1, 2, 3, CT

Normal arrives slowly and enshrouded in relativity.

Shortly after my surgery, I receive an offhand recommendation from my oncology nurse to get a CT, or CAT scan, which is a special X-ray that produces cross-sectional images. Since there had been some worry over my tumor marker numbers creeping up pre-surgery, the nurse automatically referred me. I obliged with no idea what was in store.

Upon checking in for my first ever CT scan, I'm informed of the need to drink contrast every 15 minutes for the next hour before the test. I'm offered a variety of flavors of thick, toxic looking stuff in plastic bottles marked "Barium Sulfate Smoothie" -  appetizing stuff, starting right with the name.

I select vanilla and am pretty violently cringing, gagging, and shuddering through the first cup - as in, the first 1/4 of what I'm supposed to drink. I look around the waiting room instinctually, as though to commiserate with anyone else brandishing Barium; my widened eyes search for someone to give a “Can you believe this stuff?” nod to. No one else is suffering the smoothie at the moment though.

Like a child, I reach up and plug my nose with every gulp and regret having to let go to breath; as soon as air hits my tongue, my shoulders are scrunching up and I'm involuntarily shaking my head from side to side. Wow, this is some "smoothie." 

My sister-in-law Jamie, who has kindly accompanied me on this adventure, keeps moving the trash can closer, obviously fearing I’m going to vomit. Oh no, there’s no way I’m letting this stuff come back up. 

Just before the 30-minute mark, when it's time to down a third cup, even though I've barely finished the second, Jamie and I go back to reception to swap the second of the two bottles of vanilla for another flavor. We ask our barista/receptionist for his recommendation and head back to the waiting area with a “mochachino.” I'm afraid it's going to put me off of coffee forever, but no need to worry as it tastes absolutely nothing like coffee. He is right though, it is slightly better. 

50 minutes in and I'm pretty drastically behind on finishing both bottles. I'm alternating between rationalizing body mass ratios to ounces necessary and reverting to childish impulses to hide the unfinished bottles. 

At 5 minutes till the hour, the doors slide open and a radiologist appears wielding my chart. She waves me back and doesn't even glance at my 2 half-full bottles. Apparently Barium Sulfate brings out the immature in me because I'm grinning like a child who narrowly escaped getting caught misbehaving. Hee, hee, she didn't even notice I didn’t finish it all. 

As soon I'm through the door, childish impulses as well as hopeful rationalizations vanish, and I simply mention that I didn't drink it all. "No problem; you don't need all of it. I'm sure you were tortured enough," the long-haired radiologist says with a smile. 

What? That's it? No sending me back out with admonishments? No failed test?  Alright!

Wait, could I have gotten away with drinking less than I did?

The comically uncomfortable ordeal from the waiting room is about to fade into insignificance. A real and serious torture is lying in wait ahead.

I change into a gown, ease myself onto yet another examination table hanging out of a large, expensive-looking machine, and am informed the second part of the contrast is administered through IV. Oh no, not my veins! Just give me another bottle of smoothie. Seriously, I’ll take anything to avoid involving my veins.

The veins in my arms are small, roll when pricked, and have been pretty severely taxed over the 6 chemo infusions. My left arm can no longer be used, since I've now had lymph nodes removed on that side and so it’s at high risk for lymphodema. This limits me to the poor option that is my right arm, which has already taken a pretty hefty beating. I had a chemo infusion go bad in this arm; the poison leaked and a whole part of my forearm is still discolored and numb. Then there's the busted vein on the top of my right hand, where the IV was in for 3 days while I was in the hospital for surgery.

All around, I’m not in an ideal candidate for either (A) getting a large needle into a vein or (B) keeping it there without the vein collapsing when fluid is pushed through it.  

1 radiologist, 2 radiologist, 3. 1 vein-finding light, 2 warm packs, 3 sheets. I'm still cold, dehydrated, and possessing uncooperative veins with only one usable arm. 1 prick, 2 prick, 3.... 6, 7 and still no vein that's walls don't collapse when they start injecting the contrast fluid through it.  

No one wants to be stuck with a needle and of course not repeatedly; a digging, damaging needle.

Lying there on that table, I am not a person. They don't see me. I'm just an arm - a difficult prick that might reflect poorly on them if they fail. Just an arm. Meanwhile, the rest of me is shaking, starting to cry, and wishing I were back in the waiting room drinking toxic smoothies while Jamie shoves the trash can at me.  

