The Cruelest Month

Only last Tuesday, John and I swayed on our porch swing yukking it up with our next door neighbor, Mike Sperry, in the warm evening twilight.

Today it's snowing.  And April is only days away.

"It's the cruelest month of all," John reminds me.

Spring is always bittersweet.  On a beautiful day when the birds are chirping madly and the tulips are poking through to the sunshine, my siblings and I think of our parents.  Mom died in April, and Dad in May.  For us, the beauty of spring will forever be associated with those very painful losses in our lives.  The cold falling snow seems more fitting somehow.

For the first time, I will not be scheduling my mammogram for April 1st.  No more mammograms.  Ever.  The relief is sweet, but the guilt is terrible. Mom would be the sacrificial lamb.  She would die, and my sisters and I would live.

Sitting in Arby's together, right after Terri made the monumental decision to undergo a double mastectomy last July, my little sister cried in anguish.  "I keep thinking of Mom," Terri wept.

If ever a family was in denial, it was our family.  While Mom lay in agonizing pain those last few weeks of her life, we refused to believe she wouldn't get better.  Even Dad and Grandma, who were old enough to know better, shut their eyes to the awful truth.  At 23, I was old enough to know better, too.

"Why can't I just die?" my mother moaned one day in helpless defeat.

"Don't say that, Mom!" I begged.  And she didn't - ever again.  Silent and miserable, she sadly acknowledged her family's denial.

Breast cancer wasn't talked about in the 70's, and if Hospice existed, we weren't aware of it.  So Mom writhed in her lonely bed day after day without a single family member or friend to confide to.  Instead, we rubbed her sore back, urged her to walk, and plied her with pain pills.

On Easter Sunday, two days before she died, she opened her eyes and asked us all as innocently as a little child, "Am I going to die?"  We couldn't speak. 

It was only when our good pastor, Father Harry Kurtenbach, leaned over Mom in her hospital bed to ask, "Are you afraid to die, Patti?" that the awful silence was broken at last.

"No," she sighed, her head sinking back to gaze at Father Harry in loving gratitude.

When we were older and facing the fear of breast cancer ourselves, my sisters and I began to intimately understand our mother's agony.  I was so frightened as I was wheeled into surgery for my first breast biopsy.  Just before the anesthesiologist put me under, I thought of Mom.  Only 20 years earlier, she'd been in my place.  But she would wake up from her biopsy without a breast.  That's the way it was done in 1976.  I never felt closer to my mother than I did in that single moment before surgery.

"I love you, Mom."  It was a piercing, silent prayer in the middle of the orchestration of the operating room..  Suddenly, a power surge sent every single light buzzing into high beam all around me.

"Whoa!" a masked nurse exclaimed, raising her eyes and arms in wonder.  "And let there be light!"

That Mom was beside me, I had no doubt.  Her nearness was the last comforting thought I was aware of before the nurse woke me an hour later to inform me that the lump was benign.

My sisters and I, several years ago, made two pacts with each other.  First, if any of us would end up lying in a coma, it would be the responsibililty of the others to sneak into our hospital room and remove any embarrassing facial hair.  Second, we promised each other that if we're ever dying of breast cancer, we'll talk.  No more denial.

"If I could go back to 1979," Deb said once, "I'd hug Mom until she was sick of me.  I'd sit by her bedside and talk to her and hold her hand and stroke her hair," she breathed, "and I would tell her how much she was loved."

Our greatest sorrow is that Mom never knew our spouses and her grandchildren.  I especially wish she could have known my mother-in-law, Ruth Howard.  She's the quintessential grandmother with her snowy white hair and rosy cheeks.  The mother of seven children herself, she would have gotten along like a ball of fire with Mom.  I can see them now, swapping stories about the hazards of raising a million kids.

Ruth would tell Mom about the time  her 12-year-old Tom secretly dug tunnels underneath the dirt in their Colorado farmyard.  One day, the tractor my father-in-law was driving was all but swallowed up in the ground when the weight of it sank through Tom's extensive tunnel system.

"Ruth!" my outraged father-in-law roared from the seat of his sunken tractor.  "Get Tom out here NOW!"

Mom would tell Ruth about the time my little brother Joe played with Dad's lighter and accidentally set the bed on fire while he was supposed to be taking a nap. 

And the two of them would laugh until they cried.

I'm lucky to have a mother-in-law like Ruth Howard.  In spite of the many troubles that plague her in her own life, she always views the world with fresh optimism.  After a stroke and a broken hip limited her busy world to her own modest home, she nevertheless found comfort from her countless books and her passionate love for her two favorite sports teams - the Denver Nuggets and the Denver Broncos.

"Sometimes I just have to walk away from the t.v.," she shudders to my husband, also a devoted member of the Bronco faithful.  "That Tim Tebow's trying to kill me."

