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I’m picturing myself lying in a coffin – it’s suddenly all I see. Pale skin, dark under eye circles and an emaciated body clothed in my favorite dress. I’m lying on display, while the few people that took the time to pay last respects gawk at me. I imagine a few people saying things to me that they should have said when I was still alive; others make comments about how young I was, what an agonizing illness it was and mumble how it’s ‘so sad’, while still others simply shake their heads clearly not knowing what else to say. The dozen or so people attending would be co-workers who feel obligated to attend, old friends that feel guilty because we hadn’t spoken in ages and use this time to work through their regrets, and my childhood and current best friend – a man I’ve secretly loved for years but will never have. That’s it. I have no one- not at my imaginary funeral and not now. No family, no one I can truly call friend. I shake my head as if awakening from a dream but no matter how hard I try to push the image from my mind, it remains. It’s a scene I’ve never conceived of until this very moment. It’s the first place my mind drifts when my doctor opened his mouth and said the words I’ve been hoping and praying I would never hear.
I watched him closely as he entered the room trying to determine the words that would pour from his lips when he opened his mouth. Would he just spit it out or try to break it to me gently? As he prepared, I tried to do likewise, but really, there is no way to prepare oneself for those words – no matter how many times you’ve imagined them or even said them out loud to try them on for size.
“Remy, the biopsy results are malignant,” he finally blurts out, but with emotion and concern.
I know I should be listening closely to him as he explains the findings, discusses options, tries to offer words of encouragement – but I can’t. It’s as if the entire room has filled with fog and it’s all consuming. I can’t see, I can’t focus; it’s impossible to see through the thick feeling of stifling heaviness. Words like “prognosis,” “aggressive,” “mastectomy,” “chemo,” “radiation,” are all finding their way through the blanket of fog assaulting my ears, suffocating me, causing me to breathe in shallow quick breaths. I’m hearing most of the words, or at least I think I am, but not registering them, they seem foreign, undefined. Still, clearer than anything he is saying is the vision of my dead body, lying there ravaged by the disease that has infested my breast – a disease I’m all too familiar with after it took the life of my mother. Shaking my head hard, with great difficulty I try to zero in on Dr. Peters.
“Remy?”
“Yes?” I ask, voice cracking, eyes trying to focus.
“Are you following what I’m saying?”
I start to nod automatically, but then stop. “No, I’m not. Not really. I’m sorry, I’m trying and don’t mean to be rude, but I’m having trouble. This is all just so…” I started to say ‘unexpected’ but stop because I know that’s not true - not at all. I think a part of me has always known this day would come. I just thought I’d have more time.
“Say no more, I understand. Here’s what I need you to take away from our appointment today, okay?”
I nod.
“Inflammatory breast cancer is very rare and accounts for only one to five percent of all invasive breast cancers in the United States. That means this type of breast cancer is usually very aggressive and will progress quickly. Do you understand?”
“How long?” My voice sounds loud in the room.
“Well, there’s many factors that-”
I hold up my hand and shake my head, “Dr. Peters?” His eyes meet mine and I know the second he understands what I want from him. What I need from him.
He sighs heavily, “We need to do further biopsies. Depending, with treatment and surgery, who knows. You could go into remission and it may never return.”
My jaw tightens and I feel a spark of anger. I know better than that. “And without treatment?”
“It’s hard to say…” he hesitates and I immediately shake my head which makes him sigh once more. “Three months. Maybe six. A year? I honestly can’t predict, Remy. I do know that untreated it’s fatal. The cancer will spread to your organs and it will shut them down. You will die.” It seems like his words echo in the room around us. He clears his throat, “But there is no reason to assume the worst.”
He forgets that I’ve heard that before and I sure as hell know better. Somehow I manage a shaky smile, “Don’t worry, I won’t hold you accountable if I die sooner, okay?”
My attempt at a joke falls flat as my brittle smile falls off my face and vomit rises in my throat. Swallowing convulsively, I reach for the bottle of water that’s ever present in my bag and take a sip before looking at Dr. Peters once more.
When my eyes meet his he continues, “My likely recommendation, based on the additional biopsy results, for preferred method of treatment is for you to undergo chemotherapy – every day for the first two weeks and then you’d undergo testing to see how your body is handling it. A total mastectomy and reconstructive surgery would need to be performed from there.” He tells me the biopsy is needed immediately and then talks about the chemotherapy process and how someone will call me to schedule the next biopsy and discuss next steps further. He explains the likely side effects I’ll experience. He gives me numbers and people to call in order to get everything set up, “as soon as possible.” It’s like now that he’s started, he can’t stop. He needs to get it all out. Truth is, it’s taking all I have to remain in the room at the moment. I’d like to scream. And run. Scream and never stop screaming.
“I’d like to take some time to think about it,” I rise and make it clear I’m finished discussing this for the moment.
“I understand, but again, due to the aggressive nature of this cancer, treatment needs to begin sooner rather than later. Do you understand?”
“Yes, Dr. Peters, I understand.”
“Alright,” he stares into my eyes again, perhaps looking to see that I do in fact comprehend what he’s telling me. He must see something that satisfies him because he nods to himself and squeezes my shoulder when he stands. “Please call the office to set up an appointment with me as soon as you’ve gotten your procedure and treatment scheduled so we can review the results and review the treatment plan. My nurse practitioner, Julie will help you get everything arranged.”
“I will.”
With one last look he leaves the room and somewhat amused – I find myself feeling bad for him. It has to be tough to work in a profession that requires you to be a frequent conveyor of bad news. It makes me curious why he would choose to have such a job – not a doctor necessarily – but a medical oncologist, the type he’s chosen. You’d have to be one hell of a strong individual to do this daily. To see hope in people’s eyes and potentially watch it get dimmer and dimmer if things don’t go as well as anyone wants.
Once I’ve redressed, finding it silly I had to get into a gown to begin with for nothing more than having my vitals taken and for him to listen to my chest with his stethoscope, I leave this room, knowing that in some way it will be imprinted on me forever, and attempt to find my way to the exit. Walking through the hallway that leads to the reception area, I pass several staff and swear the nurses all have a look of sadness in their eyes as they briefly take me into view. It’s likely my imagination; I don’t have a neon sign on my forehead flashing ‘DANGER: CANCER”, but somehow the atmosphere feels different – surreal. Part of me wishes I could get in my car, grab a coffee and go to work like usual. I want to pretend this appointment never happened, or that the outcome was different, and go on with my day as I usually would. Act like it was all one big horrible dream; no, a nightmare, definitely a nightmare.
I don’t speak or react to the nurses or stop at the check-out desk and after a moment of standing and staring when I walk into the bright light outside, I manage to remember where my car is parked.
Eventually, I find myself standing on my front porch, hands full of informational pamphlets given to me at the doctor’s office, though unable to recall when that occurred or what I had done with them after receipt, and I realize I don’t remember the drive home at all. That can’t be good – I could have crashed and died. I almost laugh at the thought. Like that really matters. Alarmed at the morbid thought, I do my best to push it aside.
Letting myself inside, I lean against the door for a moment after I close it behind me. I’m unsure of what to do with myself. My cat, Meatball, runs out from her hiding place and rubs against my legs. Dropping my papers and purse from my hands, I pick her up. She immediately purrs at the strokes I give her soft orange fur. Suddenly, I have a strange desire to tell her about my appointment. So I do.
