“We don’t,” he says. “Your breasts are a breast surgeon’s nightmare. They’re large and dense and full of lumps.”
I remember the pictures in the medical book. The real ones are gonna be this dangerous, let them make me a fake.
“Take it off,” I say.
He explains a bit about breast reconstruction. I had assumed it was like the breast-enlargement surgery I had seen in Los Angeles, an operation in which the doctor put a silicone implant under the muscles or tissue or the breast and the patient woke up with a new breast—except that in the case of cancer, you would remove the breast tissue first. Luke says it is not that simple: You don’t wake up with a new breast; they put an expander in your chest; it takes a few months. If I go with lumpectomy, in which radiation is required, it takes six weeks. Lymphnode removal involves three or four days in the hospital. There are no shortcuts—this is cancer. I do not have to decide about mastectomy or lumpectomy in a few days, but I should have surgery within four weeks. Whichever procedure I choose, lymph-node removal will be done at the same time. After that, there’s a good chance I’ll need chemotherapy for six months. Meanwhile, they’ll be doing more tests on the tumor: DNA analysis, hormone receptors. I can take the cotton dressing off my breast tomorrow and come to his office Friday; he’ll have those results and take out the stitches. I’m having trouble assimilating all this; so is Herb. We’re two liberal-arts guys suddenly thrown into Columbia Medical School. I’m still back with the idea that reconstruction is a long-term process and I may be walking around lopsided for five months. Luke recommends Dr. Susan Love’s Breast Book.
I have one more question. I am afraid to ask it, but I have to, anyway.
“What am I looking at here?” I ask. “Statistically?”
He isn’t any happier answering than I am asking. He doesn’t care much for statistics, he says. You can still have a cancer that has a high cure rate, and if you’re in the percentage that is not cured, it doesn’t matter. In my case, I have a cancer that has a favorable prognosis and is “more curable than average.”
I need something harder.
“When my father was diagnosed with prostate cancer, it was something like a 60 percent survival rate at four years, a 40 percent survival rate at seven years,” I say.
“I would say the statistics, in your case, are considerably better than that,” he says.
“How much better?” I ask.
“For breast cancer, the overall cure rate is 70 percent. For medullary, it’s above that. I would say 80 percent, 90 percent.”
I feel better. I like these odds. I don’t entirely believe them, but I like them. This leaves me with one immediate problem: how to tell my mother. Herb has the solution: “Lead with the positive.” I find my notebook, and we work out the lead and phone it in. The last time I did this, I remember, I was filing a breaking story for the Washington Post on a Concerto for Piano and Dog at Carnegie Hall. The dog had stage fright, which was good for me, as it gave me a new top. There is a reason people hate reporters. The phone rings, and I begin the performance.
“Well, Ma, I’m out of surgery, and I’m here at the hospital and everything went great,” I say.
“Oh, thank God, I’m so relieved, I don’t know what to say, I was so nervous I couldn’t sit still, my friends called, I told everybody, ‘Get off, get off, I can’t talk, my daughter is right now this minute having surgery in New York. . . .’”
I break through the wall of words, power-talking, a skill I developed from 43 years of training with champions.
“The lump turned out to be malignant, but it’s the best kind you can have,” I say. “It’s called medullary, it tends not to spread, they seem to have got it all. It was in one lump, I saw it, it looks like it was encapsulated, that’s a good sign.”
Silence. She believes me like I believe the doctors.
“I’m coming north,” she says.
I tell her she is staying put, I probably won’t be having surgery for at least a month, and hit her with all the other positive stuff I can think of. This cancer is very rare, hardly anybody gets it, and it has a very, very good prognosis. Yeah, it was big, but this kind grows very fast, and the doctor says we caught it early. The longer I talk, the harder it is. I am hearing my mother and my dead grandmothers and all the aunts in the family. “The worst thing in the world that can happen, the very worst thing, is for a parent to survive a child,” they are saying.