“I never liked my breasts. They were too small, too uneven.”
“They were perfect,” says her husband. “Perfect.”
She traces the dint in her chest with the middle finger of her left hand. “It's an empty and barren landscape, desolate, unlivable, foreign.” Her voice grows thin. “In a way, I'm glad they're gone.”
“Honey, please…”
She turns to her husband, face puckered, eyes feral. “What do you know? You didn't have cancer, I did.” He looks to the floor, frowned and grimaced. She smirks. “He tells me I'm passive-aggressive.”
Carol is a 48-year-old English professor and fiction writer. She's 2 years post-treatment for breast cancer, including a double mastectomy, and suffers from depression related to surgical disfigurement. She refuses reconstruction with breast implants and has been through multiple psychiatrists and psychologists and every class of antidepressant; still, she remains resolute in her refusal. In the dull fluorescent lights of the clinic, she appears an old woman, her hairdo stiff, her body stooped and aged, and her brow lines deep and shadowed.
She looks down at the emptiness on her chest. “The pain of the hollow has dwindled, but the loss of femininity remains.” Her husband stands and reaches for her hand. She stiffens, pushing him away. “Men don't understand, they can't.”
She stares out the window. “The chemo, the radiation, the fear, the uncertainty, they withered me, they withered my will.”
“I can't imagine what that must have been like.”
“No, you can't imagine, and before you ask—and you will ask—no, I don't want breast implants. I want this scar, I want this cavity, I want this ghastly residue of surgical salvation …” Her voice shrivels to a whisper. “Besides, the cancer may return. It's like a genetic noose, waiting.” She sighs a deep breath. “I can't go through chemo again; the thin arms, the thin legs, the thin hair.”
She squints as the last of the day's sun slides over her face and down the wall. “I remember when a bad hair day was a catastrophe, when a cracked fingernail ruined the evening.” She considers a mirror on the wall, then turns away. “And when a mirror was for preening my coiffure.”
Her eyes swivel to meet mine. “Doctor, the days just seem to prolong my suffering. Nothing gets better. Shards of hurt still hurt. There are days that I long for an end.” My head jerks, startled. She chuckles, cynically. “Don't worry, I'm not suicidal; lonely and despaired, angry and depressed, but not suicidal. The shrinks agree. Read their consults, they're in my chart. I've just a broken psyche.”
She opens her purse and pulls out a photo. “Look doctor, it's me, at the beach, in Hawaii, in a bikini.” A beautiful, vibrant middle-aged woman stares out from the photo, her husband at her side. I look at the photo and smile. She sighs and places it back in her purse. Then she stands, paces the room, and in a razor-edged voice says, “You know, it's easy for doctors and nurses to tell a patient to get a mastectomy, or a feeding tube, or an amputation, or whatever else that distorts and deforms the body. Then, once it's done—the figure now dis-figured—they have the goddamn righteous audacity to say, and say, mind you, in a childish voice, as if they're speaking to a baby, ‘Don't worry, everything will be okay.’ Well, it's not okay, it'll never be okay.”
She's right, it'll never be okay, at least not the physical. The deformity will remain, for it's what she's chosen. So I sit, listen, and wait, offering presence, patience, and hope. It's all I have.
