As summer fruit ripens, I discover a lump in my breast
and, while waiting for tests/test results, I explore the possibilities, the choices I would make if it were indeed a malignancy; it turns out to be an inflammation
We are being blessed with delightfully moderate, livable temperatures after our early heat wave in late April. Such bliss! Summer fruit is ripening on the trees: apricots and plums now almost ready to pick, strawberries arriving in small numbers every couple of days, petite heirloom cherry tomatoes in great abundance. Still lots of greens for salads and steaming. Gardenias galore! And, the roses readying for their second bloomings.
Fully recovered from my big fall in March, I’m back to feeling safe and comfortable taking long mountain rambles late afternoons into early twilight. Back on trails where I am quite alone for hours, the trepidation and uneasy mistrust of my body’s stability that followed the fall seem to have faded away. Their legacy: I now carry an expanded “emergency kit” whenever I’m off to one of my solo excursions. As always, I have my bee sting kit, a flashlight, an emergency blanket and some water. The new addition is a no-longer-in-use cell phone from a friend. Like all such expired cells, it has the capability (provided one keeps it charged!) to reach 911. And, too, I now carry my bamboo walking stick with me whether the terrain warrants it or not. This new “backup” notwithstanding, I seem to really be feeling quite secure in and with my body once again. Yes!
My monthly time out for silence and solitude in May brought yet another major “adventure in consciousness.” It never ceases to amaze me that while I hibernate in my quiet paradise doing little or nothing but puttering about, I can suddenly be carried off into some compelling and challenging inner adventure!
In the middle of this quiet week, I spent a good part of a day crawling under and around bushes putting in some drip irrigation lines. In the process getting my body covered with earth and my frizzy hair full of twigs and leaves and burrs. At the end of the day, I took my wildly, deliciously disheveled self in for a shower, hair wash and my much delayed daily “morning ablution” of massaging lotion into my whole body.
As I massaged my left breast, I discovered an inch long lump that hadn’t been there the morning of the day before. It was firm, regularly defined, mobile, sore to the touch and the skin above it seemed a little flushed. My first reaction was profound thankfulness that I am on such friendly terms with death, so comfortable with my own mortality. Grateful that I have made sure over the years both to have all my “affairs” always in good order and to live each day with the consciousness that it might be my last on earth. Being unafraid of dying and of death gave me an incredible spaciousness in which to embrace and explore the possibilities this lump brought with it.
Since there was nothing to do until I could reach the doctor in the morning, I finished my ablutions and took me and my newly discovered lump out for an evening meander to my favorite accessible creek. As I wandered in the silence, my mind moved back and forth between stillness and considering the possible “where from here’s.”
From what I’d learned about lumps during two earlier experiences (in the mid-70’s and again in the mid-80’s), the characteristics of this new lump suggested that it was unlikely to be a malignancy. But, then again, it might be. Clearly, only testing/imaging could provide a definitive determination. As I meandered, I found that I felt neither worried nor frightened nor disquieted. Mainly, I felt curiosity about how I’d actually be with this experience that I’d explored before only in the abstract. The explorations-in-the-abstract have been stirred by tales of other’s experiences with lumps/breast cancer. By the fact that my maternal family history of breast and ovarian cancer is totally off-the-charts. And, by the fact that, despite all the incredible self-nurturing and excellent care I give to my being and to my body, I’ve seen that keeping good health is still pretty much of a “crap-shoot” in this crazy world.
As I wandered, I’d find myself wondering on and off about what I’d be available for if this proved indeed to be a malignancy. The first thing I knew without any doubt was that I’d never consider putting toxic chemicals into my body. I’ve watched too many friends, clients and family members struggling with the vicious side effects of chemotherapy: The significant degradation of one’s quality of life. The endless days of feeling deathly sick in order to have a few decent days before having to begin the cycle all over again. Living that way to stay alive longer had no appeal for me. I could see that being afraid of dying or not wanting to let go of one’s life would make the balance of that trade-off feel quite different. I realized that, though I absolutely love my life, I truly lack the attachment to living that would open one to enduring such treatments.
