The Destruction of Silvio: The Burial
As a cancer patient, one has an almost obsessive memory of dates. When it was that a weird lump appeared, when a gynecologist was seen, when a biopsy was done, when the results came in, when the first dose of chemo was administered.
My dates are as follows:
Second week of January 2018: I am sitting on my couch late one night, working on a brief that would eventually see me billing 70-90 hours a week until I was taken out of commission. I am typing away on my computer, trying to understand oil and gas engineering. I randomly pat my chest and feel a lump in my right breast. Not one of those hard olive shaped lumps they warn you about, just a bump. I call my mother. She tells me not to worry. It’s the end of my period and my boyfriend accidentally elbowed me in the chest a few days ago. I decide to wait a week to see what happens.
A week and a few days later: I see my gyno. He says it’s probably a cyst. He tells me to get a mammogram and an ultrasound just to be safe.
Two weeks following gyno visit: My right breast does not hurt but it is red, hard and about a third bigger than the other (usually more ample) breast. I grow progressively more worried. I Google compulsively and diagnose myself with inflammatory breast cancer. People tell me not to be crazy. I realize that I probably am acting crazy. It could be mastitis, an infection or a cyst. I am 31 years old, with no family history. The likelihood of me having breast cancer is extremely low. I cry myself to sleep from worry some nights.
13 February: My appointment at Imagerie Duroc on Boulevard Montparnasse is finally here. I had tried to move it up but they had no space. Despite the mounting worry, I feel ok today. My appointment is at 11.30 AM. I have a big deadline coming up so I work from home in the morning and plan to be back at the office after lunch. I expect a prescription for antibiotics and a slap on the butt for being a young paranoid know-it-all. I have never done a mammogram. The technician is nice but clueless. It does not hurt. The radiologist asks me what I do for a living. We are in a dark room and he is gliding the ultra-sound sensor over my chest. He starts to quietly huff and puff, and says something to his assistant. I ask him whether something’s wrong. He says that there is a 3 cm mass in my right breast but he can’t see it clearly with all the swelling. My brain stops working. I ask if it’s a cyst. He says nothing. I ask if it’s a bruise. He says nothing. I start to cry. I ask if it’s cancer. He says “Madame, je ne veux pas spéculer.” We are done. He says they have space and they will perform a core-needle biopsy in 20 minutes. I lose my mind. I get dressed to go back to the waiting room. I am so sorry for the women there, I come out a total mess. I call my mother. I call one of my best friends. She is coming but does not make it in time for the biopsy. I am whisked into a small room with the same technician who did the mammogram, and the radiologist and his assistant. The biopsy is violent. I am lying on my left side. It does not hurt because my right breast was already a little numb from the swelling and they inject it with anesthetic. The biopsy needles are shot into my breast with a kind of small plastic revolver that makes a loud noise every time. Everything is happening literally next to my head. The lymph nodes are hard to get to and the radiologist is pressing the ultrasound sensor into my armpit really hard. I feel blood trickle across my back. I almost pass out. No one tells me anything. We are done for the second time today. I am left in the room with the nice technician who bandages me up. A few minutes later my friend comes through the door that was left half open and finds me half naked, crying on the biopsy table. I will have the results in a week.
17 February: The worst week of my life is nearing the end. I have called every gynecologist I know, Whatsapped my mammogram to everyone who is even mildly competent to look at it. They say it’s not necessarily cancer, but all agree that it’s a good thing they did the biopsy immediately. I incessantly speculate as to what the bump could be. I oscillate between being convinced that it’s cancer, and being sure that it’s just an infected bruise and I’m being paranoid. I am worried sick almost every minute of every day. I call friends who have had cancer to ask how bad the chemo is. Google is my worst enemy. Thankfully my parents are in Paris for an opera, and my mother will stay a little longer. I have cancelled my usual Saturday horseback riding because I am afraid that the lymph node biopsy will make it hard to mount the horse. By Friday it doesn’t hurt anymore. Morale is so low that I decide to go riding after all. I go full American-cancer-patient-movie on the horse. I fall and break my hip. Thankfully not the femur, so it’s just going to be a painful couple of months but no surgery required. It keeps me occupied for a day.
19 February: My gynecologist confirms that I have inflammatory breast cancer. 1-5% of all breast cancers diagnosed in the US. Thankfully mine is not triple negative and has HER2 receptors. It’s curable. I will need chemo, a full mastectomy and radiation, the full package. But I will not die. I feel much better than before I knew. I meet my oncologist that same night. The cancer is aggressive and I need chemo ASAP. I also need to harvest my eggs just in case, they can’t guarantee anything.
21 February: Long day. At 8 AM, I have the egg harvesting procedure with local anesthetic and laughing gas. I play Boney M and film some of the procedure. It’s painful but not that bad. They manage to get 19 immature eggs. 12 survive maturization in the lab. I now have 12 frozen eggs on hold at Hôpital Béclère. I have a PET scan to see whether the cancer has spread later that afternoon. I am cold and hungry. After a quick nap at home and some food, I go to a cardiologist. He says my heart is perfect. I am exhausted.
22 February: I get a second opinion at the American Hospital. They say the same thing. PET scan results show that the cancer is in the lymph nodes immediately surrounding my breast but that it has not metastasised. Epically good news although so much is going on right now that I have not even had the time to worry about it.