I try to be strong. I turn my head away from the white coats hovering above me and count the knobs on the cupboards. And then I count them again in Italian. I get halfway through Annie's "Tomorrow."  When I lose the focus to come up with lyrics or languages, I simply stare at the cupboards and chant desperately, "1, 2, 3.  1, 2, 3.  1, 2, 3" over and over again. 

With every locatable vein tried and failed, the technicians finally give up and run the scan without that portion of contrast. Their prodding efforts are for naught.

I'm so glad my oncologist's nurse recommended I get this fairly-ineffective test, just as a precaution. Barium Sulfate and vein exploration is a recipe for fun by any count.

My Pal Soy Patty

Time for breast MRI number two, the indicator of how effective my treatment thus far has been. (In other words, is the chemo shrinking the tumor?)

The Radiologist is the same one I had for my first MRI a couple months ago. We remember each other. She’s about my age, maybe a few years older. She wears her hair tied back like I used to, she makes a lot of eye contact, and she bows a little when she says goodbye. I wonder if she remembers me more by my face or by the cancerous images she views on her screen. Anyway, I like her.

Today she has me in her office to start the IV, through which she’ll insert dye contrast during the last scans. Thankfully, the needle goes in easy enough and we’re left chatting for a few minutes before the machine is available. 

She’s looking over my charts and commenting on my height to weight ratio. “I’m 130 pounds too! Actually, 135; I just gained 10 pounds,” she tells me. “But I have nooooo muscle. I’m just like a big, thick soy patty, or something.” 

I laugh at her analogy.  She continues to describe her lack of exercise and comments enviously on my toned legs. I’m a little stupefied at the irony of her coveting anything at all about my body or health at the moment.

Cancer doesn’t follow clean rules about who will get it and when. It will defy conventions on prior health, age, gender, or even family history. It’s not predictable or understandable. There are things we can and should do to bring our risk factors down, but even so, cancer, like most other diseases, can creep up on anyone, at any time. So, while I may be a lean fish next to my soy patty pal here, I’m still the one with a needle in my arm and cancer in my chest.

I climb on the table to lie face-down, as I’m directed. There’s a white, bowl-shaped head rest at the top that fills my forehead with painful pressure as soon as I settle into it; it feels like the entire weight of my body is concentrated into the space between my eyebrows. The bowl also confines the flow of air to my face - not an ideal situation for a person suffering from nausea. I’m imagining vomiting into all that white and still having to hold still for the remainder of the tests. 

The prickles of a hot flash descend not long after I’ve been inserted in the MRI tube. I can feel the sweat collecting at each hair follicle remaining on my head – all 12 of them. The flush of heat severely challenges my ability to remain still.

I can do this. This is a small challenge. I’m picturing floating in a cool pool of water… diving below the surface, the calm, the quiet, the water muffling the loud banging and clanging of the MRI machine.

“Here comes the dye,” says Soy Patty through the intercom. A strong chemical odor wafts to my nostrils just as I feel the liquid being pulsed into the vein of my right arm.  My weak stomach is fluttering; I feel so sick I actually laugh. Yes, I really am lying uncomfortably in an MRI machine, with bruised veins, sick from chemotherapy, and having a hot flash. This really is my life.

The imaging only takes about 15 minutes and then I’m rolled out and allowed to stand dizzily on my own two feet. I receive Soy Patty’s small bow and best wishes, get my “toned” but unfortunate self dressed and head out with a bright, red indentation smack between my eyes. 

Transfusion

Sitting in a cubby and hooked up to an IV, a strangers’ blood is flowing through my veins.

I’m nearing the fourth hour in this chair; the second bag of blood is dripping down into the tube attached to my arm.

This, as much as anything else, convinces me that I am in fact a sick person. After all, only seriously ill people get blood transfusions. I will receive two this week. Four bags of donor blood will restore me over the course of the eight hours I spend in the transfusion room.

Bobby and I are now so deeply entrenched in this life of medical rottenness that it doesn't phase us for me to come here alone. While the seriousness of the scenario does resonate with me, practicality overrides emotions. We have a young son to look after and my husband has a job to maintain. With every appointment and procedure, I can't have a babysitter at home and a friend at my side.

My mother disagrees. With a long drive, she is there to sit through the next one with me.

Today, there is a small man in the IV chair next to me; he's in for his weekly dose of a bag of blood. For some reason this appalls me. I always envisioned blood banks collecting for car accident victims and emergency surgeries. I never thought about “regulars” appropriating the supply. That this man is sick enough to need a transfusion every week does not greatly impress upon me at this point in my life. Instead, I'm thinking more along the lines of, Hey man, you're hogging the stash. Clearly, I need some of this blood to get to my brain.