As I thought about it, the only thing about living I felt at all attached to in the moment was having the time to write the musings for the last 7 of the 58 Rememberings and Celebrations cards. It seemed more than likely that I could count on having that time no matter what the lump turned out to be. With everything and everyone else in my life, I felt current and available to let go, to complete. It certainly occurred to me that had I had children this might not be quite as so for me.
The next wondering that emerged as I walked through the orchards was about whether I’d consider radiation treatments. I remembered recently hearing about a table that allowed for the irradiation of a breast while protecting one’s torso from the radiation. I felt I would be willing to consider this form of treatment if indeed it were available. But, as with my unwillingness to put toxic substances into my body, I would be totally unwilling to allow radiation to pass through any part of my torso.
Then, I wondered about whether I’d submit to a surgical removal of the lump if that were recommended. Here, I was quite surprised to discover that I would indeed be open to considering such a procedure. As I’d explored this possibility in the abstract over the years, I hadn’t been willing to deal with even a lumpectomy. My thoughts had always been focused on avoiding western approaches entirely. Yet, now, faced with this very real possibility and also having the context of some recent second hand experience of alternative approaches, my sense of what was acceptable had clearly changed. I wouldn’t be willing to travel to all the distant places one might have to consider traveling to for those alternative treatments. And, none of the programs I’d heard about felt anywhere like a “fit” for who or where I am.
Oddly (and actually even a little embarrassingly) I realized that if I had to undergo a lumpectomy, I would also choose reconstructive surgery to reduce my other breast to match the reduced size of the operated one! This was even more astonishing to me than my openness to having a lumpectomy!
I thought, too, about whether I would go to Los Angeles or New York where there might be more expert specialists/surgeons available were I to decide to have a surgical procedure. The dislocation and craziness of being in either of those places–and away from my healing sanctuary–would make such a choice out of the question for me. Santa Barbara’s medical community would do well enough for me.
As I explored these questions in my intermittent mental meanderings, I thought, too, about when and whether I’d be willing to share any of what was going on in me with any of my friends and family. I realized that I had neither wish nor need to do that in the moment. Rather I had a compelling and very strong desire to keep this experience as sacred and only my own as I moved through it. I didn’t want my experience contaminated by anyone else’s “read,” needs, input or considerations.
It was certainly interesting to find myself so unequivocally in this place in the face of my recent commitment to Spirit and to myself about re-examining my issues around receiving, allowing or asking for help! Still, I couldn’t see what of any value sharing the process while I was in it would add to my journey. Even my closest, dearest friends and family have very different relationships to mortality (their own or anyone else’s) than I do. Sharing my process from the middle of it would leave me subject to having to cope with their emotions and realities. It was clear that this would feel more like contamination than comfort or support. And, I felt no need for comfort or support from outside of me; I was on my own solid ground in this process. Yet, It was absolutely clear that I’d be willing and even wanting to share the story when I’d reached the far shore of the process, whatever and whenever that might be.
I’d walk a while in stillness and then another question would rise, I’d feel my way inside it, see where I was with it, then I’d go back to stillness. There was no fear, no trepidation, only unfolding clarity. An abiding comfort in knowing that I was finding my way to exactly what would be right for me.
On my way home from my ramble that wondrous starlit night, I felt at such peace with myself and with my life. I felt ready to cope with whatever this all might actually bring into my life. I still would have preferred not to have to deal with any of it. But, given that I might well have to face the possibility of a malignancy, it was an extraordinary comfort to find myself so clear about how it would be right for me to proceed.
I called the doctor the next morning, after a nourishing and long sleep. I saw her a day later, getting her confirming impression that it was more likely to be an inflammation of some sort rather than a malignancy. Still, mammography and ultrasound were definitely in order to get further clarity. Those were scheduled for just about a week later.