The loss of John's father almost 15 years ago was a bitter pill to swallow.  Ruth soldiered on, however, and was determined to enjoy life and her children and grandchildren.  But when complications from diabetes threatened her independent life style, she reluctantly listened to her good children, who feared for her life, and moved into an assisted living facility.

She still watches the Broncos every Sunday afternoon in the fall.  And her 86-year-old zest for life is a good lesson for somebody like me who can sometimes let spring melancholia weigh her down. "Things always work out!" Ruth exclaims, as she eases back into her recliner to cheer on her beloved Broncos.  "But that John Fox better pull those players together, or we're all in big trouble. What is Tebow DOING?"

Ruth Howard teaches me that life is an extraordinary journey, whether in Heaven or on Earth, and that even during the cruelest month of the year, it's important to look forward to a few surprises. 

Who knows?  Her oldest grandson might just bring his beautiful girlfriend to dinner at the nursing home.  Or perhaps her gorgeous granddaughter Emily might swing by with her flock of laughing college friends.  And, what the heck.  Maybe the Broncos will even win a Super Bowl next year.

But even my mother-in-law isn't that optimistic.

Cats and Kids

It’s hard to feel feminine when you’ve got pecs like Conan the Barbarian.

I am now in the middle of what Deb calls the "Body Builder Phase" of breast reconstruction. And it’s not pretty. Inserted beneath the muscles of my chest, plastic expanders are hard as rock. I could run, jump or turn cartwheels, and these babies wouldn’t budge.

Every Friday, Dr. Montag, our plastic surgeon, and Erin, the perky P.A., stride into the examination room with handfuls of syringes the size of small bayonets and fill the expanders on either side of our chests. And every week, our chests swell out a little bigger. If only the swelling made us look like we had real breasts instead of like Arnold Schwarzenegger taking a deep breath.

Mary has finished her first three fills, and Deb’s expanders are completely full. She can hardly wait for her last surgery just a week from now. That’s when the expanders will come out and the soft, comfortable implants, which actually do resemble female breasts, will go in.

These last weeks of reconstruction are a little like being nine months pregnant. You’re swollen, uncomfortable and miserable, and you want the damn things out. But witnessing Terri’s transformation helps us to feel that the months of discomfort will surely be worth it. In the meantime, however, reconstruction is an uncomfortable process from beginning to end and results in aching muscles and sleepless nights.

The best way to get through it is to own a nocturnal animal - say a possum, a raccoon, or a ferret. A cat will also do. Willy has spent every night beside me on the bed, the couch, the recliner or the floor. He’s a mangy, dirty, old coon cat, and I couldn’t have survived these last few months without him.

I didn’t even know I liked cats until Willy and Blackie came into our lives. We adopted six-week-old Willy with his ears as big as spatulas from our next door neighbor, and we discovered a baby Blackie starving in the streets. I was strictly a dog person. When I took our two new kittens in for their first shots, I remember filling out a form in the vet’s office.

"In the event your pet suffers from a medical emergency, would you prefer this office did or did not employ life saving measures to save your pet?"

Snorting, I checked the "no" box. This was a cat, not my mother-in-law.

Five years later, Willy, who can’t tell the difference between a mouse and a crescent wrench, ate a bottle cap and nearly died.

"It’s lodged right here in his colon," the veterinarian showed me on the X-ray, as I struggled not to weep over my half dead cat lying listlessly on the exam table. My son Tommy stood beside me listening intently. "He’s not able to pass it on his own," the vet informed us, "and the only way to remove it is surgically."

I swallowed. "And how much would an operation like that cost?"

The vet cleared his throat. "Close to a thousand dollars."

I stared at him, speechless.

"Mom!" Tommy nudged me when I didn’t speak.

"Okay, okay," I coughed. "We’d better do it."

I’m so glad I did. Willy is 11-years-old now. He’s a moody, filthy, unfriendly feline - to everybody except me. His devotion is the only reason I love him. There are no other reasons. Willy, unlike Blackie who spends hours grooming herself, never even bothers to lick the Fancy Feast tuna blend off his whiskers. And other than the golf ball sized mats he occasionally rips out of his fur in frustration to spit out in the middle of the living room carpet, he’s never once made a single attempt to clean himself.

But he loves me.

Blackie, on the other hand, belongs completely to my husband. As soon as John sits down to read the paper, she leaps onto his lap and nuzzles the five o’clock shadow on his chin, adoringly claiming him as her own. John strokes her, croons to her and loves her like the daughter he never had. Then she drops on his chest lounging on her side like the Queen of Sheba to regard me cooly across the room. I am the "other woman." But she knows full well I’m no serious competition for the likes of her.

