Beth had had the lump removed in June. At least it hadn't been three,
like the last time. And this time there hadn't been any spread to the
lymph nodes, so there were things about this catastrophe that weren't so
bad. But when the radiologist had refused to show her the MRI scan, she
smelled a rat. So she kept her appointment with Dr. Paterson as
scheduled in August.
"How are you feeling?" he asked.
"Worn out, but it could be stress."
"The radiation getting to you?"
"A little burn. All things considered, not too bad."
He took a breath. "You're a gynecologist—you know about these things.
It's not routine for women with malignant breast bumps to have a second
primary occurrence. In fact, it's rare. Metastasis—spreading of the
disease—we run into that, too often. This is different. Every once in a
while we see what appears to be vulnerable breast tissue. It's no
indication the cancer is rampant around the rest of the body. It
presents early—it repeats itself. The suspect spots on your MRI have
almost disappeared with radiation, but it's my opinion they'll return. I
think, Beth, you'll have a problem with this as long as you allow it to
be a factor. My recommendation would be radical mastectomy. My further
recommendation would be reconstruction. There's no reason a woman your
age should have to live without breasts. The reconstruction can be
excellent. Please, consider that along with the mastectomy."
She thought she'd prepared herself for that. After all, she didn't want
to increase her risk in any way and wasn't thinking of trying anything
heroic to save one breast. What were boobs compared to life? Ridiculous
even to think about! Besides, she was down to one, anyway. If the cancer
had been ovarian, she'd have everything yanked as fast as possible,
despite the fact she had once thought children would be in her future.
Yet it stunned her for a second, left her frozen. And the most amazing
vision came to mind—Mark on top of her, running his soft, surgeon's
hands over her breasts when he made love to her. Two small but sensitive
mounds. She remembered she would often orgasm when he was inside her,
his wonderful mouth on her nipple. So long ago…
She became aware that her mouth hung open and closed it.
"I'm sorry," he said. "It's very aggressive, but it could save a world of trouble down the road."
"I understand," she said softly. "Certainly, we'll just get it done."
"Listen," he said, coming around his desk and sitting on it, rather
close to her. "You haven't given me any details, but I think a
relationship problem with your last episode could be factoring into your
uncanny acceptance of something so…"
"Radical?" she inserted for him.
"I'm sorry. I don't mean to pry. I only mean to help."
"Then don't pry," she said, standing. "I'd prefer to have the surgery in
Sacramento or Davis, closer to home. If I remember, it's a tough
recovery. Can you recommend a surgeon?"
"There's an excellent surgeon at your hospital," he said. "And I have
the names of some outstanding plastic surgeons all around the Bay Area,
L.A., Davis…"
"One thing at a time," she said. "How soon can you get me in?"
"I can make a phone call today. How about Roger Whitcomb in Sacramento? In a week? How's your schedule?"
"I can clear it. Remember, I work with women's doctors. They're a little
soft on this malady—they'll give me whatever I need. Have your office
manager call my cell with the details." She turned to leave.
"Beth," he said, causing her to turn back. "Really, I'm sorry. But I'd
hate to take any chances. My objective is to get you past this. It
doesn't have to be a lifetime problem. Your life is in here," he said,
putting a hand directly on his sternum.
"Yeah," she said, and thought, For a guy who specializes in breast
cancer, he doesn't know enough about what breasts can do. "Yeah, sure."
Billy was on twenty-four-hour shift three times in a week, and went
to the shop as often as he could muster the energy. Everywhere he went
the bulging accordion folder went with him. He pored over months of
statements from the mortgage company, credit-card companies, insurance
company and utilities companies. He had his calculator out all the time,
figuring. There was a year's worth of pay stubs from the fire
department and the shop.
Guys would pass by the table where he was working and ask, "What's up, man?"
He replied, "Bills. Julie's been taking care of them and I'm trying to
figure out her system before she has us living on the street." He felt
bad about the lie. It was a guy thing. He just had too much pride to
admit the root of all their problems had come from the reality that he
couldn't support his family.