While waiting for the imaging appointment, I did some research to find the breast specialist who’d taken over the practice of the fellow I’d seen in the 70’s and 80’s. Delightfully enough, it turned out that the physician was a woman. And, serendipitously enough, she worked as I do. An office in her home, two days a week (as opposed to my two every other week) and handling insurance the same way I do (people pay me, get a paid bill from me to submit to their insurer and then they get to wait for their insurance to reimburse them). I set up an appointment with her for the week after the radiology appointment, when I would be sure to have the radiology films and report in hand.
At the Imaging Center, the radiologist read the films and ultrasound–on the spot, with me present–concluding that the lump was most likely an inflammatory process with some “fatty necrosis” in the middle of it
All through this time, I kept the journey to myself. All through this time I was in my life in my ordinary way. The only difference was the intense separateness I felt when talking with my sister and my friends with whom I wasn’t yet sharing the story. Some of that was certainly a continuing of the sense of distance I’d been feeling all the month before. Yet, having something so big going on in my life that I wasn’t into talking about did make for an even greater feeling of separation.
I did share the tale with one friend just after the radiologist’s report, when I felt it had become a “story” rather than a process I was still in the middle of. When I shared my tale, I felt available to hear her feelings/responses to it all. We did talk about a question that I hadn’t yet considered myself. If I were to have had a surgical procedure, whom might I have chosen to have as an advocate in hospital when I might not be in any condition to be able to advocate for myself.
I realized, as I considered this new question, that I would choose to hire a “special,” a nurse (or shifts of nurses) to watch over my post-operative treatment until I was able to advocate for myself. Again, it was clear that I didn’t want to have to cope with the feelings, needs, presence or operating style of anyone I know and love. A competent stranger who was paid for her services still seemed to be the safest kind of help to enlist. Friends and family might well visit but it would not feel okay for any of them to be “in charge” of helping/advocating for me.
Still grappling with the legacy of the dysfunctional mothering I had, the only safe help–when I really need it, can’t handle it all by myself–seems to be that for which I pay. Help from friends seems something I can consider as a possible “add on” but not if what’s needed feels essential. This commitment to dealing with my issues around receiving, allowing or asking for help is certainly bringing everything up for clear viewing! Even if I don’t yet seem to be available to making any shifts.
After the Imaging, the radiologist’s report and this first real sharing of the story, I was off to Fort Lauderdale for an almost three day visit with my folks. I came back from there in time to work a couple of days before seeing the breast specialist for a second opinion.
Her view, much more fully elucidated and explained was a confirmation of the radiologist’s conclusions. She was a marvel of real-person physicianhood, an educator par excellence and an excellent resource person to have in my “circle” for any future concerns. A six-month re-imaging was recommended both by her and by the radiologist with an eye to tracking the healing process of the inflammation.
She raised the issue of (and strongly recommended) genetic testing (because of the intense family history). She also strongly recommended that I consider the possibility of undergoing a preventative laproscopic removal of my remaining ovary (atrophied and left behind after the other, ruptured ovary and my uterus were both removed when I was 35). I have my own questions about both of these recommendations and will have to live with those questions for a while before making a any decision.
I’m just beginning to share the story with my nearest and dearest, although writing this seemed to be important to do before I repeated the story too many times. I’m curious, now that my initial journey is complete, to hear and feel how the people I care most about will receive both the tale and my delay in its telling.
I understand, from the initial responses of the second friend with whom I shared the tale, that my whole inner process around this lump–and perhaps my decisions as well–are quite a bit skewed from what might be seen as the “norm.” I guess if I’d stopped to think about that, I’d have seen that that was so. But, it certainly is and was just exactly me!
I share the story here with absolutely no wish to encourage anyone to consider making the choices I made but, more, to encourage each of us to find out what exactly is our very own way through any such challenge.
Originally published June 2004