While Blackie slumbers all night by John, Willy follows me through the house during the wee hours of the morning as I wakefully struggle to accommodate my ever expanding chest muscles. I have no illusions about Willy’s loyalty, however. Our relationship is strictly about what’s in it for him. If an axe murderer broke into our house and threatened to hack me into a thousand pieces, Willy would scamper under the bed and hide until the whole sordid episode was over.

What he wants from me is attention, pure and simple.

It turns out the kids at school are no different. The first day I returned to school after my double mastectomy, my students were polite and concerned.

For about 15 minutes.

Stealing furtive glances at my boobless chest, they at last satisfied their curiosity. Then it was back to business as usual, much to my relief. Except for one little sixth grade boy who fixed his gaze on me with solemn, tear-filled eyes. He was still worried about me, I knew, and I resolved to speak to him away from prying eyes as soon as the bell rang.

I had just assigned the kids homework and had settled down to grade papers when I looked up to see the sad little boy standing silently by my desk.

"Well," he sighed tremulously, "I guess you forgot."

I blinked. "What?"

"My birthday," his lip quivered. "It was January 16^th, and you left and forgot about it."

So much for his deep concern for my health.

"I’m so sorry," I grasped his arm. "Why didn’t you tell me?"

"I did. I told you the first day of school, and you said you’d write it down so you wouldn’t forget."

I shuffled through my planner, and sure enough, there it was plain as day. "M’s b-day." I felt like a heel.

"You know what? Go get that hula skirt off the shelf," I said.

The smile that blazed across his small face was like a shaft of sunlight cutting through the storm clouds.

The hula dance is a time honored tradition in my English class. Every student dons a grass skirt and sways in front of the entire class to our own special brand of background singing.

"And maybe," he suggested hopefully, "we could play Heads Up, Seven Up the last five minutes?"

I pretended to be mad. "Don’t push your luck." We grinned at each other.

I watched him dance his hula with the practiced precision of a New York Rockette. It was clear he’d rehearsed many times in front of his own mirror at home.

And I’d forgotten his birthday.

Cats and kids. Their needs are simple. They require only that you regard them as the center of your universe. They want you to remember their birthdays, laugh at their jokes, and occasionally scratch them behind the ears. Most importantly, they crave the security of a routine with a hula dance thrown in for good measure.

It occurred to me that not once during my first day back at school had I been aware of the soreness in my chest. There wasn’t a single opportunity to think about it.

It should be sad, really, that after a grueling surgery that’s changed my life forever, the cats and the kids in my life utterly and completely take me for granted. But instead, it’s oddly flattering.

What my cat Willy and those 165 kids I teach every day are telling me is, "We know you’ll always be here."

And I’m happy I get to be here.

Then there’s our other cat Blackie.
If she could speak, she’d tell me, "I hope you get whacked by the axe murderer."

A Bolt from the Blue

You couldn't drag our son Tommy away from the NFL network with a tow truck.  Unless it's to go to the other room to watch ESPN.

Lordie, the boy loves football.  During Christmas break, he practically wore a hole in our sofa watching his favorite football channels.  Usually, I try to coax him away from the television with a little discreet nagging.

"Tommy, it's time for dinner," I'll say, or "Tommy, the couch is on fire."

He barely hears me.  "I just wanna watch this one part," he'll mutter absently, his gaze never leaving the screen.

I don't get it.  In the land of Nebraska, the "Football Capital of the World", I am an outcast.  I can't even work up an appetite for our beloved Huskers.  Those Saturday games take up a big chunk of my weekend.  And I have the complete fifth season of "The Gilmore Girls" to watch. 

But while I was recovering from my double mastectomy over Christmas, I wasn't in the mood to nag Tommy.  One morning, arranging my drainage tubes, I settled in the recliner and resigned myself to suffering through some boring biography about Vince Lombardi.  To his credit, Tommy had been working hard to help me around the house and be sensitive to my post-op fatigue.  "Mom, I can change the channel to something else," he offered.

"This is fine," I said.  And it was.  I was surprised to discover that tough guy Vince Lombardi was a devout Catholic and even used to be an altar boy.  "Did you know that, Tommy?"

"Mom," Tommy said patiently, "everybody knows that." 

When Vince died suddenly of cancer in 1969 at the height of his football season, I welled up with tears.

Tommy was uncomfortable.  "Look, Mom," he said, "let's watch something else."

 "I just wanna watch this one part," I muttered.

The next day, ESPN aired a documentary about the University of Miami during their days as the "Bad Boys" of the 80's.  I'd never seen a more swaggering, lawless group of players in my life.

"Those boys are criminals!" I sputtered.  "Look at them dancing in the end zone.  Please don't tell me they win a national championship."

Tommy rolled his eyes.  "They won five of them, Mom.  And the first one was against Nebraska."

