The Anatomy of a Reaction     Rebecca A. S.Thomas     © Copyright 2007 by Rebecca A. S. Thomas

 I want to give her grandbabies.

That was my first thought. My second was this:

 Cancer.

It was seven days before Christmas. I dropped bags from shopping on the tan carpet, not quite yet feeling the hurt of Christmas spending on my credit card. Plopping down on a chair, I sat at my desk and called Kevin, my fiancé.

“Mom has breast cancer,” he said, hardly letting me say hello.

“What?”

“She has breast cancer.” His breath rattled in. “They caught it early. She’s already had the surgery, and they got it all out.” His voice was calm and smooth, unnatural. I thought of him standing there, running a hand through his dark mess of curly hair, unsure of what to do. I was silent, and he continued, “They’re going to start radiation in January as a precaution. She said she’ll be fine.”

 “She didn’t tell us about the surgery?” I stared down at grey outlines of where I once placed alphabet stickers along the edge of my desk.

 “You know how she is.”

“You okay?” I cringed at the question.

 “Yeah,” but his voice trailed up at the end like a question.

 I could picture it all in my head. It would be in the wood paneled sunken living room that used to have orange shag carpeting. She would have been sitting in the corner with her feet propped up out on the new BarcaLounger. Her pink bathrobe wrapped tight around her. “We didn’t want to worry you,” she would have said to him. So matter of fact: they caught it early; it was a small lump; nothing to worry about.

On the phone his breath barely came through. We said our “I love yous” and hung up. The last twenty minutes swam in my mind. I had called him up and he said, “My mom has breast cancer.”

It was then that grandbabies came. Even before Kevin and I started dating, his mother had already bought all the Disney movies on VHS for future grandchildren. She had storybooks of classics alongside each Harry Potter, waiting to be used. Procreation though, was probably going to be left up to us. His brother, Michael, was a while away from kids. The hope was for him to have a girlfriend and then settle down. Babies, if they came at all, would be in the very far future. Kevin’s sister couldn’t have any; her womb didn’t allow for it. In the end, if the Disney videotapes are ever going to be viewed, the chances are the child would have to be from our loins.

That August, we had traveled up to Canada to see Kevin’s grandparents. We stayed with his parents at the RV Park, but had our dinners at his grandparents’ condo. His grandparents’ condo hadn’t changed since the seventies. Kevin gave me the grand tour, giddily pointing out the gold snake vase, sparkly silver light switch with the orange and yellow wallpaper behind it, and pictures of his siblings that had sat on the same dresser for the past twenty years. He bent down to a cabinet on the red shag carpeting, pausing at an avocado and gold lamp, and opened the door. Taking out the dusty games, he presented each one to me: Monopoly with a cream color case, dominos, Chinese checkers with real glass marbles. “There’s this game room in the basement,” he said looking past me, picturing a foosball table. “We should go.” But his grandpa and father came back with dinner from the fabled Golden Dragon next door, and the faded games were put back for a great grandchild to play with.

We sat around the table, awaiting the Chinese food feast. Kevin’s mother, Sue, sat across from me. She opened the first container, the second, the third. Looking around, she turned to her husband. “Ron, where are the vegetables?”

 He stopped, egg roll in hand.

 “Rebecca can’t eat this stuff.”

 Nana looked around at the containers full of pork, beef, and chicken. “Here’s some broccoli,” she said, pointing to a container of broccoli with beef.

“There’s beef in it, Mom” Sue said.

 “She could just pick it out.” “It’s covered in beef sauce.” She turned to the table. “Is there anything she can eat?”

 “I’ll just have the salad,” I said. “It’s fine really.”

 “No it’s not,” she said and passed the salad bowl.

I looked over at the side table next to me, filled with pictures. “So, this is all your family?”

“Yeah,” Kevin said, “And Dad’s side is actually bigger.

 “Holy hell.” I leaned over, lowering my voice, “And they want us to add to this?”

“You want to get on top of that?” he whispered, nudging me with his elbow.

 “Sure. I can be barefoot and pregnant by the end of this year. That good for you?”

“Um hmm.” He grinned for a moment before turning back to his fried rice with pork.

 After dinner, as we were saying goodbyes, everyone talked about our upcoming wedding. His cousin, Angie commented about the possibility of Nana having another picture of a great grandchild on her table.

“There’s no more room on that table for anymore pictures,” Nana said, exasperated. “So wait a while before kids.”

 “Speak for yourself,” Sue said, going into a giggle, setting off the room.

Everyone laughed while I blushed at the blatant talk about my ovaries, eggs, and Kevin’s sperm.

