Lessons in Being

Biopsy Love

I arrive at the restaurant early, hoping to snag my favorite table for a working lunch with Carol, my writing coach.  Two weeks earlier I had approached a literary agent about taking me on as a client.  After some initial encouragement, she turned me down. Carol and I had let a week elapse to sift through ideas about what’s next—approach more agents, go directly to small presses, rewrite again…. ? I am eager to hear her thoughts and find a next step for my writing that feels right to both of us.

Carol appears at the top of the stairway leading to my balcony perch, smiling and waving to me. I note, appreciatively, that she has dressed up a bit for our lunch—as have I. She settles in saying, “The hostess claims we have the best seat in the house.”  After looking out upon the bustling market scene below us—all manner of folks foraging for gourmet goods—she turns to me and asks, “How are you?”

My customary answer, “Just fine,” sticks in my mouth. I can’t say the words. Nor can I limit her question’s scope by saying, “I’m handling the rejection just fine.”   I blurt out, “I am having a breast biopsy tomorrow.”

What a conversation stopper. We pause in surprise, staring at each other.

But then I go on: “I just couldn’t say ‘fine’ to you. In the broader sense I’m fine, but right now the biopsy is very much with me.” I discover I don’t want an untruth, or partial truth, to stand between us—not after all I have shared with her in my memoir writing.

After a few minutes of laying out the facts surrounding the biopsy, I note: “I haven’t been able to write recently, although I have wanted to. How do you help yourself write?”

Carol extracts a notebook from her handbag. “I do lists—single words or phrases that help me remember whatever strikes me as I go through the day.”

She lays the book beside her and jots down a word every now and again as we turn to our planned agenda—what’s ahead?  How familiar this feels. I hadn’t noticed before, perhaps too wound up in my own words; but now I realize she has been doing “lists” during each of our prior meetings. Eventually we decide to experiment with some writing exercises that might open my eyes to new memoir possibilities, and we set a next meeting time.

Business accomplished, talk wanders back to the upcoming biopsy.  I find myself mentioning a similar breast indignity: “I had a biopsy of the same breast about six years ago. It didn’t seem so big a deal at the time, and all turned out well.”

When I look into her face, I find interest and a nod that encourage me to go on.

“My friend Beth accompanied me; and after settling me in my bed to rest, she went off to do some errands.  But the unplanned-for happened.”  I explain that I started to bleed profusely. I grabbed a nearby towel, pressing it to the wound, but the flow continued.  I made my way to the kitchen phone and dialed the emergency number I had.  The nurse who answered walked me through where and how to press, and stayed with me for the ten or more minutes it took to stop the bleeding.  When I hung up the phone, I discovered I was shaking—and covered in blood. Looking behind me I saw the trail leading toward the bedroom and remembered the mess I had left behind. The nurse had advised me to lie down, restrict my movement as much as possible, and drink fluids. My mind raced through what possibilities were open to me. I was alone, with no family nearby.  Beth, my only close neighbor, wouldn’t return for some time. And I barely trusted myself to walk right then.  Reluctantly I called my friend Doris, thinking I would be asking too much of her.  But when I explained my predicament she said at once, “I’ll be right over.”

She undressed me and wiped away what blood she could, before putting me in clean bedclothes. I didn’t need to make any requests. She saw what to do, and just did it. She remade the bed and helped me settle in it upon a nest of towels—just in case. Then she scrubbed blood from table and floor, washed and dried the stained clothes and sheets, and was a quiet presence as I dozed. I learned a great deal about friendship that day.

“But the adventure didn’t end there,” I add, taking a sip of my second Diet Coke. “I was left with a bright purple breast that traveled with me to Maryland for a ten-day residency, a requirement of my spiritual guidance training program.”

I recount my dismay when I discovered we women were housed in a facility that had but one communal shower area, with no possibility of privacy.  My odd-looking breast would be on display to near-strangers. I fantasized about showering in the wee hours of the morning, but quickly dismissed the idea. My purple friend and I did our best to just fit in, as if nothing were unusual.  Privately I found myself chuckling over the comedy of the situation.  Our mentors were telling us things like: “Just show up as you are—in prayer, in all of life.” Well, here we were each morning—my purple breast and I.

