“I don’t care,” I say, pouting. “How about Dr. Burrows?” This is a joke and Tom knows it. “Okay, Eleanor Parsons, I guess. I’d probably be more comfortable talking to a woman about sex … if it comes to a hysterectomy.”
For the rest of the evening we research the incidence of uterine cancer with a biopsy result of complex hyperplasia with atypia. We peck away on our computers, each in our separate studies. I’m surprised to read that the chances of my having cancer are 30 percent. More than I thought. I still don’t think it’s that likely.
At midnight we go to bed. We’re lying back to back and Tom reaches around and gives me a pat.
“Don’t you worry about sex, Tom?” I ask softly into the dark.
“Not too much. I think you’ll be fine. I know you better than you know yourself.” He adjusts his pillow. “You’ll be fine.” In a few minutes I hear his breathing slow down and know he’s asleep. Mr. Positive.
Tom always anticipates the best, while I am full of doubt. I could turn to hold him, to let him hold me, but I don’t.
I completely forget to light the prayer candle.
At the end of the week, Tom and I have an appointment late in the afternoon with Dr. Eleanor Parsons, a gyn surgeon in Delmont. The waiting room is a 1950s sort of space. Signs all over the glass at the receptionist’s desk remind patients they must pay at the time of service, and blue vinyl chairs without armrests are lined up facing a TV mounted high on the wall. A lone secretary glances at her watch as she greets us with a clipboard of forms.
“Mrs. Harman,” she calls a few minutes later and opens the door to the inner office. She is apparently both receptionist and nurse, and we follow her down the narrow hall, past the empty exam rooms.
At the door to her office a sturdy woman with sandy gray hair stands waiting. “Well, come on in!” the physician shouts, sounding as if we’d just come for a party. Eleanor Parsons is wearing a flowing black jacket with a leopard-print top over black narrow slacks and is holding out her arms. I tower over her. After giving us both big hugs, she graciously indicates we should take the two leather chairs across from her cherrywood desk. Her private office makes up in elegance what the waiting room lacks.
Before leaving the university and starting out on his own, Tom had worked with Eleanor on the ob-gyn faculty at State. For a few minutes, the two physicians chat about their children and what it’s like to be in private practice, and then Dr. Parsons turns to me. Tom had called ahead, so she knows the story.
“So how are you feeling?” she asks in a soft South Carolina accent. I’ve been inspecting her paintings on the wall, the huge desk, the bookcase, but I rejoin the party; after all, it’s for me.
“Okay, I guess. We’ve been thinking about what’s the next step, and we’ve done some research.”
“Well, I did some research last night too, after we talked.” She’s looking at Tom. “It isn’t standard of care, but since Patsy can’t take progesterone orally, I agree, the progesterone IUD may be the way to go. It will control the thickness of the endometrium without having a systemic effect.”
I’m relieved that hysterectomy wasn’t the first thing out of Eleanor’s mouth. The two surgeons go on to discuss the protocol. Dr. Parsons’s face is lined and pale, but there’s a great kindness in her. She turns to me. “So when would you want to get the D and C, Patsy?”
“Soon. As soon as possible after my period.”
“Assuming there’s no cancer and you get the progesterone IUD, we’ll have to do close surveillance if you want to stay on estrogen,” Dr. Parsons continues. “This will mean frequent ultrasounds and possibly endometrial biopsies, and I’ll be in charge of making sure the ultrasounds and biopsies get done.” I know she’s aware of my recent negligence, and I nod in agreement.
We stand to leave, pulling on our winter jackets, and Eleanor gives us each another big hug. I’m in good hands.
For the next week I continue to take the progesterone with only a few serious meltdowns. I work eight hours a day, catalogue-shop for the boys’ Christmas presents, fill a shopping cart with something for everyone at the bookstore, and breeze through the holiday sales at the mall.
At work, I go through the motions of caring for patients without caring very much about them. I ask briefly about their menstruation, bowel and bladder habits, diet and exercise. I take medical histories. I perform their gyn exams. I don’t ask about stress, sleep problems, sex, or depression. If a woman’s anxious, exhausted, or sad, I pretend not to notice. This is how providers who keep to their schedules must manage.
