By Wilhelmina Grant
Geneva had endured the agony of a core biopsy just a week before and bloody fluid was still oozing from the gaping incision on her left breast. She sat motionlessly on the box-like, paper-lined examination table waiting for the doctor to check the healing progress of the biopsy site. Dressed only in a thin, light blue cotton robe flecked with tiny blue flowers, she shivered more from nervousness and anticipation than from the excess air circulating through the vents in the drafty clinic. She was also physically exhausted after spending the previous night sleeplessly tossing and turning, trying to imagine what Dr. Randall’s pathology report would reveal. As she waited for the doctor to arrive, she replayed the scenario over and over in her head as she prayed for a happy outcome.
Dr. Randall had urged her to get bi-annual mammograms to track the growth of micro calcifications, which could either be benign, harmless deposits of calcium or an indication of breast cancer. After this round of mammography screenings, the results were suspicious enough to warrant a biopsy. The anticipation of the dreaded phrase she had heard seven years before – “you have breast cancer” caused Geneva’s stomach to churn as worry and anxiety gnawed at her. A knock at the door interrupted her thoughts. Dr. Randall had arrived.
“How’s that biopsy healing up?” Dr. Randall inquired as she gently prodded at Geneva’s wound with a gloved finger.
“It’s still a little sore and messy. I have to constantly change the dressing.”
“Yes, that’s good. Keep it nice and dry. It should close up completely in couple of weeks. Here are some extra gauze pads to take home. You can get dressed now, and come across the hall to my office where we can discuss the findings on the pathology report.
Geneva hurriedly changed back into her street clothes and reported to Dr. Randall’s private office as instructed. But as soon as she was seated, Dr. Randall was summoned by the physician’s assistant to the outer office to handle an urgent matter. Geneva realized that the demand of time and attention from other patients, fellow physicians and employees was one of the disadvantages of hiring a highly-skilled, competent physician. She disappointedly had to wait a few more minutes to get her test results.
As Geneva sat and waited she surveyed the contents of Dr. Randall’s office. She noticed a stack of reports and a vase of fresh cut tulips on the credenza behind Dr. Randall’s chair, numerous diplomas and plaques on the walls, a lamp and tennis trophy on the side table next to the couch, and a crystal paperweight next to the phone on the desk. Then she focused on the florescent lighting above her head, and studied the ceiling, checking to see if a pattern was formed by the succession of pinholes that were part of the design of the acoustical tiles. At last, she closed her eyes and did some meditation and deep yogic breathing to help calm herself down.
After what seemed like an eternity, Dr. Randall finally returned holding Geneva’s pathology report with both hands. Geneva’s heart leapt as the doctor gazed directly into Geneva’s eyes and said: “The cancer is back -- I’m so sorry. You have ductile carcinoma in situ. It is a very early stage, non-life threatening cancer. This is very fortunate for you because it was detected near the beginning and can be handled very easily with a simple mastectomy. The good news is that you have the option of immediate reconstruction, which is likely to be fully covered by your health insurance.”
That didn’t really strike Geneva as good news. She was still reeling from the statement of a few minutes before. Right then, Geneva was feeling the shock, despair, fear and hopelessness of being diagnosed with breast cancer in the same breast, for the second time. She was angry at her body for betraying her once again. She thought back to that summer seven years before, when she underwent a breast sparing lumpectomy followed by four months of heavy dose chemotherapy, then seven weeks of daily radiation treatments. She even tolerated five years of Tamoxifen, an experimental pill designed to prevent uptake of estrogen by the breast, and thus avert recurrent breast cancer. It seemed unbelievable for her to be sick again. She wanted to lash out, break something, blow up the hospital, anything to release her emotional pain and anger.
“Geneva.” It was Dr. Randall’s voice that brought Geneva out of he trance she had been momentarily engrossed in. “Geneva – that’s not all. There is the issue that you could be pregnant. We picked up an elevated level of hormones on your blood work. When was your last period?”
“What?!” Pregnant? This was really too much. Life was so unfair. She was not in danger of losing her life to cancer this time, but she had another life besides her own to consider. The realization of a pregnancy suddenly came crashing down on Geneva. She might give birth, give life, but the very purpose of her breasts, to feed an infant, was being taken away. What about the anesthesia, she thought. Would it be harmful to the fetus? Would she have to wait until after her first trimester to have the surgery? Her head was swirling with questions about the safety and survival or her unborn child. She felt like the walls were closing in on her, the air in the room was in short supply. She was suffocating. Her heart muscle and brain were simultaneously going into paralysis. She couldn’t think, speak or breathe. The lights were getting dimmer. The sounds of the piped in office music was getting fainter. Now she knew what it felt to be dying. She was either having a heart attack or a stroke. As she expelled what she thought was her last lungful of air, a hand firmly gripped her shoulder and gently shook her.
Dr. Randall had re-entered her office and discovered that Geneva was in a deep sleep. As Geneva gradually began to awaken, she saw Dr. Randall’s gentle smiling face and began to remember where she was and why she was there. Suddenly the horror of the entire exchange came flooding back into her consciousness as she realized that she had been dreaming.
Dr. Randall calmly revealed to Geneva that results of her pathology report from the biopsy showed no malignancies. “You’re cancer-free.” However, I do suggest that you continue to have routine mammograms every year – and go home and get some rest.
Geneva breathed a huge sigh of relief. She was ecstatic that she was healthy but a little disappointed that she was not pregnant. She desperately wanted a baby, but wanted to wait until everything was perfect in her life. There were plenty of women who had normal pregnancies and gave birth to healthy babies after surviving cancer. In the coming weeks she would give the idea of pregnancy some serious consideration.