One of the more difficult and surreal aspects of Mary Roses’s experience with cancer has been the amount of time she lived with the tumor since diagnosis. The nature of the tumor and its size relative to the affected breast dictated that she could not immediately undergo surgery when it was discovered. So, the chemo began instead, to shrink the tumor, create a better margin for surgery, and to work systemically to kill cancer cells in the affected area and, if that was the case, beyond. The course of chemo and the pause before surgery was a period of almost 5 months, during which life was, as I like to describe it, about 90% normal, but the knowledge of the tumor itself would often intrude. Not thoughts of cancer in general, nor the amorphous fear of bad outcomes, the dark litany of “what if’s”, but the recurring awareness of the thing itself. The physical presence of it. Right there, in the breast, the upper right quadrant of the right breast, just millimeters below the surface. The killer in the room.
We could be in the midst of the most ordinary routine, standing in the kitchen talking perhaps, and my mind would be drawn to it. There it is in front of me, the thing that’s trying to kill my wife, that we are trying to kill. Right beneath the skin. So close. You fucker. If I could only get my hands on you. The thought would come and go, defiantly suppressed, only to return again perhaps days later, and so on.
How often Mary Rose’s thoughts were likewise focused I can only imagine. There were several times when we would be laying in bed and she would say that she could feel it shrinking, feels the drugs working, feel the enemy under assault, weakening. She would sometimes note how the appearance of the breast seemed to be changing for the better over the months, but I think she mostly tried to avoid it. The oncologist would examine her and ask if she had felt with her hands how it was getting smaller, or if she wanted to right then and there, but she would not. She tried to avoid it as much as possible, and I did the same. We remained focused on the surgery to come, because for all the progress that the chemo made, the killer was still with us. Only surgery could remove it, reveal the extent of it and discover what more, if anything, there was to learn about it.
On June 17 we woke up at 5 in the morning to report to Mercy Hospital by 6. The check in and prep was very efficient, the staff very helpful and reassuring. Mary Rose was in good spirits. She would be having a full double mastectomy immediately followed by plastic surgery for temporary, tissue-expanding implants. By 7:20 she was on her way to the OR. At around 9:45 Dr Quijano called me out of the waiting room. She told me the surgery had gone well. No surprises. It would be about another hour for Dr Flaherty, the plastic surgeon to finish his part.
I want to focus on this moment because I can’t overemphasize the importance of it, the significance of what little the surgeon said, of what she did not say. It went as planned, as hoped. There was an ample margin of healthy tissue around the cancer to work with. She didn’t find more of it, it didn’t turn up beyond where it was supposed to be. What was left of the definable tumor was isolated, cut out and destroyed.
I have never felt such a divine sense of relief in my life.
By 11 she was out of surgery and in recovery. By 1 she was in her room. She stayed the night. I stayed with her. By 4 the next day she was home. I played nurse, drained drains, charted meds, spread the news. The torrent of flowers began.
With surgery a page has been turned. We have arrived a place of possibility, not without risk, but of possibility nonetheless. The killer has left the room. He may have left some weapons behind, he may not have. He may have left a door ajar or he may now be locked out. We don’t know for certain, can’t know yet. Mary Rose may be without cancer at this point, or there may be some residual that only the radiation can eliminate. Or perhaps radiation will turn out to be an insurance policy or sorts, or a few last shots fired into the enemy’s grave, just for good luck. Time will tell. What we do know is that the source of her cancer, its point of origin, its most lethal expression has been eliminated, and we have moved from the certainty of the disease to “maybe”. Maybe it’s gone. Maybe it’s 99% gone. Maybe it will be completely gone by the end of radiation. Maybe it will never come back. While we would all like a guarantee of such things, sometimes the best we can do is a maybe, or a maybe with the odds moving in our favor.
Sometimes maybe can be a wonderful thing.