23 February: I have a mini surgical procedure to put in a catheter that’s directly connected to one of the arteries in my chest so that the chemo does not destroy my peripheral veins. I start the first course of heavy chemo. Epirubicin and Cyclophosphamide, it’s called. It’s not as bad as I would have imagined. My hair will start falling out in two weeks.
12 March: It is my name day. I invite a bunch of girlfriends over. They bring flowers and champagne. We order Lebanese. I have bought a bottle of Dom Perignon for the first time in my life. James from David Mallett comes over to shave my head. It’s weird but not as bad as I thought. Better bald than Donald Trump-patchy.
20 April: My lawyer personality can’t live with “your fertility should not be affected by chemo but there are no guarantees“. Statistically, every live birth requires about 10 eggs. I have a third of my right ovary removed to be put on ice just in case. I would rather have another operation now than regret not having done everything possible later.
27 April: My last heavy chemo session. It’s only a week after my laparoscopy. I have a painful infection in one of the incisions in the middle of my stomach. My blood pressure suddenly drops and I almost pass out before they even get the syringe in me.
2 May: I start a lighter 12-week chemo regimen. Taxol combined with Herceptin this time. It dries out my eyes and I lose my brows and eyelashes. Otherwise, I feel nothing.
30 July: My last chemo session. I am afraid to call it my “last” chemo session because who the fuck knows what will happen to me down the road. So I say hopefully my last chemo session. People tell me I should not be paranoid. They are probably right.
31 August: Second PET scan results come in, I am in full metabolic remission. A few days later, the cardiologist confirms that the chemo has had zero effect on my heart.
4 September: I check into the Clinique de la Muette.
Wednesday, 5 September @ 7.45 AM (sorta still projected): I undergo a full mastectomy on my right side and the removal of a few lymph nodes. In theory, a low risk operation. I should be out on Sunday or Monday.
October-November (projected): 25 rounds of radiation over 5 weeks (every work day).
Fall 2019 (projected): Reconstruction a year after the mastectomy. I am looking at three operations any way you cut it (pardon the unintentional pun): the first to put in an implant/skin flap, the second to reconstruct the nipple, and the third to reconstruct my left breast so that both match.
I remember when, at the beginning, I saw most of these dates on a calendar and started crying because it was so overwhelming. To be honest, now that I have written them all down, I stare at them incredulously. Did I really do all of that in a year that’s not even over yet?
My right breast has less than 24 hours left. It has spent its last night in my bed, it saw my parents’ house for the last time a couple of weeks ago. It will never see my boyfriend again and it will never go back to Italy. In less than 24 hours, it will be in a lab, to be dissected and tested for remaining cancer cells. I wish I could bury it myself but people don’t do that kind of stuff. Plus, if anyone ever gave it to me in a box, I’m sure I would not be able to resist. I’d take a peek and be traumatized for life.
During these past few months, it has become harder and harder to live with the knowledge that I will have a mastectomy. Most mastectomies are performed soon after diagnosis. In my case, I have had more than six months of knowing that I will have to do this. When I was diagnosed, my breast was red, hard and swollen. It looked and felt dangerous. If they had told me I needed it removed the next day, I would not have blinked. Now that the tumor has melted away, it looks normal, it feels normal. I feel normal, apart from my pixie cut and (mostly welcome) absence of body hair. In many ways, the impending mastectomy feels more like an amputation. Many times this week I have cupped my right breast and said “I’m sorry. I’m really sorry.” And I really am sorry. I was never one to name my boobs. I did however, with as little affection as one can have, baptize my cancer Silvio. I named it after Silvio Berlusconi. I was looking for a small, assholish and ultimately insignificant dictator. Unbeknownst to me, I was following a family tradition – it turns out that thirty years ago my grandfather named his cat after an African dictator (because the dictator was anti-communist, not because he and the cat were both black). The PET scan last week confirmed that Silvio is dead. Now I just have to bury him in several coffins and deep, deep underground. And as much as I would like to, I cannot do that in my own body.
So, however much it may pain and scare me, I have to let go of you, right breast. I will miss you more than words can say. It’s not fair. It’s not your fault. It’s no one’s fault. But you harbored something that could have killed me. And I would rather have a memorial for you on my body than a memorial for myself. You have served me well (so well!). We had good times, bad times, and a lot of fun in between. I promise to resurrect you one day in spectacular fashion. And you will never really go away, you’ll just be invisible for a year or so, a phantom breast, so to speak. Be nice to the people in the lab, they mean well.
I, rather fittingly, saw Mamma Mia 2 last weekend (only 6-7 stars out of 10 unfortunately, but still somehow irresistible). One of the songs that has surprisingly made me weepy in recent months is ABBA’s Chiquitita. I had never really paid attention to the lyrics before. I was randomly listening to the song many months ago when I was overcome by a sudden swell of emotion and a realization – this is the perfect song for (my) breast cancer:
Chiquitita, you and I know
How the heartaches come and they go and the scars they’re leaving
You’ll be dancing once again and the pain will end
You will have no time for grieving
Chiquitita, you and I cry
But the sun is still in the sky and shining above you
Let me hear you sing once more like you did before
Sing a new song, Chiquitita
Try once more like you did before
Sing a new song, Chiquitita
Even though it breaks my heart to put an end to this marvelous act we’ve had going on for the past thirty-odd years, I will be dancing once again, and find a new song to sing. Au revoir ma chère amie.
Love,
A.
P.S. A huge thank you to everyone who has supported me on this involuntary journey, we’re about 50% done!
