Stiff Upper Lip

Is your stomach churning? R asked. She'd called to see how I was doing the day before getting my breast cut off due to a disease that could kill me. My stomach wasn't churning. I wasn't in turmoil. I wasn't trembling. I was calm and fairly cheerful. I haven't cried for a while. I always thought I was an easy crier. I've never thought there was anything wrong with crying. I've cried at work, on public transportation, on the street, probably in restaurants, possibly on three continents, almost-sort-of in two job interviews. But I haven't cried much lately. I remember I felt disdainful of a woman sitting outside the biopsy corridor at Fancy Hospital, holding ice (or magically-created packaged "ice") on her breast, and crying. And I'd never felt disdainful before of women crying. Or children. Or men. But I feel, I'm not going to let them see me cry. Who is "them"? Hospital staff? The world? On the other hand, I'm not consciously trying to remain calm. Or trying not to cry. I just don't feel like it. And I started today to feel there was something wrong with me for not feeling terrible. Do I have a death wish? Did I leap from denial to acceptance in one fell swoop? Do I see the diagnosis as a black-humored punch line delivered by Fate? Why else would I laugh when my friend P reminds me that a writer died of breast cancer? Is that a nervous laugh? (See Nervous Laugher below.) On the other other hand, I'm a person who's checked out from the library the only legitimate book of Holocaust humor extant--and what's more, I thought the book was funny. Not joyously funny, but dark cackly funny. It was full of satire and irony by people who were living through it. Some making fun of the Germans, some of the situation. The essence of the Jewish joke, after all, is that a smart, weak person is in a helpless situation.

So I am living a Jewish joke. My father used to say that the hypochondriac's tombstone says, I told you I was sick. All this worrying about everything, and here I am with a malignancy. Three tumors, or else one big one that's made up of three smaller ones.

Quick, a joke, which may or may not have been in that book: Two German Jews are in Paris in the late 1930s, having fled Berlin. They're sitting at a sidewalk cafe and see a group of French soldiers march by, barely in step. Ach, says one derisively, ours are so much better.

Will my world finally cave in on me when I wake up Wednesday night and see the bandage covering what used to be my left breast?

The Bad Girls of Cancer

Tonight was my last yoga class with two real breasts. I thought about it as we lay face down on the floor to do our leg stretches. We did a lot of back arches, too, and I wondered when I would be able to do them again. I was excited that my Bad Girls of Breast Cancer t-shirt came in the mail today so I could wear it to yoga. The front has a big black X on it over my left breast, so I thought that was especially appropriate. I ordered it from the Breast Cancer Action folks, and I like their attitude. My politics are aligned with theirs, as far as I can tell; they criticize the mainstream Pink Ribbon people for being so corporate-sponsored, and they want to get at the environmental causes of cancer. I don't know if their method of going city by city to ban certain chemicals is the best way to go. I don't honestly know the best way to go. They're based in San Fran, and are apparently a force there, though if I get my friends to plaster the BCA Cancer Sucks stickers everywhere here, they might get notice in our fair city or a sliver of my fair neighborhood. In Cancer Made Me a Shallower Person, Miriam Engelberg fantasizes about a Cancer Channel. On her imaginary detective show, one cop says, "Uh oh--it's the Pink Ribbon Gang going head-to-head with the Cancer Sucks Gang." The other responds: "I'll call for backup!"

You don't have to go far to find criticism of the Pink Ribbon people. Our Bodies Our Blog noted Feb. 1 that the newly-named Susan G. Komen for the Cure spent $1 million for advertising. It has new slogans, and they're shown on photos of t-shirts worn by women's torsos (no heads). The t-shirts say: "When we get our hands on breast cancer, we’re going to punch it, strangle it, kick it, spit on it, choke it and pummel it until it’s good and dead. Not just horror movie dead but really, truly dead. And then we’re going to tie a pink ribbon on it." And, "If you’re going to stare at my breasts you could at least donate a dollar to save them." I agree that this new campaign or "branding" sexualizes breast cancer. But you can't blame Komen for sexualizing the breasts. L says the ads are aimed at funders, which is true. I don't think looking at such messages on billboards is going to make someone decide to get a mammogram. Barbara Ehrenreich covered this ground in her essay, Welcome to Cancerland: " ... breast cancer would hardly be the darling of corporate America if its complexion changed from pink to green. It is the very blandness of breast cancer, at least in mainstream perceptions, that makes it an attractive object of corporate charity and a way for companies to brand themselves friends of the middle-aged female market." The I Blame the Patriarchy blogger is blunter: "Komen, it can’t have escaped your eagle eye, is the author of those asinine, pink-visored 'Race For The Cures,' as well as that most pernicious arm of the megatheocorporatocracy responsible for turning breast cancer — which used to be a vile disease that kills people but is now a sweet little personal struggle that gives middle aged white women the golden opportunity to grow — into branded 'awareness.' Breast Cancer Awareness the Brand, with its army of unpaid pink volunterrorists, sells, with unprecedented success, everything from cars to football to potato chips. All, remarkably, without making the slightest dent in breast cancer deaths."

I don't know if this last is true. I usually oppose the Establishment on principle, whether it's supporting pink ribbons, high heels, or war. I like being angry at the Pink Ribbon people, but wonder if my anger is misdirected. I remember how angry I was at the inept radiation Fellow who called me to say that the biopsy was "positive," never daring to utter the word "cancer." I was irate, and at the same time wondering if I was blaming the messenger. I disliked the Fellow for being awkward and defensive and shifty. I dislike the corporate-studded races for the cure, and marathons for AIDS and bicycle races for MS, because I don't think they raise enough money and they are set up to make the participant Feel Good. They're like the annual program where you go to participating restaurants on a certain Thursday night and a percentage of your bill is donated to AIDS. You get to eat well and feel good about giving. But is all that really so bad, Cancer Bitch? Isn't sugar-coated philanthropy better than no philanthropy at all? Isn't it better that 75 percent of the take goes toward research instead of 100 percent of nothing? But what kind of research? I don't know for certain. Breast Cancer Action presses for more research on the link between cancer and the environment, and pesticides, and plastics additives. BCA studied the side effects of new drugs. The tiny groups should be allowed to criticize the big group, the humongous group, for becoming so blind-sided by its own dog-and-pony show that it loses sight of its original mission. It becomes impure. It's hard to be big and successful and pure.

Was it ever pure? I think Komen was founded in grief, and I think that was pure.


In yoga, my friend G thought my shirt said The BALD Girls of Cancer. In time, in time.

A Day in Which I Buy a Mastectomy Camisole & Fail to Sway an Alderman; plus Strangers on a Train

The nurse at Fancy Hospital had e-mailed me, asking if I wanted a mastectomy camisole. I looked it up on line and it seemed like a good thing. It's supposed to be smooth against your surgical wound, protecting it from the outside world, and it has a pouch where you can put the drain/s that are attached to your incision. I told the nurse I would like her to write an Rx for one. She left it for me at the front desk of the Breast Cancer area, which takes up a whole floor at Fancy. Friday I retrieved the Rx and also--lucky me--picked up a free (!) pink emery board from a basket at the counter. What is the purpose of a pink emery board? To remind you to have a mammogram when you're sawing down your nails? That's the most benevolent interpretation. I think this whole pink ribbon thing is supposed to make you Feel Feminine even though you've lost the outward manifestation/s of what men think of as feminine in this country. Thank you, Hugh Hefner. Though we can't blame Hef. He took his obsession from his repressive childhood and it just so happened to be the same one as the rest of mankind's.

I had imagined a mastectomy camisole as a pinky-peach frilly slinky thing with adjustable slip-like straps and lace on the top. It is not. I got it at a back corner of the hospital gift store. The breast-cancer products are in back, sort of like a bookie operation hiding behind a legit business. The camisole looks like a sleeveless t-shirt but has elastic underneath the breastal part. Inside is a velcro band where the drain pouch attaches. The straps aren't even adjustable. There is something so depressing about the camisole. It's called a post-surgery camisole ("Designed for comfort and function"). It looks medicinal, like the white shoes nurses and nuns used to wear. The pretty, blond square-jawed woman on the package has her head impossibly to the side toward one shoulder, though she's still facing forward. She looks defiant and come-hither. Her hair is parted on the left and pulled back and she has a flip of hair sitting on her right collarbone. I suppose this is supposed to hint of asymmetry. She is standing in a doorway with beige curtains and a white lamp behind her. She does not look like she just endured having a body part cut off under general anesthesia. The camisole comes in S, M, L, XL and XXL and you have to get it sized to your hips because you have to step into it. You can't put it over your head right away because you're not going to be able to move your arms up. There's also a falsie that comes with it that you can use to stuff the empty side. It has batting inside it so you can adjust the size.

What is it that's so depressing about this, besides the $56 I forked over for it (reimbursible by insurance)? Its genericness and ugliness. The lack of adjustable straps. Its one-size-fits-all, Iron-Curtain-like, Army issue-ness. It reminds me of undershirts, which I never wore. It reminds me of the stretchy material of the first "training bra" I bought in fifth grade. We knowingly called them "status symbols" and bought them because everyone else was buying them. I didn't need a bra at 11. I don't need a bra now, even though I'm a B cup and pass (or fail?) the pencil test. If your breasts can hold a pencil horiztonally under them, you need a bra. I forget whether keeping the pencil in place is passing or failing.

The camisole is not like any item of under- or over-clothing that you would buy voluntarily. I guess it reminds me of the dailiness of the cutting and scooping and sewing that Fancy and every other hospital does day in and day out, one breast after the other, bring on the next, hup hup. Praise the Lord and pass the ammunition. A mastectomy is a singular event in a woman's life and it's just ho-hum everyday for the surgeons and nurses. As we lie on the gurney with tubes and monitors attached to us, we are not, as the rose said to the Little Prince, unique au monde. We are dead to the world, all blood and vein and tissue. Hamburger, my friend F says. And tumor. Don't forget tumor.