Phone still in hand, I sat at my desk, thinking of Sue’s desire for grandchildren and her cancer. The use of my womb for a few grandbabies seemed like the least I could do. She wanted them, I had the capabilities, so who was I to hold off? Instead of a casserole to alleviate her pain, I could offer up my ovaries. At least they lasted longer than a baked dish. My rational side eventually kicked in, and I knew that graduating, finding some sort of inkling of what I wanted to do, and making a little bit of money was needed before I put my baby making skills to use. It was after pushing the irrational grandbabies out of my mind that cancer started to creep in.

Cancer is being afraid of the dark when you’re young. Your mom would close the door, and soon the hat rack in the corner of your room would turn into a witch. You would have to turn the lights back on and take an inventory of the room. Only then, could you try and go back to sleep. Even then though, despite your efforts, the threat of the dark and the hat rack witch still lurked in the back of your mind.

 I did not go to bed that night planning to arm myself with an arsenal of information, but when I woke up it was automatic. I started my daily routine of breakfast, the Today Show, and checking email. Alone, in my room, I watched Al Roker tell of the Christmas forecast. In my neck of the woods, my room was cold and crowded with mess. On my bed, laptop in lap, I Googled “breast cancer.”

 When I was in first grade, my Grandpa Don died of leukemia. At the time, I only really knew that he was in the hospital, and we visited after church on Sundays. We would go with Snoopy puzzles, and Grandpa Don and I would put one together. He would tap each piece in with his index finger, letting the room know that he was that much closer to finishing. By the end of our visit, Snoopy would be complete. At the hospital and at home it was all hushed voices. Cancer got thrown about, as did blood cell count, both white and red. What I understood was that soon he would not be there to tap each piece into place, and before second grade, he was gone. I didn’t know why, exactly, but I knew the words that had to do with it. Since then, cancer has always been mysterious, peering out ominously behind some dark curtain. And now, once again, cancer barged into my room, this time in the shape of breast cancer. I needed some way to make cancer turn back into a word and stop being the hat rack witch. The web links in front of me that morning seemed like a way to do that.

The knowing is essential, describes Breastcancer.org. It provides “a common way to describe the extent of breast cancer…so that… [a] treatment can be compared and understood.” In order for people to come to terms with cancer, they need to have the vocabulary. Without it, breast cancer remains Breast Cancer, a void, an uncontrollable force.

 Simply, breast cancer is the uncontrolled growth of breast cells. It has “the potential to break through normal breast tissue barriers and spread to other parts of the body. While cancer is always caused by a genetic ‘abnormality’ (a ‘mistake’ in the genetic material), only 5-10% of cancers are inherited from your mother or father. Instead 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and life in general” (Breastcancer.org).

I read this, in my childhood room, a senior in college, about to be married, and not knowing what I was going to do when I graduated. For the first time in my life, I did not know what I would be doing a year from now. School would be taken away from me, and I was going to have to face the unknown, dreaded, real world. Reading about mistakes and abnormalities, highlighted the fact that I could not control what would be happening to me a year from now. Hearing cancer, at that moment, illuminated the uncertainty of life, and all it took was a simple phone call to Kevin to say hello.

It was like the phone call on 9/11. I was halfway down the hall, in my house, senior year of high school, hair wet and dangerously close to being late for zero period. The phone rang, and the Twin Towers were gone. The phone rang, and life changed. Isn’t that part of the reason why 9/11 affected so many? There was that potential that it could have been you. People knew a friend of a friend. A woman whose husband was on the plane that crashed into the Pentagon, and now she has his platinum wedding band that is flattened on the side where his hand was clutching the arm of his seat.

Six days after the cancer phone call, on Christmas Eve, I sat around watching television with Kevin, Ron, Sue, and his brother, Michael. Mike, wearing his usual Jeff Gordon NASCAR t-shirt, had just stopped the channel on ESPN’s exclusive coverage of ice dancing.

I sat transfixed as a couple floated around the television screen in Lycra and neon. “Ice dancing, really?” I asked.

 Kevin squeezed my leg. “My aunt was actually a professional ice dancer.”

“Ah, good to know.”

 “Plus, Mom’s from Canada, and they like their ice sports.”

 “Well, Ice dancing it is then.” The orange and pink clad couple glided along.

 They hadn’t gotten a real tree that year. In the past, when Kevin stayed there more, we would all go to Home Depot, walking around the lot, studying each tree. Because it was my favorite thing about the holiday, I would always get to give the final approval. Later, while we all watched Desperate Housewives or Extreme Makeover: Home Edition, Kevin and I would decorate, carefully deciding where each ornament went.

