Three Weeks in Spring

Chapter 3

Sunday, April 13

She planned. Saturday she had raked the front yard. Sunday she raked the back. And while she raked, she planned her approach to the lump in her breast. Tomorrow is the day I do something, she thought. Now what am I going to do? I teach Mondays from nine to one so the doctor appointment has to be in the afternoon. She got the tines of the rake caught in the branches of a small azalea and yanked at it savagely. From the house she could hear Dan scream at David. Why in hell doesn’t Ace do something about that? Why in hell doesn’t he make them stop? There was a thunderous clattering from the house. Don’t run up and down stairs, she murmured to herself.

When shall I call Dr. Barry? Who would he around on a Sunday? Just the answering service. They couldn’t make an appointment. Just like the kids, she thought, only get sick on weekends when no one’s around. Have to call Dr. Barry from school for an appointment. I’ll do that tomorrow. And, as she raked, she phrased how she’d do it. How casually she would phrase her request for an appointment. ‘I’m very sorry to bother you,’ she would say, with a lot of those cultured overtones she’d learned from her early years as a service representative with the telephone company, ‘I’m very sorry to bother you, but I believe I’ve found a lump in my left breast. Probably it isn’t anything, but would it be possible for the doctor to see me?’

In the woods behind the house, a cardinal swept down to the ground, picked something up and flew off. A cardinal. For heaven’s sake. I haven’t seen a cardinal since about third grade.

Of course if they gave her a hard time then she would scream at them: ‘Jesus Christ,’ she would yell, ‘if you don’t see me, I’m going to put a gun to my head.’ She rehearsed her phone call over and over and over, saying it to herself again and again. ‘I’m very sorry to bother you, but I believe I’ve found a lump in my left breast!’

The cardinal came back, brilliant and flitting in the new-leafed shadows of the spring woods. She remembered the little girl in the third grade on the nature walk that they had to take every week, and how she’d had to hold hands with Billy Van Bueren as they went two by two and the teacher named birds and plants that they passed. Billy Van Bueren, she remembered, had fallen on hard times. His parents had died and he’d gone to an orphanage or a foster home, or whatever. But that had been later and, that day, looking at the cardinal and holding hands, they hadn’t thought of things like that.

Monday, April 14

She called Dr. Barry’s office from school and got squeezed in for a Monday night appointment. She told her husband and her sons that it was a routine check on some minor vaginal bleeding that she’d experienced occasionally before. He said something about front end trouble and they both smiled at the joke. Like all of their humor it was a several-layered thing, making fun not only of her, but of him as the kind of person who would say that, and of the clichéd phrase and the kind of people who would use it. And they both knew all of the layers and smiled at them all without a pause to think about it.

“But it will be all right, won’t it?” Dan said. He was the youngest of them and had not yet acquired much ability to mask his feelings. David had already learned to internalize. Too much so, she sometimes thought, like his father. She was more like Dan. She felt and she allowed the feelings to show.

“It’s nothing,” she said. “I’ve had it before. Most ladies do at one time or another.”

When she left at eight-fifteen the boys were doing homework and Ace was cleaning up the kitchen. The appliances were poppy-red, and in the brick wall at the far end Ace had set a stained-glass window that she’d found in an antique shop in New Hampshire. It was a beautiful kitchen, the collaboration of their imagination and their hands.

It was eight-thirty when she got to Barry’s office. It was quarter of eleven when she got in to see the doctor. Waiting there was one of the most traumatizing things she did before surgery. No one had ever seen the office so busy; it was unusual on a Monday night. “We’re really awfully sorry you ladies have to wait so long.” Joan’s nervousness expressed itself in diarrhea. I may die of terminal diarrhea before I get in the office, she thought. Between sieges she read a magazine article on redecorating the bathroom. Appropriate, she thought. But amazing. I’m sitting here getting ideas for a new bathroom decor while waiting for an examination for breast cancer. There’s the little part of my brain that separates out the terror, and the rest responds to whatever the environment dishes up. She looked at the magazine pictures of a gallery wall treatment in a bathroom, and stored it away. We’ll do that. That’s really a neat idea.

When they ushered her into the examining room it was very lonely. Barry wasn’t there yet. She took off her blouse and bra and folded them neatly on the chair, the blouse modestly covering the bra. She put on the paper johnny that gapped open in the front and seemed to emphasize her nakedness. She wondered as she always did at the doctor’s why they bothered. The only thing it conceals is my hack. If someone’s a shoulder blade freak I’ve got him thwarted. She always hated sitting there alone on the table with the stirrups, waiting to be examined. But this was worse. Much worse. It was a very, very alone feeling.

