It's interesting working in the world of cancer treatment. Like so many things in healthcare and medicine the sexier ailments get the attention and it's hard to look around my clinic without seeing something with a pink ribbon slapped on it. The ribbons are so ubiquitious now I find them a bit disingenuous and prefer the t-shirts that say,"Fight like a Girl!" or "Save the Tatas!" Both very worthy sentiments. Especially if you have tatas or someone you love has tatas.
Because of all the funding and research though breast cancer treatment has become much more refined to the point that specific types of breast cancer has been identified and methods to treat them developed. Women have more options every year for how they can be treated, what kind of surgery they want to opt for, what kind of reconstruction they have (if any) and no one looks at them as if they just landed from Mars if they request a prophylactic mastectomy due to their family history.
All the advances though don't really address the frustration of having your body turn against you though, especially a part of your body that is so finely attached to your sexuality, femininity, and even your maternal abilities. For better or worse getting your first bra is a significant right of passage for a girl and so is the constant compare and contrast of breast size that begins about the same age.
I have a dear friend who went through a double mastectomy and reconstruction. Intense pain and a long recuperation left her questioning the decision to do the full surgery instead of a lumpectomy, but as she wryly observed many months later when it was time to get her new nipples tattoed on, " I'm going to get them light enough so if I want to wear a tshirt braless I can!" Since she had actually been to hell and back to get the new, sag free, bra less boobies I resisted the urge to call her a bitch and cheered.
I ponder myself what I would do if ever the big C comes to visit my set of tatas. My gut says I would not opt for reconstruction-mostly because the idea of taking out a foreign body and putting in a new one doesn't thrill me. But then I consider my husband and family and wonder if seeing me with a pretend bosom would be better than no bosom at all.
All this was called in to sharp relief one recent morning when I had a lovey 70 year old woman in my section. She was exquisitely turned out for her chemo treatment, hair (wig), nails, makeup, Talbots outfit with coordinating spring shoes, etc. Her daughter accompanied her and patted her hand while I prepared her for treatment, which in her case meant having her port accessed.
A port is a small device that is surgically implanted under the skin and allows quick venous access to a patients bloodstream while protecting smaller fragile veins in people hands and arms. Most patients who have a port have it in the upper part of their chest wall and when they come in for treatment we use sterile procedure and a large Huber needle to access the port. Once the needle is in we can remove blood for lab work, start IV fluids and prepare for treatment.
Ports are a Godsend for patients with nausea and vomiting and the nurses who care for them. No fishing for veins, X marks the spot and and allows you to start hydrating a patient immediately if possible. Completing the sterile procedure can be tricky sometimes because people have to keep their hands and clothing away from the area and there is a certain amount of jockeying to get in the right spot. Most patients learn to wear a button up blouse/shirt on chemo day, we pull a curtain for privacy and within 5 minutes all is well.
Well for Mrs. Talbots her treatment began with lab work and having her port accessed. She complained about feeling hot and then acknowledged she was having lots of problems managing hormones and that might account for her level of discomfort. Other patients came and sat in our section and Mrs. Talbot became progressively more irritable and disheveled as the morning went on,"Good lord no I don't need a blanket are you crazy it's like an oven in here."
Her daughter offered water and pats on the hand, and attempted to change the topic multiple times with no success. Until finally, the patient proclaimed, "THAT IS IT!"
Her daughter sat and gaped at her prim and proper mother while I hurried over to see what was going on. "I'm done," she said and she began unbuttoning her blouse. "Done?" I asked. "Yes my dear, I am done. I am no longer going to sit here and sweat, that guy over there is unbuttoned down to his navel and he (she pointed at the 22 year old surfer dude sitting bare chested in the next section) is half naked." "Ok, well what can I do to help you feel more comfortable so we can finish your chemo?"
"Hold these," and she handed me her prosthetic breasts. By the time her daughter had recovered the power of speech her mother was topless. "Mom, what are you doing? You can't do this, you just can't sit here naked." "I am not naked. I am topless. I no longer have breasts, hell I don't even have nipples-that guy over there looks like a walrus and I am sick of pretending to be all pretty and quiet. To hell with it, I no longer have any legitimate reason to cover up-so I'm not going to."
Her daughter sputtered, gasped, gaped, pouted and attempted to draw the curtain around her mother's chair. "Nope, you leave that curtain open or leave and I'll let you know when to pick me up." At this point the three other patients in my section (walrus, surfer dude, and retired baptist preacher) offered their subdued appreciation with a small round of applause and a "Right on Granny." I simply put her bra, blouse, and breasts in a pile on the counter and continued my work.
"But mother? What will people say?" Her daughter attempted reason, tears, and even bribery at which point my patient looked at her and said,"I am no longer following the rules for good southern ladies. If I want to misbehave I intend to."How liberating at age 70 to get cancer and finally free yourself from the idea that any part of your body defines who you are as a whole. Like Eve before the apple she no longer felt any shame in her body and there simply wasn't any good reason to cover up anymore for this Talbots girl and if someone didn't like it, well that was no longer her problem, it was theirs.
"Right on Granny."