them “anti-anxiety medications.” But I hadn’t yet signed the consent form, so I couldn’t have any. I did not get my Ativan (aka Vitamin A) until just before they wheeled me into the operating room, and by that time I was like a feral cat on speed. So my advice? Sign the consent forms ASAP and then as soon as they get an IV in your hand, ask for the Vitamin A or Valium or whatever.
They put me on a gurney the size of a cruise ship, and Wes came with me as far as the doors to the pre-op area. We kissed one another good-bye as if I were simply running out to the store. What else could we do? Would a longer kiss make a difference?
In pre-op they put inflatable stockings on me, which made me feel like the Michelin man, and then they wrapped me up burritostyle in a forced-air warming blanket, as it’s like a meat locker in the OR. Oh, yeah, then they put that hideous shower cap thing on me.The last thing I remember is my surgeon looking down on me and asking, “Okay, are you ready to do this?”
“Yup.”
So the plan was to remove the breast, nip out a few lymph nodes, and that would be that. I woke up to my surgeon saying, “Your lymph nodes look good!” I smiled and envisioned my nodes as elongated, luminescent pearls connected by a string of diamonds swirling and swaying in a sea of clear and pulsing light. Then they gave me more morphine, and I went back to sleep.
When I awoke again a nurse was standing over me. “If you don’t pee I’m going to have to catheterize you,” she said.
“But I’m dehydrated,” I said. “I ran five miles before my surgery!” I managed to produce enough urine to avoid the catheter. “May I have some water, please?”
She brought the water, I drank it, and I promptly threw up. After that, it was nothing but Wes feeding me ice chips. The next time I peed, I was pleased to see they had cleaned my toilet already. I could tell because it was filled with bright blue toilet cleaner. I liked that they had not only done this quickly, but quietly. I had not even heard anybody come in.
It was only after I used the toilet the next time that I realized the bright blue was the color of my urine. I was excreting the dye they had injected into my breast that eventually found its way to my lymph nodes.
I spent only twenty-four hours in the hospital and here’s why: Trying to sleep in the hospital is like trying to sleep during an NPR pledge break; like trying to sleep in the middle of Costco on a Saturday; like trying to sleep in a hen house after the fox walks in. In other words: impossible.
Wes drove me home the next afternoon. It was the “Princess and the Pea on Wheels.” I felt every bump, rock, and piece of gravel on the road. Every stop I thought I was going to fly through the windshield. Every turn I felt as if I were being thrown against the door or the steering wheel.
“Could you take it a little slower?” I growled. “I think this car needs new shocks.” Then I just kept muttering, “New shocks,” all the way home. How could I have known I was prophesizing?
Wes drove up to the front door, helped me out of the car, into the bed, and gently kissed me. I fell asleep thinking, “The worst is over now.”
We took the big bandages off in forty-eight hours, and then there was nothing but the steri-strips and little pieces of suture sticking out on either end of the incision.
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I had a total mastectomy. This is not like slicing off a chunk of baloney. It’s more like removing a wallet from a purse. The surgeon makes an incision, an ellipsis in your skin, and then removes your nipple and the breast underneath. Some people thought I was either going to have a round open wound or a circular scar as if I’d been stabbed by a biscuit cutter. I had a four-inch horizontal scar.
Because I had an implant put in at the time of my mastectomy, I had a little mound there, almost the size of my other breast. In fact, in the medical literature, it’s called a “breast mound.” We found this so amusing that we began using “mound” after everything, as in, “I need to wash my hand mounds,” or “Just a minute while I blow my nose mound.” But because I had a little something there, I didn’t experience the shock that many women do.