I am laughing at myself as I finish the tale, and full of gratefulness for friends—including this woman now laughing beside me.  And telling this story jogs my memory about another.

“Even longer ago that same breast and I ended up in the hospital,” I say, lost in thought. I recount how I went to a routine checkup late in my pregnancy with Lisa and found myself hospitalized. I had a routine bout of flu, but my high fever had increased Lisa’s heart rate to a dangerous level.  For days I lay on a water mattress through which cold water flowed as medical folks carefully monitored the fetus’ heart rate—making the water more frigid each time her beats or my temperature climbed toward the danger zone.  It worked. Lisa was born healthy. But it probably was during this hospital stay that I picked up a bad staph bug. In the early weeks of nursing Lisa, a painful breast abscess developed that defied all conventional treatments. Finally my doctor decided surgical draining was required, and I was introduced to a tall blonde blue-eyed Nordic god who did the breast surgery right away.

After a few weeks of healing, I took four-year-old son Brett and Lisa to our faculty center pool—on our first real outing. As I stood in the water holding Lisa and watching Brett at play, I became aware of a conversation behind me.  A male voice was recounting, in detail, the unusual operation he had performed on the breast abscess of a nursing mother.  It sounded like my operation, my breast, they were discussing. I turned to see who was talking.  There was my surgeon, looking even more gorgeous in his swimming trunks.  Before I could slink away, he recognized me.

“Oh, hi!  How are you doing now?” he called out.

I sputtered out something like “fine,” caught between a desire to dunk him or disappear under water myself.  I was embarrassed, sure my face was aflame, and left as soon as I could.

But now, as I finish telling my tale to Carol, I am laughing at this human predicament, and myself.  She slips me a sheet of paper from her notebook. “The History of My Breast” appears as a title at its top, and the word “biopsy” stands in a circle at the page’s center.  Here’s an invitation to probe my associations to “biopsy,” and to write. I nod my understanding, and thanks.  My breast does seem to have an interesting history—perhaps one I can learn from.
As we part in the parking lot, Carol reiterates her hope that all will go well with the biopsy and that I will let her know any news. She adds something like: “I will be doing my own ‘thingy’ for you.”

I smile in delight, knowing she is resisting any use of my word, “prayer.”  I think of her as a deeply spiritual person, despite her protestations that she is “an agnostic.”

As I drive home, I ponder what has just transpired. How had I gotten here—unable to say, “Just fine?”  And look what happened in response to sharing my news. I experienced caring, and found new ways to engage the history of my breast.

As the afternoon unfolds, I remember an earlier abnormal mammogram, midway through my marriage to Dave.  Despite my apprehension, I said nothing to Dave.  I didn’t want to worry him, knowing that one of the wounds he carried was his mother’s early death from breast cancer. Perhaps that was a reasonable decision then. I don’t really know.  But I feel again the loneliness and sadness of that time.

I won’t bother him with this—what an old pattern that is for me.  “Hide all parts of yourself that might bother others.  Try to make yourself lovable. Deny fear, anger, pain…  Just keep doing.”  I had lived by these childhood lessons for decades, largely unconsciously. But now I like to think I can recognize these remnants from the past and let them go.  Still they can sneak up on me, in new guises.

In the gloaming time of late afternoon, I sit in my favorite living room chair gazing into the woods beyond my wall of windows. I find myself reviewing the events of the past two weeks—how the old fear of bothering others hadn’t taken hold. I reached out; not at first, but soon. I had gone to my annual mammogram with the customary low-level concern and a wait-and-see attitude.  The technician told me I would get a call the following Monday or Tuesday if there were a problem.  When both days passed without a call, I felt relief. But the call came on Wednesday morning. A female voice said: “Something new, a mass, has shown up on your screening mammogram; I want to schedule you as soon as possible for a diagnostic mammogram.” We had set the exam for the next day.

