In Danger

by Josepha Dietrich

  I became frightened and focussed on steadying my breathing. I knew that if she missed, a shooting pain would go up into my armpit. She found the magnets and inserted a needle through the skin and muscle into the valve. Clunk. She’d missed. Pain shot into my right armpit. She got it second go. Sixty millilitres would be injected into each expander every week until I was the desired size.

  Medical anthropologist Professor Lenore Manderson has written about people’s experiences of their bodies after catastrophic change. I loved how she examined the ways people re-made themselves. I too was establishing a different sense of my own body and self. The sickness that permeated everything during chemotherapy had predominantly lifted. In the many surgeries, and my status as someone whose life was threatened, I found a radicalising principle.

  Just as my forced menopause springboarded me into considering older women in society and how they felt about socially desired bodies, breast removal realigned my view of my own femininity. As a changeling going through a kind of puberty again, I was aware that part of the social construction of femininity is around women’s breasts: having them, showing them, milking them. Yet I now chose exactly what size and shape of breast I had and showed to society. They didn’t require a bra and would appear perfect in clothes until I died and they were cremated alongside the flesh I was born with. (It’s not necessarily a one-off operation. Silicone implants do need checking to see if replacement is required from rupture, capsular contracture or scar tissue. Every ten years I’ll return to my plastic surgeon to have them checked.) When I caught a man’s lingering look, I smiled to myself with the thought, I’m fooling you, aren’t I?

  The ever-present scarring across my chest stood for the disease and the surgery. Manderson researched many women’s responses to their post-surgical bodies. In her findings the scar also represented the breast, femininity and sexuality. My scars didn’t bother me, psychically, like they did my mother. She once asked, Don’t you mind me like this? Referring to her bald head from chemotherapy and her one-breasted chest.

  Mum, I couldn’t care less what your appearance is. You’re beautiful and I love you. Your lack of hair and one breast mean absolutely nothing to me, I replied.

  And it appeared that, for B, the same was true. At night, with our son asleep, he turned to me – with my bald head, half breasts and emaciated body.

  Cancer etiquette: does cancer change you?

  But the cloud never comes in that quarter of the horizon from which we watch for it.

  Elizabeth Gaskell, North and South

  It was 5.40 a.m. the day after my 36th birthday, and I was on my way to Mater Private. Floor lights were on in the office buildings. There was little activity in the street. Dawn was an hour away. It could have been any time of night.

  We make so many laws we become lawless, said the tattooed, middle-aged taxi driver. A man the other day got unintentional death for killing a man at a taxi rank. He thought a guy pushed in so he king-hit him. At first it was murder, then manslaughter, then unintentional death and now off on a good behaviour bond. A man can divorce a woman over the internet and she’s left without a leg to stand on … Sometimes I want to divorce the world, he concluded.

  Okay, thanks, I said and shut the taxi door.

  In front of me were the sliding doors to the entrance. The day had come. My new breasts lay somewhere within this building.

  When I was suited up in the familiar truckers’ undies, stockings, back-to-front dress and flannel dressing gown I sat down in the plush area for patients awaiting procedures. The noise of the TV intruded into the silence: there was news of a nurse whose throat was cut by a former patient. I jerked as if slapped. I tried to calm myself down by focussing on the exhalation through my nose. I took two Phenergan to relax me, which I now knew assisted the post-anaesthesia nausea. By the time I was on the trolley ready to go in I was tranquillised cool.

  What are you having done? the anaesthetic technician asked. Everyone, from admitting nurses to surgeons, had to check I knew what was about to happen.

  Changing my saline inserts for silicone ones – new boobs today. I smiled up at him with a goofy I’ve taken drugs expression. My breast expanders acted like a water-bed and the pitter-pat rhythm of my heart sent waves through the saline solution. I watched my heart beating its watery song for a second.

  The technician had the well-rounded vowels of a good education, and a light touch. He joked and was sensitive to my situation; I was a woman about to have breast surgery for the third time. Once I was under the bright alien lights of the operating theatre he busied himself attaching my scuds (leg pumps), arranging me and teaching a trainee technician.

