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Journaling My Biopsy

by Diana Raab

The following excerpt is adapted from Healing With Words: A Writer's Cancer Story, forthcoming Summer 2010, Loving Healing Press.

Those who don't know how to weep with their whole heart, don't know how to laugh either.

-Golda Meir

The waiting room for the women's health center in Dallas was decorated with needlepoint chairs and rugs, all nestled in a wood-paneled room. The receptionist welcomed me and handed me a clipboard with papers.

Soon a nurse called my name and directed me to the change room-four barren cubicles with clothes hooks and a small mirror. Outside was a cozy sitting area with magazines and women old enough to be my mother. What was I doing here? Wasn't forty-seven too young to be diagnosed with breast cancer?

A sweet-smiling nurse directed me to the biopsy room. I desperately looked for a window into her thoughts. Her face offered no answers, but something about her grimace echoed concern. As she closed the door behind me, a tear fell upon my cheek.

After untying the strings of the hospital gown, I glanced down at my breasts, a gentle reminder of my past. My breasts had served me well-they had nursed three beautiful children and brought me endless erotic pleasure. For me they were the perfect size for my petite frame-tottering between an A and B cup size.

As a warm smile emerged from his lips, Dr. Phil walked in and extended his arm.

"It's a pleasure to meet you," he said. "The biopsy will go fairly quickly, but the trick is you must remain very still, and sometimes that's difficult for a long period of time. You'll need to lie on your stomach for a little over an hour. We'll anesthetize the part of your breast we're working on."

I heard every word, listened to every intonation in his voice, and raked his face for any revealing expressions. Although he had a warm demeanor, I sensed a reserved concern.

His recounting his steps broke long periods of silence. Part of me wanted the details, but another part didn't. Some of the information froze me in time and impeded my desire to daydream. During the quieter moments, I nodded off to recap my past and present and dream about my future. My life became a movie reel before my eyes, and something inside me said that the film was running out.

"We're just about finished. I can't say the findings were good. I took about twenty small biopsies. You have something called ductal hyperplasia-too many cells in your mammary ducts. This happens over the years and can be perfectly normal. But, sometimes the cells start looking strange and that's called intraductal hyperplasia with atypia. If the cells continue multiplying, and the number becomes abundant, it's called DCIS, or ductal carcinoma in situ. My suspicion is that's what you have."

"I'd recommend a surgical biopsy." My eyes became flooded. Just before asking my next question I realized my throat felt paralyzed.

He put his arm around me.

I tried taking a deep breath, but the air wouldn't enter my lungs. Did he clamp off part of my lung while he was doing the biopsy? All I wanted to do was curl up on the examination table and remain there for the rest of the day. How could I face the world and the bombardment of phone calls from concerned friends and family members?

I needed time to think, rehash, and protect my thoughts. I wanted to mull over my past, present, and future.

I pulled myself up from the table. Dr. Phil shook my hand and said, "I'm sorry," as if I'd already lost my breast. I sensed he knew my prognosis, but he didn't want to be the one to spill the news. I stared at him as if this would get him to talk to me. Instead, he just wished me a safe trip home.

* * * * *

As it turned out, I was referred to a specialist in L.A.

"Hello, I'm Dr. Silverstein." His smile widened and his glasses slid up his nose. There was something humble about him. You wouldn't suspect him to be one of the world's most renowned breast surgeons.

"I see that your DCIS is fairly widespread, although I've seen it a lot worse."

My jaw muscles went slack. The other doctors mentioned DCIS, but didn't mention it being widespread. Hearing this from Dr. Silverstein made it seem more real.

"I suppose you've done some reading. All nurses do. But let's review."

He slid his swivel chair toward the blackboard on the other side of the room. "Okay, let's say these are your breasts." He drew two droopy figures. "Your breasts have mammary ducts running through them, and what you have are atypical cells growing in those ducts. My concern is that these cells have broken through the walls of the ducts. If this is the case, then you have invasive cancer, and that's not a good scenario."

I felt the color leave my face.

By Thursday morning I lay wide awake on the stretcher on the way to the operating room for a biopsy. I glanced down at my breasts and thanked them for taking such good care of my wonderful children. Within moments my head felt light and then all I remembered was being wheeled into a very cold room.

I woke up to Dr. Silverstein's hand on my shoulder.

"I'll call you in a few days with the results. Don't worry."

Two days later I boarded the red-eye back to Orlando. When I saw my husband waiting at the airport, buckets of tears poured down my face. The pent up emotions of the previous days had finally erupted.

I flung myself into his arms and the scent of his cologne was a gentle reminder of being home. His blue cotton shirt against my cheeks warmed the chill inside of me. I realized the power in his hug and how much it meant to me. My gratitude plunged deeper than any ocean.

* * * * *

Since that day, every breath has become a march of time, even after my subsequent mastectomy and reconstruction and this eighth year anniversary of my breast cancer journey.

Diana Raab, MFA, RN is a memorist and poet and award-winning writer. Her Memoir, Regina's Closet: Finding My Grandmother's Secret Journal was the recipient of numerous awards including the 2009 Mom's Choice Award Adult Non-Fiction. Her second memoir, Healing With Words: A Writer's Cancer Story is forthcoming by Loving Healing Press in 2010. She is an active member of The American Medical Writers Association, Poets & Writers and the Authors Guild. She is a journaling advocate and facilitates workshops at conferences around the country. She also teaches in the UCLA Extension Writers' Program.