by Rona Jaffe
“Lucie’s pregnant,” one of his friends told her finally.
Carl’s child . . . her husband’s child. “How does he feel about that?” Gara asked, needing to know.
“He’s actually very pleased.”
Although she and Carl had never wanted children, this was another blow. How easy it was for him—at sixty this was the final affirmation of his continuing youth and virility, his hedge against mortality. In a world that had not gone insane, Gara thought, the child should have been his grandchild; and when the family went out people would probably think it was. His own sons were not married yet and were still childless.
Carl signed the divorce papers. During their two-year separation, while she was depressed and frightened, hoping he would get tired of Lucie and come back, the idea of having a date, an affair, had been as remote to Gara as cheating. And now she was free. She knew Lucie’s hormones were surging, that she had swollen breasts and morning sickness, that she was cozily sleepy. She herself was on hormone replacement for hot flashes and vaginal dryness, her breasts reminded her of dwarf bananas, she knew she needed a face lift; she was another disposable wife. All the years of her marriage she had thought Carl would die and leave her a grieving widow, a woman of dignity; but he was alive, he had lied. She wondered if another man would ever sleep in her bed, if she would ever feel his arms holding her all night so she would not feel so unloved and unlovable.
She needed closure, a time to grieve, finality. Since Carl had not had the decency to die, she needed to make him dead in her heart.
On the weekends Gara went to her beach house in Amagansett, by herself, by choice. She cherished the absence of speech, the sound of the ocean, the foggy air, the sunrises and sunsets when the beach was empty. She walked alone for miles along the hard sand at the water’s edge and tried not to think about the past. She wondered how long it would take to become a normal person again. The loneliness there was healing, unlike the way she felt in the city when she felt only alone.
She redid the apartment so it would be fresh and new, so it wouldn’t be a shrine. She knew Carl would never see it again, and that was strange. She could hardly look at the things that were left because they had too many memories, but she wasn’t ready yet to throw those memories away either, and she knew it was important to keep good memories, even when they hurt.
She already knew the names of the best plastic surgeons in New York because Jane had made it an active life’s study, and in August, when she had the month off, Gara had a face lift. She looked youthful and refreshed, and wondered if she should have done it before, if it might have kept her husband with her for a few more years, and then she realized it was fruitless to second-guess the past. It was her face; she had done it for herself. She thought it was strange that Carl would never see this, either. And she would not see his child.
She had read it took a year of grieving for every five years of a good relationship. She waited. All these years she had told her patients that you finally recover and they couldn’t imagine it, but she knew it was possible, even though now she herself found it hard to imagine. And finally there were whole days when she was happy, when she didn’t think of him, of his domestic life there so far away, of her lost future. Now she would simply have a different future. She was determined to be stronger now than she had been when she depended on Carl for her protection against her mother, for assurance of her identity as a lovable woman. From now on she wanted to be able to take care of herself.
None of her friends knew any men to introduce her to. “We only know married people,” they protested, sounding surprised to have discovered it. It seemed that when a man left his wife he usually already had a replacement ready, or if not, he was taken in the blink of an eye, even if temporarily. Someone introduced her to a recent widower at a cocktail party; he looked happy talking and laughing with the men, and ignored her, and afterward Gara discovered he had been having an affair with a younger woman while his wife was dying, and now he was going to marry her. Jane knew younger men who were involved in the movie business with her husband, but they liked Jane better than they liked Gara. Jane was safe, she was their buddy, and when they wanted a relationship they found women their own age. Everyone knew gay men; without them how would a single woman have a male pal to go to dinner with, to escort her to a party when she felt both conspicuous and invisible going alone? Gara went to cocktail parties and to art openings, remembering she had met Carl at an art opening, and to the occasional dinner party, wishing she could be seated next to the interesting man of her dreams, but it never happened.
She knew there were women who went from husband to husband, and she wondered how they managed it. She read about them in the newspapers and magazines: the superwives who handled every aspect of their men’s social lives, or the great beauties . . . until they faded. She had even heard of women who met their next husbands at their own husbands’ funerals, but they had been of a previous generation and they needed to be a wife more than she did. She had needed to be Carl’s wife. Now she doubted that she wanted to be anybody’s. If she was going to have a romance, she thought self-protectively, they would find each other, it would have to happen naturally. But everywhere she went, no matter what else was going on, she couldn’t help looking.
“Stop looking,” people told her. “When you’re looking you never find anybody.”
“You have to keep looking,” others said. “You have to put yourself out there, even thought it’s difficult and we all dread it; you have to be emotionally available. When you feel sexy inside you look sexy outside.”
She was a therapist who dealt with these questions all the time with her lonely patients, and while she had all the textbook answers for them, she had none for herself. She was used to responding to a particular person, not to someone in the abstract.
