by Amy Boesky
My mother tried to keep Sylvia alive for us. She pointed out traits she thought we’d inherited from her: Sara’s gift for watercolors, Julie’s music, my love of poetry. But none of it seemed real. Sylvia was no more than a black-and-white photograph hanging in the hallway, laughing, arms linked with her younger sister, every bit as dead as she was. What could she possibly have to do with us?
Evidently, a great deal.
In the 1980s, the world began to change. My father, psychoanalyst by training and sleuth by nature, had been doing his homework. He was in touch with two different medical centers—one in upstate New York, founded when Gilda Radner died, the other at Creighton University, in Nebraska. Periodically he got bulging envelopes from one or the other of them packed with information. We knew cancer ran in our family—we just didn’t know how. Now, researchers were beginning to put the pieces together.
It looked like we’d inherited more from Sylvia than a love of the arts. Dying young was another trait she’d passed on, and it was beginning to appear we were linked together in a long, fatal chain, one generation bound inextricably to the next. The only woman on my mother’s side who’d made it past fifty was my great-grandmother Bea. She was a despot, but she lived to almost ninety, and Julie decided she liked her picture best. “I think I look most like Grandma Bea,” she’d say hopefully, peering up in the hallway at a smudge of wavy, obsolete hair.
My mother wasn’t interested in any of the information my father culled from Creighton’s medical school or from the Gilda Radner Institute. She took a fatalist’s point of view. “What will be, will be,” she’d say with a shrug, sitting out on the deck highlighting a text on ancient Egypt for her AP students. They freighted the boats of the dead with treasure so they would be prosperous in the afterworld. What was the point in wasting time with worry?
My father felt differently. Medicine was the lens through which he saw misfortune. “See that man?” he asked us one night at a Chinese restaurant. He lowered his voice. “Bell’s palsy,” he said sadly, shaking his head. “His face is frozen that way. See how he only has half a smile?”
We saw.
Illness stalked the doorways of my childhood like Grendel. I used to thumb through the medical journals my father kept on the rattan coffee table in our family room, poring over pictures of skin ulcers that bloomed rose and apricot, like spoiled fruit. Petechiae rashes, fungi. Tumors lit up by green and vermillion dyes, like fire-works. Such vivid reminders of the body’s frailties, and my father was determined to protect us from all of them.
First, he had my mother to save. He haunted her with articles gleaned from the geneticists at Creighton, urging her to have a hysterectomy from so early on I can remember no time when the word ovary wasn’t linked for me to a sense of doom and inexplicable grief. Long before we’d gotten our periods for the first time, all three of us had been catechized: Grow up; have children fast; and get those things out of you.
Time bombs, Sara called them.
Ovary. The word was beautiful, like a poem—like things that open or encircle: overture, oval, ovation, but it was a sinister, destructive beauty. I pictured my ovaries inside of me like milkweeds, whispery, white pods ready to burst, and the slightest ripple or heartbeat might blow their seeds out, poisonous, to disperse their terrible harvest deep inside me. In between other things I wanted—for the Vietnam war to end, to become a judge, to write poetry—I wanted the curse on my family to be lifted. I wanted not to worry. I wanted to forget, to live my life the way other people did. And I tried. Though never exactly carefree, I pushed away worry the best I could. I had boyfriends, forgot our story for a while, then (shuddering) welcomed it back. Then pushed it away again. If I didn’t think about it, it wouldn’t happen. Couldn’t the fates leave us alone? All the old relatives were dead, and my mother had never had a sick day in her life. I never even saw her sleeping. She was always up before us, awake after us; sharp-tongued, sharp-sighted; planning, cooking, reading, making lists. Maybe Sylvia had broken the curse and set us free.
Then in 1983, my second year at Oxford, studying metaphysical poetry and living in a mushroom-colored building without heat, my mother’s only cousin—Gail, Pody’s only child—was diagnosed with stage 4 ovarian cancer. She was forty-seven, only two years older than Pody had been when she died. The prognosis was bad. My mother described it all to me on the phone. “She woke up one morning and it was like she was eight months pregnant,” my mother said, her voice trembling. Her whole abdomen filled with terrible cells. Gail—sweet, loving Gail, who loved discount shopping, who let me store my sagging couch in her basement each summer when I was an undergrad at Northwestern, whose vivid snapshots were glued right down in our own family albums among the living, not stuck up on a wall with the dead. Gail wasn’t part of the past, she’d taught me how to make poached eggs and introduced me to Marshalls! She was part of the here and now.
My mother was out of her mind with grief. It’s like Sylvia all over again for her, my father told us. Like posttraumatic stress.
I was twenty-three by then, and forty-seven didn’t seem all that old anymore, and it clearly didn’t to my mother at forty-nine, because soon after learning about Gail’s diagnosis, she finally let the doctors “take everything out.” She had a complete hysterectomy: her uterus and both ovaries removed. She wasn’t taking any chances. Why leave anything behind to tempt the fates?