I went to the alderman's office to buy a stack of parking permits. In my neighborhood, visitors need to stick a bright blue permit in their dashboards in order to park legally, on most streets. When this first started, it was $1 for 15 permits, and they were undated. You could use them indefinitely (though each one only once) and you could buy two packs at a time. Pretty soon it cost $3 for 15, and the permits were good for a year. Now it's $5 for 15, each good June 2006- June 2007, and you can buy them only in intervals. I said to the girl at the counter, I'm having surgery and expect a lot of people to come over, can I buy two packs? She said impassively, We only sell one at a time. I said, I know, that's why I told you. She said, You have to ask her--indicating a woman standing next to her, dealing with another constituent. She said it as if she were saying, You have to jump through a hoop of fire while juggling and turning three flips while whistling show tunes, recent Tony-winners only. I then laid my card on the table: I have cancer. She remained impassive. The other woman remained busy with someone else. My customer-service gal relented; she said I could come back next week. Implying that she would pretend she didn't recognize me and I would be allowed to buy another stack even though I was supposed to wait a week or two between purchases.

My friend M says he's tried to use the HIV-positive card before. It doesn't work that well, either.

(So it wasn't really an alderman. It was one of his minions.)

We went to the train station Friday to meet V, who was due on the Wolverine at 9:54 pm, but of course her train was late, and what's worse, both the monitor in the depot and "Julie," the warm-sounding voice program of Amtrak, never tell you in enough time just how late a train will be. V called us on her cell phone and said the train was stopped about an hour away. So we took the subway back home. It was only about 10:30 pm but the giddiness in the air made it seem like 2am on New Year's. There was a young guy across from us in a striped button-down shirt, jeans, white socks, and black ear muffs. He was eating what looking like sesame noodles in a to-go container, and taking up two seats. His two friends sat behind him. Then an onrush of girls came on. Whenever we see a group of girls (young women) we suspect a bachelorette party, because that's what they often are. One of the women had a silver hair band on but no veil on her head, or plastic penises attached to her coat, another give-away. A straight-haired blonde sat across from us, and her friend, who had dark bangs, plopped herself down next to the noodle-eater. The girl in bangs had herringbone-patterned gloves, a black jacket and pointy white flats with a pattern cut into the leather. Soon she was announcing that she'd had five cocktails. (One of the effects of having five cocktails is that you feel the need to announce the fact.) She was a rugby player. One of the guys asked if she'd played tennis, and her blonde friend replied, Tennis isn't a dyke's game. The boys were asking her where she played rugby. Northwestern? one asked, Northwestern? It turned out somewhere out of town. Soon the noodle guy had his arms on the girl's shoulders, from behind. He unbuttoned her jacket, and started massaging her shoulders. She smiled and sighed.

In the meantime, the Prophet had gotten into the subway car. Both L and I have seen him before. He has thick straight gray hair, is in his 40s or 50s and is nice looking, and recites with fire in his eyes and seeks to lock his eyes on yours. The moon was uniquely large and full--he was intoning, and the valley... the left of the river... side by side... he was saying, and one of the boys asked the girl: Where have you been? Seattle, she replied. A different language they do not understand, said the Prophet.... you're Noah... and one of the boys said of one of his friends, I haven't had sex with him yet. He took it from my hand and ate it, the Prophet was saying. One of the two guys behind the noodle guy said, We never got this in Iowa.

It was the second time I'd seen the Prophet. The first, he was sitting behind me and I figured because of his pauses he was on the phone. I assume he's psychotic and needs medicine. Is there poetry in what he's saying? logic and meaning? He doesn't shout like a street preacher, he just recites. He is trying to impart an important message. He is taking words that have lived in our culture for thousands of years, and giving them to us. Without the voice in his head, what would he have? I imagine that people have urged him to take pills. But why should he? he might ask. He'd be perfectly happy if only other people would listen to him.

V arrived in a cab soon after we got home. Later I thanked her for coming and she said she was performing a mitzvah, a good deed, by visiting the sick. A few days before she had sent me a huge hollow (breast-shaped) Hershey's Kiss with the note, This is not a kiss.

A Nervous Laugher

I have become a nervous laugher. I told N that she should meet with my student intern, that I would normally want a three-way meeting, but I didn't think I could schedule it because--lower my voice, move in closer, laugh a little--I'm having a mastectomy Feb. 28. I hate nervous laughter. It seems so fake. It seems to be covering up. It seems to be negating what you're saying. I don't want to be a nervous laugher. When I was talking to X a couple of years ago about her mastectomy she was all barky nervous laughter. It put me off. But I am doing it. I'm getting a part of my body cut off, ha-ha. If the cancer has spread I could die, ha-ha. I know that laughter is close to crying, I know that people's faces can take on similar expressions laughing and crying, I know that people say: I didn't know whether to laugh or cry, and: We laughed till we cried. Do people ever cry till they laugh? We laugh nervously. The Frenchman in the famous Liberation of Paris photo--or is it a newsreel? He looks like he's laughing but he's crying. Or vice versa. Or is it a newsreel of the German invasion? Crying at weddings because you're so happy. That doesn' t make sense. People cry at weddings because they're sad or touched. Because they'd getting older. Because the bride and groom are leaving, separating from the groups they came from. Sometimes we laugh in recognition: Hey I d0 that too. But why does that make us laugh? When you do a book reading before a big crowd, the nervousness and anticipation of the crowd makes a little shudder run around the room, and everybody laughs so readily. It's easy to make a happy, willing crowd laugh. They want to laugh. They need it, to let off steam, from their waiting, their wanting. The nervousness of all being together, chairs set up in rows, side by side. All the raggedy breathing. Maybe it's the potential danger of the crowd that makes us nervous. Note the side exits. Leave bags at your seats and walk silently and calmly... A retort to the calm. We are animals that need to make noise. Hush hush.

The Auschwitz smile. I gave that name to a certain type of survivor smile--a frozen smile that has nothing to do with and all to do with what the survivor is relating. A smile to keep out the horribleness of it all. A smile that keeps some of the past at bay. That keeps the past from rising and twisting and striking again and again, as the voice of the survivor is telling the story once again. First we had this then we didn't and we had no food and we had typhus and they rounded us up... The death and the dirt. The unnecessary loss. There was no reason for the loss. A madness to it all. A madness that made no sense but cut a swath of terror.

Madness, craziness. The mad are laughing crazily. At nothing. At you. At me. Voices that aren't there.

When I was in love with R my junior year abroad we planned to meet in Rouen, the place where Joan of Arc had been burned at the stake. His train was late. I kept waiting and waiting at the station, face looking up and searching every time a new crowd of passengers came off the trains. I remember one man, frozen in my mind maybe because he looked like that Frenchman at Liberation--he was standing in the middle of the depot and at first it looked like he was pissing but it was a bottle of wine that had broken and he was holding it before him and it was flowing out and he was crying, his face cortorting as if he were crying.... Years later when I described it to someone, he said, Sounds like he was drunk. And he probably was. And in my mind I remember that moment going on and on, the wine flowing and flowing, all around him, making a mess, and I was waiting forever for R to arrive, and when he did he said to me in our little hotel room on the rue du Cygne, I feel like you expected me to come here and say I love you, and I demurred of course, saying, Oh no, not at all, but it was true. And he said, You're not fun like you were in the summer, and that was true. I felt like that man despairing in the middle of the depot with his wine flooding out of his control. I was depressed and didn't know what I was doing in France. And I was in France because I was depressed at school and didn't know what I was doing there. There should be a way you could freeze yourself for a year or two when you're 20 and then you could jump up and know what you wanted do with your life, so grateful for the warm blood flowing in your veins. In the car listening to the radio the other day L cried because the mascot from his undergraduate school is being forcibly retired. He knows that Chief Illiniwek is racist but he was a symbol for the four best years of L's life. He loved going to all the games. He loves hearing the fight song. He was part of some student fan organization that sat as a group in the stands and held up colored paper in a pattern. My college life was more like the one described in my new favorite book, Cancer Made Me a Shallower Person. Author & artist Miriam Engelberg depicts herself in college: "I can't wait for finals to be over next week! Then I'll be able to enjoy life again." One week later: "Hooray! We're done. I feel great! What a relief." Two weeks later: "What the point of anything? We all die in the end anyway."

There is always the void.

Let's laugh to cover it up.

Uh oh, fell into the man hole. Our laughter wasn't thick enough to cover it.

When I was in grad school I interviewed for an internship at a Major Newspaper and thought it went well. When I'd been working at the paper for a while, one of the editors who'd interviewed me happened to say, That was a terrible job interview. We hired you despite the interview, we hired you because of your writing. And I'd thought the interview had gone well--because I'd laughed. And I pretended to him that I'd recognized how bad the interview was. But I'd had no clue.

I was looking for Engelberg on the web today and I found out that she died on Oct. 17, 2006. I'd wanted to write to her.

The Willy Loman of Female Diseases

(Warning: This section, especially the end, is not for the faint of heart. If that's you, I suggest skipping this and going to For Better or for Worse, the best melodrama on the comics pages.)

First, I have to say that I speak pretty clearly. I took speech lessons as a kid with a dramatic maiden lady from Texas who spoke with the slightly British intonation of American movie stars of the 1930s. We took speech because our parents had taken lessons when they were children. I'm not talking speech therapy. Miss K had dyed red hair and was very dramatic and tried to get us to say "towel" as two long syllables, emphasis on the second. I also took speech as a class in junior high. I went to tournaments. I was a contender. I have a Midwestern accent tinged with the South. If people don't understand when I say y'all, I understand. Everything else is the fault of the beholder.