I've never understood Tommy's passion for football.  He doesn't exactly possess a killer instinct, any more than his 6 ft. 10 in. older brother Kenny does.  The two of them can't leave our little cat Blackie alone for two seconds.

"Oh, my BABY!" Tommy croons in a high falsetto, cuddling her against his chest and rocking her like a baby.  He'll be horrified when he sees this.  Oh, well.  Let him write his own blog and tell embarrassing stories about me if it bothers him so much.

But because football is so important to Tommy, it's important to me.  He's spent two years preparing for an offensive tackle position at the University of Nebraska at Omaha.  Even though he hasn't seen a lick of playing time, he felt his chance was coming next year.

Then a bolt from the blue.

Two days ago, UNO dropped their football and wrestling programs.  With no warning, 120 football players, 30 wrestlers, and a group of stunned coaches learned that their programs were about to become extinct.

"I can't believe it," Tommy called us yesterday morning in disbelief.  "I'm not sure what to do."

I've tried to shield my boys all their lives from pain and sickness.  And I've done a damned lousy job.  Kenny, who managed to snare a Division 1 basketball scholarship at Denver University, had to give the game up.  He was born with Pectus Excavatum.  That's a nice way of saying "caved-in chest."  Although an operation when he was five helped to create a little more room for his heart, he's never had more than 75% lung capacity.  After his first two years of Division 1, he tried playing Division 2 basketball at Regis University, a small Catholic college in Denver.  But the rigors of college basketball at any level proved to be too much.

Tommy, on the other hand, has always been barrel chested and sturdy.  But when he was 14, his adrenal gland was assaulted by a benign tumor causing his blood pressure and heart rhythm to fluctuate wildly.  His entire adrenal gland was removed in a risky operation, and after a year of sitting out, he was finally able to play high school sports again.

Their trials in life have shaped Kenny and Tommy in ways that John and I never could.  I've learned a lot from my sons about courage and persistence and new perspective.  Our two boys can roll with the punches.  Kenny showed us that not long ago when he was diagnosed with epilepsy.

"You just need a new plan," my good husband has always taught our boys.

When Kenny couldn't play basketball, he applied for a little part time job at the college alumni department and for another position as an R.A. for the dormitory.  That little part time job at the alumni office developed into a full time position when he graduated.  And his R.A. job introduced him to a beautiful girl named Katie. 

Now my husband John reminds Tommy that good things can come from wrecked plans.  "It'll work out, Son," he reassures him in that rock steady voice that has soothed me through many a crisis.

And I know he's right.  A double mastectomy was never in the plans for my sisters and me.  We would have considered such an operation nothing less than a nightmare.  But it's all worked out for the best.

Tommy may never play football again.  Or he may discover he can't live without it and find success at a small college.  Whatever he decides, he'll begin with a new plan - one that never in his wildest dreams would he ever have imagined.

Our darling former pastor, Father Don Larmore, used to tell his parishioners, "There is a God.  And it's not you or me."

But sometimes, just for a fraction of a second, I wish it was me.

Trouble Times Three

Trouble comes in three’s, they say.  It’s been sniffing around our house for a couple of weeks now.

It’s my own fault.  I invited it right to my doorstep with my cocky attitude.  This double mastectomy at long last left me with a feeling that I had some measure of control over my destiny. 

Will I never learn?

On a Wednesday night two weeks ago, my husband, who insists on walking home in the dark every night from his part time job at the city library, was assaulted.  He had just purchased a couple of chicken sandwiches during his walk home when he noticed two young men following him.

“Can I do something for you boys?” he turned around to face them.

They wanted his wallet.  “I don’t have any money,” John told them, refusing to give up the wallet tucked inside the chest pocket of his jacket.

“Why couldn’t you just hand it over?” I demanded later in exasperation.

“And be forced to cancel my credit cards and get a new driver’s license?”  He was indignant.

The thugs followed him to our driveway – yes, to our own driveway  - kicked him to the ground and searched for his wallet.  John huddled close to the ground and grabbed the leg of the man in front who was kicking him in the head.

“Let’s go!” the other one finally yelled in frustration.  “He doesn’t have a wallet!”

They didn’t leave, however, before stealing our chicken sandwiches.  Consequently, the police log in the paper the next day reported John’s call.  “Food was stolen,” the report read. We looked at each other and burst out laughing.  But John was sheepish.

“I’m feeling pretty foolish,” he said.

Much more was stolen from us than a couple of chicken sandwiches.  While John has promised me that he will drive to and from his job at the library from now on, we both find ourselves looking behind our shoulders, checking to make sure we really locked the doors, and pondering a move to a safer neighborhood.  Maybe there is no safer neighborhood.  Besides, we’d really miss the good people living on our block.

It wasn’t two days later, still reeling from John’s assault, that I received a call from our next-door neighbor.