This wasn’t like my mother. I knew she must be terrified.
She didn’t tell any of us about the operation until it was over. I found out on the pay phone in the back of the Middle Common Room at Pembroke College, feeding octagon-shaped fifty-pence pieces into the octagon-shaped hole at the bottom of the phone. They hadn’t wanted to worry us, my father explained. “And there was nothing you could do—from over there,” my mother added. “It’s much better telling you now it’s over.”
My father said the surgery had been “successful.” The pathologists had gone over the tissue and it was all clean. Not a single cell awry. They’d gotten everything out of her.
“It’s all about timing,” he added, palpably relieved.
Timing meant my mother would survive.
Gail didn’t. She rallied, relapsed, rallied again, but only briefly. It was a long, difficult struggle. She died on April 29, 1985, eleven days after her first grandson was born. They were in the same hospital, my mother told us, when she was finally able to say anything about it at all. Gail dying on one floor; her grandson born on another.
“Thank God Mom had the surgery,” my sisters and I told each other.
Timing, it was becoming clear, was everything. Timing was different from time. Time was an abstraction, impossible to understand. When I was little, my father took me once to the planetarium in Chicago and when I tilted my head back, trying to comprehend the artificial enormity, he whispered that everything we saw in space had already happened. It took light so long to reach us, he told me, that the stars we were admiring might already be dead.
Time, you couldn’t do much about. Timing was different. Timing meant managing what you were allotted, making things work, taking control. Timing meant being on guard.
Timing meant we didn’t define ready the way other people did. We always had to be ready. We were like evacuees, belongings squashed at our feet, waiting at an unknown border. There was no time to spare.
I don’t remember exactly when I told Jacques all of this. Was it early on, in those wild, love-drunk early days of dating, staying up all night in his old Accord, naming constellations, lying back in each other’s arms, enchanted with our different night skies and early histories? Or later, planning soberly, putting his house on the market, signing job contracts for DC? I don’t remember a time when he didn’t know what I know about my medical history.
I know he wasn’t especially concerned. “Why worry? You can’t control the future,” he said.
I appreciated how calm he was, but underneath, I was afraid it meant he didn’t really get it.
> I tried to talk to him about heredity. About what we pass on.
Jacques shrugged. “Everyone has something,” he said.
I didn’t feel like I had “something,” though. I felt like I had this. Known, assailable. Like a sharpshooter was out there, eye to the scope, waiting for me. Wherever I went, I stayed inside his compass.
Every so often the researchers at Creighton University mailed us diagrams, each woman in our family represented by a small circle. The ones who’d died from ovarian cancer had their circles colored in black. In the spring of 1985, they colored one in for Gail. The diagram looked grim, like the models of molecules we used to build in high school chemistry. Ours had way too many black circles in it—long life looked like a trait we hadn’t been lucky enough to inherit.
In our twenties, my sisters and I dealt with this by staying busy. Sara was teaching elementary school in the Pacific Northwest, where she’d lived since graduation. She and Geoff, her high school boyfriend, married right out of college. Jenny was born a few years later, and then Rachel—both before Sara was thirty. Between teaching and being a mother, Sara barely had time to read the paper, let alone worry about our family history. But once she was done having children, she decided to go ahead and get the surgery over with—well ahead of schedule. Julie looked like she was on the fast track, too. She’d whizzed through law school and gotten her first job all by her midtwenties. She and Jon were both working a zillion hours a week and had already gotten married and bought a house in northern Virginia while I was still struggling through my orals.
For my part, I got through my twenties with a mixture of superstition and denial. I paid my parking tickets promptly. Finished my dissertation. If I was “good,” whatever that meant, I figured the fates would leave me alone.
Just in case, I added a hefty dose of high Alpha Medicine. In graduate school I started a new phase of expert-worship: the best universities; the best residencies. Top doctors. Academic fame and fortune. I actually tried translating the Latin in the diplomas hanging on doctors’ walls. Harvard—OK, that’ll do—but was that a magna or a magna with highest honors? Why not a summa? Instead of ordinary physicals, I went to see a high-risk gynecologist at the Dana-Farber Cancer Institute. In those days, there was a whole department at the Dana-Farber dedicated to high-risk ovarian cancer, and I had ultrasounds and blood tests there twice a year. The blood test—CA-125—was new and relatively controversial—there could be false negatives as well as false positives. The test measured a tumor marker in the blood, and in theory if the numbers stayed low—under thirty-five—that was a good sign.