Second, my menstrual periods are long. Because I have uterine fibroids. (For more on this, see last paragraph of Jan. 17 entry. And I was speaking clearly that day too, I swear.) So by Day 18 of bleeding (with a one-day respite) I thought it might be worth a call to my gyne to say I was still bleeding and was there anything he needed to tell the surgeons about? Maybe my thoughts were fuzzy about this. But it seemed that he should know that I was still bleeding and that I was having a mastectomy. As Willy Loman said, Attention must be paid. The gyne also had felt my breast lump in early fall and said it was nothing. I'd thought it was nothing, too, though my regular doctor thought it was something. But because last time she'd felt something it was shown on an ultrasound at St. Skimpy Hospital to be nothing (and the St. Skimpy radiologist scoffed at the alarmism of internists, which I realize now was snobby and inappropriate), and because the gyne said it was nothing, I just waited till my mammogram. Which didn't really make a difference, the breast surgeon said, because the tumors had been there for five years or so and were slow-growing. But still. You'd think the gyne might feel a little chagrined. He's not supposed to be my gyne, he's my accidental gyne. A friend recommended him and I liked him and he took out my ovary and salpingo last spring. I had an ovarian cyst and it was pretty clear it was nothing but even he who knew it was nothing said it should be removed. And it was. And it was benign. My real gyne is a midwife who is tired-looking and very sweet and lefty and gives you plenty of time to talk. When you call her she calls you right back and then she'll call you back again, apologetically, because she thought of something else. The narrative of the discovery of the ovarian cyst is too tedious even for me to recount. Suffice it to say that the midwife sent me to a young gyne who said defensively to L and me: I know I probably look like your daughter, and eventually told me she didn't want to do the surgery because then I was lobbying for the removal of cyst and not the whole ovary, and she was afraid I'd get mad if she took out the whole ovary. So I turned out having both the ovary and tube removed at Fancy Hospital by the accidental gyne. Who seemed fine.

What's wrong with him is what's wrong with Fancy Hospital--it's a bureacracy and he's in the middle of it. I called yesterday (you remember) to ask him about bleeding and surgery, and I got someone on the phone who asked about my vasectomy. MASTECtomy, I repeated. Oh, she said. What, had I been connected to the hermaphrodite section? She was typing up the message and it would go somewhere and then somewhere and maybe it would end up in the hands of the accidental gyne, who was at lunch when I called. So she said.

An hour or so someone else called me from the gyne's office and she was under the impression that I was getting a vasectomy, too. When I explained it all to her, she basically said, in a nice way: Your bleeding is not our problem. It's the breast surgeon's problem. You get your blood tested in your pre-op and if it's OK, the surgery goes on. In the meantime, I'd emailed the surgery nurse about the bleeding. I guess I wanted her to know just so the surgeons wouldn't freak out that I was hemorrhaging while I was lying there, knocked out and unable to explain. I'm assuming that chemo will give me early menopause, which will stop my periods and maybe the fibroid-induced bleeding. Menopause, with its lessening estrogen, is supposed to "dry up" the fibroids, too. From what I've heard and read, I've come to imagine the fibroids as hard white raspberries, but I think they're flimsier. I know two women who've had hysterectomies because of the heavy bleeding cause by their fibroids. My heavy bleeding is sometimes fascinating, especially the blood clots. The clots are as big as banana slugs. I tell L that I'm going to save them and put little plastic eyeballs on them and sell them to the anti-abortion people as fetuses. I think this is funny but L doesn't and neither did our friend M, when I told him. And M used to be a doctor.

Lesser of Two Evils

Tonight I walked to the Lesser of Two Evils chain bookstore and went wild in a Cancer-Bitchy way. I had a $50 gift card as part of payment/thank you for two workshops I did in a high school this fall. I was also paid by check and got a clock that had a plaque with my name on it. We couldn't get the clock to work so L pried off the plaque and we put the clock out by the Dumpster. I put the plaque on one of my file cabinets. At Lesser of Two Evils I bought Pink Ribbons, Inc: Breast Cancer and the Politics of Philanthropy by Samantha King (who teaches at Queen's University), Uplift: Secrets from the Sisterhood of Breast Cancer Survivors by Barbara Delinsky, and Cancer Made Me a Shallower Person: a Memoir in Comics by Miriam Engelberg. Got them all in the same section of the store. They cost me the whole card plus about $7. The one I wasn't sure about was Uplift, because it's a very lazy, randomly-arranged book. It's divided into chapters, and consists mostly of comments from women from all over the country. It's a very clever marketing ploy, because I'm sure all the contributors ordered books. I went through it in the store and thought a few of the snippets of info would be useful. Like tips on combatting chemo-induced nausea. Suggestions ranged from the very particular: "Morinda noni juice," blueberry muffins, chicken soup, Mexican food, Lorna Doones--to the obvious: crackers, hard candy, ginger ale. Someone also recommended "Chinese tea." I didn't know there was just one kind. I was also interested in reading about women's experiences with their hair falling out from chemo. I want to cut my hair now as a pre-emptive strike, but I'd really regret it if it turned out I was one of those people who *didn't* lose her hair from chemo. One woman talked about having a head-shaving party and inviting 15 women friends. That sounded like a good idea. I'm hoping to find other home-entertaining tips. It is a very corny book. Two chapter titles: Radiation: Soaking Up the Rays; Chemo and Hair: Mane Matters. If this sounds interesting to you, watch this space. I might end up giving the book away.

I've always worried about losing my hair to chemo. Just like I always thought I wouldn't get reconstruction, at least if I lost (is that the right word??) just one breast. (I'm reminded of the line from The Importance of Being Earnest: "Losing one parent is a misfortune; but losing both parents is plain carelessness.") I said even before I was afflicted by it that it seems that breast cancer is invitable, like gray hair and menopause. I swear I said this, way before I read it in Barbara Ehrenreich's essay, Welcome to Cancerland. You can find the essay on the Breast Cancer Action site.

I had a friend, a jokester, who used to open his wallet and ask if you wanted to see his pride and joy. Then he'd pull out a card with a picture of Pride floor wax and Joy dishwashing liquid. For many years my pride and joy has been right there on my head. In junior high I didn't appreciate my hair. It was "frizzy" and needed to be straightened chemically with Curl-Free, and then physically, by a process called "wrapping." The method was passed down by older female friends and relatives, like a folk custom,. You needed long bobby pins and a clean, empty orange juice can with both ends removed. After using shampoo and creme rinse (conditioner had not been invented), you would towel-dry your hair, of course, then comb out a section from the top of your head and wind it around the orange juice can, pinning it with the bobby pins. Then you would take the rest of your hair and wrap it around your head. The "theory"--yes, this process had a theory--was that the larger the roller you used, the straighter your hair would be. The juice can made for a very large roller. But the largest roller of all was your own head. We needed many bobby pins for this. Then after wrapping your head tightly you would sit under your hooded hair dryer and talk on the phone for the two hours it took your hair to dry. This is why we washed our hair only once a week.

I don't talk on the phone much to my friends now. E-mail seems to have replaced both long letters and long phone calls. I'd carpool with my friends, see them before and after school and during lunch, then at night talk to them on the phone. And then write them notes to give them the very next morning.

Somewhere in my 20s, probably when Cher's hair-do changed from curtain-straight to curly, my hair turned from high maintenance to low. Instead of complaining about my hair, I became vain about it. I was proud, though I had no right to be, that curliness and "body" were things that others strove for and that I achieved effortlessly. Strangers would ask me what I ate to get such thick hair. Women grooming themselves in bathrooms have complimented me on my waves and curls. On the other hand, when a college friend of mine brought me to her parents' for Christmas dinner, her very WASPy mother looked at me carefully and said slowly, Your hair scares me. My own mother has threatened, when I'm visiting her, to cut my hair in my sleep. My hair is what hers would look like if it were left to its own devices, which it isn't. Ever. L is always after me to cut it so he can see my face. So he will.

A Filling Without a Sandwich

I am a member of the Sandwich Generation--Baby Boomers (mostly women) who are caught between taking care of cranky teenagers and creaky parents. Except I have no children and my surviving parent walks the mall five days a week, lifts weights in her morning exercise class, goes to more movies and lectures than I do, and still sends me money--for my birthday, Chanukah, Valentine's Day, and whenever she makes a withdrawal from a limited partnership, in some financial transaction I don't quite understand. She doesn't need me to send her checks or to help her understand Medicare Part D. (For this I'm grateful. And I'd probably pass my mother's questions on to L, who explained it to his mother.) Now I am the one going into the hospital for the second time in less than a year, and she's the one flying up to take care of me. On the phone Sunday she asked me if I needed her to do anything. I said, tentatively, If you're going shopping... Are you going shopping...? Because she is a shopper. Not a clotheshorse but a lifelong shopper and comparer of merchandise. She is comfortable shopping. And as she strides through the mall she goes into the stores and sees what's on the racks. She said, Yeah, and I said, Maybe you could buy me a robe--because my two robes are terry cloth and I think they'd be too heavy to wear in the hospital bed. But she'd already beat me to it. She'd bought me a silky robe and a washable one and another one, and is bringing them with her, and I can choose any or all, she said, and she also bought me a button-down top, and my sister has approved of the purchases. I mean I just realized two days before that most of my tops go on over my head and that I hardly have any that button or zip, and that I probably won't be able to raise my left arm for a while, and she's more prepared than I am.

What I'm trying to say is that my mother still takes care of me and by rights she shouldn' t have to, and she's 28 years older than I am and is healthier. Cancer-free. She is thinner and more moderate in her habits. I am faster and stronger and my hearing is better, I could beat her at mall walking, as well I should.

I feel like I'm complaining. I don't want my mother to be sick and feeble. My friend H is almost 60 and he says he's never grown up because he never had children. To parent (well) you must sacrifice and think of others--who are helpless--before you think of yourself. I have never taken care of anyone in that way. L and I have, I suppose, a mutual care-taking pact, but he's not helpless (except when he's trying to find something in the refrigerator.)

Do I feel guilty bringing my mother out of retirement to take care of me? No, because she's not flying here to be my full-time nursemaid. It's only for a week or so. And she likes it. (What kids always say when they're pulling too hard on the dog's tail: But she likes it, Ma.) Really, she does. She likes feeling needed. Am I feeling guilty for having a mother capable of taking care of me? For being pleased that she wants to? Guilty because I'm not taking care of her. She doesn't need help. I researched hotels for her last night and then she called and said that when she made her plane reservation, the agent offered her a good rate (This price won't last, he told her) on a hotel. She'll pay for her flight and for her taxi and hotel. (She doesn't stay with us. She prefers a hotel.) I feel guilty, most of all, I guess, because having a healthy 78-year-old mother to help me after my mastectomy is a luxury. And luxury, by definition, is excess.

