When the Big Thing Happens

I thought I’d run a piece I wrote a couple of years ago in honor of my annual exam, this morning (This essay was originally published in MORE magazine). It's about my getting a letter from the breast imaging center. I'm not proud of my reaction, but I learned a lot:

I’ve been fearful all my life.  I black out when I give blood.  I can’t walk to the top of the Guggenheim without hugging the inner walls.  It takes two valiums to get me to the dentist’s door and a promise of nitrus oxide and gum-numbing gel before I will sit in his chair of pain.  During turbulent plane rides, I’ve been known to scream, “HOLY CRAP, WE’RE ALL GOING TO DIE.”

I’ve been fearful all my life.

But I’ve always known that when the chips are down – when the big thing really happens - I will dip into my untapped reserve of spiritual and physical strength and rise triumphant. 

I’ve imagined the scene many times.  The doctor tells me that I have breast cancer.  Tears sting my eyelids, but I stop them from flowing.  I have no time for tears. I must live.  I must fight this thing, if only for my children and my husband who would be lost without me.  I am frightened, yes, but determined.  I will beat this.  I will do the chemo, shave my head, run the marathons.  I will be an inspiration to my friends, solidly upbeat, even funny about my cancer.  They will say, “Who knew that Brett could be so strong, so sure.  We are awed.  We are inspired by her bravery, her generosity, and how good she looks bald.” 

When I saw Melissa Etheridge jam on that guitar at the Grammy’s, with her hairless pate gleaming, I was so pumped I thought, that’s what I want to be -- a rock-n-roll lesbian with stage three breast cancer.           

            My husband, Pat, hands me the letter from Cedar Sinai Imaging Center.  I imagine bad news would come directly from my doctor, so I confidently slide my finger under the flap and rip open the envelope.  I expect this to be a form letter saying that my recent mammogram was clear. 

It is a form letter.  But the news is not what I anticipated.

We are writing to inform you that further information is required regarding your recent mammogram.  Please contact the center to schedule a sonogram. Please note that this request in no way indicates that you have cancer.  Contact your physician for further information.

            Adrenaline shoots through me like a cocked and loaded gun’s being held to my head.  Sweat pours through my skin.  My heart races.  The letter falls to the carpet.  I grab on to the desk and gasp, “I’M GOING TO DIE!”

            Pat grabs onto my shoulders, and yells, “Is it your heart?  Are you having a heart attack?”

            “No,” I pant, the pounding in my head so loud I can barely hear him, “The letter!”

            I point to the letter on the carpet with a shaky finger.

            “Is someone dead?” yells Pat.

            “No,” I yell back.  “The letter!  I’m going to die!”

`            “Someone’s threatening you?” he yells.

            “No,” I scream, my head spinning.  “It’s cancer!”

            “Who has cancer?”

            “The letter.  I have cancer!”

            Nausea churns my stomach.  I’m going to throw up.  I slip to the floor and stretch out on the carpet.  The floor is the safest place to be, as I’m going to pass out, I can feel it. 

            “Where did the letter go?” Asks Pat.

            I feel the crinkling of the paper beneath me, “I think I’m on top of it.”

            “Can you give it to me?”

            “I can’t move.”

            I feel Pat’s hand work it’s way under my back to get the letter.  I hear a rip as he pulls his hand out.  Then I feel his hand return, worming its way under my back again to retrieve the other part of the torn letter. 

            Oh God, I have cancer.  This is the moment you’re afraid of all your life.  The moment when you can see the end.  And that end is close.  It’s very close.  What do I have?  A year maybe? If I’m lucky.  If the cancer hasn’t spread to my lymph nodes and spinal column.  My legs feel numb. That probably means that the cancer has spread to my shins. 

            “It says here ‘in no way indicates that you have cancer’,” says Pat, scanning the two wrinkled halves of the letter. 

            “That’s the way they say it, Pat.  They don’t send out ‘You have cancer’ letters.  They have to introduce the idea gently so you don’t have a heart attack and die on the spot just from reading the letter.”

            “Isn’t it possible that the letter is telling the truth?” Says Pat.  Maybe they didn’t get all the information they needed from the mammogram.”

            Pat is not a person who reads between the lines. He is an empirical thinker.  Only seeing a thing for what it is.  When he looks at a chair, he sees only a chair, not a possible weapon.  This is a maddening quality in a man who is otherwise bright. 

            “Pat. For God’s sake. They don’t send letters asking for further information on nothing.  They only send out letters saying they need further information on your cancer. It’s code for ‘you’re going to die’.”

            Pat exhales. 

            “OK,” he says, “Let’s call Dr. Ricky.  The letter says to call your physician.”

            I roll onto my side and pull my knees up to my chest.  Thank God the children are playing at a friend’s house. I’m going to need time to pull myself together. I have to figure out a way to be brave for them.  I remember that Susan Sarandon did a movie in which played a dying mother of two kids.  She sewed each child a cape that had photographs silk-screened onto the fabric.  I can’t sew a cape. But maybe I can write them each a poem that’s chiseled into a small stone they can keep by their beds. 

            Pat starts to punch numbers into the phone.

            “Wait,” I say. “Don’t call Dr. Ricky.”

            “All right.  Why?

            “I don’t want him to think I’m being hysterical.”

            “You are being hysterical,” he says.

            He hangs up the phone and sits crossed legged next to me, as I breathe deeply for a few seconds. 