I didn’t mind the blood work, it was the ultrasounds I dreaded. In order for the doctors to “visualize my ovaries,” I needed to distend my bladder, drinking thirty-two ounces or more of water in the waiting room, and I’d sit there reading months-old issues of Family Circle magazine, palms sweaty, bladder aching, waiting my turn. Why are there never any windows in waiting rooms? They’d call my name—they always mispronounced it—and I’d head back into the dark, tunneled depths of radiology, my bladder swollen to bursting. Once on the table my heart would pound while the technician worked the cold wand back and forth inside of me, squinting at the monitor. Total silence. Back and forth with the wand, pressing murderously on my swollen bladder. I would lie there in misery, eyes straining to see what she saw: the gray shapes on the screen; the illegible shadows. Something would rise into view, like a gray, gibbous moon. What was that? Was it an organ, or a tumor? My heart would pound, long, slow beats: not yet—not now—not this—not me—It was always dead quiet in the darkened room; no expression on the technician’s face. Then it would be over. I’d be free to get up, wipe the goop off myself with the blue paper gown, and tear to the bathroom before heading out to the waiting room, where a nurse, poker-faced, would ask me to fill out a questionnaire. One of the doctors at the Farber was running a clinical trial on potential links between talcum powder and ovarian cancer. You could guess his hypothesis from the order of the questions:1. Do you use talcum powder? What brand? How often?
2. Do you smoke? How many cigarettes a day? A week?
3. Do you eat fatty foods?
4. Do you suffer from depression?
5. What does the word risk mean to you?
When I was finished—four “nos” and one “I’m not really sure”—I’d stuff my completed questionnaire in a wire basket along with one or two others. I didn’t have much confidence the talcum powder theory was going to be proven any time soon. That was it. Six months would pass in a flash, and I’d be back again.
I lived from fear to fear.
Once in a while I’d see another patient or two in the waiting room, but none of us talked to each other or exchanged information. It was a lonely world, high-risk ovarian cancer.
I didn’t say good-bye before we moved.
Instead, I headed down to Washington and left the Farber behind. I tried to act the way a thirty-year-old with a new job and a man she loved should act. Happiness was new and unfamiliar to me, like permanent good weather, and I just wanted to enjoy it. When it came time to look for doctors in DC, I skipped oncology and went straight to ob-gyns.
EVERYTHING ABOUT MY LIFE IN DC felt new. New man, new job, new house. I felt myself letting go of worry, bit by bit. I almost stopped worrying (almost) about cancer. For the first time in conscious memory, I stopped convincing myself each mysterious pain or bruise was the first symptom of a hideous, fatal disease. Instead of obsessing (was one of my pupils usually bigger than the other? Had that mole always been blurry at the edges?) I focused on ovulation and conception. I turned my laser beam from death to life. It was exhilarating. Being pregnant, I decided, was the opposite of having cancer. Just thinking about pregnancy gave me immunity.
And the best part was, I wasn’t doing this alone. Julie was deep in baby planning, too. We traded information: best doctors. (The doctor we both coveted was Dr. Andrea Weiss, in Dupont Circle. But she had a long waiting list.) Basal-cell thermometers (where do you buy them and do they really work?). Stories about colleagues who got pregnant the first time they tried. Can you imagine? Getting pregnant now struck me as the world’s greatest achievement. Who cared about Rhodes scholarships or Guggenheims? It was pregnant women who were geniuses. Imagine—producing life! If I couldn’t be pregnant yet myself (and let me tell you, it wasn’t for lack of interest), I wanted to talk about it. Not so much with Jacques, who was of course convinced things would happen “when the time was right.” No discussion needed.
But with Julie, type A plus planner—mon semblable—ma soeur!
I VAGUELY REMEMBER HEARING SOMETHING that year about a “breast cancer gene.” Was it late in 1990? Or early 1991? A friend of a friend, an oncologist at the National Cancer Institute, was talking about it at someone’s house one night. I remember mentioning it to Julie, one Saturday afternoon, having coffee together in Virginia. It was all cast in the future tense—one day, they may be able to test women for certain kinds of breast cancer.
“I wonder what Mom would say about a test like that,” I mused.
My mother had had breast cancer—a tiny, curable tumor—four years earlier. It was a freak thing—like a meteor falling out of the sky, was the way my mother described it. You worry and worry about wearing your seat belt, drive as carefully as you can, and then wham—a meteor comes along and smacks you in the head. (My mother, mixer of metaphors.)
Thank God, this had been a small meteor. One that let her get up, brush herself off, and go on. Back to seat belts and ordinary worries.
“Oh, Mom would hate that,” Julie said. “You know how she is.”
I nodded. I knew. My mother, AP History teacher and ultrarationalist, was at heart more mystic than scientist. In her mind, asking too much of the future was bad luck.
“I wonder if I’d want to know,” Julie said, fiddling with her spoon. “If we had breast cancer in our family the way we have ovarian cancer. Would you want to take a test like that and find ou
t?”
“I don’t think so,” I said. I didn’t give it a lot of thought—it sounded like science fiction to me. Some people like speculating about things like that—my roommate in college was always trying to drag me into hypothetical quandaries at three in the morning. Like cryogenics. Would you want to be frozen right before you died so they could wake you up in a thousand years, when ninety was barely middle age? Or would it be too lonely, wandering around in a world filled with unrecognizable gadgets and people ten or more generations younger than you were?