Thanks, Britney

In solidarity with Cancer Bitch, pop star Britney Spears has shaved her head. She's also gotten a few tattoos. This after going in then going out of a fancy rehab program (fancy as adj., *not* at my Fancy Hospital). Thank you, Britney. I didn't know you loved Cancer Bitch so. At the moment Cancer Bitch is still tossing her curly salt-and-pepper hair. She just trimmed it the other day to liberate the curl after a long hair-flattening winter. But it is very likely that CB will need chemo which will cause her coarse dark and gray hair to fall away, and she will be left as bald as Britney on a crazy day. O darling, you lost your blond locks for me. Thank you. If you'd thought it through, you might have gathered the hair to donate to Locks of Love. So, lots of luck, Britney, and I'll be thinking of you.

Locks of Love hair goes to kids. According to its web site, "Hair that is short, gray, or unsuitable for children will be separated from the ponytails and sold at fair market value to offset the cost of manufacturing." So some poor shlub will be receiving my ponytail and be bent over separating the dark brown from the gray. I hope you have a magnifying glass and frequent breaks.

Gotta Date

Gotta date. Finally. To the prom. The total mastectomy prom. My date is Wednesday, Feb. 28, at 4pm at Fancy Hospital. A total mastectomy is not the same as a radical mastectomy. The latter is hardly done anymore. A radical is so total. Totally total. You are totaled. Like the way the ancient armies used to pour salt on their defeated enemy's territory. To make sure that nothing would grow. Insult to injury. Now in modern times the insult (chemo, radiation) won't start for a few weeks after. In the radical mastectomy, the surgeon would remove the pectoral muscles and the lymph nodes up to the collarbone. A total removes all breast tissue. Dr. Fancy will do a sentinel node biopsy, get the sample rushed to the lab, and if the report says it's malignant, she will take out the first level of lymph nodes. That surgery would add 2 hours to the already 2-hour-long surgery. The lymph-node surgery is what causes the most pain afterwards, the nurse said. The mastectomy itself usually doesn't cause a lot of pain. I talked to A, P's partner, who had a mastectomy without any digging around in her lymph nodes. She was fine almost right away, except she was sick from the anesthesia. She had it done *out patient.*
I will at least stay overnight. My doctor won't snip off the extra skin, saving it for the reconstruction to be done later by the Plastic Surgeon to the Stars. I feel calm about this decision to delay but I hope I won't regret it. P said that their friend B, who had node surgery, recovered very quickly from her mastectomy.

The nurse says I should make appointments with a medical oncologist (chemo) and a radiation oncologist, even though I probably won't need radiation; I can always cancel. P gave me the name of an oncologist that B liked a lot. I hesitate to tell the oncologist about the recommendation: Oh yeah, your name was given to me by a friend of B. She liked you very much. You know B, the gal who died...

Do I want a referral from the grave? I think that B had Stage IV cancer, though. A and B had their surgeries at about the same time, and A is doing well. As B was dying, and after she died, A and P thought about how capricious life is, and they mourned her passing, even as they felt lucky for themselves, for the moment.


The Other Hand

A new study shows that men with vasectomies (such as L) are more likely to suffer from a certain kind of dementia where you can still garden but you can't think of the name for tulip.

Get ready for an onslaught of late-middle-aged male mimes.

On the other hand, there are at least two graphic (comic) memoirs about breast cancer, which I ordered today, Cancer Made Me a Shallower Person, and Cancer Vixen. I'm sending a copy of Vixen to my mother. I was going to send her Dr. Susan Love's Breast Book, but Vixen seemed more fun. My mother just got a pile of material from the American Cancer Society, which should hold her for a while.

In the Office of the Plastic Surgeon to the Stars/Following the Lump

Yesterday I went to see the Plastic Surgeon to the Stars. The office was near downtown in an old building with seemingly endless arcades in the lobby. The "lobby" was actually in a cross shape, containing stores and entrances to residences. The office upstairs was deliberately decorated, pleasingly so. Some original art in bright colors, red and blue animal poster in the kid section, everything horizontal with clean lines. But it wasn't fancy. The ivy at the end tables was fake. While I waited, a sleek woman with very short hair was leaving her appointment and getting some face creams from the staff. She was very pleasant, asking staff person A if B was pregnant, because she hadn't wanted to ask B, in case she'd gained weight. The patient looked about 35, like an Audrey Hepburn without the waif eyes, and I wondered if she had gotten a face lift. She had a lacy white knit shirt, dark pants and a long dark coat that hung straight down to mid calf. I had come in with my puffy down coat, plastic bags in my shoes to keep the snow from leaking in, and four layers on top under the coat, and silk longjohns beneath my corduroys. How did she keep warm? I assumed she hadn't taken the subway from one end of town to the other.

My impression of the doctor was that he'd been a nerdy science kid in high school and had grown up to become someone fluent and skilled. He measured my breasts across and in between and up and down--in centimenters, which he pronounced "sontimeters," and I wondered if he spoke French, because that's more the French pronunciation than English. The true French pronunciation, which would sound pretentious, would be "sonh-ti-mehtreh." Very very soft on the r. He did the measuring in a room for kids, and there was a sign on the wall about the patient having to pay for splints and bandages, and I realized he must do a lot of surgery after accidents. There was a brochure or magazine about prosthetics.

In his office he showed me the tissue expanders, which I hadn't seen before. Imagine a large, flat round piece of soap. Then imagine that it comes in a soft plastic skin. Now magically remove the soap and you have a tissue expander, with a little hole in it. Magically again, and painfully, it is put *under* your pectoral muscle, then filled through the hole, at intervals, with water, to expand your tissues. When you're expanded enough, that plastic comes out and a more durable one is inserted, via outpatient surgery. He had me handle the silicone-filled insert, which was soft and more natural, as he pointed out, and the saline one (filled with aqua mouthwash), which didn't feel as if it were as thick and viscous inside. He was pushing for the silicone, but I don't want it. He said I could decide later.

Then he showed me, on his computer, some before and after photos. I thought they looked better than the ones the other plastic surgeon had shown me. I was bothered by the other one's telling me that a reconstruction wouldn't look like a real breast, that it would be high and round. I thought that W's had looked real. So that's why I was in this guy's office. He showed me one picture and said, I could have done that better. He seemed so serious about his sculpting, and talked about what he'd learned about letting the top part of the breast be flat, and ways he had of making the bottom of the new breast rounder. Through stitches inside, here and there, he sasid.

I decided I want him to do the reconstruction. The problem is he doesn't have privileges at Fancy Hospital, which is down the street from his office. He said it wasn't possible (I pretended I was joking when I asked) to wheel me from mastectomy surgery at the hospital into his private surgi-center. But he said I could get the mastectomy and come to him later, after chemo/radiation. I'd been told it's easier to get all done at once--the tissue expander put in while you're still under--but I liked that idea of waiting. He said the breast surgeon could leave on the extra skin instead of cutting it off, but that it didn't matter. I do feel guilty that I'm making a decision that will be slightly more difficult for me but this is what I want. How quickly I went from No-Reconstruction-Hear-Me-Roar to getting a new breast installed by the Best (as I perceive it) in the Business.

Two surgeries! said L. But I like the idea of faster recovery now. I've always been more into immediate gratification than he is. I hope I won't regret this. I also like the idea of living without the new breast for a while, just to check out what it would be like *not* to have reconstruction. I can always decide to just let it alone, au naturel. Which of course it isn't. And I don't want to get a tattoo, like Deena Metzger, in the famous photo. It would hurt too much. Though I'm willing to get a nipple twisted from the new breast later on and to get that tattooed nipple-color. Under anesthesia. Local. My friend J said the hospital lost her nipple sample so they didn't know what color to make hers. She decided on the same color as her husband's nipples but now she says that was too dark, and the nipples show under her clothes.

The lump of anxiety

Had it all day Valentine's and I wasn't looking forward to class, which bothered me, because I usually do look forward to it. The lump makes me feel so desperate and helpless. About an hour before class I had some dark chocolate and some ginger-peach tea. And the lump went away. I will need to do scientific investigation (chocolate alone; tea alone) to see which one it was, if either.

Lump in the Throat/Hail to Tricky Dickie/Marbles in a Barn

Today I had a lump in my throat most of the day. That is what I call anxiety. That is what I felt throughout high school and college and after, during two dozen years of talk talk talk therapy and insight therapy and diving-down-deep-intoto-your feelings therapy and transactional analysis (I'm OK, you're OK--remember that?), and vitamin-nutrient therapy and take-aloe-vera-capsules therapy and a no-fermented foods regime, and no refined sugars and no alcohol and acupunture and little drops of allergens to put under my tongue with a needle-less syringe, and feminist/not-so feminist therapy, and finally the thing that got rid of the lump was Prozac. It was prescribed by the MD acupuncturist who'd tried Eastern and other cures on me. It worked. And its cousins in the SSRI family. To this day. Except if I don't get enough sleep, or if I drink a latte without enough food to balance it, (Today I didn't get enough sleep and our literary magazine intern so kindly brought me a latte first thing in my morning.) Or if my body gets too used to the medly of Prozac relatives. Or if (and this is troubling me right now) I don't get any effect from the generic equivalent of a pill that's in the medley. Our insurance changed and won't cover a certain brand. I would rather not pay $5 *each* for a brand-name tablet I take twice a day. But the generic has a history of not working for me. So today was it the generic not working or the lack of sleep and the early latte? Such things, I'm afraid, are only of interest to me, so sorry that I've brought you here with me. But you knew I was a delicate instrument.