            As my breath slows, I think of all the things I will miss.  This carpet I’m lying on, for example. My parents bought it in Turkey and gave it to us for our wedding.  I love this carpet.  I look at the glass globe that we bought in New York a year before Spencer was born.  I think of New York every time I look at it.  The wooden puppet with the broken hand.  Someone gave it to me for Christmas.  Who was that? 

            “You ready?” asks Pat.

            “Um.  Sure.” I say, feeling considerably calmer.

            I pause for a moment to marvel at how simply breathing can soothe the system.  In fact, I feel a tiny bit groggy.  Maybe I should take a nap.  Everything looks better after a nap, even cancer.  My eyelids start to close as I hear Pat punching in the doctor’s number. 

            Pat puts the receiver in my hand.  Now weary, I bring it to my ear.

            “Can I help you?” Asks the receptionist.

            “I hope so,” I say, suppressing a yawn.

            There is a pause while the receptionist waits for more. 

            “I got a letter,” I say.

            “A letter?”

            “Yes,” I say, feeling the wool of the rug on my cheek.

            “What does the letter say?”

            I start to shiver slightly.  Tears spring out of my eyes and trickle onto the rug.  In a small tremulous voice that sounds nothing like my own, I say, “It says I have cancer.”

            The receptionist’s voice is gentle, “We don’t send out letters telling people they have cancer.  Can you read it to me?”

            “Um.  Sure.” I snivel. 

            I take the receiver from my ear and point to the two pieces of the letter Pat still holds.  He hands them to me.

            I try to steady my hands as I move the two pieces together.  I blink several times to clear my eyes and can barely read the phrase, “further information is required regarding your recent mammogram.”

            “Oh,” the receptionist says, “It doesn’t say you have cancer.”

            “But that’s what it means.”

            The receptionist takes a breath, “Look.  Let me assure you.  When you get a letter like that it’s almost always nothing.”

            “Almost always?  But sometimes it is,” I say.

            “Very, very rarely.”

            “But it happens,” I say.

            “Almost never.”

            “Then why do you send out these letters?  They’re very scary.”

            “All the imagists are saying is that they need more information.  It should make you feel good that they’re so thorough.” 

            “What makes me feel good, “ I say, “is not having cancer.”

            “I’m sure they simply couldn’t see everything they needed to see,” she says.

            “Sure,” I say, “because it’s hiding behind a virulent, aggressive tumor.”

            The receptionist pauses, “Do you want to make an appointment with the doctor?”

            I make an appointment for the next day.  But that means I’ve still got to get through the night. 

I speed through the five stages of grief in about half an hour, landing squarely in a sixth stage:  self-pity.  I submerge myself in it like an emotional warm milk bath.  I move around our apartment in a stupor that’s deepened by a couple of glasses of wine.  As I sit at dinner, I gaze at my children chatting happily.  I want to tell them that I won’t always be here.  That I might die sooner than I planned.  That I will miss them terribly.  My eyes hurt.  I want to cry.  I want to demand that we all stop eating dinner – that we all stop pretending that this is just any old day – and let’s all get in bed with mommy and pull up the covers and snuggle her and stay with her the whole time so that night time never comes and sleep never comes and death never ever takes me away from them. 

            I look across the table at Pat who looks back at me with a “Relax-you-don’t-have-cancer” smile.

            I look again at my sons whose confident faces lift me out of my warm pity bath, regardless of my desire to soak myself into prune-like self-absorption. 

I can’t tell them that I might be dying.  In fact, I can’t bring myself to interrupt their conversation with even the most banal of observations.  The young one grabs his cup of juice and drinks.  He’s recently started drinking from a big-boy cup.  I’ve had to remind him daily to sip slowly so he doesn’t spill.  I watch him put the cup back down.  No spill.  These are the things I must be here for.  The little triumphs that make up a life.

            I feel warm and still and almost lightheaded with ridiculous joy.

`            A thought occurs to me.  It is this:  If I have to go through it all, I can. I will. 

            The next day, Dr. Ricky assures me that whatever it is or isn’t can’t be detected manually so I still have to wait a whole month to get the sonogram.  He tells me that the fact that I’m not being bumped to the head of the sonogram line means that the imaging center is confident that this is either no problem at all, or a very small one. This is and isn’t a comfort throughout the month.

            The month is July and we’re all on vacation.  We’re visiting my parents who live on a lake.  I rarely think of shadowy cancer that might be growing its tentacles into my breast tissue – an image that obsessed me the day I got the letter.  My fear has become smaller -- a tugging in the corner of my psyche.  What if?  What if?  What if?  I spend the days splashing around with my sons in the lake and gabbing with my mother in the kitchen. Sometimes, at night, Pat and I make love.  Though I am careful not to touch my own breasts for fear of finding a lump as hard as a marble. 

            And when the month is over; when we go back to Los Angeles and I finally get my sonogram, the nurse tells me what Pat knew all along -- I don’t have cancer. 

When I tell Pat he says, “See I told you it was no big thing.” 

But it will be one day, I think.  One day, the big thing will happen and than you’ll be sorry that you didn’t live in a state of constant readiness. 

I don’t say this, of course, because he’s been complimenting me on how well I’ve been managing my fears for the past month. 

But I haven’t been managing my fears. I’ve simply been managing the rest of it.  This is how I’ve come to find out that when the big thing happens you fall apart and then you get on with it. 

And every smaller thing is a practice run.