  The trainee put sticky monitors on my back and went to put a blood pressure cuff on my right arm – the arm that had had nine lymph nodes removed from its armpit. After a sentinel node biopsy the arm cannot be used to take blood pressure, as a precaution against lymphedema.

  Not there, on the calf, said my anaesthetist. He was slapping a vein on the back of my left hand to get an access point. It hurt.

  The trainee didn’t understand him properly.

  Her calf! Do you know what a calf is?

  The main technician jumped in and showed his underling the ropes. I saw the shame and suppressed annoyance in the trainee’s eyes. The man appeared of Sri Lankan or Indian origin. I felt for him. He had a lovely, humane smile.

  I found out after this operation that once you’re under a general they often put tape over your eyes. I roused from the general with purple shading under both of mine from an allergic reaction to the tape. The head nurse told me that they tape eyelids if they are flickering or remain open(ish).

  I summoned the image of standing next to a person you were about to operate on. I would find the flickering-eye thing distracting too. After they’ve taped your eyelids shut, they intubate you – insert a tube into your throat to take over your breathing. The thought always made me breathe in deeply like my throat was constricting.

  The comfort of two orbs on my chest went right into my skull. My sense of myself as still female, due to my false breasts’ very existence, did the trick. The red dashes marked where my nipples once were.

  The pain post-surgery was minimal. An oddity of my new false breasts was that I could make them go up and down. I figured if muscle was used to secure my silicone implants then I should be able to flex my pecs. Once after a shower I stood in front of the mirror and flexed one then the other: rat ta tat tat. They looked like breasts but beneath I was She Robot.

  The traumas of my 30s dissolved my selfhood until ‘I’ became a quilt pieced together by traumatic experiences, memories and various educations. If someone had asked me to describe what I did or who I was I’d have to wrap the quilted self around my shoulders and read off the patches. Well, I did this two years ago, and that seven years ago … so I guess I’m a …

  There’d been an accumulation of depersonalising experiences: my body changing under the knife and facing cancer, and what that meant for my living a possibly shortened life. What I’d planned was no longer going to happen; what lay ahead was most definitely unknown. What was in front of me was, was … what? At this point I was blinking in the new dawn of being cancer free. I had a changeling body, from adolescent to woman, but also a changeling mind. My identity appeared fluid.

  Hair gave character; you changed it and people drew different conclusions about you. My long locks feminised me. I had done a lot of dancing and outdoor adventuring in my life and my arm muscles (from climbing) were prominent. I used to feel my body had a natural tendency towards the masculine. This belief was inflated by my diagnosis of polycystic ovaries, but my long, feminine locks counteracted the perception I had of myself.

  Before chemotherapy started I got a short do and loved the younger-looking self in the mirror. When I went bald I joined the cancer community and became one of them. With no hair on my head, up my nose, a
nd little left on my eyebrows and eyelashes, I was desexualised.

  When the spiky beginnings of my hair appeared after chemotherapy, I noticed a change in how people saw me. We’d had our first fun time together as a family on the victory holiday in New Zealand.

  We’d driven a Happy Camper, their basic model with a small kitchenette and seats that converted to bedding. We hung Celso’s feeding formula bag off a hook, which we set up on a window latch.

  My son has Down syndrome, the woman had told us on our arrival at the oversize luggage area to collect the backpack with Celso’s formula bags. She was in her 50s with faded blonde hair and an open face. I think it’s great you continuing to travel as a family, she said, that’s important. She waved us off with a broad smile.

  We’d packed enough formula to last a fortnight, with extras in case something happened, plus an extra kangaroo feeding pump. This pump was kept charging off the camper’s engine battery, while the other was in use. Australia has a reciprocal health care agreement with New Zealand so we knew if Celso became ill or his peg got pulled out we could rush to a nearby hospital.