I didn't meet L until I'd been on Prozac six months. I tell him he's never seen me in my feral state. He's seen enough of my moodiness so that he gets the idea. He says. Once, years ago, an aquaintance (one of those people who thought law school was the answer and--surprise!--hated being a lawyer) wondered aloud why it was that so many people, especially women, need these pills to get through their lives, much less their days. She thought that the social environment was the culprit. Her view is feminist, and Marxist, both lenses that I like to use, but I don't think the patriarchy is putting the lump in my throat. I wish I could blame it for that. I can blame it for my non-participation in sports--that, and asthma. The patriarchy kept women from moving freely for centuries. We didn't get a semblance of sports equality until the passage of Title IX during the administration of Richard Nixon, of all people. A Democratic Congress helped. So let's tip a hat to Tricky Dickie and go about our way. One easy explanation for my tension and anxiety is the continual persecution of the Jews. But not all Jews are as troubled and worried and tense and anxious as I am. I have an overdeveloped "flight" (as in fight or flight or freeze) response, which may have been a boon, from Neandertal time onward through pogroms. How devious Mother Nature is, though, to have given excessive "flight" to a person who gets asthma when she runs. Mother Nature makes Tricky Dickie look like... a third-rate burglar.

L says the anxiety is from, well, you know: b----- c----.

Sentinel nodes redux

I corresponded with Dr. Fancy's nurse about sentinel nodes. She told me that the doctor has performed thousands of them and has had very few problems with them. She went into some detail. So that's settled. I want her to do the surgery. I have an appointment tomorrow with the Plastic Surgeon of the Stars. His office is at a prestigious address, and the decor is supposed to be beautiful. I suppose such things count when you're in the making-beautiful business. I hope I don't love his photo album of before-and-after breasts more than the one in the Armenian plastic surgeon's office. This plastic surgeon operates only at private clinics and at Plainer Hospital. But I want the regular surgeon at Fancy Hospital. L says I 'd better make an appointment for surgery tomorrow afternoon, that it doesn't matter if I get a new breast or what it looks like if I do get one. He's afraid the invasive cancer is making its way right now into my lymphatic system and bloodstream. We mentioned this fear to the doctor at Plainer Hospital, whom I should probably call Dr. Trope, for the all the figures of speech he used. He said that the cancer is like a horse that's already out of the barn. How did that go? He also talked about going into a box of marbles but not disturbing their position, but that was in relation to the second level of lymph nodes. And something about how not counting furniture in a room is like not knowing how many lymph nodes each person has...

But he didn't say how fast the horse is going toward the lymph nodes...

Confusion sets in

We went to Plainer Hospital today, formerly known in this blog as Pretty Good. Plainer just seems more apt. We waited more than two hours in the modest (white and gray cherry blossom wallpaper, two real and one artifical plant, dun-colored industrial carpet, easy-going reception staff) office of the Much-Recommended Surgeon. Part of the reason for the delay was his caseload and part was my lack of all the proper reports from Fancy Hospital. It took phone calls and faxes to get them. Finally we saw him and he said virtually the same thing that the Fancy surgeon had said: Need a mastectomy on the left, up to me what to do with the right. He would support me if I wanted a prophylactic mastectomy or if I wanted to leave it alone (which I want to do). One thing he said that was different from Dr. Fancy was that he would remove a whole level of lymph nodes under my arm. He said he doesn't do sentineal node biopsy, which is a way of isolating the node most likely to have cancer, removing it and sending it to pathology to see if it's malignant. This preliminary check happens while you're still on the table. The node gets a more thorough analysis later, one that takes three to four days. The problem with this, he said, is if the node is found to be negative at first, but then, after more analysis, it's shown to be positive, the surgeon will have to go in *again* and take out more nodes. He'd rather take out the first level of nodes and feel around to the second level while he's in there, and can see if the second level looks suspicious. The problem with taking out those nodes is you can get swelling in your arm. I was confused and when we got home I called W, who was one of the people who had recommended him. She said he and another surgeon did a sentinel node biopsy on her, but reminded me that she had Stage Zero cancer and I probably have Stage 2. L is sure that the surgeon said he doesn't do sentinel node biopsies, not just that he wouldn't recommend one for me. I consulted The Bible aka Dr. Susan Love's Breast Book, and it seems that a sentinel node biopsy is the thing to do, unless a surgeon isn't skilled in it. She also warns: "If you have two lumps that are in different places in the breast, the sentinel nodes may be in two parts of your armpit and the procedure won't work."

But Dr. Fancy didn't say anything about my lumps precluding a sentinel node biopsy. I will have to ask her.

I don't want to ask her. I don't want to do more research. I don't want to do any of this work. I don't want to try to understand about different kinds of receptors and look at cut-away drawings of ducts and lobules and vessels. I don't want to read about steroid antiestrogens and aromatase inhibitors and GNRH agents. I don't but there's no choice. I also don't want to curl up and ignore all this while the cancer grows and spins through my bloodstream and lymphatic system. I told L tonight that I was upset and he said, Finally!


When Y came over last night he talked about how he was asked for ideas on how to commemorate the famous 1937 Memorial Day Massacre in Chicago. He suggested a
re-enactment. That it would be much more interesting that three or four hours of speeches, he said. The idea made sense to me. If there are Civil War and Revolutionary War re-enactments, why not one of a labor struggle? I started thinking about re-enactments in general, how psychology is based on showing us how we re-enact our childhood ways of being, with all their frustrations and reward systems. Cognitive therapy is supposed to show us how we repeat and how we can stop repeating that which harms us. Anna O., the famous patient of Freud's friend Josef Breuer, reportedly repeated all her symptoms a year after she'd had those symptoms. A re-enactment. How would I re-enact my breast cancer? Would I want to? Jews have an unveiling of the headstone a year after a person is buried. At my father's unveiling the rabbi re-read his eulogy from the year before. (It hadn't improved with age.) What is the difference between re-enacting and going through the motions, being in a rut? There is conscious re-enactment and unconscious. Lady Macbeth: Out, out, damned spot.... What, will these hands ne'er be clean?


I am thinking I should have something more cheerful here instead of death and cancer. Even the Cancer Bitch needs some non-cancer space. I'm grateful for the oases of time when I don't think about breast cancer. All of a sudden I'll think: I haven't thought about breast cancer for a few hours.

Tonight our friend Y came for dinner. He is a costumed activist. (My term. Like a costumed hero.) Meaning he works for a labor union and also organizes protests that often involve the wearing of costumes. Several years ago in order to protest the policies of a company, he targeted the CEO, and held protests at events connected to the CEO. The CEO is on the board of the opera, so our friend got a number of people to dress as recognizable opera figures and they stood in front of the opera as it was starting, blaring out Wagner and handing out leaflets. I don't say "costumed activist" in any pejorative way. I would like to be a costumed activist. I have been one a little bit--once in the days of Ladies Against Women (feminists pretending to be non-feminists in order to show how silly the opposition was ) and last year through Code Pink. What I like about Code Pink is that the organizers insert fun into the protests, which are about the serious subject of war in Iraq. There's the same anti-Establishment sense of play or street theater that the Yippies employed. Remember the Yippies? They threw dollar bills on the floor of the New York Stock Exchange and watched the traders grasp and grab for them in a rank display of dog-eat-dog capitalism. They also tried to exorcise evil spirits from the Pentagon and to levitate it. They organized the ill-fated Festival of Life in reaction to the Convention of Death that was the Chicago Democratic Convention in 1968. If only Daley had allowed them to sleep overnight in the park.

Could this sense of protest-fun be harnessed in breast cancer activism? I'm not sure what breast-cancer activism is. Is it getting more women to get mammograms? That's nice, easy, mainstream, doesn't target anyone as the Villain. Except if you look at disparities in the quality of health care in this country. Is it going after the environmental causes of cancer? Of course. But that's so much more difficult.
Which brings us to joy. I agree with Barbara Ehrenreich that there's too much treacle out there about breast cancer--positive attitudes, what my cancer taught me. But there is something to be said for joy. Even Ehrenreich's newest book is about public celebrations. And I noticed that the AWP convention (which I'll have to miss because of impending though not-yet-scheduled surgery) will have a panel on creative nonfiction and joy. Enough of memoirs about trauma and sorrow and addiction.

But we do *not* need breast cancer to remind us of our mortality or to remember to savor each moment. That's what we have therapy, and meditation, and religion, for.

Public and private

In Bathsheba's Breast I'm reading about William Halsted, the creator of the Halsted radical mastectomy at Johns Hopkins, and I suddenly remember that my great-grandmother's sister had cancer (breast?) and was treated at Johns Hopkins: a strange frisson of public and private. How to explain? That here's an outside reason, written in a book, for something that was private within the family. Each piece of information makes the other more real. How intent they must have been to get the very best treatment. I think about this for a few days. I have my cousin (the cancer patient's daughter) on tape from 1990 talking about moving up to Baltimore to be near her mother and not saying a word. Today I finally had time to listen to the tape. The time was probably the mid to late 1920s, and she moved in with her aunt and uncle and cousins in Baltimore. She was in seventh or eighth grade. Imagine a high-pitched Southern voice.

Cousin (who is my first cousin twice removed, my grandmother's generation): ...Mama went to Baltimore to see the doctor at Johns Hopkins. And she was there at the hospital and for two years I lived there, the most miserable two years of my life.

My father: Was she in the hospital for two years?

Cousin: Off and on. After she died I stayed on. Every time I wrote Papa a letter I said, I hate the M---s. I want to go home. And I don't blame them. I don't hold anything against them. They didn't know what to do with their own lives. The M---s knew nothing, absolutely nothing. They knew nothing about life. I never opened my—I didn’t talk to anybody. I remember sitting on the porch and S would say something. I needed somebody to talk to. I didn’t have anybody to talk to.

She remembered that the cousins lived across from Druid Park, and you could walk across the park to Johns Hopkins. As the tape goes on, she says that her mother did have cancer. So I was right about that. But throat cancer. She'd gone to New Orleans first for treatment then Baltimore. And she died, and her daughter stayed on, living with the cousins who didn't know anything about life. Whatever that means.