Then one spring night when she was undressing after coming home from a dinner party where she had had a very good time, where she had not thought about a man or the lack of one, where she had enjoyed the friends and the evening, she felt a strange, sharp pricking under her left arm, between her armpit and her breast. She put her fingers there to see what it could be and they touched a small, hard lump the size and shape of a shelled almond, which hadn’t been there before. It was a lymph node.
She knew.
You know, she thought with a mixture of panic and calm resignation. Women always say afterward that they knew. So many times they’re wrong, and it isn’t anything, but you always think the worst, and so you knew. But despite her attempt at logic something told her it had happened at last: breast cancer, the thing every woman feared. In all her regular self-examinations she had never found a suspicious lump in her breast that had turned out to be anything but a part of the bumpy cystic terrain that was her own particular nature, and that she had gotten used to, and her mammograms had shown breast tissue so dense that there was nothing else to be seen—so it had sneaked up on her. Now it’s moved there, Gara thought, into the lymph node, while a part of her denied it, wanted it not to be true.
I’m going to have to have a mastectomy, she thought, if it’s gone this far.
She spent a sleepless night, and the next morning she made an emergency appointment with her general practitioner, Dr. Lombardi, an older woman she and Jane had been going to for years, one of the last of the breed of doctors who did everything, and who telephoned you personally to nag you when you were late for your regular checkup.
Dr. Lombardi palpated her breasts and found nothing. “You must have cut your finger,” she said. “Do you remember doing that?”
“Well, actually, I did,” Gara said. “But that was several weeks ago.”
She looked at the small scar. “You must have had an infection that went into the lymph node. That’s where it always goes. The lymph nodes are the immune system. The cut is healed so there’s no point in giving you an antibiotic now. We’ll just watch it.”
; Ecstasy: It’s just an infection! Anxiety: Why isn’t it going away? Gara continued to live her life as a normal person on the outside, but inside she thought of nothing else, it consumed her days, while she was “watching it.” There was nothing to see, but she kept feeling it, her right hand tucked into her jacket like Napoleon, fondling the pain, measuring the lump with her fingertips, feeling it grow, for two months. One day she thought it felt smaller and she was filled with joy and relief. The next day she knew she had been mistaken and the fear came back. Finally Dr. Lombardi sent her to a breast specialist, an older man who had been a colleague of Dr. Lombardi’s for decades. He sent her for another inconclusive mammogram and gave her an antibiotic.
An antibiotic, Gara knew, should start to make a significant improvement in twenty-four hours. But nothing happened for the entire week she took it, although she had already given up hope it would; the lump was still there, and it still hurt all the time from the tension of the pulled skin.
“I think you should have a biopsy,” the breast specialist said. “It’s too big. I don’t do surgery anymore, but you should have Dr. Lombardi send you to someone.”
Dr. Lombardi sent her to a highly recommended woman surgeon, Dr. Fink, who looked to Gara, for some reason, as if she might have gone on peace marches in the late sixties. She was the right age, early forties, and she had a kind of straight-talking idealistic toughness about her. When Gara asked her if she had been an activist she laughed and said it was true. They arranged to do the biopsy at the New York Collective Center for Surgery, on an outpatient basis and under a local anesthetic. Dr. Fink intended to take the whole thing out, whatever it was. It’s about time, Gara thought, afraid but relieved that the waiting would be over.
Jane offered to come to the hospital with her, but Gara said it was unnecessary, although she would need someone to pick her up because they wouldn’t let her go home by herself. “Then I’ll come get you afterward and take you to my apartment,” Jane said. “You can’t be alone after surgery.” Jane didn’t mention the subtext—You can’t be alone if the news is bad—and with one of the odd tricks the mind plays, this time Gara didn’t even think about it.
She lay on the operating table, full of Valium, calm. “Do you want to see the creature?” Dr. Fink asked, holding up what she had removed. It looked like a small, skinned mouse, bloody and raw.
After the surgery Gara went out and sat at a metal table in a brightly lit, undecorated anteroom while a man in a white coat worked in the next room on her dead mouse. She could see his head through the glass window. Dr. Fink came in and sat across from her at the metal table.
“It’s very malignant,” she said.
Very malignant? Gara was surprised and completely numb. She didn’t know if it was self-preservation or the tranquilizer. I guess I’m going to die quickly, she thought. Very malignant? Not me.
The doctor on the other side of the glass said something. Dr. Fink went to talk to him and came back looking happier. “He thinks he found lymphoma and breast cancer,” she said. “If that’s true, then it’s the best thing you can have.”
As opposed to what? Gara wondered.