I don’t remember feeling any fear in response to this news, but before long I became aware of a heaviness—sorrow, I think. And the weight of sadness stayed with me throughout the day.  I began to think about what radiology or chemotherapy treatments would involve. I knew details because in recent years I had accompanied two women through treatments for breast cancer. I had witnessed the important roles their families played, and I knew I would be without a family like theirs. My children had full lives elsewhere, and there were no other biological family members in my life. My two closest friends were unavailable, too. Beth was visiting in New Zealand; and Doris, taking care of her husband.

This sorrow felt akin to my childhood experiences of being alone in troubling, even terrifying events.  I saw the temptation to go to the old place of fear. But I didn’t. I was an adult now. I had discovered a mysterious loving presence in my life, even in its darkest places; and my vision of “family” had expanded beyond biological and marital ties. I really was not alone. But the heaviness stayed with me. Could I be rooted in the present and still be in touch with the residue of sad times in the past?  I thought so.

That evening I went to my regular Wednesday prayer group meeting, not expecting to say anything about my medical news.  But during our time for sharing prayer concerns or celebrations, words came.  “I have a concern,” I say, with only a brief glance at one or two faces. “I am scheduled to undergo a medical procedure tomorrow, and I find myself a bit apprehensive about it.” No one said or did anything. But before long the sorrow felt lighter—because I had spoken of what weighed on me to this circle of people who cared for one another.  I had not hidden behind that old barrier of not bothering others. 

I went to the Thursday procedure alone—my choice. I wanted to just be where I was and not get distracted by trying to take care of someone else. Five further X-rays confirmed the mass, but couldn’t determine its nature. Next came ultrasound testing, but the mass couldn’t be found this way. The radiologist, Dr. Karen Johnson, told me I would need a needle core biopsy to determine whether the mass was a problem. She seemed fully present to me as she laid out all the possible outcomes and shared her guesses. She told me what to expect in the biopsy. This would be different from the one I had before. I would be lying on an elevated table with my breast falling through a hole; and folks would be working beneath the table, using mammogram images and a computer to guide the needle to the mass and suction out tissue samples.

Grateful for her care, I struggled for words.  All I could come up with was: “Thank you for your manner.”  They were far less elegant and precise than what I yearned for, but I think she understood.

She disappeared into an adjacent room saying that she would schedule the procedure as soon as possible, and with her—“so you will have at least one familiar face.”

The biopsy was set for the following Wednesday morning—six days away.

For one day I kept the biopsy news to myself, just holding it with the intent to be open to whatever lay ahead. The next day, Saturday, I met Brett and his wife Ellie at Greensboro’s Museum of Life and Science.  When I first learned about the abnormal mammogram I had asked to spend some time with them over the weekend. I knew it would feel good to be with family, but I had no intention of telling them what was happening. Weren’t parents supposed to protect their children—not worry them unnecessarily? But over our lunch, words flowed out about the upcoming biopsy and felt just right—freeing.  Then when Lisa called later that day, I shared the news with her.  And on Sunday, I invited Doris and her husband to lunch after church and let them know about the upcoming event.  I had embarked on what for me was a rampage of telling. And each time the words seemed to appear on their own, without self-conscious intent.

Throughout this time, moments of sorrow continued to punctuate each day—as I walked in the woods, relaxed in my favorite living room chair, or engaged in silent prayer. I was able to let the feeling just be, neither working to understand the sadness nor running with it to “what-if’s” or fear.  I continued to hold the possibilities before me with something like calmness and openness to “whatever.”  

All my tellings, I now see, had set the stage for blurting out my news to Carol. Telling her was part of some larger process. I wonder what might be next.

As I finish my reverie, Brett calls. “Just wanted to know how you are doing tonight, Mom?”  He, who seldom keeps distant events in clear chronological order, has remembered that the biopsy will be tomorrow morning. The timing of his call speaks volumes about his caring.  Doris, too, calls to say her thoughts are with me.  And I find myself in dialogues with my right breast—sometimes an imagined or spoken verbal exchange, at other times the physical communication of gently patting the breast or holding it lovingly. I start to make my own “lists.”

Just before heading off for the biopsy, I surprise myself by kissing the breast and whispering words of solace and appreciation. What a new way of relating to my body.  I suspect the tales I told to Carol and her prod to explore “the history of my breast” have a good deal to do with this newness.

