“That is a more radical choice,” said Dr. Truman, “but some women choose it to avoid the radiation, or just for peace of mind.”
Kathleen reacted instantly, instinctively: no mastectomy.
“That’s fine,” Dr. Truman said, and explained that if the margins around the excision were cancer-free, there would be no need for further surgery.
“And if the margins aren’t cancer-free?” Kathleen asked.
More surgery, Dr. Truman said gently, but cautioned against getting too far ahead of the facts. “At this point, I want you to be perfectly clear that you do not have the kind of disease that killed your sister. Your sister had inflammatory breast cancer, which is rare. Back in the 1970s, it was almost always fatal. But that is not your diagnosis.”
“I understand,” Kathleen said. “But I want you to do the surgery, the excision. Will you? Will you do it?”
“Sue Cooperman is a very good surgeon, Mrs. Levine.”
“Please,” said Kathleen, leaning forward in her chair. “I know you’re busy, but it would mean the world to me if you could do it.”
The doctor started to explain that her schedule was very busy when she noticed the yellow Post-it note on Kathleen’s chart. “You have an inside track here, but the fact is, I don’t control my own OR schedule. Dr. Cooperman could probably operate much sooner. You’ll have to make that decision yourselves.”
At the desk, Ellen looked at the computerized calendar, pinching her mouth over to one side. “Gee, the best I can do for you is the very end of June. But I’ll call if there’s a cancellation. It happens. Not often, but once in a while, and you’re right at the top of that list. So you be ready and keep a good thought.”
Kathleen tried to smile and said, “I’ll do that.”
But in the elevator, she started to panic. How could she get through two more months with this thing inside her? Maybe she should let Dr. Cooperman do the surgery. But Dr. Truman had made her feel so much more taken care of. So . . . cradled.
She wanted to talk about it on the way home, but the traffic was bad and Buddy was too tense to pay the kind of attention she needed.
When Jack heard her dilemma, he said, “I’ll try to get an extra day off and come home next week.” Hal spent an hour on the phone with her, going over the pros and cons. Finally, he declared that medically there was probably no harm in waiting for Dr. Truman, but if it would drive her crazy, she should schedule the surgery with Dr. Cooperman.
Kathleen felt as if she were wearing a lead cape. She couldn’t bear waiting nine weeks. Still, she needed Jane Truman to take care of her. And yet, she was also convinced that it made no difference which doctor did the surgery. Kathleen was certain they would find more cancer. She knew it in her bones. No question.
She tried calling Jeanette again, but hung up as soon as the answering machine switched on.
After another sleepless night, she made an appointment to have Dr. Cooperman do the surgery on May 9. But the following day Ellen called to say there had been a last-minute cancellation. Next Monday. Six days away. In the meantime, she would have to come down to Boston for a pre-op visit with the anesthesiologist, and to meet with one of their nurses. She’d also need to get a clean bill of health from her own internist.
“See you soon, Mrs. Levine,” said Ellen, sounding as if Kathleen had just booked a haircut.
She wrote down her assignments and then put the receiver down a little harder than necessary. “This must be my lucky day.”
Driving to school, she was suddenly furious. She counted all the ways she was angry. About having cancer, about being too scared to sleep, about having to disrupt everything in her life. And it was going to ruin the whole summer.
It would have to happen now, she fumed. Summers in Gloucester could make you forget the miseries of winter, just like those drugs. What were they called? Amnestics.
Summers on Cape Ann erased the cumulative assault of January darkness, the relentless February chill, the raw misery of March, and the final heartbreak of April, when the light returns but the wind still stabs you in the back.
In May, there are birds everywhere, and by the end of June the beach roses bloom and the supermarket fills with sun-stunned vacationers loading their carts with chips and lemonade.
In June, every wave and rock and gull is lit up from inside, the sky is a daily miracle. But I won’t be able to enjoy it, Kathleen thought bitterly. The margins won’t be clean. They’ll find invasive cancer cells on the margins. There will be more surgery, and radiation and chemotherapy, and God knows what. I’ll be too weak and nauseated to sit up, much less have energy to pull weeds or plant bulbs.
Kathleen loved the steep, rocky hill behind the house. It had been a “nature preserve” — her own euphemism for scrubby and neglected — while her sons were growing up. But once they left home, she fortified the worn-out soil with coffee grounds and manure, and now there were flowers everywhere, daylilies mostly, in and around the ten granite boulders on the hillside. A few years ago, Buddy had hired a cherry picker so she could get up to the top, and she had planted a big stand of yellow Stella d’Oros up there. They bloomed the whole summer.
She wouldn’t be planting anything this summer. No new lilies. No tomatoes. Nothing.
By the time she pulled into the parking lot, she was in a rage. “Damn it!” she shouted. “Damn it all to hell.”
She leaned back in the seat and calmed down enough to walk into the building, retrieve her date book, and tell the principal that she would be out the rest of the week. He put his arm around her shoulder and said, “You take all the time you need.” Then he got that look on his face and Kathleen knew what his next words would be. “My sister had breast cancer.”
Back home, she called Buddy to tell him the news. She called Hal and Jack. She talked to receptionists at medical offices. “We can fit you in Friday, but it may be a long wait,” said the woman at the internist’s office. “Bring a book.”
Kathleen sat in one waiting room after another, unable to read. She picked at her cuticles and wondered what had happened to the woman who had canceled her surgery with Dr. Truman. Had she come down with the flu? Found a better surgeon? Did she decide she’d just rather die?