According the Red Cross, some 5 million patients receive blood in the U.S. in a year. Many sickle cell and chemotherapy patients require frequent transfusions.

On behalf of the regulars and the emergency 1-timers alike, thank you to anyone who has ever donated blood. Such a simple act saves lives.



To find a blood donation location near you, click here:

Empty Ultrasound

With my new hormone prescription, I begin a monthly injection of a drug that essentially shuts-down my lady parts, as well as an order for a pelvic ultrasound the following morning. 

Like a normal person, I associate ultrasounds with pregnancy.  

My first pelvic ultrasound took place 6 weeks after I learned I was pregnant with my son; it was a standard check on the viability and health of the pregnancy - and it was one of the most joyous days of my life.

We had been trying to get pregnant for several months, approaching a year, and were starting to get consumed with fears and yearning. I was extremely happy when that home pregnancy test was finally positive, but I was also nervous and set my eyes upon the first ultrasound, where they check for the heartbeat, as the real indictor of what was to come. (If a heartbeat develops on schedule, the chances of miscarrying decrease drastically.)

I couldn’t wait to see that tiny little heart pulsing on the monitor and was in a state of pure euphoria when it did. The memories of that joyous day are clear: what my little gummy bear looked like bouncing around in there, what I was wearing, how big Bobby smiled, the flavors of celebratory ice cream we ordered at the ice cream parlor afterward. It was beautiful; it was happiness.

The second such ultrasound of my uterus took place on week 2 of my second round of chemotherapy, under considerably less pleasant circumstances. After 4 days of unnaturally heavy bleeding, I was a deathly anemic cancer patient being checked for fibroids or other abnormalities that might explain my extreme reaction in response to the chemo’s alteration of my hormones.   

My mother and I sat in the waiting room amongst a slew of pregnant women and tried not to be cut by the sadness of my visit in contrast with theirs. This was a demon I had already faced - many times. 

My husband and I had just begun trying for our second child when my health took a dive and began the process of uprooting our life plans. Every medical center I have entered over the last 8 months has had an OB-GYN office within. It’s been cruel. 

I have jealously watched an unhealthy number of adorably pregnant women walk down hallways or enter elevators on the way to their check-ups. “That is why I should be here,” I think. Every time I look up from my little nightmare and upon a round belly, I am tormented with longing. I want to slump down in a ball and scream, “Give me what she has!”

So, as it was, I was far ahead of my mother in coming to terms with that unpleasant contrast on this morning. Nonetheless, nothing prepared me for the torment I was about to endure upon getting the ultrasound.

I entered the little room and climbed onto the table, just as I remembered doing for my previous such visit. The technician, the doctor, and a third woman in scrubs all peered at their computer monitor at my side and discussed what they were seeing in my insides.

My head turned to the opposite direction, where a second monitor was set-up for patient viewing. I was curious to take a peek in there too, maybe attempt to follow their conversation. (Creative measures are necessary in withstanding the dullness of medical appointments.)

When my gaze hit the screen, a stab of sadness sliced into me so completely I stopped breathing. There it was, that same round sack, the inside of my uterus, in black and white, up on the screen. But it was empty. Painfully empty; no gummy bear bouncing around, no tiny pulsing heart. No joy.

I had to look away.

My heart is breaking.

More On Waiting

I spend a disgusting amount of time waiting for doctors. Waiting for them in the reception area, waiting for them in the exam room, waiting for a phone call, waiting for a prescription to be called in …waiting for answers.

Why is poor service so acceptable in the medical profession? As though the experience of illness is not unpleasant enough, ridiculously long wait times, inaccessible providers, and costly mistakes are frighteningly common.

And the waiting takes place in such awful locations: usually hot, small rooms with overly bright fluorescent lightening. The worst is when you do your time in a crowded reception area - aptly named a Waiting Room - only to be taken into the exam room (with short-lived enthusiasm) and then are made to wait longer there. 

In the restaurant world there is a rule that customers should not be seated at a table until the server and the kitchen can provide them with timely service. People tolerate waiting to be seated but as soon as their backsides hit the booth, they want a menu, a drink, and their food to be ordered and arrive in an appropriate progression. Restaurateurs know, even if a table is available, don’t seat it until the customer can be given prompt service. 