I go to the biopsy on my own, again by choice; although I think I would have asked Beth or Doris to go with me had they been available.  I arm the car with my cell phone, a heavy towel, and sterile gauze—thinking about the earlier bleeding episode.  I carry, too, the new water bottle Lisa gave me at Christmas, filled to the brim with flavored seltzer water—I guess for hydration.

After checking in, I sit for thirty minutes in the waiting room aware of holding my intent for openness to “whatever.” I feel calm and yet alert, attentive to all around me.  At the start an elderly white man is the only other person in the room.  I try but fail to catch his eye in greeting. Soon an African American family arrives.  The mother enters first and is clearly ill-at-ease.  She sits beside me without making eye contact, fans herself vigorously, and squirms in the chair. Occasionally she talks to herself: “I have a migraine now.”

The father and elementary school-aged daughter enter shortly, I suppose after parking the car. They sit side by side across from the mother, declining my offer to move so they could all be together. Father and daughter look through a notebook into which the girl has pasted magazine pictures. He asks questions, “Who are these folks?”, and she answers with delight and a teasing tone, “My favorite band, daddy.” I don’t catch the band’s name. But she catches me looking on, and we begin to exchange shy smiles. The elderly man seems disengaged from the whole scene, perhaps even disapproving.  But when a nurse invites him to join his wife in another room, he sweeps his glance over all of us and graciously requests, “I hope you will please excuse me.”

Somehow I am attentive to all these happenings and at the same time engaged in a reverie about the breast stories I had shared with Carol. Possible titles for writing emerge—“Beast Wisdom,”  “My Breast Talks”…  I chuckle to myself as I imagine what breast tried to say to me during the swimming pool encounter with the surgeon: “He recognized me. You thought it was you, but it was me. After all I was all he had eyes for in the operating room. I like being seen and talked about, but you’re getting all stirred up. I can feel it. Don’t dunk him! And don’t try to disappear under water. It’s OK to be me—no reason to hide!”

Now it’s my turn, and I exchange one last smile with the girl before leaving.  A technician leads me into the operating room, labels the odd-appearing equipment before me, and explains where and how I will lie and what I may feel. I know lying flat and prone upon that table will be a challenge for my back, and work with the technician to find ways to reduce the likelihood of back spasms or worse. 

“Just keep talking with me,” she says.  “And we’ll work together to do what we can.”  

Karen Johnson arrives. It is good to see her familiar face. She introduces me to the male doctor who will be working with her. I climb onto the table, and after a few attempts I find a position I may be able to maintain. My head faces toward a wall, away from the technician and doctors.

I begin my time of rigid stillness. Any movement at all, I am told, will mean we have to start over. I find myself sending silent words to the breast that is the focus of everyone’s attention—“It’s OK.  I am right here with you.” The words comfort me and I begin to focus on all the sensations of my body, much as I do in yoga.  I hear talk among the others present, but soon it becomes a background murmur without distinguishable words.  I scan my body, especially back, neck, and breast, asking how each is doing.  And when I discover that the mammogram pressure isn’t painful at all, the strange manipulations of my breast become just part of the overall picture.  I smile when I realize I have no idea whose hands are on my breast.  It doesn’t matter.  Even in all the tugging and pushing of my breast, I experience the comfort of human touch.  The technician discovers my hand is cold. She begins to rub it between her warm hands. I feel her heat entering me. My fingers curl around hers, and she keeps holding my hand. She begins to gently rub my back.  I feel the pressure of the needle’s invasion and hear the suction noise from the big box introduced as “the vacuum.”  I remain calm and vigilant throughout, breathing into the crick in my neck and discomfort in my back, immersed in body sensations. At what I imagine are critical moments for me to not move at all, I feel arms thrown over my back.

Only at the end do I move. One leg jerks involuntarily in response to something like pain. I hear a chorus of voices of concern, “What’s happening?”, and reassurance, “It’s all over. We’ve just removed the pressure from your breast.”  I appreciate the voices, but feel no need to break my silence.  Then someone’s hands are applying steady pressure to the wound so that the blood will clot. Whose hands are these? Nice hands.  I enjoy the comfort and warmth of human touch. Finally I am helped to sit up and climb down from the table.

