Past Perfect: The Grammar of Healing

My husband is the math mind in the family; I’m the English nerd. But lately I’ve found myself thinking less about settings and symbolism, and more about symmetry and statistics.

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Mirror, Mirror…

Many years ago, I did an experiment where I held a small mirror up to the center of my face while looking in a second larger mirror, so I could see how I’d appear if my face were perfectly symmetrical. All of us are at least a little asymmetrical, so the trick quickly reveals the differences, large or small, in the two sides of one’s face: the right eye has a little more tilt than the left, maybe, or one cheek is a bit fuller than its counterpart. The altered reflection, for me, almost felt like looking at different person, perhaps a sibling of myself.

notetnc2The process of bilateral breast reconstruction has a tendency to highlight other asymmetries. The first thing my reconstructive surgeon said to me when he looked at my pre-surgery chest was that my left rib cage sat a little more forward, was a tiny bit more prominent, than my right. I’d never noticed this particular (minor) anomaly, but it’s apparently just as common for there to be asymmetry in the rib cage as in the face. The difference in my bone structure became most noticeable immediately after surgery and during my early tissue expander fills; for a while the right expander lagged behind the left, making me look lopsided. I also discovered I have a pocket of fat on my right upper back, unmatched on the left, which appeared only when I didn’t have breasts to pull the skin forward and keep it flattened out.

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Even Olympic athletes’ bodies vary dramatically. (Photo by Schatz and Ornstein)

Studies indicate we equate higher levels of symmetry with perception of beauty, so it’s only too easy to worry over our various anatomical irregularities. But there’s so much about our bodies that’s out of our control: the set of our features; our bone structure; height; the size and shape of breasts, booty, genitals, hands and feet. We can exercise and lift weights to affect our body composition—but the ability to bulk up muscle mass, and the places our fat cells are predisposed to distribute themselves? That’s pre-determined. Significant elements of our health are hardwired too: some suffer multiple allergies from birth, for example, while others are born with immune systems seemingly hewn from impenetrable stone.

Bodies are glitchy and unpredictable in surprising ways, for better and for worse. The fact my body grew a malignant mass is somewhat mysterious: I am, as best we can tell, the first person in my blood family on either side to develop cancer of any kind. My body’s responsiveness to treatment is, to my mind, equally mysterious, and awe-inspiring: I learned this week that only 20 to 30 percent of triple negative breast cancer patients have, as I did, a “complete pathologic response” to chemotherapy. I was thrilled when we got the pathology report stating they’d found no evidence of remaining cancer during surgery, but the news felt weirdly abstracted. Learning the actual statistical probability of achieving that response was sobering. It made me realize just how incredibly fortunate I am. Having a complete response lessens the chance of recurrence dramatically, dropping it from 35+ percent down to 5 percent. As my oncologist said, it’s cancer, so there are no guarantees. But short of never having developed it in the first place, the odds for long-term survival are the best they can be.

davinciI’ve often felt lucky to be in the body I am. Aside from some cranky tonsils, a couple bouts of pneumonia, and one broken bone, I’ve been hale and hearty most of my forty-seven years, and I’ve managed to stay active and maintain a healthy, if not altogether svelte, weight into my middle age without Herculean effort. Excepting the sixth grade, when my legs had a sudden growth spurt separate from the rest of my body that briefly turned me into a sort of hybrid stork-human, my parts are mostly proportional, and my face, while perhaps not symmetrical enough for Hollywood’s standards, is reasonably attractive.

I did nothing (unless you count that bane of puberty, wearing braces) to “earn” any of these features of anatomy. They just are, like my cancer, like my cancer’s responsiveness to treatment. Why did my body grow malignant cells in the first place? I don’t know. Why were those cells especially sensitive to death-by-chemotherapy? I don’t know the answer to that either. I do know I’m extremely lucky and profoundly grateful to be in the relatively small percentage of survivors who have that experience.

survivorship4I’m just vain enough to feel relieved that the obvious asymmetries that appeared in my chest and back are slowly evening out as reconstruction progresses. But I’m far more reassured by a different realization. As I walked into the dining room Tuesday night, preparing to sit down to dinner with my hubby, it suddenly occurred to me: I no longer have cancer. Granted, my treatment isn’t quite done–follow-up radiation is the standard-of-care for triple negative diagnoses, even with a complete response to chemo, and reconstruction will take a while longer. But the chemotherapy worked; the surgery confirmed it. No more need I say, I have cancer.  Now I can say, I had cancer.

My inner English nerd reappeared, rejoicing: the simple past tense has never sounded so beautiful.

They’re Not “Just Boobs” to Me

“They’re just boobs.”

More than one well-meaning friend or acquaintance has uttered that or a similar statement in an attempt to comfort me, minimize the anxiety I feel as I face a bilateral mastectomy. I will willingly say good-bye to my natural breasts in the interest of prolonging my life; it’s the wise choice. But there’s no “just” about it.

They aren’t “just” boobs. They’re my boobs. My breasts are part of me. I have not, and will not, “use” them, it is true, for their evolutionary purpose, to feed a child or children. As such, some might say they are extraneous.