“Can you come over?” her voice shook.  “I’ve just been diagnosed with breast cancer.”

Something inside dropped clear to the pit of my stomach.  Anne is one of those women whose sweetness spills right out of her smile and eyes.  She and her husband Scott are the greatest neighbors in the world.  They trundle over a crockpot of potato soup when you’re feeling under the weather and carry over their adored baby granddaughter to let you hug as long as you want.

Now Anne was scared to death.  Although her cancer was early, she had scheduled a bilateral mastectomy due to a complicated pathology report and a significant family history.

“Dr. Goering’s performing my surgery,” she said.

I was filled with confidence.  Johnny Goering had graduated from Central Catholic High School and had been a student in my husband’s classroom and mine.  He was one of those earnest, true-blue boys.  I remember the time in my seventh grade English class when I unwittingly sat on a planted whoopee cushion.  Johnny Goering laughed so hard he nearly fell out of his desk.

Thirty years later, he performed my colonoscopy.

Go figure.

Had my sisters and I not sought out a breast cancer specialist for our particular situation, I would have gone straight to John Goering for my double mastectomy.  “Take ‘em off, Johnny,” I would have told him.  “And be quick about it.”  He would have, too.  He might be the best surgeon in town, but I’m still his English teacher.

“You’re in very good hands – the best,” I assured Anne.  We talked about all the particulars of double mastectomies, and she asked lots of questions, her voice quivering sometimes.

“This is the hardest part right now,” I told her.

“I know,” she said hoarsely.  “I wish I didn’t have to worry about my girls and my little granddaughter.”

Don’t we all?  Would there ever be a cure for this hideous disease?

Anne would be all right, I convinced myself.  Her cancer was early and very treatable thanks to her vigilant mammograms, and she had a wonderful surgeon. All would be well.

Then our son Tommy called.  “Mom?  I thought I’d better tell you about this before you read it in the paper.”

That sinking feeling of doom was becoming all too familiar. 

While working at his part-time job at HyVee in Omaha where he attends college, Tommy was stocking shelves when he heard the security officers screaming for customers to drop to the floor.  A man had just shot another young man in the parking lot.  The victim, who was shot in the head, lay dying as the shooter rushed into the store - the same store where my youngest son was stocking shelves.  The killer was apprehended by the security officers who managed to take away his gun, but every customer and employee in HyVee that night was shaken by the event.

For the third time in two weeks, the unthinkable occurred.  It seemed there was no way to protect my family and friends.

I needed a good visit with my little sister Terri. She’s always a breath of fresh air.

“Come see my new boobs!” she invited my sisters and me after her final surgery last week.

We couldn’t wait.  Sneaking up to her bedroom, away from all the Lewandowski kids, we waited in anticipation for Terri to disrobe and display her new breasts.

“Terri!” Deb, Mary and I squealed in unison.  They were beautiful – soft and round without any of those hard plastic expander bumps and edges rippling her skin.  The three of us, in our various stages of development, couldn’t stop staring.  Ter allowed us to poke, prod and examine with wondrous curiosity.  It was the emotional lift we all needed.

“You really think they look okay?” Terri looked at us anxiously.

“I want mine to look just like yours,” Mary breathed fervently.

Terri’s 8-month journey has come to an end.  I’m happy for her.  I’m happy about a lot of things.  I remind myself that my husband and my son are alive and well, unscathed by recent events. 

But I can’t help stewing over the what-if’s. What if Tommy had been carrying an elderly woman’s groceries out to the HyVee parking lot and had confronted the man with a gun?  And what if I had only come home a little sooner in time to help John the night he was assaulted?

“You’re kidding, right?” John laughs.  “What would you have done had you pulled in the driveway?”

I can see those two young men clear as day in the blaze of my car lights kicking and beating my husband, a gentle giant if there ever was one.

 “I would have run them over,” I say with low urgency.  Then I check myself, a little frightened.  Is this what those two young thugs feel?  This overpowering rage coiling up in your stomach like a snake ready to strike?

If I ever thought an operation to remove my breasts would offer me more control over my fate and the fate of my loved ones, I was wrong.  The world can be cruel.  My neighbor Anne knows all about that.

“It’s just as well you aren’t in control of the world,” John scolds me lovingly.  “It probably wouldn’t have been a good idea for you to mow over two guys in our driveway.”

Probably not.  After all, they only got away with a couple of chicken sandwiches.  It could have been so much worse.  I’m trying to be more charitable today.  I really hope those two young guys get help.  I hope they can straighten themselves out and lead good, decent, productive lives.

But most of all, I hope the chicken in the sandwiches they stole was grossly underdone.

And that they got severe diarrhea.

The Unvarnished Truth

A woman I know was shocked to learn I’d had a bilateral mastectomy.