The technician leads me into another room where she dresses the wound and demonstrates how to care for it.  After the teaching ends, I calmly tell her what Dr. Johnson had said at our initial meeting six days ago—that I could call on Friday afternoon to see if the pathology report is available.

“But what number do I call?” I ask. 

To my consternation, she contradicts me: “No. You can call on Monday afternoon, if you haven’t heard; and the number is included in the material I will be giving you.” 

I repeat my understanding about Friday, and she hers about Monday.  Back and forth we go three times.  On the third try, she stands directly before me, looks squarely into my face, and asks: “Didn’t you feel Dr. Johnson rubbing your back at the end, talking right into your ear, and telling you to call on Monday?” 

Suddenly I know how far away from usual human encounters I have been.  I can’t recall any of these words; nor can I associate any sounds or physical contact with Dr. Johnson.  Looking at my watch a few minutes later, I learn that I maintained the rigid stillness for well over an hour, deeply grounded in my own body and its sensations.

Two and a half hours after entering the waiting room, I drive myself home—full of gratefulness.  I prepare myself lunch. Mediterranean tuna salad and chicken and dumplings soup never tasted quite as good. I check my email and find Carol’s message. “I hope you’re resting and peaceful and not in pain. I have been doing the seeds of kindness chant for you on my special beads.” It feels like love.

I also find a message from a woman I do not know, asking to receive spiritual direction from me.  I am struck by the timing of her request; it is the second one to come my way during this week surrounding the biopsy.  In past months, I had wondered if it were time to refer new people to someone else. My plate felt full. Under the present circumstances, I could easily rationalize doing so. But this was not what arises. I feel instead the invitation to open myself to others, to keep walking the path I am on.

After a nap, I am drawn to the kitchen, to a mix that has been out on my counter all the past week—double chocolate chip brownies.  It seems just the right time to make them, and indulge a bit.

In the evening, good wishes arrive from a friend I companioned through her radiology treatments.  And Brett calls: “Just checking up on you.”  Next thing I know, my former-husband is on the phone, inviting me to breakfast the next morning. “Let’s catch up before I take off to visit with Lisa.”  When Dave asks, “How are you doing?” I don’t hesitate to tell him about the breast biopsy. But I decline his invitation saying, “I want to start tomorrow more leisurely, more gently.”  He tells me he would like to call while he’s on his trip, and I say “fine.” I call the woman asking for spiritual direction, and we arrange to meet four days hence to explore this possibility.

Biopsy day plus one brings a call from Lisa to find out how everything went and how I am doing.  And she recounts her early morning conversation with Isaac, my three-year-old grandson. 

“You know how much Isaac is into dinosaurs,” Lisa says. She explains that he’s been worrying about meat-eating dinosaurs; he doesn’t want them to eat plant-eating ones. When he woke up this morning, he seemed to have an answer. He told her that all the dinosaurs hide every morning, and meat falls from the sky for the meat-eaters. It’s not clear where the food comes from. At first he said it came from a big rock in the sky.  But now he’s less certain. It just comes.

“I think we have a budding vegetarian,” concludes Lisa, who at age fourteen declared herself a vegetarian living among a pack of meat-eaters.

Recalling Bible stories of birds dropping from the sky and manna being provided in the desert, I make a counter-claim: “I think we have a spiritual being.”  We laugh, relishing both possibilities.

Biopsy day plus two is the day before Valentine’s Day, a celebration that has held little meaning for me since Dave left our marriage. After hearing a noise at my front door and watching a man sprint away toward a delivery truck, I peek out the door.  Two large florist boxes lie on my doorstep. I sit back in the hallway, before the open door, and just bawl. I already have received so much caring. When I open the boxes I find a card nestled among the blooms. “Happy Valentine’s Day Mom!  Love, love, love, love, love! Our thoughts and prayers are with you through everything.”  It’s signed, “With love, Lisa and the Boys.”