I guess no such rules are needed in the medical field. They'll trick you with waiting in one room and then move you to another, only to wait longer, in private and with a false impression things are moving forward.

Oh, do I sound bitter?  

Sorry, this is my life now. The dullness of those neutral walls… the sterile smell… the smallness of the rooms… the stolen hours from my day… 

Fifteen minutes is an understandable wait time; thirty is very inconvenient; forty-five makes me insane; sixty or more makes me cry. 

Just waiting. To feel like my life is my own again.

Another Day of Terrible

Capping the worst couple days of my eighteen weeks of chemotherapy, I spend Monday in the Oncologist’s office, bleeding and miserable in a crowded waiting room.

When they finally manage to squeeze me in and squeeze some blood out of my finger for a hemoglobin test, I am informed how severely low on the red life-force I am. A blood transfusion for the following morning is scheduled.

Passing me down the line, I am sent to a neighboring city to see a Gynecological Oncologist who can work with my hormones to stem the bleeding (this round and during future rounds of chemo.) 

We drive to the OB/Oncologist’s office, have another long waiting room stint and I'm told the doctor is actually in the same building we just came from. Oh, of course! This is my life now.  We drive back, pay for parking for the third time, and, shockingly, have another hour in a waiting room.

I’m starting to lose it. Waiting room number 3, hour number 6, emotional breakdown number 1.

I’m working at passing the minutes to turn the day into tomorrow.

Lacking blood, energy and patience, I finally meet the newest specialist to my growing team of medical experts. I can’t bring the corners of my mouth to upturn into a smile as he introduces himself. Just give me the prescription. The patience has been bled right out of me.

As I’m standing in front of the building, waiting for Bobby to pick me up, two women stop and comment on my “amazing complexion.” Good Lord, I’m about to keel over right here on the sidewalk for lack of blood. But I’m glad it shows flatteringly in my pallid complexion.

My life really has become really, really odd.

Bone Scan Birthday

It's my birthday, my 29th.

I can imagine a lot of lovely ways I might like to spend this day, none of which involve getting a bone scan. But imagine and reality exist with an ever-widening chasm between them these days; the day is spent undergoing the procedure.

After a cancer diagnosis, a bone scan is often ordered to determine if the cancer has metastasized (spread) to the bones. The test is a two-step process. It takes place in a Nuclear Medicine center where a radioactive substance is injected into a vein and then, after three hours, a machine that screams “this test is going to be expensive” scans your body and creates a digital image for the experts to analyze. 

I awake on this Monday morning optimistic that I can still have a pleasant day, in spite of the circumstances. The test shouldn’t be too strenuous or uncomfortable, and my husband and son, Bobby and Little H, are coming with me. (I’m in a take-what-you-can-get kind of mentality these days.)

The 17 mile drive to get to the medical center, that has readily become my second home, takes us a full hour on the Los Angeles freeways and is seriously unpleasant. My optimism for the day is quickly curtailed. Bobby is unusually chatty, discussing whatever topic enters his mind, but I’m too focused on the ticking clock to concentrate. There’s too much traffic for the middle of the day; we’re cutting it really close. Why is he always in the wrong lane? Am I going to make it on time or have to repeat this trek? I can’t even bring myself to partake in the usually exciting business of spotting trucks for Little H in the backseat. 

Just in time, Bobby finally pulls in front of the medical plaza and I hop out. After a quick trip down the wrong set of elevators and back up, then down the correct set, I enter the waiting room at exactly my appointment time. “Just one paper for you to fill out and I’ll let them know you’re here.” That sounds promising; except the waiting room is so packed that it belies any succinctness. 

I fill out the paper rapidly, as though that will help me get in faster, and then take the sole remaining chair. There are a lot of old, sick-looking people waiting. 

I stare at the edge of the coffee table. I stare at the clock. I realize I’m sitting on the edge of my seat and try to relax into the chair. It’s fairly obvious they won’t be calling me anytime soon. That lovely plan I concocted of Bobby and Little H picking up our picnic lunch and then coming back for me is starting to look bad. Maybe I should have come by myself.

After 30 minutes I ask the receptionist, as politely as I can, how the wait is looking. She makes a phone call and then cheerily tells me “5 more minutes.” That makes me cheery too. 

15 minutes later I’m called to the back. The tech prods around in that sensitive part in the fold of your arm - preciously where I’ve already had blood drawn twice in the last couple of days. Ominous looking metal box and needle kit appear; injection into bruised, sore skin; done. And I’m literally running out the door.