  Celso had had a peg put in as his not eating appeared semi-permanent. The temporary nasogastric tube we’d been using to keep him alive, hoping he’d pick up eating and drinking, was no longer viable. He pulled it out too often and, really, enough was enough for him after having it taped to his face for the first 18 months of his life. It was unlikely to come out but it had happened once, soon after the peg had been inserted. We’d gone for a day out to the Botanic Gardens, as he loved the ponds with their large goldfish. When I put him back into his front-facing car seat, the temporary thick tube, which stays in until the site heals and toughens into a large version of an ear piercing, got stuck on the seat belt unbeknownst to me. I put him in, feeling some resistance but thinking it was just clothing tucked in somewhere. The tube ripped out, his stomach contents immediately oozing out of the hole.

  Sick and appalled at what I’d done, I shoved two nappies over the site to absorb and slow down the seeping formula and rushed to the Children’s Hospital. It’s okay, darling, I yammered at Celso over my shoulder. It’s okay. I’m so sorry, honey. Mummy didn’t know it was stuck in the seat belt. We’ll get it fixed now. Don’t worry.

  They got us straight into the triage nurse’s observation room and she put it back in. The skin hadn’t ripped, nor had the newly made surgical hole closed up. Throughout the hours waiting in the hospital to see if the new insert took, Celso looked around and made use of the room around him to have fun. He does this. He examined the baby weigher with its scooped sides, placing his weight on it to see the numbers changing, and giggled; he read the glary pictures of giraffes and birds on the walls around him for meaning.

  In the New Zealand airport, I stood in the duty-free line with a packet of cigars for a family member. A burly man with a shaved head behind the counter said, I love your haircut, it’s great seeing women with short hair. I blanched, amazed that anyone found my buzz cut appealing. I explained in a hurried fashion that the decision for short hair wasn’t really mine and that, no, I didn’t get cancer from smoking, despite the cigars in my hand.

  In the same period of regrowing my hair I took my son into the wading pool at our local swimming centre. Somewhere under 50 kilos, I still had my muscular appearance; in fact the chemo body-stripping had emphasised my musculature. I wore a bikini with a white singlet over it and as I was lifting and bouncing Celso in the water my biceps resembled a triathlete’s. I faked fit well. A lesbian couple with their daughter kindly approached me in the pool to make conversation, because I was clearly without a partner that day while everyone else had their families around them. One of the women, tall and built like a basketball player, introduced her partner and child to my son and me. We talked kiddie talk as all parents do and I could tell that they thought I was a lesbian too. This time I wasn’t a member of the cancer community. I was in the lesbian one. The conversation was pleasant and we each said a warm See you next time.

  My buzz cut received second glances in the Blue Room cinema, in an affluent suburb of Brisbane, but familiar greetings in alternative cafés.

  Six months on from the mastectomy I was part of a media awareness campaign on breast cancer and, I realised, the feminising of oneself again. The very thing I thought I’d escaped the desire for.

  Through the Choices support program, hair care manufacturer Nak provided three women with free natural hair extensions, hair dye and cuts for a year. The Today morning show on Channel 9 ran a three-minute interview with us about the impact of losing hair from breast cancer treatment. The segment was called ‘Hair Hope’. I walked out that day with a Kristen Stewart version of Joan Jett on my head. Robin Bailey, a radio personality, did before and after interviews for Think Pink Week, which raised money for the Choices program. Once the hair extensions came out I had a Japanese anime femme fatale look: ragged, short fringe, and straight, dragged-through-a-hedge-backwards sides. My hair gave off an edge of cool I didn’t feel.

  People responded to how I looked post-cancer. They also responded to the fact of my cancer. It appeared that both of these things unearthed deep fears of their own death. I was drawn to Joan Didion’s reflections on this phenomenon in The Year of Magical Thinking. She wrote:

  We are imperfect mortal beings, aware of that mortality even as we push it away, failed by our very complication, so wired that when we mourn our losses we also mourn, for better or for worse, ourselves. As we were. As we are no longer. As we will one day not be at all.

  How people reacted to my cancer news has made me think there is a need for cancer etiquette now that so many people are diagnosed with it. That people should be careful what they say. Like when you’re pregnant: for some reason the bump opens up the Pandora’s box of hellish birth stories that passing acquaintances must tell you about. Ditto cancer.

