Making mom cry

The name "ductal carcinoma in situ" has three parts:
* "Ductal" means that the cancer started in the milk ducts.
* "Carcinoma" refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs.
* "In situ" is Latin for "in its original place." This means that the cancer is non-invasive: it hasn't spread into any normal surrounding breast tissue


The first surgery was last week. Dr. Schuh is supposed to be one of the best breast cancer doctors in St. Louis, I keep hearing from around the grape vine. I don't really like her because she has long hair. But always tucks it under her white lab coat so that it appears like she has shoulder length hair that is curled under like a bob. Well that, and she keeps giving me these annoying diagnostics.

At the surgery center, i suppose they are really careful about not operating on the wrong thing. So every time someone comes in the room they ask you three questions. 1. what is your name 2. what is your birth date, 3. which side are they operating on. I struggle to not say "if you guys don't know then we're both fucked."

During the biopsy, they placed a tiny marker in my right breast to let the surgeon know where start removing. On the day of the surgery they used some Novocaine and injected a needle that they then threaded a wire through. Then removed the needle. Leaving the wire connecting the marker and trailing out of my skin. Then they taped the wire down, strapped me into the gurney, iv, chit chat, followed by a memory erasing injection. The surgeon was then supposed to follow this wire to the marker, remove the suspect tissue, then close everything back up. They then take the tissue and send it over to the hospital. The hospital then sends me a bill for a couple hundred dollars. Some where in between there they examine the tissue and decide everything is not right. The cancer cells needs to be contained in the sample taken. But it seems that in my case there are more cancer cells running along my milk ducts of an indeterminable number.

So Dr Schuh is laying this all out for us with a crude cross section illustration a week later in her office. She has two recommendations. The first being a mastectomy with a plastic surgeon on site to reduce my left breast and insert an implant to the scooped out right side. The second option being a second procedure same as the first. Taking more tissue this time, probably leaving me with a gaping whole of a breast. Then if "successful" I will follow this with 6 weeks of monday - friday radiation. A commitment that really just makes me angry.

I ask "Well what if, option 3, I do nothing at all."

My mother gasps and begins to grow red in the face.

The doctor looks at me blankly, as if no one has ever asked such a ridiculous question.

I push further " Ten years? 5 years?" I'm good with both, no need to live forever. "Less than five years?"

She looks up, as my mother is starting to loose control of her emotions. "Not even, she says, the cancer is contained for now, but in less than two years, it will begin to spread rapidly through your body." then stands up to reach for some tissue for my mother who now has entered Joan of Arch mode. Offering her own 52 year old breasts to her god in place of my life I am so nonchalantly throwing under the bus.

I'm thinking that this whole process is going to end up costing me thousands of dollars, destroying the lifestyle I know and love, and thus extending my life by many years but now they are years filled with self doubt, years of hiding my chest from the mirrors I once stood in front of admirably, years of sex with shirts on if sex was even in the cards at all, my phantom right nipple longing to be caressed and sucked. I look at the cards in my hand. And really for a moment consider walking out. Talking my money and buying a plane ticket. Spending the next "less than two years" in some tropical remote location soaking up sun, and blowing all the bronzed muscular locals I could find.

And now my mother is full blown ballin'. And not the kind with gold chains and a bank roll. I have no choice but to make the next appointment. Schedule another surgery. At least I'd get more vicodine. And I drive home, down 270 bumper to bumper at 5pm on monday evening. But I don't cry. I think about dinner, about stopping for a block of Romona cheese and a bottle of medium grade wine i won't share with my roommate.