This year Christmas was celebrated on Christmas Eve, and their Christmas tree was small and plastic. Mike said he needed to be back at his store for the 26th rush, and so he arrived Christmas Eve and left on Christmas. We sat around, exchanging presents. There was the usual of pajamas, kitchen supplies for future use, and books that I knew Kevin told his parents to get for me. After, we settled down to watch A Christmas Story, the story of a disharmonious but loveable family braving Christmas in Indiana. Ralphie, the protagonist, and his brother bundled up, looking like marshmallow men, preparing to go to school.

Ron was born in Indiana, and the cold weather registered with him. He laughed in recognition as the two characters waddled around, legs unable to touch from the amount of clothing.

“I can’t believe you’ve never seen this,” I said and snuggled into Kevin as Ralphie and his brother ventured out into the cold.

A few months later, in April, Kevin and I were driving on the 57 freeway back to his apartment. It was dark, and I was going over my thoughts on revising this essay. Christmas stayed in my mind. “You didn’t find it weird that we didn’t talk about it?”

“What would we’ve said?”

 “I don’t know. It was the first time we saw her since she told you.”

 “It was Christmas. She didn’t want to talk about it.”

“I know.” I looked out the window as the pattern on the cinderblock wall danced up and down. “I just expected someone to say something. That’s all.”

 The information Sue gave us was that “they caught it early”, and so, if I wanted to know the stage, I had to go with the facts at hand. Breastcancer.org describes the staging system as at first being possibly a negative thing, a “jail term…[but it] is a key part of figuring out how you and your doctors will approach your treatment.” Staging generally falls under the TNM approach with three components: Tumor size, the number and location of cancerous lymph Nodes, and the question of Metastasis (has the cancer spread?). There are five stages, four being the worst and zero the best, by being noninvasive.

Surgery—a lumpectomy, not a mastectomy—and radiation had been what Sue told us. It seemed simple enough. She had a small tumor, which had not spread to other parts of her body; metastasis was not an issue. The problem? Tumor size did matter. According to Breastcancer.org, “breast cancers are as varied as the women affected by them. By looking at the many different characteristics of the cancer, you can size up its ‘personality’ almost as the way you analyze another person. Is the tumor small and low key? Angry, aggressive, and fast moving? Or is it very large but easy going?” Sue never discussed how her tumor was treating her, if it was enraged, laid back, or peppy. Small was not a helpful term.

To know her stage, I was left with her treatment. I needed to know what exactly a lumpectomy with radiation meant. Did radiation instead of chemotherapy even make a difference? The websites told me she had “breast conserving surgery (commonly known as lumpectomy) in which only the tumor is removed from the breast. This is usually followed by radiation therapy to the remaining breast tissue” (Breastcancer.org). Komen.org said that radiation was only “an option for women who have ductal carcinoma in situ, early stage breast cancer, or locally advanced breast cancer.” The new definitions relieved me. It was common, routine, and a new mantra formed: lumpectomy, not mastectomy; radiation, not chemotherapy.

In my attempt to control cancer, I compartmentalized it by searching out its definable stages. It made the process easier to understand. “The purpose of the staging system is to help organize the different factors and some of the personality features of the cancer into categories, in order to: best understand [the] prognosis (the most likely outcome of the disease), guide treatment decisions, since…[treatments] are partly organized by the staging system, and provide a common way to describe the extent of breast cancer…so that the results of [the] treatment can be compared and understood” (Breastcancer.org).

“In stage one, the cancer is invasive but has not spread beyond the breast. Either a mastectomy or breast conserving surgery is recommended. With either procedure some lymph nodes will be removed from the armpit to determine whether the cancer has spread there. Radiation and either chemotherapy, hormone therapy or both always follow surgery to help ensure that the body is completely rid of cancer” (Komen.org). Stage Two had the same definition. In stage three cancer, “a modified radical mastectomy is recommended” (Komen.org). She did not need that, ruling out the third and fourth stages. I was left to make the diagnosis that she had early invasive cancer either stage one or two, but that was it. I could not go further on my own.

“Didn’t it bother you that she didn’t tell us what stage she was in?” I asked Kevin as we drove along the freeway.

“She said they caught it in its early stages. That meant she’d probably be okay.” “I know,” I said, “but…” My voice trailed off. “Doesn’t it seem as if it’s our right to know too?”

When she talked about the cancer it was always nonchalant. That March, we stopped by the house before heading over to the Mexico/Korea baseball game in the first World Baseball Classic. I had already finished eating when Sue wiped her mouth and said, “I’m probably starting treatment this week.”

“The infection’s gone?” Kevin quickly asked, forgetting his mac and cheese. “Yep. Dad’s going to take me up to the center in LA for the first screening. After that, I can finally start radiation.”

 “You have to go to LA for your treatments?” he asked before I could.