"I’d die before I’d let anybody cut off my boobs!" she sputtered without thinking.

Instantly, she was embarrassed. I told her I understood. I remember when I felt the same way. But that was five biopsies and two affected sisters ago.

The Omaha World Herald interviewed my sisters and me last Friday afternoon in a quiet studio high above downtown Omaha. Unseasonably spring like, the day was warm and hopeful. Our interviewer, Live Well Nebraska editor Stacie Hamel, was wonderfully kind and sensitive. But none of us bargained for the raw emotions that would erupt in that quiet room.

"How did your mother’s death impact you when you were young?" Stacie asked my sister Terri who sat resolutely in front of the video cameras.

To our horror, Terri’s eyes filled. Barely able to speak, she struggled valiantly to pull herself together. "It was very hard," she said at last, her voice barely above a whisper. She recalled Mom’s terrible suffering and spoke of her constant fear that her own breast cancer would return and of the agony she endured imagining her children growing up without her.

Terri’s grief, so instantly unveiled, shook all of us. After her tearful interview, we clustered around to comfort her. Her stoic demeanor these last five months had fooled all of us. It took an interview at the Omaha World Herald with a kind journalist to help us realize Terri was still reeling from her breast cancer diagnosis.

Even more surprising was my youngest sister Caroline’s reaction. Stacie Hamel particularly wanted to talk to Caroline about her reasons for being the only sister who chose not to have a prophylactic mastectomy. Like Terri, Caroline immediately became emotional.

"I’m scared to death," she sobbed. "I’m a single mother who wants to date and have a life again." Even more heartbreaking was the admission that she would possibly have considered the surgery had she been able to afford it. "I know insurance would pay for it," she burst out. "But I can’t take six weeks off from work."

After that, Caroline refused to have her picture taken with us. Terribly upset, she would have no part of a photo in a large city newspaper that would circulate her image as a woman "marked" for breast cancer.

Soaking up kind attention from our families and friends, I’ve conveniently closed my eyes to the very real dark side of prophylactic surgery.

"If you’re going to write responsibly," my good husband reminds me, "you have to tell the truth."

So here’s the unvarnished truth about an elective bilateral mastectomy: It’s a difficult operation, and it’s not over in a day. The entire process is long and uncomfortable. One morning, you will rise to inspect your scarred chest in the bathroom mirror, and you will wonder why you ever persuaded yourself to do such a terrible thing to your body.

A young woman wrote to me recently that her husband was not able to understand her decision to undergo an elective mastectomy, especially since she didn’t have cancer. "He’s scared to look at me," she said. "I’m not sure if he’ll ever see me the same way again. I wish I’d never had this awful surgery."

Some of us don’t have supportive families to buck us up. Some of us, in spite of health insurance, can’t afford the surgery. And the grim reality of prophylactic surgery is that it’s not 100% effective.

"It’s impossible to remove all the breast tissue," Dr. Grange warned us. "But it can reduce your risk by about 90%."

While I feel liberated by those odds and feel certain that I will never confront this disease, Terri agonizes over the single cell in her breast cancer that may have escaped. "I’ll always worry about breast cancer," she admitted to Stacie Hamel.

After a long and difficult day, we thanked Stacie and said goodbye to Caroline. Deb, Mary, Terri and I fell into my little car and headed back to Lincoln feeling subdued and worried about Caroline.

"Look at that beautiful sky!" Terri exclaimed once we had driven out of town and were tooling down the interstate. Over the Nebraska prairie, the sun was disappearing behind a glowing red horizon, and we felt peace and perspective returning.

"Let’s go to the Macaroni Grill!" I suggested. It was our favorite restaurant, and it had been ages since we’d had dinner out together.

Over margueritas, Coronas and steaming pasta, we relaxed and celebrated our milestones thus far. Mary was two weeks past her surgery and feeling good. On March 3^rd, just days after her 45^th birthday, Terri would undergo one last operation to get her brand new boobs. In spite of the worries of the last five months, we had much to be thankful for.

"The four of us just had double mastectomies!" Mary informed our lovely red-haired waitress. The waitress looked at all of us, astonished.

"That calls for cake," she smiled. She returned with a huge piece of chocolate cake for Terri’s upcoming birthday and also brought the restaurant’s strolling opera singer with her. He sang "Happy Birthday" in Italian to Terri. During his serenade, we could see that the eyes of our waitress were misting over.

"My sister died of breast cancer," she told us.

 I gripped her wrist.

"Have you had your mammogram?" Mary asked in her very direct fashion.

"No," the waitress shook her head.

"Make an appointment tomorrow!" Mary commanded her sternly.

"Don’t be afraid!" Deb said.

Terri reassured her gently. "It’ll be okay."

The red-haired waitress promised us she’d make an appointment for a mammogram the following week.