The staff all know about the abnormal endometrial biopsy. “Why don’t you just have a hysterectomy and get it over with?” Abby asks me.
“I would in a minute,” joins in Celeste. I know they’re being supportive but I don’t want to explain, don’t want to tell them about my fears of not being able to have an orgasm. That’s something I wouldn’t even mention to the women in my meditation group. Yet I talk to women in the exam room intimately about sex every day.
On the ninth night, I gulp down the last two tablets of progesterone just to get it over with. That makes the ten doses. Then I settle down to wait for the withdrawal bleed. I still haven’t said anything to our boys about what’s going on. It will probably turn out to be nothing.
Two nights later, I begin to bleed. By bedtime, I’m changing my pad every two hours, and in the morning I check into same-day surgery and Dr. Parsons scrapes and sucks what’s left of my endometrial lining out of my uterus and sends a sample of the tissue to pathology. I work the next few days as if nothing has happened. I haven’t even told Trish what’s going on; maybe she’s heard. I just don’t feel like discussing the shame of my negligence, how I’ve screwed up my body.
Tom checks twice daily on his computer for the pathology report. We don’t talk about the future. I don’t think about it either. I’m sure that I don’t have cancer.
For the past three years, we’ve had our office holiday luncheon at the Riverview Inn on the Friday before we close the office for Christmas. At home after the party, I ask Tom, as I take up my knitting, “By the way, did you check the computer for the results of the D and C?”
“Yeah, it’s back.”
“It is? When was it posted?”
“This morning.”
“Why didn’t you say anything?” I reach over to untangle the blue yarn attached to the scarf I’ve just started for Mica.
Tom stands at the end of the sofa, still dressed in black Dockers, white shirt, and his holiday tie with holly and berries. “I didn’t want to ruin the Christmas party.”
“You’ve known all day? You could have told me.”
“I didn’t want to ruin the party,” he says again.
I still don’t get it. “So, what did it say? The pathology report?”
“It’s cancer.”
There may have been more but I didn’t hear it. The echo shuts everything out.
C A N C E R … CANCER … C a n c e r … cancer …
I knit four rows. “That’s all it says, ‘cancer’?”
“No, it said, ‘Well-differentiated adenocarcinoma.’”
I knit another three rows.
“So there’s no choice,” I say finally.
“No.” He flops down beside me. He doesn’t reach out, and I don’t either. The shiny silver knitting needles flash in the candlelight. I want to run away, but there’s nowhere to go. I’d just take the cancer with me.
“So when can I have the surgery?” There’s no quibbling now. You want to live, you have a hysterectomy.
“Tomorrow,” he says.
I nod.
Cancer! The word is still rolling around in my head like a boulder after a landslide. No one in my family has ever had cancer.
“Don’t we have patients in the morning?”
“The staff will cancel them. I’ve already called Dr. Parsons. We’re scheduled for seven in the morning. Everything’s set.”
Before bed, I e-mai
l the kids, the women in my meditation group, and a few friends around the country and ask them to hold me in their thoughts. In between e-mails, I knit twenty-three more rows.
After lights-out, Tom and I lie under the covers, holding hands. It’s the first time we’ve touched since he told me. “Don’t you care about sex?” I ask quietly.
He reaches for me but doesn’t say anything.
“Do you want to make love?” I continue. “This is the last time I’ll have all my parts.”
“Sure,” he says, chuckling, tilting my face up to his. He has the softest lips, full and tender. I run my hands down his belly and then lower.
In the end he climaxes … I want to but can’t.
Still holding me, he says, “Don’t you need to cry?”
I want to but can’t.
Early the next morning, I check into the surgical center with my knitting and my insurance card. That’s one of the perks of being a gynecologist’s wife. You need gyn surgery, no problem, you’re on the schedule the next day.
Nurses I met last time when I had the gangrenous gallbladder, and more recently the D & C, nod, but no one stops to talk and no one meets my eyes. I think they know why I’m here and are distancing themselves. Then again, maybe they’re busy. Tom plans to continue seeing patients at the office until they take me back to the OR, then he’ll assist Dr. Parsons with the hysterectomy.