The four people on the tape--my cousin, her sister and brother-in-law, my father--are all dead.
The most recent death was my cousin's sister, at 97, in 2005. She was vibrant and blunt, had friends of all ages, especially lots of non-Jewish friends (a rarity in my family), played the piano, knitted her own clothes, had pierced ears. The last few years when I would go home, I would call to say hello and she would invite me to come over and pick out what I wanted of hers. I have some earrings, a German plate from her in-law's family, a silver pasta server. Her earrings are heavy, so I don't wear them too often. We do use the pasta handler (one of those claw-like things), and think about her when we use it. I don't understand the power invested in inherited things. I have my grandmother's carved hardwood table (because no one else needed a dining room table) and chairs and buffet, my other grandmother's stone-topped coffee table, desk and chairs, and a hokey painting of a boy and bearded man, presumably a bar mitzvah boy and grandfather, who wears a beatific and benevolent smile. It may be that same old thing: we think of them when we touch or see the objects, and we feel connected to the past, and we think about how the objects will survive us, and we hope go to someone who remembers us. In 1990 I went away for a year on a fellowship and gave my collection of dachshund figurines for safekeeping to a dachshund-addled friend. She asked later if she could have them if anything happened to me. I was glad to oblige. She had breast cancer about 10 years ago, had a lumpectomy and radiation and is fine.

Halted died in 1922, so he probably never saw my great-great-aunt. He was a pioneer of surgery, introducing rubber gloves to hospital practice, formalizing the medical residency program, advancing anesthesiology. He brought fame to Johns Hopkins, and so my great-great-aunt went there for the best treatment. When my father and his siblings were sick, his mother would take them on the train to New Orleans, the nearest big city, which was about three hours away. When I was diagnosed, my mother said she would go anywhere with me, to M.D. Anderson or the Mayo Clinic. I have a second opinion scheduled for tomorrow at Pretty Good Hospital, which is supposed to be Very Good at breast cancer treatment, and I am waiting to get an appointment with a fancy plastic surgeon who is Surgeon to the Stars (or at least public figures, according to his web site). The only hospital the surgeon works with is Pretty Good Hospital. He's not affiliated with any insurance companies, because, I presume, he doesn't have to be to in order to reel in the patients. L is appalled that I am actually thinking of switching hospitals, not just looking to confirm Fancy Hospital's recommended procedure. If you keep futzing around, he said last night, the cancer could go to your lymph nodes. This is the team that worked on W's breasts. I keep thinking of the breast photo album I looked at in the other plastic surgeon's office, and how he said the reconstructed breast doesn't look like a real breast, it's very round, like half an orange (I thought this; he didn't say it), and I want to know if that's true, or just true of the breasts he creates. I do have invasive cancer, but it seems less than aggressive, from what the surgeon told me. There was no urgency in her voice, like: We have to do this today. Here I was not long ago so sure I wouldn't have reconstruction at all, and now I'm wanting to have a Very Good-looking breast. Vanity, vanity.

(And I must add that I'm lucky to have fabulous health insurance from my husband L, and that my family was lucky that it could afford to go to the best places.)

Doing well

People say I'm doing well. They say I sound good. I joke. I don't think it's denial. But do people in denial admit they're in denial? On the phone N said something to the effect that everyone hates hospitals. But I don't. You might find it all interesting, she said. I think that's right. Which brings to mind the Chinese curse, of course.

(May you live in interesting times.)

When my young friend F was diagnosed with cancer and then was in remission and then back in the hospital, I didn't mind visiting. Visiting felt like being in the middle of time standing still. Because you were doing nothing but you were supposed to be doing nothing. But visiting. And trying to give succor. To him, to his parents, who were and are my good friends. And of course frustrating and heart-breaking because there was so much you couldn't do. My friend C went through a hospital volunteer chaplain course and was a "shadow" chaplain following a real chaplain around and then he had his own patients to visit but he was frustrated; he didn't get to know anybody. He'd rather work in hospice. Where you are doing something. You are helping facilitate a journey. We saw The Painted Veil tonight (a toss-up between that and Puccini for Beginners; of course we chose the movie with the dying spouse) and it did seem so comforting for Naomi Watts to be there by her husband's side. Comforting to him. And maybe to her.

I still haven't figured out mortality. We know we're here only for an eyeblink of time but everything is so important to us because the eyeblink is all we have. So it matters what color car and shoes and cauliflower we buy. (I saw cauliflower last week in creamy yellow and pale green, and both were cauliflower, not broccoflower.) It matters that our actions should help others of our species live well (whatever that means) and live well for the entire course of each person's allotted eyeblink, which the ancients put at "three score and ten." It matters that we read the ancients because it makes us feel connected and immortal through chewing on the immortal. Here, chew on this. Learn Greek and Latin and Aramaic and you will taste the past. You will inhabit it and it will inhabit you. The oldness of the idea of the body of Christ in the wafer (not what I mean, I don't mean *inside the wafer,* like the stripper who waits inside the cake before jumping out), the oldness of the belief that the body *is* the wafer, and the wafer, the body--is what gives the wafer its magic.

(Says this Jew.)

Why don't we all learn to read Sumerian and hieroglyphics and Dead Sea Scrolls, why don't we all carve out the aleph-bais on the nearest flagstone? Why do we keep looking forward, ahead, beyond? They might forget us up there in the future. There is no there yet in the future. It's all here, it's all already gone before us.

(Says this non-mother.)

In the beginning was the Word. (Say the Christians.) In the beginning was the Void. (Say we.)
Then light and dark and wet and dry and hot and cold and names. Adam, meaning red, meaning earth. The notion of Adam and Eve naming the animals; what fun! what a delight! To call it a rhinocerous because it looks like one and know that everyone else forever more will call it that.
Adam and Eve opened their eyes and stepped into the future. (But if you're the Original Pair, where else can you step? Can you find a tutor to school you in the ways of the past, meaning the Void? Step back, folks, away from that Void, nothing there, folks, nothing to see. Move along, move along.) Instead of the Void we have a sign that says Void. The word for Void has replaced the Void. The Void has gone missing.

(But it's here. I feel it. And it's in Ecclesiastes: All is vanity.)

Die defending the Torah because others died defending it and others will die defending it. And then you are calm in knowing that the memory of you, the memory of your name and possibly being, will be preserved in the memory of those who study Torah. (I am peeling off my steri-strips from the biopsy, I am writing this on the Sabbath, we drove a car to the movie, we did not pray.)

I meant here to explore the notion of not being so upset about the cancer. Is it because I feel I deserve to die? I have always felt I did not deserve to live, because my lungs are weak, because the tubes and passageways leading into and out of the lungs are weak. Because so much medicine and time and money has gone into opening and re-opening and re-opening those passages and clearing them out and out again. (Albuterol and Azmacort and Prednisone and Pulmicort and Tedral and Brokosol and Singulair and a shot of adrenalin and once an oxygen tent, and a vaporizor for so many years, and a breathing machine twice a day even when traveling from one youth hostel to another, and other remedies too numerous to mention.) Because I am defective, have always been defective, I did not deserve to live. I have always felt that. But I think that I am not so upset now because nothing has happened to me yet. The surgeon doesn't even bring a sharpened pencil to our meetings. A few people poke a few holes in me and push and pull at me but nothing has happened yet. I have not lost a breast, I have not been told that the cancer has escaped past the lymph node guards, or is copying itself as it rides through my bloodstream, I have not been zapped and poisoned. I am whole.

Driving to Distraction

My emotions have been pretty even all this time, but my brain has been scattered all over the landscape. Or maybe I'm prematurely experiencing the symptoms of cancer therapy. I feel like I already have "chemo brain"--memory lapses that come from chemo. Tonight I had a class in Far-away Suburb. My plan was to stop in University Suburb in the late afternoon, because it's on the way. There I would pick up some papers at WRU (Well-Regarded University) and meet a student in a coffee house to talk about her thesis. When I got out the car in the first suburb I realized I'd left all my class papers at home. So I met with the student for about 15 minutes, talking about her thesis but also about her breast cancer six years ago, drove back home, realizing there was no way I could get from home to Far-away Suburb *and* prepare for class and still get there on time. The only option was to drive back to University Suburb, take the 6:50 p.m. express train that got to Far-Away at 7:08 (covering something like 20 miles), and walk the few blocks to the class, which starts at 7:15. I parked near the train station at the first meter I saw, feeding it with all my quarters even as I saw a sign that said parking was limited there to 20 minutes. Parking restrictions are enforced fanatically in that suburb. I decided that getting a ticket was better than being late. I made the 6:50 train, graded papers at top speed, got to class on time and later took the train back to the first suburb, where I found that I hadn't gotten a ticket. If chemo brain is worse than this, I'm afeared.

The other night I threw up for no reason, except as dress rehearsal, perhaps, for chemo nausea. The only thing I'd had that night that L hadn't had was apple cider, and that didn't seem like a reasonable culprit. So I can say with authority that chemo ain't so bad, especially before it's started.

But I'm still afraid of it. And of fatigue. And weakness. And losing all my hair.

And of course the cancer coming back.

I Am Milked

You can be, too. You can try it at home. Put cream on your nipple to soften it. Cover with a plastic see-through band-aid. Over that lay a warmed purple velvety bag filled with stale-bordering-on-rancid flax seeds. After 10 minutes have someone come in and wipe off the cream with a cloth, roughly but nicely. "I'm clearing away dead skin," she'll say, "like a facial." Then get her to massage the nipple, from just outside the areola, then closer in. Have her put a little suction on the nipple and apply pressure. Then watch as 4cc of thin yellowish liquid comes out of your nipple. She'll collect it in a tube.

If you do it at Fancy Hospital, you'll receive $50 in the a couple of weeks. If you do it at home, no telling.

It's not *really* milk--this will not qualify you for a new line of work as a wet nurse.

Yes, folks, this is what I did, as part of a study to see if there's a relationship between breast cancer risk and hormone levels in nipple fluid. When I was first asked to participate, I was hesitant, but then L said, "It might help someone. I told this to the physician assistant who was massaging (the proper term, not "milking") my nipple and she said something like, "Yeah, sometimes husband say smart things." I said loyally, "I have a very good husband." I haven't had him as a husband for even three years yet; it seems way too soon to joke about him in a general oh-those-husbands way.