The next two and half hours of waiting time before I have to be back for the actual scan are spent at the only feasible option within a 20 minute driving radius, the local park.

The three of us eat the sandwiches the boys picked up and then Bobby pulls out a Birthday treat for me, a brick of pecan-bar pastry that he’s sure is “just my style” of sweet. It makes my stomach churn. (We’ve been together 11 years but the dear man still hasn’t mastered my tastes.) The dessert is like the birthday itself… just so far off from good. 

While Bobby runs around on the play structures with Little H, I camp out in the sunshine, amidst the nannies talking in Spanish into their cell phones. I’m too tired to join my family.

Watching them and not being able to participate is a severely unpleasant activity that I have become familiar with over the past months. When my inflammation problems were at their worst, I was forced to become an onlooker, watching with a deep longing to participate in my unfolding life. On this day, I blessedly have the ability to move, but instead am weighed down with the heaviness of fatigue. I’ll witness their energy and save mine.

I’m jealously peering at the homeless man dozing a few trees over with a blanket under him and a backpack-pillow. Dang he looks comfy. 

It may be my imagination but I’m pretty sure the alert nannies in the bunch are starting to give me suspicious glances. My child is now nowhere near; I’m just the really-short-haired weirdo sitting alone and unmoving in the kid area. 

Finally, with our limp attempt to have a pleasant afternoon picnic behind us, it’s back to Nuclear Medicine for me. A quick 10 minute sojourn in my favorite waiting room and I’m led back to the machine room. I change into a robe and I’m up on the table. The scan is only mildly uncomfortable. I’m wrapped up in a cocoon of sheets so I can’t move, the table under me gets a little shaky and warm, and a large, square slab is lowered just above my face. Over the course of the next 45 minutes, the slab moves very slowly down my body. Then it’s over.

And there it is – traffic on the way home, a bowl of cereal for dinner, an unpleasant medical bill in the mailbox – and my 29th birthday is over. 

Inching Foward

Day after day is spent driving to medical appointments. I meet my surgeon and her staff, my oncologist and his staff, am referred to a plastic surgeon for reconstruction, and a psychologist, to make sure I’m holding it together. I have a chest MRI and a mammogram on a breast still very sore from being cored like an apple. I have x-rays and blood panels drawn. I have genetic testing performed.

The early weeks amount to putting one foot in front of the other and showing up at appointment after appointment.

I am not coping or processing. I am simply inching forward into the battle.

Apple Core Biopsy

A Core Needle Biopsy is a misleading name for the type of breast biopsy I underwent, misleading because it has the word needle in it. Core is the much more accurate describer in the name. It’s not unlike an apple-corer, which gets shoved in small increments through an extremely dense apple, until the core, or lump, is reached and a sample can be collected.

 

My biopsy unfolded with the smoothness of sandpaper.

The ultrasound the week prior brought me here, "just in case," since there was a bit of tissue that looked different from the rest. “It's most likely nothing to worry about… especially at your age,” assured the technician. 

The biopsy, like most unpleasant things, took place very early in the morning, and in the middle of a visit from out-of-state friends. I left home before my house guests, husband, or son had awoken for the day and am tucked into the corner of an empty waiting room. It’s too early to read a magazine, so instead I’m staring at the TV screen, a good 30 minutes into enjoying a display of deluxe steak knifes that I too could own with only six payments of $14.99. I hate that I’m here. Why is it so cold in here? And really, who picked this channel? 

Finally, a nurse opens the door and calls me back. We walk together down a long hospital hallway, during which I can not think of a single topic of small-talk. Apparently she can't either.

 

We enter a cubby of a room and she breaks the silence to direct me to a gown and small operating table and then leaves me to more waiting.

As I'm passing the time in a state of growing agitation, in walks a man in a white lab coat. A man? You’ve got to be kidding me? (Understand, I’m a young, inexperienced patient who has been spoiled with a lifetime of previously stellar health. Biannual trips to the dentist and annual Pap Smears (with my female primary care physician or my female OB-GYN) were previously my greatest causes for anxiety. I think I’m a generation past having to see male doctors for issues concerning distinctly female parts, and I haven’t yet crossed the threshold into the disenfranchisement and lost modesty of experienced patienthood.) I don’t want a man – a young, moderately attractive man with poor bedside manner and an unsettling lack of confidence - poking and prodding my sad little exposed breast.

I also really don’t want to be here and that hasn’t done much for me, so I’m trying to move on in my head. Let’s just get this over with.