After she departed, we stared silently at each other. The four of us had made the difficult decision to undergo a prophylactic surgery that comes with no guarantees. But it’s required no less courage for my sister Caroline to keep her breasts. Staying on top of annual mammograms and waiting desperately by the phone to hear the results, good or bad, is an act of bravery in itself.

You choose. Then you live with it.

And you remind yourself, in the meantime, to take time to savor the sunset.

And to enjoy a marguerita with your sisters.

Mary

There’s a painting on the wall of the waiting room at Midlands Hospital.  It depicts a beautiful woodsy scene at sunrise with railroad tracks winding away in the trees.

I could tell you about every painting in that little room, about how the rocking chair leans a little to the left, and exactly where to find the Splenda.

We clustered together – Mary’s three girls, Deb, Terri, Terri’s daughter Patti, and me – waiting to see Mary who was prepped for surgery and talking to Dr. Grange.

“You can see her now!” the sweet woman behind the desk informed us.  Sitting up in bed without a speck of makeup, Mary was smiling and looking like a middle school girl.

“Mom,” her teenage daughter Steph said immediately, “as soon as we came to the hospital this morning, Katie wanted to check out the cafeteria.”

Katie, a six-foot athlete who doesn’t weigh a hundred pounds soaking wet, glowered at her older sister.  “I did not, Mom.  I’m only worried about you.”

Ken, Mary’s husband, anxiously paced the floor, but Mary smiled serenely.

“Dr. Grange wants to look at the sentinel node,” she said.  We sensed apprehension behind her calm smile.  Because of a small spot that surfaced on Mary’s MRI, Dr. Grange explained that checking out the sentinel node, the first node where breast cancer would spread, would be the wisest course.

“Otherwise,” Dr. Grange said, “if the pathology report would indicate disease, we’d have to go back in later.” 

A little frisson of fear swept the room.

“It won’t be anything,” I ruffled Mary’s hair.

We kissed her goodbye, and in the waiting room, Katie and Steph, along with Jessica and Patti, sprawled out on the floor.  Long-legged and carelessly beautiful, my four nieces settled down for a game of cards.  Ken fidgeted in the rocker, and my sisters and I pretended not to be nervous.

When our stepmother Kris and our brother Tom arrived, however, we instantly brightened.  Kris and Tom always make it better.  Kris regaled us with a story she’d just read in the newspaper about the paralyzing blizzard in Chicago.  A courageous city bus driver, trapped in the blinding mess, rose majestically to face his passengers.  “We’re all going to die!” he screamed.

Kris, who has the most contagious laugh in the world, giggled helplessly, and pretty soon we were all howling over the distress of the hapless bus driver who, along with his passengers, thankfully did manage to survive the storm.

Kris’s ability to laugh has been life giving to all of us.  No one has had more reason NOT to laugh than Kris.  Almost 30 years ago when she was four months pregnant, her young husband Tom was killed in a car accident.  She raised little Nolan alone, and when he was six-years-old, she met and married our own widowed father, Dick Brown, and became the instant mother of ten more children.

Kris was 40, and Dad was 60.

“Just give me 20 years!” she begged. 

He could only give her ten before he collapsed on his treadmill at the age of 70 and died.

It took Kris and all of us a very long time to get over Dad’s death.  Dick Brown had been bigger than life and every thing to all of us.

“You know,” Kris pondered one evening as my sisters and I sat with her over margueritas.  “I hope the name of my third husband is Harry.”

We looked up, surprised.

“Then I can say I’ll marry any Tom, Dick or Harry.”

She couldn’t say it with a straight face.  After a stunned second, we laughed.  We laughed so hard, we cried.

Kris and our brother Tom are very close.  Tom is the rock steady member of the family.  Always and forever our baby brother, he nevertheless inherited Dad’s ability to radiate calm strength by merely sitting quietly in the middle of a room.  All our brothers are like Dad in that respect, but Tom has driven through three hours of early rush hour traffic to be present at all our surgeries.

“Except mine,” Deb accuses him frequently.  “You didn’t come for mine.”

Tom chuckles.  “Now, Deb.  You know you’ve never been my favorite sister.”

An emergency at the retirement facility Tom oversees kept him away from Deb’s surgery.  Otherwise, he’d have made the long trip for hers, too.

Tom was ten-years-old when Mom died.  I’ll always remember how he comforted our grandmother.  Devastated at the loss of her only child, Grandma suddenly broke down during Mom’s funeral, her shoulders heaving with sobs.  Sitting next to her, Tom, my sweet little brother who’d just lost his mother, reached up to pat her consolingly on the back.  He’s been that same sweet boy all his life, and the elderly residents at his nursing home adore him.  But not as much as his big sisters do.