But they’re mine. And I like them.

And I grieve their loss.

~~~

I didn’t always like my breasts. They debuted, when I was a young teen, as small knots on my chest, literally: hard bumps arose underneath each of my nipples. I was embarrassed to ask my pediatrician to examine these buds, but he reassured me (and my mother) everything was fine. For years I worried I was “too small,” even after I turned seventeen and suddenly gained a cup size, perhaps a result of the hearty German fare I ate while an exchange student that year. I still felt my minimal cleavage didn’t quite balance out my womanly hips, that my nipples were too prominent.

And they were troublemakers, these breasts of mine. When I was in my late twenties, I found a lump. It turned out to be nothing but a benign, fluid-filled cyst, and some doctors in the medical center at Ohio State, where I was in grad school, drained it. That was the first of many more benign cysts, too many to count.

makeup2It was also the start of many years of creative commentary by various medical professionals. I’m a “cyst-maker”; I have “busy breasts.” Enough nurses and doctors expressed surprise at the number and volume of my cysts that I felt like a curiosity. One surgeon in Georgia, who I’d been referred to for draining yet another set of what one nurse called my “natural implants,” greeted me by exclaiming, “Why, you’re just a little bitty thing!” He waved a copy of my scans through the air. ”After seeing the size of your cysts, I thought you’d have great big ba-zooms!”

I didn’t, though I was slowly learning to appreciate them just as they were. Practically speaking, smaller breasts offered maximum wardrobe flexibility: I could wear low-cut or clingy tops without attracting unwanted attention, and button-downs never gaped. But I also finally realized they were, actually, pretty nice breasts. Kind of perky, actually. By the time I reached my early thirties, I’d have said they were my favorite part of my body.

Like many women, I’ve often struggled with body image and self-doubt. It took me more than half my life to love my breasts. Now I must let them go, and re-learn to embrace my body, post-surgery, all over again.

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I know I am no more or less a woman with or without my breasts. My identity as a woman, my worth as a human, is not defined by the shape or size of my chest. Nor do I assume that breasts are universal signifiers for femininity, womanhood, or desirability. In fact, the way breasts are weirdly glorified and overly sexualized, especially in American culture, has often puzzled and annoyed me. I once argued with a man who insisted that breasts were always sexual. No, I replied. If I choose to walk out my front door with my breasts exposed, or with no clothes on at all, that does not necessarily constitute a sexual act; minus a display of express and clear intent, it’s definitely not a sexual invitation. I’m just naked, and we’re all, as the saying goes, naked under our clothes.

portrait-poseSomething else I know: attachment is the root of all suffering. Yet I find it difficult not to be attached to something that is, well, attached to me. Front and center.

My breasts have been my conscious companions at the beach, suited up and sun-screened in a cleavage-baring bikini; on the figure-modeling dais, revealed in the service of a painter’s line, curve, and shadow; on the running trail, compressed and protected in a jazzy neon sports bra.

My breasts have brought me pleasure in private moments, sensual pleasure wrapped up in sensitive nerve endings and a lover’s tender touch, his open admiration. My breasts have brought me aesthetic pleasure, when I slip into a pretty dress that fits just so, hugs the curves of my hips and breasts in a way that makes me feel sexy and beautiful.

My breasts are not some idle, remote organ like an appendix, whose absence I’d scarcely notice. They are a daily presence and a source of pleasure, and I will miss them.

~~~

I will have reconstruction, and I’m grateful for that. I’ve talked to enough survivors, however, to understand the process is no picnic. And my bionic boobs, as I’ve come to call them, will look and feel quite different from my natural breasts.

I’ve been trying to find ways to reconcile myself to the coming changes. I’ve begun to try to re-frame the mastectomy in my mind: instead of thinking about losing my breasts, I focus on regaining my health. I’m saying goodbye to a cherished part of my body, but I am also saying goodbye to the cancer.

I’ve tried to imagine my breasts as being like an old friend, one whose friendship has become toxic. She was a perfect match in my younger years: we liked the same music, went to the same parties, celebrated good days and commiserated over bad ones. Then, she began to lash out, to drink too much; when I was around her, so did I. We had a great run, my old friend and I, but now—well, she’s not healthy for me anymore. I appreciate the good times we shared; I’m grateful and glad for her having been in my life. Even though it hurts, I know I have to say goodbye.

Still, my body isn’t a metaphor. Metaphors don’t go numb or swell with lymphedema. They don’t scar or press your chest with pain. They don’t change what you wake up to every morning, what you see in the mirror, for the remainder of your days.

I’m working on cultivating greater self-compassion and acceptance. I recently hired a photographer to document and celebrate my pre-surgery body, highlighting my bald head with a beautiful custom headpiece. And this time, after surgery, I don’t want to wait thirty years to decide to like my body, my (new) breasts. It won’t always be easy, but loving myself as I am is a choice I will endeavor to make every day.

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The photos included here are a preview selection from the shoot described in the post: photos by Michael Wilson, Bohemian Robot Photography; make-up by Jolina Goad, Jolina does Make-up; bespoke headpiece by Sandra Eileen, Every Girl a Goddess Couture Headpieces.