A core needle biopsy unfolds with the area being numbed for a small incision, through which a very long and thick “needle” with a clipper-tip is inserted. Guided by ultrasound, the so-called-needle is placed appropriately to collect small tissue samples. The procedure takes about 15 minutes - purportedly.



Yeah, kind of like that.

I’m exposed, sanitized and readied. Man-Doctor raises the anesthetic syringe and plunges it into my breast, but it hits wrong, or is bent, or snaps… I don’t know what happened, but in an instant I’m shocked with a spray of cool liquid across my chest and face; it’s on my lips, it’s in my wide, startled eyes. 

That was the twig that broke the dam; I start to cry right there on the table.

 

The pain and immobility of the last 6 months, the tests, the doctor's offices, it's all playing before me with a parade of dark emotions. The tears spill over into my ears and down my neck. I want to wipe them away quickly, but I also don’t want to draw attention to them. Which is more discreet, I quickly debate with myself, flowing tears or hands wiping them away? The answer is neither.

I’m only at the start of a path that will produce so many more tears from medical tables, beds, and chairs. I’ll never overcome feeling pride at hiding emotion in front of my doctors or shame at showing it.

Today though, crying publicly is painfully new.

My face and chest is mopped up while profuse apologies are offered. The nurse, either in a failed attempt at consolation or simply startled herself, is repeating how she has never seen that happen in all her years of nursing. Lucky me.

Like a spooked mare, tense and angry on the table, I watch the successful reattempt at anesthetic administration. A small incision is made just above my nipple. I don’t feel anything, save the unpleasant sensation of droplets of blood running down the side of my ribcage. The “needle” I’m going to more fairly call a probe is brought forth and inserted into the incision.

Then the shoving starts. 

I was formerly quite certain that “firm” was not an adjective that would ever again be applied to my post-breast-feeding boobs. But apparently, the tissue in there is still dense and firm, as it is for most women in their 20’s, (in spite of what their outward shape would imply.)

 

Man-Doctor is struggling with the probe, trying to get it to travel through the couple of centimeters of tissue over to the tumor location. I can’t feel the prodding, but uncomfortably am witnessing the jamming process. There is a lot of grinding, like a new driver with an old transmission.

Finally in position, the probe turns into a grab, wherein the actual tissue cutting and collection occurs. It has the force and sound of a staple gun. 

 

1 sample… 2 samples… 3 samples obtained… The collections aren’t going well; a second type of apple-corer probe is brought in and given a go. 1 sample… 2 samples… 3 samples… I’m watching the clock across the room and cursing the fools who quoted the procedure at 15 minutes; we’ve already tripled that estimate. I’m staring at the ceiling. I’m staring at the bottle of sanitizer in the corner. Anything to keep me from looking down, because I prefer to not actually watch myself get cored.

Then it’s done. They are finally satisfied with the samples they’re able to procure. I’m wiped up, taped up, and sent out. 

I sit in my car in the parking lot and let myself cry (again) over the unpleasantness of it all. Resting my head on the steering wheel, I close my eyes and imagine that my run with bad health has just concluded. “I have survived this all and I’m okay. Everything will be okay.” I tell myself.

Then I start the car, drive home, and continue down the path of unravel.

~   -  ~

 

I spend the remainder of the day enjoying our company while I ice my bandaged breast intermittently in front of them. A holiday weekend will pass before the results are processed and I get the phone call.

Preface

A young and frightened woman stands in the parking lot of a nondescript medical building, hugging her fiancée. The life she hasn’t yet lived suddenly looms in jeopardy... the wedding she is just beginning to plan, marriage, a career, travel, pregnancy, motherhood… the future that is so big in her 19-year-old eyes.

She has a small lump in her left breast and is about to go inside for an ultrasound. Her paternal grandmother had breast cancer late in life, which is enough to make the possibility frighteningly plausible. She has a tearful prayer in the arms of the young man she can’t wait to marry and then makes her way inside alone to discover what will become of her.  

The ultrasound technician squeezes the cold gel onto her chest and slides the wand over the small lump. After a few minutes, the technician leaves the room to get the radiologist for a second opinion, which of course further incites the fears of the young woman. But the doctor who comes in, rather quickly determines the lump to be nothing but a cyst that will heal in time. The oh-so-young woman, awash in relief, leaves to return comfortably into her life that is unfolding with normalcy and good-fortune.

She is innocent and happy; she is perfectly healthy - or so she will think for another nine years.