We drink to it, guard it, and strive to maintain it. Some say it’s the most important thing to have in life, when it’s in good shape. So we’ve devoted our feature this month to stories about health in its many forms—being ill, caring for a loved one, surviving, and struggling with serious disease. These personal and moving essays are proof that even when our body fails us the spirit still has vitality.
When his young fiancée discovers a lump in her breast, a writer watches her bravely face the outcome.
By Mike Rosen-Molina
A young woman’s look back at her descent into mental illness and the cost of finding stability.
By J. Cafesin
The five other essays can be read in the print version of The Monthly.
It didn’t feel real when my fiancée Claire was diagnosed with breast cancer; it seemed more like the horrible, surreal sort of dream where you wake up, briefly unsure if what you dreamed was real or not. At 22, she was much too young. I told her so myself.
“I found something in my breast,” she told me one morning four years ago.
“It can’t be anything serious,” I said, as if I knew the slightest thing about oncology. “You’re much too young.”
I was used to Claire’s worrywart nature. In the three years we’d been together, she’d proven a massive hypochondriac, happy only when she discovered some new and deliciously awful ailment. And when people weren’t sick, she’d diagnose the pets: Our bookshelves were full of thick hardbound books on the exotic diseases of rabbits and chinchillas.
But this time Claire’s fears carried more weight. She had a longfamily history of cancers—mostly skin—but enough to teach her never to ignore a suspicious lump. I knew about her family history, but it had become a habit for me to make light of her frequent worries.
This time, she was right.
Tests revealed she had ductal carcinoma in situ (DCIS), a slow-growing but notoriously difficult-to-detect cancer. She’d discovered it while it was still young, just a seed of what it could have become, because it was ensconced within a large benign lump. There wouldn’t be any chemotherapy or radiotherapy, just plain surgery. But at her age and with her family history, the future was clear. It’ll come back, doctors warned. Like the psychotic killer in a B-grade slasher movie, it could never be completely defeated. And just like those killers, every time it came back, it would be stronger, deadlier.
But there was one way to head it off. To make sure it never came back, they could surgically remove both of her breasts. They’d replace them with saline implants, so the outside world would never know the difference. A double mastectomy. Even for her family, with its history of cancer, nothing like this had ever happened before.
“But that’s so drastic,” I said. “Can’t they just, you know, cut around the bad bit?” I had visions of cancer growth as being like a bruised apple, where it was easy enough to cut out the bad bits once you knew they were there.
“ No,” Claire said. “This cancer is easy to treat early, but almost impossible to detect before it spreads. If I don’t do this, I’ll always be worrying about when the cancer will come back. I have to do this, even if it’s just for peace of mind.”
She was philosophical about the decision. “I’ve had 22 years with them,” she said. “That’s a good long time, when you think about it. And besides, it’s probably easier to have a mastectomy when I’m in my 20s than later in life. I’d be more attached to them because I’d have had them for longer.”
It might have been the practical approach, but it scared me. By good fortune, I had never had any loved one diagnosed with a serious disease before and the future that this promised, one of doctors and hospitals and surgeries, loomed so ominously that it almost seemed easier to bail out. We had started dating back in college, when we were both 19, and we’d weathered some hard times since then—Claire struggled with depression, I floundered through graduate school. But I felt very small and powerless in dealing with this.
She held my hand. “After this is done, I’ll still be the same,” she said. “You know that, right?”
“ Yeah,” I said, “I know.”
Claire is a small girl, the sort politely described as petite or boyishly slim. She has a delicate face above a whispery frame; everything about her is small, except her smile. She can’t fake a smile, because her eyes give her away. When she smiles, it’s an enormous lop-sided shark grin, her face creasing easily, her eyes squinting just so. She smiled when we talked about the surgery, but it wasn’t a real one.
The lumpectomy was scheduled for December; the big surgery—when they would remove her breasts and replace them with silicone implants—was scheduled for the start of summer. They were at the worst possible times. In the winter, she’d miss the premiere of the new Lord of the Rings movie (she thought Elijah Wood was dreamy), and in summer she’d still be recovering when her written exams started. Claire was studying for a doctorate in psychology at U.C. Davis, and she needed to pass those exams to stay in the program. Claire dedicated the same paranoid devotion to school that she did to health, and she was poring over her textbooks until the night before she left for the hospital.
I knew that when Claire was scared, she rarely showed it, instead focusing on small things like movies and channeling her fear into a deadpan, Vulcan calm. Her parents nodded knowingly at her reaction; they were used to her clinical mindset in these situations. At hearing the news, my little sister flung her arms around Claire, wailing, “You poor thing! It’s so terrible!”
“Oh, it’s probably harder for Mike,” said Claire matter-of-factly. “He’s the one that likes them so much.”
For my part, the hardest thing was explaining our predicament without sounding rude. When I talked about the mastectomy to women, they’d invariably grab their own chests and wince in sympathy pains—much the same way that tales of testicular woe cause men to protectively cover their groins.
“She’s going to get her boobs cut off?” gawped my 18-year-old cousin Jolene. “How are they going to do that?”
I had no idea.
“ I think they scoop them out,” I said.
Jolene cocked an eyebrow. “You’re so sensitive,” she said sarcastically.
In my own typically chauvinistic way, I had never really thought of the breasts as an essential body part. After all, I didn’t have them, so logically they had to be superfluous. I only thought of them in the same sense that a stereotypical ugly American tourist views the geography of a foreign land: as something different and unknowable and weird and, ultimately, just there for my own viewing benefit. Now they seemed much more important. In a deeply intimate yet also inescapably vulgar sense, they were part of what made a woman. Faced with their loss, they now seemed every bit as vital as an arm or a leg or an eye.
