My husband and I were sitting down at a neighborhood pub for a quick beer and a light dinner last January when he ordered the wrong thing off the menu and I let loose.
There wasn’t anything wrong with his decision to go with the cheese platter, but, really, he should have seen the verbal assault coming. I had been barking at my husband for a number of non-sensical reasons off and on over the previous couple months - ever since I had made up my mind to finally go through with restorative breast surgery.
The decision had been a long time coming - in fact, five years to the month after I was diagnosed with Stage II, triple negative, invasive ductile carcinoma in my right breast. At the time of my diagnosis, I was 38 years old and the cancer was aggressive. The kind where the doctors suggest you cancel your upcoming wedding in Hawaii. The kind where there’s really no time to even discuss egg retrieval or skin sparing anything. The kind that requires six months of work-stopping, hair-losing chemo. And radiation. And mastectomy.
For the record, I never really had a problem losing my breast. I was more concerned about my hair, but as that grew back and life began returning to normal (that “new” normal everyone talks about), I began to focus more and more on my chest. In the beginning, still angry about the cancer and all it had taken from me, I felt empowered by my lopsided-ness. I went to the gym in a fitted tank top without my prosthesis and silently dared anyone to look at me askew. I wore strappy summer sundresses without padding and ran in 10Ks with one side of my sports bra empty.
But I could never fully block out the chatter I heard at support group meetings, where conversation would quickly turn from introductions and infusion schedules to reconstruction options and preferred surgeons. It seemed everyone was in some stage of recon - from expanders to tissue transfer. And there was always the inevitable show-and-tell after the meeting, when everyone would gather around a volunteer who would pull her top up to her shoulders as everyone ooh-ed and ahh-ed over the symmetry, the fullness or the 3-D-ness of the nipple tattoo.
As time went on, my warrior attitude slowly began to fade and I found myself dreaming more and more of uniformity. I was nearing my five-year cancerversary when, two glasses of wine into a wedding reception, my prosthesis fell out of my dress as I leaned over to grab my husband a beer out of the ice bucket. I decided I’d had enough.
The next day, I called up my friend Kristine, who had recently undergone the first stage of her reconstructive surgery. She’d had tissue removed from her abdomen and moved to her chest, creating two small mounds of flesh where her breasts once had been. She’d spent several weeks recovering from the eight-hour procedure, and was gearing up for stage-two: another invasive surgery that would involve shifting more tissue, filling in some gaps and minimizing lumps and bumps. She would later undergo a third procedure to smooth things out, then return to the clinic yet again for nipple tattoos.
Over a cup of coffee and a scone, I listened to her rave about the procedure, the doctors and the results. We slipped into the ladies’ room, where she lifted her shirt and showed me her chest, still swollen and red from the surgery. She also folded down the top of her pants to reveal the hip-to-hip scar.
See? It’s not that noticeable. It was to me.
On the ride home, I tried to convince myself that this surgery was really what I wanted. I tried to put the scars and the recovery and the dollar figures out of my mind. I consulted a few more friends, went to a few more panel meetings, and looked at a few more reconstructed chests on the Internet. I convinced myself that I was just scared and that I should just be brave. I would be glad I had the surgery. In a few months, it would all be behind me.
I was ready. Wasn’t I?
I decided to call the breast reconstruction clinic. After a prolonged phone discussion about insurance coverage and half a dozen emailed nudie pics, I had officially begun the process leading up to a tissue transfer. I chalked up the butterflies in my stomach to pre-procedure jitters. There’s nothing to be afraid of, I kept telling myself. In a few months, the worst will be behind you.
I shared my decision with friends and family, who were supportive, but understandably curious. Over the past several years, I had been very vocal about my decision not to reconstruct. Many asked me why I had changed my mind. My answers were vague.
I guess it was just time I feebly answered. Just tired of being lopsided.
As the pre-surgery process moved forward, my stress level began to rise. I gritted my teeth every time the clinic called. Conversations about my health insurance, travel plans and after-surgery care left me irritable. Coordinating child care and work responsibilities during my surgery and two-week hospital stay overwhelmed me.
This should have been an exciting time, so why wasn’t I more enthusiastic? The women at my cancer support group meetings certainly were. They discussed expander fills and follow-up procedures like they were talking about manis and pedis. They seemed more than ready to go under the knife. Why wasn’t I?
The day I sent in the first half of the deposit to secure my surgery date was the day I nearly bit my husband’s head off for ordering the cheese plate.
No. And I don’t want the surgery I blurted out when he asked if I wanted the fruit plate as well.
Then let’s not do it he said quietly.
And then the tears came. And out of my mouth came more words that felt good to say: I don’t want to do it I said again, choking back sobs in the middle of a crowded bar. I just don’t want it. It’s too much.
Jason nodded in silence.
I don’t need it, I continued, saying out loud all the things I had pretended didn’t matter. I’m OK with things the way they are.
It was an emotional download, and once the words were out there, my conflicted feelings and frustrations of the previous weeks started making sense. Was I scared? Yeah, of course I was scared. Surgery is scary. But I realized I was also subconsciously pushing myself into something that I felt I should want. Did the other women want reconstruction more than me? Probably. Why? Maybe breasts were more important to them than they were to me. Maybe they felt they were unable to put cancer behind them until they reconstructed. I totally got it. For them. But not for me.
When I got cancer at age 38 and had to tell my then-five-year-old son that the next nine months were going to rock his world, I realized, for the first time, that life is fragile and fleeting. Luckily, more than five years after my diagnosis, surgery and treatment, I show no evidence of disease. But we all know that can change in an instant. I felt there was no need to take any chances. It’s not broken. There’s no need to fix it.
I called the clinic the next day and cancelled my surgery and all the appointments, scans and procedures that went along with it. The nurse had obviously been through this with other patients, and gently tried to change my mind. I calmly told her no, I was sorry for wasting their time, but I wasn’t going to have the surgery.
As we prepared to say goodbye, the nurse signed off with a heartfelt salutation.
It’s a big decision she said soothingly. It’s OK to be scared.
I thanked her and hung up the phone, then smiled to myself. Scared? No. I had never felt more fearless in my life.
Sheila Cain is a freelance writer living happily unreconstructed in Seattle with her husband, son and two cats. She celebrates her cancerversary every January 13.