As long as Kris and Tom are with us, we can manage those three long hours in the waiting room.  Even Ken began to relax.

“I’ll certainly miss all of you,” the sweet grandmotherly desk volunteer told me on my way to get coffee.

“We’ll miss you, too,” I said.  “Let’s exchange Christmas cards!”

After three and a half hours, Dr Grange and Dr. Montag finally pushed open the swinging doors.

We waited breathlessly.

“No evidence of disease in the node!” Dr. Grange smiled.  “She did just fine.”

We rose laughing to hug our two favorite doctors.  Four sisters and four double mastectomies.  This most difficult part of the journey was over, and we’d come through it pretty much unscathed.

“Dr. Grange, I’ll miss you!” Deb said.

“We’ll expect you at Thanksgiving!” I joked, clapping her on the back.

We collected our coats and threw away empty coffee cups.  Mary would remain in recovery for another hour, but we were leaving that small waiting room for the last time.  I moved the rocker back to its accustomed corner and cast a departing glance at my favorite painting on the wall. 

This little room had been good to us.

And I hope I never see it again.

Waiting for spring

There isn’t much that ruffles my little sister Mary’s calm demeanor.

On Thursday, the day after tomorrow, she will be the last of us to undergo an operation to remove her breasts.

"Mom," her 20-year-old daughter Jessica tearfully confided, "I’m so worried about your surgery. What if something goes wrong?"

Mary stared at her in amazement. "What could go wrong?"

If Mary doesn’t ever think to worry about herself - and she doesn’t - the rest of us do. I’ve had to reach out frequently in the past week to hug my slightly built, fine-boned little sister. She is precious to me. I wish for the day after tomorrow to be only a distant memory for her.

My sisters and I are in a holding pattern right now. Mary waits for her double mastecomy, Terri waits for the final operation to exchange her plastic expanders for soft, comfortable implants. Deb is waiting to finish her expander fills while I’m hoping just to start mine.

"I’m feeling like a sixth grader today!" Deb crows. That’s her joke as her chest slowly fills out with the expanders. After the next fill, she hopes to have developed into a nicely rounded ninth grader.

I’m just trying to hit puberty.

A few weeks ago, when I was feeling particularly ravishing in my husband’s over-sized flannel shirt and a pair of sweat pants blown out in the crotch, I inspected for the first time the pair of falsies the hospital sent home with me.

"Just slide these in the provided camisole," a kind nurse instructed me in the hospital, "and you can get dolled up for Christmas!" she said brightly.

I haven’t "dolled up" for any thing in six weeks. But the thought of returning to school motivated me to pull the falsies out of their box. Sliding them underneath my shirt, I discovered in the mirror that I was instantly transformed into a flannel-covered Dolly Parton.

John was just coming through the front door stamping the snow from his feet, and I sauntered into the living room to greet him.

"Well, hellooo, Handsome," I crooned, arching my back seductively against the door jam.

He laughed. "Didn’t the hospital know what you looked like before?"

I abandoned the falsies.

Terri and Deb have warned me for weeks that it’s difficult at first to venture out into the public fray without breasts.

"Some people stare right at your chest," Terri informed me.

"And some of your friends won’t know exactly what to say," Deb said.

They’ve been right on both counts. But going out into public again is one of those hurdles every woman who’s endured a mastectomy has to overcome. Tomorrow I return to school for the first time, and I’m nervous. One hundred sixty-five students will stream in and out of my classroom. Truthfully, they wouldn’t be human if they didn’t try to sneak a glance or two at my boobless chest.

I understand.

But what I fear is the TotallyCluelessKid. Like my little eighth grade nemesis Bueller.

"Mrs. Howard, what kind of surgery did you have?" Bueller will surely ask in oblivious innocence.

I could tell him it was a transgender operation.  And that wouldn't be far from the truth. "I was living a lie, Bueller," I’ll say. "And please. Call me Mr. Howard."

He’ll stare at me, bewildered. "But your husband is Mr. Howard!"

I’ll shrug. "So now you have two. I’ll be the slightly more effeminate one."

Except that Bueller won’t know what "effeminate" means, and then it just isn’t funny anymore.

I’ll worry about Bueller tomorrow. Today we’re snowed in, and I’ve been given a reprieve from Bueller for one more day. Two thirds of the country is gripped by paralyzing wind, snow and sub-zero temps. I’ve been gazing out the window all day longing for blue skies, porch swings, singing birds and whistling mailmen.

What a long winter it’s been. And there’s more to come. My little sister Mary is having her breasts removed Thursday. Tomorrow, my boobless chest has to withstand the scrutiny of a hundred sixty-five pairs of adolescent eyes.

Will it really only be the second day of February?

I need it to be spring.

If he dares to see his shadow, I swear I’ll torture and kill that freaking groundhog.