NDJ:6 Susan O’Dell, PhD

The Breast

Susan O’Dell, PhD

Her fingers slowly slither and methodically linger on cushy terrain of my right breast. Over and over, back and forth, pushing deep and prodding, she hesitates and glides over my nipple. Finally done she moves deftly to my left breast. I breathe; my right breast passes this dogged inspection. I lay on the white paper covering the black table now sticky from the gleaming sweat on my neck. The blue green cotton gown, untied, falls off my shoulder. My feet press hard into the cold metal stirrups. The stark florescent light fills the examining room.

She chatters at me. Her fingers move up and over and under my left breast. There is more pushing and prodding. Her doctor presence is penetrated with details of her summer trip to France. It was her husband’s 65th birthday. She talks of wine and castles. She pushes deep into my left breast. She asks if my practice is affected by the recession. I say no, but the end of the year means the end of yearly insurance benefits for some of my patients. I say my insurance is changing. She tells me to get Blue Cross and Blue Shield because the reimbursement for her is high. She tells me she is tired of insurance companies dictating how much money she can make.

I start to say something but she cuts me off. Wait, she says, I feel something. Her pushing and prodding slows down and she rubs a spot back and forth on the side of my left breast. Her fingers quickly and then slowly trace a meandering path all over my breast. She makes deep circles around my nipple. She goes back to the spot. She goes back to my right breast and back to the left. I feel something in your left breast that isn’t in your right breast, she says. Maybe it’s a cyst. I’m not comforted.

The stark florescent light beats down on me. My foot cramps, locked in the stirrup. I’m dizzy. My head starts to buzz. I say, I just had a mammogram last month. I went to that place you told me to go to. I can’t remember the name. You read their report. You sent me a postcard and told me it was OK. She doesn’t hear me. Or, maybe I didn’t say it. She tells me I need an ultrasound. She tells me the place where I got my mammogram doesn’t do diagnostic mammograms. Why not, I say. She doesn’t answer. What do I do? She says maybe Rush Medical Center does them. Why should I go to Rush when she’s connected to Northwestern Hospital? She says that she will check Rush out for me. She will send to me a referral. I believe her.

A day goes by. Another day goes by. The weekend comes. Another day. Nothing. I call her office. I leave a message. I check my mailbox. I check my fax. I check my voice mail. Nothing. I call her office again. I leave a voice mail message for her secretary. Nothing. I call again. I leave another message. I leave a message on her cell phone. I explain what I want. I need a referral to Rush so I can get an ultrasound.  Nothing.  The holidays are coming.   I know I won’t get an appointment with Rush soon.

I replay her voice over and over. I feel something. I feel something. I’m angry. I’m scared. I try hard to reassure myself with the OK results of the other mammogram. Just as I am almost comforted, fear grabs me again. Maybe that mammogram wasn’t read right. Maybe that technician didn’t really know what she was doing. Over and over, I make a list of all of the women I know who have had breast lumps; mastectomies; diagnostic mammograms; breast cancer; cysts; lumpectomies. I remember them. I remember running cancer survivor groups at Gilda’s Club all those years ago. I remember that poster of the woman with the tattoos over her mastectomy scar. Courage. I have none.

Finally, finally she calls me back. Sorry, she says, my secretary walked out. Just left one day. I haven’t been able to replace her. Things are backed up. Sorry. She says she can’t fax the referral to me. Sorry. She’ll put it in the mail. I believe her.

A day goes by. And, another. And, another. No referral. My partner offers to go to her office to get the referral. I write a letter giving someone permission to turn it over to her. She gets the piece of paper and brings it home. There’s a picture of a breast with a circle where the “palpable mass” is located on my left breast. I can’t look at it.

I don’t call Rush for two days. I have to do it. I call. A woman answers the phone at the Breast Imaging Center. I flinch. I talk. I tell her what the doctor said. I tell her I need an ultrasound. She tells me to bring the film and the report and the referral. She tells me to call her after I have the film and the report so I can get an appointment. She says they are booked, but I have a lump so I can get in soon. I flinch. I call the mammogram place. They tell me to write a letter so my partner can have permission to pick up the film and the report. I do this. The film and report is on my desk. I can’t look at it. I put it in the back of the file cabinet until Wednesday at 8 AM.   Five days away.

Wednesday comes with a snowstorm. I drive us in the early morning traffic. I want control. We arrive and I fill out the paperwork. Lots of questions about lumps and cancer and surgeries. I answer everything. Soon I am with the mammogram technician. She angles my breast in just the right way and then tells me to hold my breath. She takes six pictures. I ask her about the ultrasound. She says that it will be done if anything shows up. She tells me to wait while she checks the films out. I wait and wait. I read the signed list of all of the days the room has been cleaned. I read the certification declaring that the mammogram machine is up to official standards. I don’t pace. But, I want to. My mind flickers and fades and I read the cleaning list again. The mammogram technician comes back and tells me to follow her for the ultrasound. I follow her. I surrender.

I meet the ultrasound doctor. She introduces herself and I forget her name. She tells me that the mammogram matched the first mammogram. Nothing showed up. Nothing. Normal. Fine. She tells me she wants to do an ultrasound in the area my doctor felt something. I lay down. I shut my eyes. She rubs warm jell on my breast. It isn’t comforting. The ultrasound wand slowly traces my breast. No pushing. No prodding. Just easy gliding back and forth. I open one eye and see the ultrasound doctor focused on the screen as she goes back and forth over my breast. Finally she turns off the ultrasound machine. The wand stops. She says that nothing showed up. The two mammograms are fine. The ultrasound is fine.

It’s done. There’s nothing more to do. I leave. I find the locker holding my clothes. I hook up my lacy red bra. I guide my breast into the left bra cup. I flinch. I pull my wool sweater over my head and down my chest. I glance at my breast, once again a familiar mound under my sweater. I zip up my down jacket.   My breast disappears.