  One day at Celso’s playgroup I stood watching him playing around a tunnel in a jungle gym. He was contemplating going through it – head in, then out, squirm halfway in, then squirm out. The week before I’d made a pitch for The Ride to Conquer Cancer: a 200-kilometre ride over two days to raise funds for the QIMR Berghofer Medical Research Institute. My team, Breast Friends for a Cure, were raising funds. After announcing this, of course, I was the go-to person to discuss cancer with. This was fine by me. Though on this day I was left smiling with amusement from the sheer verbal battering.

  You had breast cancer? a mother asked.

  Yes.

  Did you have a mastectomy?

  Yes, both breasts, I replied, pointing to my reconstructed breasts.

  I got a text this morning that my friend’s wife died last night from breast cancer.

  Oh, I’m so sorry to hear that.

  She was young like you. It was aggressive and she died really quickly.

  Words jangled in my mouth but I didn’t spit any out. Hmm … I kept my eyes straight ahead on Celso at the top of the slide, now in full sun.

  On my way out of the playgroup a volunteer assistant stopped me to ask if I’d seen the show on TV the night before about a mother’s breast cancer experience.

  I was about to tell him I didn’t have a TV in my living room, but instead said, No, I didn’t.

  I heard it was really good. It was called ‘My Breasts Could Kill Me’.

  By this stage I wanted to raise my hands in the air, look up to the sky and yell, Listen to what you are saying, people.

  In the same week I was bombarded at playgroup, a close family friend tried to reassure me: Celso would be taken care of if God forbid you weren’t around.

  I wished to face my own mortality alone, without others openly addressing their passing thoughts on my death. The late writer Christopher Hitchens in his regular Vanity Fair column expressed similar confrontations. One in particular made me in turn laugh then grimace.

  An elderly woman approaches him at a book
signing and relays how her cousin had liver cancer, which went away then returned more aggressively. Christopher Hitchens does his public-school English cough and turns on his charming self to offer his condolences.

  She fails to feel the many eyes on her head wishing her to move away and relays how her cousin died alone and in agony – oh, and that he was a homosexual his whole life. She concludes with the unthoughtful words of, I know exactly how you feel, which of course she never could.

  In Hitchens’s piece he makes the argument that ground rules for interactions between people from Tumortown and Wellville are needed, especially as more and more people are inhabiting that other place.

  Joan Didion turned to Emily Post’s seminal book on etiquette for advice around grief and how people ought to respond to the grief-stricken:

  Persons under the shock of genuine affliction are not only upset mentally but are all unbalanced physically. No matter how calm and controlled they seemingly may be, no one can under such circumstances be normal. Their disturbed circulation makes them cold, their distress makes them unstrung, sleepless. Persons they normally like, they often turn from. No one should ever be forced upon those in grief, and all over-emotional people, no matter how near or dear, should be barred absolutely. Although the knowledge that their friends love them and sorrow for them is a great solace, the nearest afflicted must be protected from any one or anything which is likely to overstrain nerves already at the threatening point, and none have the right to feel hurt if they are told they can neither be of use or be received. At such a time, to some people companionship is a comfort, others shrink from their dearest friends.

  So too a cancer diagnosis and living with the disease. My immediate thought was So this is how I’m going to die.

  I’d both lived as a person with cancer and experienced an intense grieving period. For six months after my mother’s death I did not work, I did not watch TV, I did not drink alcohol and I didn’t want to discuss my grief, as it was mainly inarticulate. I exiled myself and gave way to ‘sitting’ with my loss. If I were of a tradition that wore a black band on my arm to indicate mourning I would have done so. Alma Whittaker in Elizabeth Gilbert’s grand novel The Signature of All Things expressed it perfectly when she said: There is a level of grief so deep that it stops resembling grief at all. The pain becomes so severe that the body no longer feels it. The grief cauterizes itself, scars over, prevents inflated feelings. Such numbness is a kind of mercy.