Silently, a medical assistant escorts me to a cubicle in a large pre-op bay with fifteen or twenty beds arranged around the perimeter and I’m told to get into my thin cotton gown and put my clothes in a plastic bag. Only flimsy peach curtains separate the spaces where men and women wait on wheeled cots for their IVs and pre-op lab tests. I can see their shadows on either side of my cubicle. They have family with them, and I listen to their low conversations while I undress.
I can tell by their dialects how different the families are. One group is from the mountains, maybe farmers, the other from the academic community, but they’re each trying in their own way to distract their loved ones. The patients, me included, are all the same under these blue cotton gowns. Naked and scared.
I part the curtain so the nurses will know that I’m ready and get out my knitting. The soft blue yarn is a comfort. Even though Mica lives in Atlanta and will have little use for a wool scarf, I want to finish before Christmas.
Then an RN wearing a poofy paper surgical cap and reminding me of Nurse Ratched in One Flew Over the Cuckoo’s Nest comes by with a clipboard and takes my vitals. She pumps up the blood pressure cuff like it’s a flat tire, but I don’t complain. Next there’s the anesthesiologist, and finally Dr. Parsons.
“How you doin’, hon?” she asks, sitting on the edge of the bed in her green scrubs. “Nervous?”
“I don’t know … I’m shut down right now. Just going for the ride and wanting to get it over with.”
“Well, try not to worry. I really think things will be okay. I do. I just have a good feeling.”
No one has said the word cancer.
I’m sitting in the living room a few days later, wearing loose knit black pants and a red sweater and looking like nothing has happened, when the boys begin to arrive for the holidays. First Zen with Callie. His shoulder-length straight brown hair is now cut in a buzz. He throws his blue parka on the floor and opens his arms to me. “So, how you doin’, Ma? You look pretty good.” Zen is jolly, Callie quiet and concerned. Young women like Callie have come in and out of my boys’ love lives for years, and I would adopt them all, but I’ve learned to guard myself, see how long they’ll last.
Around midnight, Orion arrives with his hound. It’s snowing, and he’s driven six hours from Cincinnati after leaving his job at the art gallery. He parks his backpack and leather jacket neatly in the hallway and knocks on our bedroom door. Dozia, his unruly dog, comes in and jumps up on the bed, and I grab the pillow to protect my incision. “Hi, Mom. Hi, Dad,” he says softly into the dark. “Down, Doze!” He pulls at the animal’s collar. “I just wanted to tell you I made it. The roads were a bitch.” He leans over the bed and gives us both hugs, pauses a beat, then retreats to the refrigerator. “Love you,” he whispers as he closes the door.
The next morning Tom picks up Mica and Emma at the Pittsburgh airport. They come in about noon, stomping snow. Mica’s shirt collar is half up and half down, sticking out of his trench coat, and I resist my impulse to straighten it. Emma’s long fawn-colored hair wisps around her thin face. They make a good pair, both rumpled and elegant, brilliant and organizationally challenged. Unlike Zen and Orion, who have brought handmade gifts or intend to shop at the mall last-minute, Mica is laden with presents, all stylishly wrapped in green and gold holiday paper by a paid professional. I am careful to be cheerful.
The Christmas tree has been decorated for weeks. I’d put up a wreath and the manger scene when I first accepted that I might have surgery. This is minimal. I usually go all out. In the next few days, I do my best to participate in family activities, but mostly I sleep, recover from the surgery, and wait for the final pathology report that will tell us how far the malignancy has spread.
“If the cancer has gone more than fifty percent through your uterus, you’ll need radiation,” my husband tells me. But with all the festivities, there’s no time to discuss what that means.
“How many days will it take until they post the report?” I hear Mica asking Tom in the kitchen.
“Sometimes as long as a week. With the holidays, maybe longer.” Nobody speculates. Nobody discusses the odds, and the house is in continual commotion. The boys’ old friends from high school arrive to visit. There’s wrapping paper, ribbon, and Scotch tape everywhere. Shoes and boots pile up by the front door. Wet coats and hats are draped over the banister.