The right breast ((o)) , that is.
The left one will still have to go.
Maybe I'll have a farewell party for it.
And serve scoops of peach ice cream with cherries on top.


The cashier at Trader Joe's who asks, How was your week? Do you say, Well, I had my first MRI, and I'm going to find out if I have cancer in my second breast?

The good friend of a good friend you run into who asks how you are, and you say, OK, and then , Well, I was diagnosed with breast cancer. She says she'll do whatever she can, but there's really no reason because you haven't been in touch and though she means well she doesn't drive. But you didn't want to lie to her and say, I'm OK, I'm fine, and let it go at that. Because, you said, your mutual friend might have told her already, though you know that he is the ultimate in discreet.

The barrista you see every day who says, What's new? How are you doing?
The neighbor who says, How are you?
Everyone who says, How are you? The ones who know and still ask, How are you? How are you? You don't know. You think you're OK. You consider this the calm before the storm. The time when you are still intact, with your still-perky breasts and sticking-out nipples that will probably be gone gone gone down some swirl of medical waste.
The time when you have little slits and scabs on your breasts from the core biopsies, the time when you say, My breast has a black eye, knowing from your teaching that you are employing an indirect metaphor. The time when you think about telling. You email this person and that, you know that this person will tell this one, you think of ways to keep from springing it on people. What you write on the subject line of emails: Me. Bad News.
You tell your yoga teacher that you won't be able to lie on your stomach tonight because of your biopsy and she says, Oh, but everything's OK, right? and you say, Not really. There was a tall blond chiropractor who was in the yoga class after yours, she was known as the yoga goddess because she was so lithe, and then she had cancer and poof she died. It went to her brain. You suggested naming the yoga room after her but it became clear that rooms were named only after people who donated money.

But this is about not telling. About not telling D, D, your ex-best-friend, who you used to call every morning at 10 to share dreams. Actual dreams. As in, Last night I dreamed that... You shared the other dreams, too. They were the same: to be famous writers. Instead both of you were bitter, obscure writers fighting for the same things: publication, jobs, and over the years you brought out the worst in one another.

Do you tell D? But you're not dying. If you were dying, would you tell D? What would you tell her? That you are dying. Hello, is that you, I'm dying. What should we do? Will you have to be nice to me now? Which isn't fair. There was tension between the two of you, she was impatient, you were resentful, she was resentful, you wanted too much of the same things, you both had a scarcity mentality, thinking the world was not big enough to give both of you what you wanted.

Her mother died and you heard about it from a friend, and you sent her a note. And she wrote about losing her mother and you were jealous, really, that she had it published. Because every piece in every magazine must be written by you, and you alone, and every book written must be written by you alone, because there is not enough, never enough. And every time you think you're ready to talk to her you feel that squeeze, that never-enough-she-doesn't-deserve-anything squeeze inside you.

How could the Belief-O-Matic say you are much like a Buddhist when you have so much raw and deep resentment and not-enoughness in you? Where is your acceptance of life as suffering? where is your compassion and how will you cultivate it?

Austro-Hungarian Empire/Breast Grid

We left the house at about 6:40 a.m. for my MRI-biopsy appointment. The sky was pink over the lake. I knew it was sunrise, and I knew I'd seen sunrises before, but I couldn't remember the last time. I try not to get up during the single-digit hours. I thought of the Hungarian playwright Ferenc Molnar, who was a night owl. (I read about him in a book on insomnia.) One day he had to appear in court for a deposition. He got up in the morning, went outside and started walking to the courthouse. He was amazed at all the people on the street. He said: Do they all have depositions to make?

Molnar was born Neumann (Jewish, of course). And of course even a sunrise would make me think of Jews. You never hear about him but his play Liliom was eventually transmogrified into Rodgers and Hammerstein's Carousel. During World War I he was a soldier for the Austro-Hungarian empire and his dispatches appeared in the New York Times. (I just looked it up and found: "Shot Like Rabbits As They Climbed: Hungarian Novelist Describes Russian Attacks in the Carpathian Snow" from March 11, 1915.)

This morning I'd been looking forward to (well, that's going a little far: I was curious about) finding out how a surgeon goes about doing a biopsy with the help of an MRI. When I went inside the MRI last week I lay on my stomach on a mattress/gurney with a cut-out rectangle for my breasts to hang through. I had my head facing left on a pillow. I couldn't imagine how a surgeon would do the biopsy: lying on the floor and looking up at my breasts, scalpel poised like Michelangelo's paintbrush? All was revealed today, though I was asleep for much of it. The staff kept talking about putting my breasts in a grid. From what I could tell, the grid was like a plastic basket that strawberries come in, with little squares formed by the criss-crossed lines. It attached to the cut-out rectangle. So I lay down on this mattressy thing, my breasts caged in this basket, and my head not on a pillow but face down against a face cradle like massage therapists provide, except it wasn't comfortable. The surgeon sat in a chair next to me, and she performed two core biopsies along the outside of my breast. They would send me back through the MRI from time to time, I think to make sure that she was digging in the right place. This is what I think she did: Put a needle in, take it out, put a marker in its place, then send me back under to make sure the market was in the right place. At least that's what it sounded like in my early-morning haze. And I had a Real Surgeon doing this. I had asked the nurse earlier if a Fellow would be doing this to me or an Attending, and he said the Fellow, but the Attending would be there. However, he said, I could ask for an Attending. So I did. I felt a little sorry for the Fellow, who seemed friendly and confident, and even carried my backpack for me afterwards. .

Afterward I went upstairs to the Breast floor for a mammogram, to make sure that two markers had been embedded in the right place during the biopsy. (As I write that, I cringe at the word "embedded." I've noticed how we use it all the time now, because of the embedded journalists with troops in the Iraq war. Is accepting the jargon the first step toward accepting the policies? Probably.)

Tonight we were cleaning up the kitchen after making a stir-fry and L said to me, I don't want them to hurt you. And he cried. I'd hardly ever seen him cry and I wasn't sure at first that he really was. He looked a little like Walter Matthau when he cried. And then he stopped.

An aside: Today I am a Unitarian.

I ran across a "Belief-O-Matic" quiz today and took it. I line up 100 percent with Unitarians and 94 percent with secular humanists. I'm 52 percent attuned with the tenets of Reform Judaism, neck-and-neck with Christian Science. I never thought I would even write about those two religions in the same sentence. My beliefs allegedly match Buddhism more than the most liberal branch of Judaism (at least the most liberal branch known to Belief-O-Matic; Reconstructionist and Renewal Judaism were not listed). But since so many Jews are Unitarians and Buddhists, the results are skewed. Therefore, to be Unitarian is to be Jewish; to be Buddhist is to be Jewish, to borrow a litany from Lenny Bruce. (Find his routine on this page.)

From Belief-O-Matic:
Your Results:
The top score on the list below represents the faith that Belief-O-Matic, in its less than infinite wisdom,thinks most closely matches your beliefs. However, even a score of 100% does not mean that your views areall shared by this faith, or vice versa. Belief-O-Matic then lists another 26 faiths in orderof how much they have in common with your professed beliefs. The higher a faith appears on this list, themore closely it aligns with your thinking. How did the Belief-O-Matic do? Discuss your results on our message boards. [Which I didn't do; figured it was trying to sell something.]

1. Unitarian Universalism (100%)
2. Secular Humanism (94%)
3. Liberal Quakers (91%)
4. Mainline to Liberal Christian Protestants (88%)
5. Theravada Buddhism (77%)
6. Neo-Pagan (70%)
7. Nontheist (67%)
8. New Age (64%)
9. Mahayana Buddhism (60%)
10. Taoism (60%)
11. Bahá'í Faith (55%)
12. Christian Science (Church of Christ, Scientist)(52%)
13. Reform Judaism (52%)

That's all for today from Cancer Bitch, who noticed, by the way, that Whole Foods had its Jewish Food Items set out today, in anticipation for Some Wacky Judeo Holiday. There was matzah, gefilte fish, etc. What holiday is Whole Foods thinking of? St. Valentine's Day? Purim ain't till March 4, and Passover (aka The Festival of Matzah) isn't till April 3. Could it be that Whole Foods heard about Tu B'Shevat this past weekend and is trying to help us observe, belatedly?

Jews and Jesus, Death and Taxes

I cried two-and-a-half times today, for about 20 seconds each time, and mostly because I was feeling irritable. It was embarrassing to cry, even in front of myself, because the cause was sentimental claptrap for one-and-a-half of the times. But the first was out of shock. My high school best friend J called me this morning; she'd had a mastectomy and reconstruction five years ago. I'd tried to reach her; I'd sent her e-mails but hadn't heard back. She says that her workplace is clamping down on Spam so maybe the "breast" in the subject line relegated the messages to the trash heap. She asked if Fancy Hospital had a good web site and I said the breast section is down for revitalization, or whatever it's called. She said M.D. Anderson has a very good site. I googled and found the breast-cancer page then clicked on the link for a guide for Jewish women about heredity and breast and ovarian cancer. All of a sudden on my screen was a picture of one of my mother's good friends. She'd had died of ovarian cancer several years ago. Apparently her family has set up a foundation at M.D. Anderson. The sight of her just caught me. I knew she'd died, and of ovarian cancer, but I'd forgotten. My mother has a picture of her on her dressing table shelves, along with family pictures. I know it had torn her up when her friend died. Why did the picture affect me so? I can't figure it out. I guess I'd expected to find generic information on the site, and here is someone from my personal past. The second picture was of the woman's daughter and granddaughter. I didn't recognize the daughter at first, though she used to be one of my sister's elementary-school friends and I remember the time she came on a picnic with us and got her tongue stuck on a popsicle. There was lots of information about genetic factors in breast and ovarian cancer and the higher incident of both among Ashkenazi Jews (such as myself and my friend J and my mother's friend and my cousin and aunt and Gilda Radner). I can say I was shocked because the cancer hit close to home, but how much closer to home can it hit than my own breast? The real answer may be that Death was hitting close to home. I was looking up my own diagnosis and there on the screen was the picture of my mother's dead friend. That doesn't seem to be all of it, but I will ponder it.