Barry came in. A nice guy, friendly, quite distinguished-looking, also very tired at nearly eleven at night. “Doctor,” Joan said, “I’m very sorry but I’ve got to know what this thing is.”

“I know,” he said. He pressed his fingertips gently on the surface of her breasts, kneading and prodding both breasts, touching the lump in the left and then beginning to feel it, and all around it.

“Does this hurt? Does this hurt? Any discomfort there?”

“I don’t think any of it hurts,” she said. “But I’ve been thinking about it so much I can’t tell anymore. I’m so aware of it, you know?”

“Yes,” he said. “Does this hurt?”

She shook her head. He moved his fingertips in a small semicircle around the lump in her left breast. The Muzak played softly above her head. Other than that it was quiet. Dr. Barry was a physically reassuring man. Logical-looking. He finished examining her breasts and said, “Well you’re not imagining something. There’s a lump in your left breast okay.”

Joan said, “Uh-huh. What do you think it might be?” So calm, so matter of fact. Might it be a malignant tumor? Might you have to cut off my boob?

Barry said, “I want to try something.” The nurse gave him a long hypodermic needle. “This won’t hurt,” the nurse said. “It looks bad but it isn’t.” And it wasn’t. Barry probed for a long time at the lump in Joan’s left breast. What the hell is he doing, is he trying to move the lump? Is he trying to figure out how high it is? Dr. Barry was the kind of man who answered such questions, but she didn’t ask. She wanted only that he be done and tell her it was nothing. A simple bit of fatty tissue, a small sebaceous cyst that could be excised on an outpatient basis.

He took the needle out and said, “You know, I would really be a lot happier if I could aspirate that.”

“What’s that mean?” Joan asked.

“If I could have gotten a little fluid out, we’d know a lot better,” he said. “Then we could inject a little fluid in and it would dissipate. That doesn’t seem to be the case, however. Why don’t you get dressed and we’ll talk.”

She was alone again. She took off the johnny, slipped into her bra. Her hands shook as she hooked the catch behind her. Her hands shook worse as she buttoned her blouse. So he couldn’t aspirate it. He couldn’t aspirate it. We’re going to talk. She went into Barry’s office and sat. He was grim-faced. She was good at body language and she knew it was not good. He was grim.

“I know you’re worried,” he said. “That you are worried that this is an ovarian cyst. Ovarian? Oh God, I don’t mean ovarian I mean mammarian cyst.”

Joan said, “Jesus, Doctor, you’re in worse shape than I am.”

He laughed and his face went grim again. “The next step for you is a mammogram.”

Joan said. “Okay.” Okay. Mammogram. “I’m beginning to get scared of this, Doctor. Mammogram to me means I should start thinking about this as a malignant tumor.”

“There’s simply no way of knowing,” he said. “Until we do further tests. The next test is a mammogram. You’ll go over to Union Hospital and have a picture taken. A mammogram will give a much better idea. I think you should be thinking in terms of a biopsy, which is the only certain way to know what the lump is. And I would be happier if I could aspirate it. That’s all I know now. And the next step is a mammogram.”

She said, “Okay. If I need surgery, who would you recommend?”

He said, “Dr. Eliopoulos.”

She nodded.

He said, “Are you going to be all right?”

She said, “Yup, I’m going to be all right. I haven’t told my husband yet and I wonder if now is the time.”

Barry said only what he could say. “It’s up to you.”

“I can’t miss work,” she said. “I can’t miss work. I have to go on working.” In three years she had not missed a class at Endicott College. She was puritanical about it.

“We’ll schedule it in the afternoon,” Barry said. “We’ll try for tomorrow, but it’s more likely to be Wednesday.”

“But Wednesday my husband is speaking and I need to be there. I don’t want to screw it up with a mammogram. He doesn’t even know about this yet. And tomorrow afternoon I have to supervise a student who’s taking over the classroom for the first time. It’s important to her that I be there.”

“And,” Barry said, “we’ll have to have the mammogram. We will tell the girl that we’ll take the first appointment they have, and we’ll work around that.”

Joan said, “Okay. If this does lead to mastectomy how long will it be before I can work? What’s the recovery time?”

“The surgery is not terrible. Say, ten days in the hospital. And most women are back on their feet in six weeks, four to six weeks.”

They looked at each other for a moment, then Dr. Barry gave Joan’s hand a small pat. “We’ll hope for the best,” he said. “And take one step at a time.”