Ordinarily it would bother me, and I’d be buzzing around trying to organize everything, but it doesn’t matter to me this week. In the midst of the chaos, I’m alone in a clean white waiting room with rows of empty white wooden chairs. I sit in the silent room, staring at nothing, just waiting to find out how far inside me the black cancer has spread.
Orion makes herbal tea. Zen and Callie cook pasta with pesto for dinner. The smells of good food and the pine tree fill the house. It all looks so normal, so cozy, as we gather around the fireplace. Tom and the boys play cribbage. The young women knit and watch me out of the corners of their eyes.
The morning of Christmas Eve is the first time the house has been empty since I came home from the hospital. The sun sparkles on the lake between the bare trees. On the bird feeder, blue jays and cardinals, tufted titmice and mourning doves jockey for food.
With everyone out doing last-minute shopping, I wander into Tom’s study and find a text on gyn oncology. When the phone rings, I’m thumbing through the index looking for the chapter on radiation for uterine cancer.
“They paged me,” Tom says. “I’m at the mall. I’ve got the pathology report. Dr. Morgan rushed it, because he knew it was you.”
I wait, expecting the worst. “So …”
“You’re okay.” Tom laughs. “Pats, you’re going to be okay.”
“What … what do you mean? There isn’t any cancer?”
“No, there is. There was, but it was stage one, totally confined to the lining of the uterus, the endometrium. It was just a polyp. It didn’t go through the organ at all, and the cytology washings were perfect. There were no cancer cells in your pelvis.”
I lean back, staring at the oncology book in my lap. Brilliant sunlight floats into the white room.
“So what’s up? You okay?” Tom asks.
I smile feebly. “Yeah, I’m fine. I’m great. It just feels weird after all the worry … I have cancer, now I don’t. I was just sitting here reading about radiation therapy, and now I won’t need it.”
“I didn’t think you would.”
I’m standing up now at the window, looking down at the lakeshore, at the silver patterns shimmering in the ice.
I take a deep breath. This is too s
trange. I have to think about this. But I don’t get to think about it. It’s Christmas Eve, and the family comes home and acts as if we just won the lottery. Mica goes into the kitchen to break out a bottle of champagne. Even Orion’s dog and our dog, Roscoe, get into the celebration, racing around the living room.
“What a great Christmas present!” everyone says. And it is. It is. The festivities swirl around me. It couldn’t be better. I’m aware of the smile on my face, but it’s only skin deep. I had cancer, now I don’t … I fell through the roof of the world, now I’m dropping back in.
Outside the big windows, it’s snowing again.
Christmas is over. Then it’s New Year’s. Then the scurry of kids packing. There are hugs and kisses, wallets and keys to be found at the last minute. Tom loads the last of them into the Toyota and heads for the Pittsburgh airport. Orion, driving himself and Dozia home, will call to check on me tonight. Zen will call in a week. Mica will call in a month, but he’ll feel guilty about it. That’s how he is.
I gingerly walk around the house tidying up, putting cups and bowls in the dishwasher, wrapping paper in the trash, and dog toys in the basket, always with one hand on my incision. Tom will be gone for six hours.
When I can sit down without cringing at the mess, I make myself a cup of peppermint tea. Then, in the quiet, tidy house, I wait for the flood of feelings I’ve been too busy to feel. I stare out the window at the snow-covered branches, but nothing comes. No grief, no anger.
Since my emotions are apparently in hibernation and not available for reflection, I put in the Grateful Dead CD and start to dance, swaying to the rhythm, using my arms and hips more than my feet. We will get by. We will survive.
Then, since the cancer is apparently gone, I take my empty body to bed to see if it still works. I lie under the red and green quilt touching myself and am relieved to feel a faint motor purring. After another good long while, I’m able to climax. My female parts are gone, but I can still come! I’d feared the hysterectomy more for the loss of my sexuality than for potential complications. Tom had told me I would be okay, and he was right.
The Blue Cotton Gown Page 17