Before The Mountains
Shadows lope along the mountain’s rumpled flanks; they elongate like root tips, like lobes of spilling water, faster and faster… the light warms and reddens; the bare forest folds and pleats itself like living protoplasm before my eyes, like a running chart, a wildly scrawling oscillograph on the present moment… I am more alive than all the world.
– Annie Dillard, Pilgrim at Tinker Creek
(Long-overdue) update: the biopsy of the new lesion in my remaining breast was benign. We got the news in a hotel near the Grand Canyon, my husband recovering from a state of mild shock after hiking rim-to-river and back up in a day. He logged onto the hospital system and happened to read the pathology report twelve minutes after it came out. I listened to the report with a relief so numb it felt like its own brand of shock. Of course we thought it would be benign: everyone knows MRIs are sensitive but not specific, flagging every little thing. Still, I hadn’t been able to entirely suppress an underground anxiety that hovered at the edge of everything. I knew now what a positive biopsy would mean; I could see miles down that road, and I wasn’t sure I could go down it again.
That’s the thing about cancer treatment. It messes with your sense of things. On one hand, I know, I really know now, that I am lucky to be alive. Lucky my treatments come with an expiration date. On the other hand, I also know what it’s like to live through and with all the test and procedures and medications we doctors so easily order with a click of a button. Ports and needles and scars and soreness and all the side effects small enough to survive but big enough to disrupt your well-being, all of it grinding me down into a state of detachment. I remember feeling last year like I wanted to stay wide-eyed and aware, to wring from this experience all it had to teach me. Now I’m just trudging along putting one foot in front of the other, unable or unwilling to look too far ahead.
Yesterday marked the first three-week-interval-Wednesday in a year that I haven’t had to go in for an infusion. That means as of three weeks ago, I have finished treatment for Breast Cancer #1 (invasive ductal, found on screening mammogram): lumpectomy, mastectomy, six doses of chemo, and a years’ worth of intravenous immunotherapy. But I’m not done yet. There’s still Breast Cancer #2 (noninvasive lobular, found incidentally on pathology). #2 has the exact reverse receptor profile as #1, meaning none of the (targeted) treatments I’ve been doing for the past year have touched it. Unlike Cancer #1, Cancer #2 bears hormone receptors, so treatment would involve pills that suppress estrogen. Standard treatment is tamoxifen, a selective estrogen receptor modifier (decreases estrogen in the breast, increases it in the uterus and bones), in a small daily dose for three years. I’ll discuss it with my medical oncologist next week, but I’m expecting her to recommend it as it decreases the risk of Cancer #2 popping up in my remaining breast by half.
At least now I don’t have to deal with a Cancer #3: thank you, God, for that much. The biopsy itself was the messiest one yet, done under MRI, and snagging a cluster of vessels along the way that bled like stink. Four people took turns applying pressure afterwards but it was still seeping when I left the hospital. Somewhere during the canyon trip it rebled, the blood nestling within the breast tissue in a giant hematoma, bruises flowering across the skin like my breast was weeping into itself. Just when I wanted to move on, here I was again with the kind of pain and bruising that only time can heal.
We passed the new year in Zion National Park. How appropriate, I thought, to be in a place so marked by the passage of time. Unlike trees with their hidden rings, these rocks wear their age on the outside: layers and layers of striations marking stretches of time that boggle the mind. If my year were a cliff, the ridged lines would mark every three weeks. Seventeen lines, fifty-one weeks, stretching up and up, and me standing, breast throbbing, in their shadow. You don’t come out of something like that the same person. I’m still figuring it out, but I know that much. Healing was never about getting back to what I had, but coming to some new sort of place, making peace with it, and look how beautiful this is, the erosion of millennia carving such arresting monoliths of texture and color, and who would have known? Who would have known that water and wind, by virtue of sheer endurance, could lead to such majesty? I stood there, feeling the landscape break through my numbness for a moment. I felt glad to be alive. Glad to have made it. But also tired and sad. And still sore. My cancer was never anything my body could feel. Last year, my mind was rocked by the diagnosis but my body felt the same. This year, my mind knows the worst is over, but my body feels bad. Some of that will go away; some of it I will live with forever.
I remember someone telling me, back when I was trying to decide whether to do chemotherapy: “do it, and you’ll never have to look back.” She was right in the sense that Cancer #1 is now much less likely to pop up one day in my brain or bones or liver. I am as close to being cured as someone can be. But the year isn’t so easily left behind—it has made its mark; it commands the view much like those cliffs in their fearsome and terrible beauty. I want to make my peace with it. I want to make my peace with it.
