When My World Was Very Small by Ruth Rakoff

Author:Ruth Rakoff [Rakoff, Ruth]
Language: eng
Format: epub
ISBN: 978-0-307-35819-6
Publisher: Random House of Canada
Published: 2010-09-28T04:00:00+00:00

11

I’m Number One!

FOR A BRIEF PERIOD right at the beginning my mind was stuck at “I am willing to do what it takes to get rid of this.” I knew that it would be brutal, but I don’t think it really occurred to me that one of the possibilities still was death. I think after I got my “good news, stage II cancer” report I somehow thought I was in the clear. I forgot I was still at risk. The doctors reminded me regularly.

When I had met with my oncologist the day before starting chemotherapy I had been like a swollen river overflowing with questions about my future. They were important, well-thought-out questions. For instance, if I chose down the road to have a prophylactic mastectomy on the other side, would I be eliminating a potential early warning signal? My thinking was as follows: Breast cancer is a primary cancer. As long as it’s in the breast tissue or lymph nodes, it is treatable, with statistically good outcomes if found early enough. Metastatic breast cancer spreads to the bones or liver. Once that happens, it is incurable. This is what I surmised from previous oncological encounters and sporadic reading. Therefore, finding breast cancer at the primary stage, meaning in the breast as opposed to in the bones or liver, is actually a good thing on the cancer scale. Ergo, if you remove a healthy breast to prevent cancer, which may or may not occur at some later date, is it like sending the miners down the shaft without the canary?

“Stop thinking,” my oncologist had said to me. “While your question, despite its lack of medically sound information, is certainly an interesting one, the process that led you to it is no doubt exhausting. Conserve your resources to face the impending challenges of chemotherapy.”

And yet, the sickness, the weakness and the brain-numbing effects of the treatments could not shut down my own personal panic-processing plant.

“Should I have a prophylactic mastectomy on the other side?” I asked my breast surgeon.

“I can’t make that decision for you,” she replied.

“I don’t want you to make that decision for me. I just want your input. Based on your knowledge and experience, what would you do?”

“My experience is all secondhand. I haven’t had breast cancer. It’s a very personal decision.” The professional, cover-your-ass response.

“Should I have a prophylactic mastectomy on the other side?” I asked my oncologist again at an appointment about halfway through my eight rounds of chemotherapy.

“Well, statistically, it wouldn’t affect your outcomes either way.”

“Statistically.” Except I didn’t want stats. I wanted input. I wanted human, emotional, “what would you do if it was you, your mother, your wife, your daughter” opinions.

I tried to speak his language.

“Statistically, I’ve heard that one in nine women will get breast cancer, correct?”

“That’s what the fund-raisers say,” he replied.

“What does that mean?” I asked, suppressing a what-the-fuck-does-that-mean tone.

“Well, before age ninety, one in nine women will get breast cancer. In other words, if they live long enough, statistically, one in nine women will get breast cancer.

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