 “It’s where Kaiser tells us to go. They provide a shuttle from here to the treatment center in LA. I have to take it, and it’s for patients only.”

 “They make you go alone?”

“I just hope I don’t get lost.” She laughed. “Dad always knows where he’s going, but me...”

“Just follow the person in front of you,” Ron said, laughing a hoarse laugh.

“And hopefully they’ll know where they’re going. I guess I’ll get a lot of reading done, huh?” She laughed, eating the rest of her salad.

 The thought of Sue being shepherded along with a flock of other men and women with cancer was not right. It seemed too impersonal. Sue, Kevin’s mom, Ron’s wife, my future mother in law, would have to go and sit on a bus, not knowing anyone, for at least an hour, more with traffic, until she arrived at Kaiser’s center. From there, I pictured her being herded off with the others. Each would follow the other down corridors, hoping somebody knew where to go. She would arrive at the room at Kaiser’s center where she’d take a number for her treatment, waiting, alone.

To help people understand each component of breast cancer, Komen.org provides a slide show, “Anatomy of Breast Cancer.” It begins with the breast. The picture is not realistic, but cartoony and crowded with each intricate part. Its detailed diagrams labeled the ducts, lobules, dilated section of the duct to hold milk, nipple, fat, pectoralis, major muscle, chest wall, and rib cage. When describing each stage, the cartoon woman becomes transparent. Flesh acts only as an outline of the body. Bones, organs, the circulatory system and cancer are jumbled together. Flashing yellow circles show the stages of cancer as it spreads. With each slide, the stages and steps of cancer are concisely described in compact, clear sentences. The slideshow “decancerizes” cancer, but, as a result, it dehumanizes the patient.

I stared straight ahead at the dark freeway in front of me. “I think I’m going to focus the essay on control,” I said to Kevin. “You know, talk about my reaction and everything.”

 “When you looked everything up?”

 “Your mom’s not going to tell us just what she’s going through, you know? I just wanted to know what it all meant.”

“I know.”

 “I think your mom’s response is also a form of control. I mean she held stuff back from us. She never brings it up.”

 “But why would she tell us everything?”

 “A lot of people do. They’re proud that they battled a disease. They want to talk about it, to share with someone what’s going on. She just kept silent… to us at least. It seems as if she doesn’t want to be known as the breast cancer survivor.” I stopped for a moment. “But,” I continued, “I guess there’s no reason for that, huh?”

 We missed our off ramp, not able to get over in time. He merged to the right lane for the next exit. We made it and waited for the light to change.

 Before 9/11 the Taliban was distant. Al Qaeda was barely in our vernacular. There was a vague understanding of Fundamentalism in the Middle East, and names like Osama bin Laden floated around with the abstract idea of terrorism, but it was not constantly in the public’s consciousness. After the attacks, numerous books and countless hours of film and television were produced from people’s desire to come to some sort of understanding of what happened. To move on, people needed to know more.

And so it is with diseases. People walk around with vague notions of breast cancer. There are certain stages, and the words chemotherapy and radiation are mixed up in it all, but, I’m guessing, like me, it stays vague until someone you know is stricken with it.

This attitude is seen on the breast cancer websites. Dr. Beverly J. Anderson, on Giftfromwithin.org, addresses the reader: “Chances are that if you are reading this, either you or someone close to you has been diagnosed with breast cancer or is at a high risk for developing it… I’ve decided to share my story with the hope that someone will benefit from my year and one-half triumph over breast cancer.” Komen.org has a similar mission statement. The foundation arose only after Susan G. Komen was diagnosed and then died from breast cancer. Although the Susan G. Komen foundation puts much of their effort on research, they still focus their attention on community outreach and support groups as well. These websites are one of the vital outreach sources. In order for people to deal with cancer, they need to have facts at their fingertips; they need to know that this has happened before; people have already gone through this and survived it.

Faced with the unknown, we feel helpless, and so we arm ourselves with knowledge to get through the process. Although there are practical reasons for knowing and naming cancer, it is the knowing and the naming that makes it seem less overwhelming. At first, cancer screamed at me. I ignored Kevin’s assurances and leapt to grandbabies. In disasters, people give money, shelter, clothes or food. For those you know personally, cooking, gifts, or knitting is involved. I thought grandbabies. But that wasn’t enough to equip me with facing the dark word of cancer. Instead, I had to know more and see for myself what was going on. Deep down, I knew that Sue would be fine, and she is. The doctors had caught the cancer early; she had her treatment, and was cancer free in about six months. Her original assurances though, were not enough. At that point in my life, I could not face another unknown. I had to throw light into the situation and examine the word for myself. I was simply unwilling and unable to remain “in the dark.”
 
 

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