And I worried that their loss might prove psychologically devastating. But as the surgery date approached I began to fret more about her simply surviving the operation. Claire told me again and again that the chances of anything happening were tiny. Now that she was confronted with an actual crisis of health, her characteristic hypochondria had vanished. Instead, now it was me agonizing over her health.
For some weird bureaucratic insurance reason that I never fully understood, she had to travel to Los Angeles for the operation—she drove down with her mother the night before. Right before she left, I held her one last night. “It’ll be OK,” she whispered, although I felt like I should have been saying that to her. She climbed into her Corolla and left. And there was nothing to do now but wait.
Claire was in the hospital for two days, and returned with angry black stitches across her chest. Over time, doctors removed the stitches as she healed and gradually filled her replacement implants and tattooed on replacement areola. Recovery took weeks, and she was unable to move her arms easily for the shooting pains they sent through her chest muscles. Apart from the physical pain, she adjusted more quickly than we’d expected. Reminders of the surgery came in the strangest ways: One day in the supermarket, she had an abrupt case of phantom nipples—which she felt reacting to the cold in the frozen food aisle—but things slowly returned to normal.
“It’s kind of weird when I think about it hard,” Claire said once, “that there’s something else inside me. But I don’t doubt for a minute that I did the right thing.”
It’s been four years since the cancer. Compared to a lot of cancer stories, this one ends easy. It wasn’t without scars or sacrifice, but it was a victory in the end. She still gets tested annually, but has always tested clear.
I worried that the loss of her breasts would weigh on Claire somehow, in some intangible way, but we both soon forgot the implants. It’s amazing how quickly you adapt. I know she is safe now, that we didn’t need to worry that somehow, some vestige of the cancer still lurks, undetected. For a few awful months, between diagnosis and surgery, I thought Claire might die. And now knowing that she’s safe makes everything else OK.
And as for Claire? She passed her writtens.
Mike Rosen-Molina is an East Bay freelance writer and regular contributor to The Monthly. His work has also appeared in the East Bay Express, Sacramento News and Review, and San Francisco Chronicle. He and Claire are now married.
I haven’t always been mentally ill. I’ve always been on the fringe of the norm—the glass wall between me and humanity kind of thing, but I didn’t feel myself start to fragment until my mid-20s.
The first time it happened I was working as a bank teller. It was closing and I was counting out the cash drawer and doing my balance sheet. I got this idea to close my checking account, take the $5,000 I had to my name, and use it as a down payment for a Mercedes. I knew it was a bad idea. I could hardly afford rent. My job, like most of the others I’d had, was tenuous at best.
And then I separated.
I stood outside myself and watched me clear out my account.
At the dealership I tried to tell the other me not to sign the purchase agreement, but I did anyway. I gave the guy my five grand and drove off in a new, midnight-blue SL450 convertible. The other me sat in the passenger seat—her head thrown back, her short hair blowing around. She laughed and laughed. And I let myself get sucked into her lightness.
Two days later I was stuck in traffic on Highway 101 and it hit me what a stupid idea it had been to buy the Mercedes. I couldn’t return it and get my money back. It wasn’t a pair of jeans. I couldn’t afford it either. I got so depressed about it I got out of the car, left it on the freeway, and walked away.
The car was never found. I’d let my insurance lapse so they wouldn’t compensate me, even with my documented tale of carjacking. I was $50,000 in the hole for a car I didn’t have anymore and no way to pay it back.
And I separated again.
I started taking money from the bank. The customers actually. I’d take a little off the top of deposits over a grand.
I didn’t. The other me did.
Again I stood outside myself watching this other me steal. I tried to stop her with moral and value judgments. She came back at me with justifications: You get paid shit. You get treated like a bottom-of-the-rung lackey.
I told her I was afraid of getting caught. She laughed me off. No one will notice. Nobody keeps tight track of their money these days. But I knew the bank did. Sooner than later they’d discover what I was doing.
Three weeks into stealing and both sides of me finally came together—joined by fear. So I ran away. Two days before the end-of-the-month audits I left the bank at closing and never went back. I walked away from my life with $17,000 in cash in my pocket and became the other side of me—the wild side—for the next nine months.
I have only brief, fleeting images of those nine months. The first thing I remember clearly is my mom standing next to my hospital bed staring down at me, her face tear-streaked and gaunt. She started crying again the moment our eyes meet, and I got how hurt and scared she was. I wanted to hug her but I couldn’t. I was strapped down.
I spent three days at the UCLA Medical Center Psych Ward. I was diagnosed manic-depressive, given Lithium, and sent home with my mother. No cure. No hope for a cure. Manageable only with medication—side effects to be expected.
Three years later, Lithium does keep me together but it reinforces the glass wall separating me from the rest of the world. I walk around in this thinly veiled haze all the time, which I suppose is OK, given the alterative. But I wonder if sanity is really worth the price. It gets harder and harder to justify feeling sick and tired all the time.
I’m passive and passionless. Every time I put the pills in my mouth I think of trashing them. I’m fine now, I tell myself—just like everyone else. I’m sure I can fake normalcy without medication. But then I look in the mirror and catch a glimpse of her smiling at me. And I put the pills in my mouth, take a sip of water, and flipoff my reflection before turning away.
J. Cafesin is a freelance writer from the East Bay, married with two kids. She recently completed her second novel, Reverb, to be published in 2007.