The second time I cried was in the car, coming home from buying the two cancer books mentioned in yesterday's post (below). I turned on the country music station and there was a song, sung in the voice of a father whose young daughter comes home from school reporting that she has a new friend named Alyssa, who lies. She lies when she's on the playground, she lies to the teacher--"as she tries to cover every bruise." That made me tear up some. On Monday the father knows what he has to do, but it's too late, he finds out: "Alyssa lies with Jesus/ because there's nothin' anyone would do." That's the only hint of regret. Why didn't he pick up the phone as soon as he heard and call the local child-abuse agency? Why doesn't he castigate himself for not doing anything, instead of passively accepting that she's with Jesus? The bigger question is why do I expect any sophistication from country music lyrics? Why do I listen? Just for something different, and because I like the narrativity of country music songs. I'm a writer who hardly writes with narrative, though I appreciate it in what I read and hear. Not always. I like it in folk and fairy tales. I don't need it in contemporary stories.

Why oh why do cheap sentimental lyrics get to me?

The third-ish time I cried was when a commercial came on about some little boy who was a "typical ten-year-old" except he almost didn't make it to his first birthday. But some hospital saved him. The commercial was full of cliches and sappy, but it hit me.

I don't know if this breast cancer has made me more weepy or if it's merely because I ran out of one ingredient in my anti-anxiety cocktail and did without a dose of it last night.
We went to a small Super Bowl gathering. There was a commercial for hair dye featuring Sheryl Crow, and I thought but didn't say, She had breast cancer. On last year she said, "...for me to know that God had me in his hands, I never felt alone." Would she have said the same thing if she were *dying* of cancer? Or would she say that God had had her in his hands but had dropped her?

At the little party I talked to C., who'd had breast cancer about four years ago. It turns out she'd had a mastectomy, with reconstruction performed by the plastic surgeon I'd met with. She liked him and his work very much, and showed me her breast and scar. I said I thought her torso looked familiar from the scrapbook the doctor had shown me. During the game I repaired two sweaters and began reading "Bathsheba's Breast," with its gruesome descriptions of mastectomies. The author is a professor at Sam Houston State University in Huntsville, TX, and reported that Sam Houston's wife had had breast pain and then had surgery at home without anesthesia. The doctor offered her whiskey, but because she was a teetotaler and had gotten her husband to give up the bottle, she didn't want to take a drop of alcohol, even for medicinal purposes. She bit into a silver coin during surgery instead. The author surmised that she probably had mastitis, a benign condition.

The author, James S. Olson, began the book after he was treated for cancer of the hand, at M.D. Anderson. Eventually his left hand and forearm were amputated. The hospital came about partly because Monroe Dunaway Anderson, a cotton king, set up a foundation so that his company wouldn't be ruined by estate taxes.


Whodunnit: two household mysteries

1. The plumber came to figure out why water leaked downstairs yesterday when I took a long shower. After running the water and going downstairs and back, he couldn’t figure it out, because of course it didn’t leak when he was here. It could be that the water had splashed on the tile and there was a hole in the grout.

2. I have breast cancer and no one knows where it came from. Pollution? What about all the other people who didn’t get it and live in the same environment? What is the history of breast cancer? The first patient described (as a young woman) in Freud and Breuer’s "Case Studies on Hysteria" lived into her seventies and died of breast cancer, in 1936. That’s as far as my knowledge of the history of breast cancer goes. There must be histories of it in ancient Egypt, Rome, etc. Nothing in the bible as far as I know. (Pause for Google search.) A short history
here. And: the recent book, "Bathsheba's Breast: Women, Cancer, and History," by James S. Olson. From the book description: “A horror known to every culture in every age, breast cancer has been responsible for the deaths of 25 million women throughout history. An Egyptian physician writing 3,500 years ago concluded that there was no treatment for the disease.” I will order it (from my local independent bookstore) and report on it here.

Regular doctors
I went to the podiatrist Friday, the one who L goes to and who fixed L’s painful heels by injecting dextrose into them. It was so nice to go into a modest office with a friendly feeling, where Serious Disease did not hang in the air. (Of course, people with serious diseases see podiatrists.) The doctors are three brothers so they’re each referred to as Dr. First Name. I had diagnosed myself last year with chilblains, and then Raynaud’s: in the cold my toes turned white, then red and stayed cold a long time. When they warmed up they’d be itchy. Apparently chilblains aren't mentioned much any more, gone the way of neurasthenia. My toes have been sore this winter so I figured I should get this taken care of before I was locked into Cancerland. Dr. First Name agreed with my diagnosis and gave me a shot of something and recommendations for vitamins: B-6 twice a day, E once a day. He also got me strapped up to measure my vascular something or other. It was like having my blood pressure taken in my arms and legs. I felt vindicated that my diagnosis was right. I’ve also diagnosed L with Raynaud’s in his fingers but he doesn’t believe me. He told his doctor about his symptons and the doctor brushed them away. I told him to tell his doctor that I’ve diagnosed him and that I have experience with several medical facilities.

Teapot/Societe Anonyme
Our third free meal was with our good friends E and H. They have Italian ceramic dinnerware, as we do, but in a different pattern. They have mostly Raffaellesco, with a yellow dragon in the middle, and we have a mix of Veccio Deruta and Arabesco. Last year a friend gave me a Raffaellesco teapot. At dinner when E and H were in the other room, I whispered to L that when I’m gone he should give them the teapot.

Do I really think I will die soon, before L, before E and H (who are about 15 years older than I am), meaning, that I will die from this? No one dies from breast cancer, as far as I can tell, you die from the spread of the cancer to other parts of your body. I’ve thought about death a lot, from early on, partly because I would imagine what would happen if the Nazis came here, and partly because of having asthma. Then I would put the two together and know that I would go like that (snap o fingers) if I were taken to a concentration camp, because I wouldn’t be able to breathe without my medicines. Though I think about death a lot, I still can’t fathom what life would be like without *me* in it, the way I couldn’t understand how the schoolday could go on as normal if I was home sick. “If I die,” people say, as if there’s a doubt it will happen. I wonder about people who go to live in nursing homes, and if life seems meaningless because they know it will end soon. I’ve always thought that people in nursing homes should be harnessed to write letters for Amnesty International. Others have pushed for combining old-age homes with daycare for kids, and that makes sense. I’ve always felt part of the stream of Jewish history, which makes me feel less alone in the world, as if there is a place for my memory to reside. Certain rabbis have been known by the titles of their books; the title becames the guy’s name, so that two, three hundred years later, when you say the guy’s common name, you’re saying the name of his most famous book. I would like that.

Which brings up the question of the anonymity or “anonymity” of this blog. I started out anonymous, but giving friends the URL. I don’t want to libel people in the medical profession, especially--as my friends have pointed out--when they’re about to hold a sharp instrument to my skin. L has always been in favor of anonymity here, so that I won’t self-censor. But I’m already self-censoring, not saying every absolute thought in my head, about the doctors or friends or even L. My friend T says that I deserve credit for my bons mots, and I do want credit for my bons mots. And I want everyone to read this blog and then to buy my books. Everyone. But as far as I can tell, this blog is under the Google radar, it’s not findable at random in a Google search. So is it just for friends? It’s for me, to eventually turn into a book.

When I was a college a guy N, a hippie wanna-be, asked me if it would be enough for me to live on a commune and write just for the people of the commune. And I thought, No, though it seemed egocentric and impure to say No. You move from that question to, Would it be enough if five people read you? Then four? Then two? Then no one? Even Emily Dickinson sent her poems out for other writers to read. But mostly she stayed upstairs. Kafka had his coterie and was known in the equivalent of our literary-magazine world. In his famous speech and essay "Poetry and Ambition" (search here), Donald Hall chastises poets for ambition—the ambition to be famous, to live the poet lifestyle, to churn out book after book. Instead, says Hall, you should aim “to be as good as Dante.” But if Dante hadn’t published, how would Hall be able to name him as a standard ?

Insult to Injury
I never wanted to write book reviews. When a new book editor came to our local daily, she told my friend D that she wanted people with distinctive voices, such as [Cancer Bitch’s]. At least that’s what D told me. So I called the editor and we met for lunch and I started writing reviews for her. After a few years I somehow fell out of favor. I wrote reviews for a couple of other publications. The last two reviews that I wrote for Our City’s Main and Shrinking Alternative Weekly were very critical, and of books by women, and I felt slightly guilty about that. I proposed a review of The Bastard of Istanbul to my editor at the weekly, and when I sent in the review last week, she had some comments. I rewrote it, and sent it to her Friday, though it still had some holes in it. I’d never sent anything so rough before to an editor. She wrote back later and said it wasn’t really a review, it was a plot summary, had no thesis. So she killed it. I have never had a book review killed before. I never thought of myself as a good book reviewer, and was amazed that I could pull it off. Whenever I have trouble writing something I ask myself what’s holding me back. Was something holding me back with this review? Maybe. The book was absorbing but disappointing because I wanted to learn about the people of Istanbul and I learned mostly about Westward-looking Turkish women and an Armenian-American girl and her American mother. I think the author was trying to prove something by writing this book in English, with a couple of American protagonists. It was as if she were trying to prove to Americans that she could write about America and Americans. But we have plenty of America-based fiction homegrown writers. Her English was pockmarked with the awkward phrases of someone who is holding a thesaurus too close because she learned English from reading books. But I felt I couldn’t criticize her focus because, as we still say, it’s a free country: she can write about whoever she wants. The book was translated by someone else into Turkish, and it was published in Turkey in March 2006, and here, early this year. I was disappointed that her Turkish characters seemed very Western-American, but that’s the fault of American cultural hegemony and not the author. Or it could be because she grew up abroad, daughter of a diplomat. If I were my own student, I would say to myself, Cancer Bitch, why didn’t you write all that instead of struggling so?

And so I will get a kill fee. I was bravely writing and rewriting the book review while reeling from the cancer diagnosis (that’s not true; I wasn’t really reeling, just going to a lot of appointments). They call it a kill fee because it kills you a little bit to get it.