Less than two weeks earlier we had learned that her second child would be a boy. And just a few days ago I had joked with Lisa about my wish for her and Aaron to become more romantic in their celebration of special days, more like the “hopeless romantics” Brett and Ellie were.  I can’t reach Lisa by phone at first, but I leave a message: “You’re a hopeless romantic—only in a way I never imagined.”  When we catch up with each other, I learn she only ordered and paid for one box.  But I received two identical ones.

“Love is the way messengers of the mystery tell us things.”  These words of the Sufi mystic, Rumi, arrived by email just a few hours before the flowers, from the Panhala website that sends me daily messages. The quote had struck a responsive chord when I first read it. Now I am chanting these words as I arrange the flowers, and I think of them each time I enter a room with a bouquet.  “Love, love, love,” the blooms shout.  And I remember again all the ways I have experienced love and caring since I ventured that first telling.  Each of these messengers of the mystery tell me I’m not alone—no matter what. 

I call on Monday afternoon to ask about the pathology report.  Soon Dr. Johnson is on the phone. “I have good news,” she says. “There is no evidence of malignancy—just normal breast tissue. Nothing more is needed now, but I will want to do a follow-up mammogram in six months.” 

A gentle wave of relief and gratitude rolls through me. I am delighted to not need surgery, radiation, or chemotherapy, but also grateful that I am more ready than ever before to face each of these.

My first move upon hanging up is to call Brett and Lisa. Then I take a long walk in the woods, savoring the sensations of my body in motion, the bird song, the spring wildflowers—tiger lilies, spring beauty, and periwinkle—just beginning to peek out, as well as the chill of the air and the gusts of wind that play the leaves and trees around me like instruments.  I drink in the reflection of sunlight off the creek beside me and the symphony of sounds as water pours over and around rocks. By the end of the day, I have shared my news with all those I told about the biopsy.

The next day I meet Beth at the airport upon her return from New Zealand.  I had thought often during the prior weeks about when she was to return and what news I might have for her. Her mother had died at an early age from breast cancer, and I know Beth fears this disease. What if I have to tell her I have breast cancer? I had decided to tell her the news, whatever it is, when I pick her up. I want her to hear it from me.

We go to a restaurant near the airport, and over a fine Italian meal I ply Beth with questions about her trip. Finally I say: “After an abnormal mammogram and weeks of more testing, I learned yesterday that there is no sign of malignancy.” 

Almost the first words out of her mouth are: “And I bet you didn’t tell anyone, did you?”
I laugh heartily. She knows me well. Then with a broad smile, I slowly list all the people I told this time.

The next evening, I am back with the Wednesday evening prayer group.  “I have two prayers of celebration tonight,” I say.  “The first is that I learned on Monday there is no evidence of malignancy.  I celebrate this.  But even more important to me is gratitude for what I have learned during these weeks.”  

I didn’t tell them what the messengers of the mystery had taught me.  But I know I have learned more about the importance of being open everywhere to the loving mystery I call “God”—in the people I meet, in me, and in all of creation. And “yes,” in an abnormal mammogram or a biopsy—in “whatever.”  I recall the words of Thomas Merton that accompanied me through Mom’s dementia and dying, my past illnesses, the long process of forgiving Dave for leaving, and my children’s bouts with cancer:

Life is this simple.
We are living in a world that is absolutely transparent
and God is shining through it all the time.
This is not just a fable or a nice story.
It is true.
If we abandon ourselves to God and forget ourselves,
we can see it sometimes
and we may see it frequently.
God shows Godself everywhere, in everything.
In people and in things and in nature and in events.
It becomes very obvious that God is everywhere and
in everything and we cannot be without God.
It is impossible.
The only thing is that we don’t see it.

And I say aloud to myself, “Yes, and I can block myself from seeing, from abandoning myself to God, by holding onto old defenses and fears.” 

It is now two weeks since the pathology report, and I have just spent the morning with a circle of spiritual companions, reflecting on our growing edges in pursuing a path of contemplative living.  I shared some of my learning surrounding the biopsy.  As I return from lunch with one of these spirit friends, a cancer survivor, she turns to me and says: “I am sorry you had to go through all that testing.” 

Skipping not a beat, I find myself saying, “Thank you, but I find I am not sorry at all.”