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The Tender and Unruly Body
Content warning: cancer
Let me start with reassurance. I do not have cancer. Or rather, there is no evidence to suggest I have cancer. You can't ever rule these things out completely, I suppose.
The title of this post riffs off the subtitle of Kate Lebo's The Book of Difficult Fruit: Arguments for the Tart, Tender, and Unruly, a collection of essays ostensibly about fruit, that are contemplations of other themes.
I began reading the book in the waiting room while I waited for a diagnostic mammogram and breast ultrasound. The book chapters are fruits A-Z. She begins with Aronia, an astringent fruit full of antioxidants.
The chapter is about chronic illness and plant medicine. She talks about her mother's migraines and how her mother felt about leaving her children alone to play while she hid in a dark room. I fight back tears. In the radiology waiting room.
Lebo concludes that she didn't mind her mother's absences, that she remembers enjoying the chance to read quietly. I believe her but I identify deeply with her mother's expression of loss and grief. I hope when my child is grown he will also focus on the silver linings of my absences. Perhaps he will conclude that it strengthened his relationship with his father, who is always there to pick up the slack. But at four he is sad that my fatigue and pain keep me from being there for all his adventures, and that is heart wrenching.
It is while I am waiting between my mammogram appointment and the ultrasound appointment that I get to the chapter where Lebo reveals that her aunt died of breast cancer. This is not the journey I expected this book to take me on. Indeed, I am starting to be mildly annoyed that nothing I saw in the blurbs for this book served as a warning about the focus on illness. This was supposed to be my fluffy book about fruits. I was supposed to be fantasizing about what rare fruits I might choose to grow in the garden someday, not reflecting on my mortality. Nonetheless I enjoy the writing enough to stick with it.
After the ultrasound, a doctor comes to talk to me nearly immediately. There is a small mass in one of my breast ducts. The doctor says that these are most often something called a papilloma, which she compares to the polyps sometimes found during colonoscopy. She recommends a biopsy to confirm and, if it is a papilloma, surgery to remove it so that it does not cause problems later.
The doctor never says the word cancer. She exudes cheerfulness and does not seem worried. I am not worried either. She also does not use the word benign in her explanation, but her tone implies it.
It is not true that I am not worried. I am trying very hard to not be worried, but biopsy is a scary word. And this feels similar to the first time my mother had breast cancer, a small mass discovered after a routine mammogram. They found her cancer early and were able to treat it without chemotherapy. I reassure myself that this is perhaps my worst case scenario: a small cancerous mass that can be removed and easily battled back.
I schedule my biopsy for the following Monday morning. I am not concerned about the procedure itself. They will inject lidocaine, do a needle core biopsy, and then place a small metal marker so they can find the spot again if it needs to be removed. I drive myself to the appointment and since I am working from home anyway, do not arrange to take the rest of the day off work.
These are not mistakes that I will make next time. The lidocaine dulls the pain of the needle entering the skin. It makes the procedure itself extremely weird but tolerable. There is pressure but not much pain. The pain starts afterward and is significant. They give you ice packs to help with the bruising. I have a work meeting that afternoon, which I sit through with an ice pack in my bra. Afterwards, I log off for the day and lie down. It hurts less lying down.
The next day I stand in my kitchen, staring out the window and thinking of my mother. Briefly, I think that I am not as strong as she is. She never complained about pain from the biopsy. I was blind sided, did not expect it to hurt this much, did not expect to develop a large bruise that makes it look like I was punched squarely in the middle of my left breast.
My mother continued working all the way through her radiation treatment. I don’t think she had much choice, not if she wanted to still have a job when she was done. At the time I was angry about that, the lack of safety net in this country. So many workers without real job protection, many without short-term disability coverage. And even if you have short-term disability can you get by with a reduced percentage of your income if you’re already living paycheck-to-paycheck?
It is sometimes tempting to regard people who work through their treatments for severe illness as strong, inspirational. Standing at my kitchen window, making tea, feeling my pain, I try to let go of the comparison to my mother. There are many reasons to admire her, but this is not one of them.
If I have cancer I will take a leave of absence from work to treat it because I can, not because I am weak. There is strength in resting and it is a privilege I wish everyone were granted.
The results of the biopsy are as expected: benign papilloma. I am given a referral to a surgeon to discuss removal.
Lebo’s L-chapter, “Lump,” is the only one not about a food. In it, she describes finding a lump in her breast, which a mammogram reveals to be only a cyst. She calls her mother and tells her “I had my first cancer scare.”
I resent her this easy resolution. I am bruised and sore. And I am dreading surgery to remove this thing that is not supposed to be there, even though it is, currently, benign.
I am also not done. I see my primary care physician two days after the biopsy results come back benign. I am there to discuss with her a constellation of vague symptoms that I will not detail here, but that are on the list of things that often serve as the only warning sign of ovarian cancer.
Unlike my initial mammogram, these symptoms I am actually worried about, and have been worried about since reading Nadia Chaudhri's twitter thread detailing her experiences leading to her ovarian cancer diagnosis. By the time I see my doctor, Chaudhri has passed away from her illness (this is not a shock as she was already in the hospital when she wrote the thread. I shed tears at her death, though she was a stranger).
I am not terribly surprised, then, when I get to the chapter where Lebo discusses her college roommate's ovarian cancer. By this time I have accepted the weird synchronicity of this book and this experience.
I am afraid, not just of cancer, but that my new doctor, who I am meeting for the first time, will not take me seriously. My experiences of trying to advocate for myself in the medical system have been mixed and I am aware that mentioning a concern this specific can backfire. Fortunately, she takes me seriously and orders a transvaginal ultrasound.
I have done this before, once in my 20s to check for ovarian cysts, and again while I was pregnant. I remember vaguely that the one in my 20s was painful (though the ones while I was pregnant were not) so I have the foresight to not try to go back to work afterwards.
During the procedure I find myself on the verge of a panic attack. Not so much because having your abdomen probed from the inside is invasive and uncomfortable—though it certainly is—but because I have been swimming in worry about this for weeks. I focus on my breathing and, as my brain is paddling toward panic, I make a bargain with my body, “if you let this not be cancer, I’ll buy you a pony.”
This is a ridiculous. It is already either cancer or not cancer. There is nothing my body can do in the moment of imaging to change that. Moreover, I have never actually wanted a pony, not even as a child.
Still, I am just superstitious enough that when the ultrasound results come back showing only two small fibroids and nothing that indicates cancer, I keep the deal. A small figurine of a carousel horse now sits on the bookshelf above my desk.