Some time went by; she didn’t know how much. “Yes, it appears to be what he thought,” Dr. Fink said. “But we’ll have a full report in a few days.” Then she told her to call Jane to come get her.
“It’s cancer,” Gara told Jane. It was the first time she had said the word. She was holding on now, trying not to let her voice quaver too much, trying not to get hysterical. What was she going to do?
“I know,” Jane said. “Dr. Lombardi called me already. She has an oncologist for you to call. A woman who specializes in breast cancer and lymphoma. Dr. Beddowes. Dr. Lombardi says she’s the best.” She handed her a piece of paper with the number.
How quickly they act when they finally know, Gara thought, relieved that she didn’t have to make decisions. She knew of other women who had spent weeks researching every doctor and hospital they could before they chose someone, but she had no more time to waste, if not because of her physical condition then because of her mental state, and she felt comfortable just having been led to this specialist by a doctor she trusted. She liked that she was surrounded by women physicians. They were in the club, they lived with the same fear of breast cancer as she did; they would understand.
Dr. Beddowes sounded kind and pleasant on the phone. She gave Gara an appointment for two days later, when the full report would be in.
“Are you tired?” Jane asked. “Do you want to take a nap? Does it hurt?”
“No, I’m okay,” Gara said. “I took some pain killer, and I’ll take it again tonight before I go to bed.”
“Let’s go out tonight,” Jane said. “It’s your night, we’ll do anything you want to. Where do you want to go?”
“I don’t know,” Gara said.
“It’s so nice tonight we can go outdoors. We can have dinner at an outdoor café. Eliot will take us.”
So later the three of them sat in a sidewalk restaurant near Gramercy Park in the mild evening, watching the throngs of people walking by. Somewhere there was music playing. I have cancer, Gara kept thinking. She felt wrapped in a cocoon of her own, set apart, vulnerable, temporary. She looked around. Everywhere there was brightness. She had never seen colors so vivid, or details so alive and intense; the buildings, the people, the trees. She didn’t know if her mind at this time of fear was distorting what she saw, or if things had always looked that way and she had never noticed before.
I don’t want to leave a world that looks like this, she thought. I never knew it was so beautiful. If I have to die soon, then I’m going to try to see everything this clearly for the short time I have left. As she sat there looking and listening, mingled with the sorrow that all of this might end so suddenly, she felt an odd kind of peaceful happiness, as if a vision of what the universe was really like was finally hers.
Dr. Beddowes was in her forties, with short gray-streaked hair and a round, unlined, pretty face. “This is probably going to happen to me, too,” she said with a smile, “so I’m always nice to my patients so someday someone will be nice to me.”
Gara smiled back, liking her immediately.
“When Dr. Fink took out the lymph node,” Dr. Beddowes went on, “another one was stuck to it and came out too, and they both had cancer and lymphoma in them. It’s a very mild form of lymphoma, one of the few that’s almost benign. It’s called well-differentiated lymphocytic lymphoma because you can feel the lymph nodes without surgery and it’s easy to watch. You don’t have to worry about the lymphoma. I wouldn’t even treat it. When you get an infection of any kind, the lymph nodes near the site will jump up. That’s what happened here.”
“So the lymph nodes were a kind of watchdog,” Gara said.
“Yes. We can’t find the primary source, although we know it’s breast cancer, so it’s in the breast. Breast cancer can go elsewhere, but it always starts in the breast. In your case we don’t know where in the breast. We have to discuss what you want to do.”
“A mastectomy,” Gara said calmly.
“That’s what I would recommend. A mastectomy probably followed by chemotherapy. And then reconstruction.”
“So the whole process will take a year,” Gara said. A year lost in a life that was already indefinite, but it could not be helped.
“Yes,” Dr. Beddowes said sympathetically. “About a year. I’ll send you for some tests at the hospital tomorrow to see if it has spread anywhere else in your body. You’ll have to stop taking your estrogen replacements because breast cancer likes estrogen. Here’s a book for you to read, and a list of some others you might want to buy.” She gave Gara a copy of Dr. Susan Love’s Breast Book, a thick paperback. Gara had heard of it.
She stayed up all night reading it, looking for the chances of a postmenopausal woman on chemotherapy surviving cancer. I have cancer, she t
old herself over and over, not really comprehending it yet. Overnight her life had completely changed. I have cancer, she thought the first thing when she woke up. It was always everybody else. Now it’s me. I have cancer. She still couldn’t relate to it, even though she was going through all the right motions. She was aware that she had not shed a tear. It had not even occurred to her to cry. I just want to survive, Gara thought.
And then she was at the hospital again, in an area ominously called Nuclear Medicine, drinking radioactive liquid in the waiting room, then standing in front of a clicking machine, looking at a tiny television screen and seeing there her body segmented and photographed in a series of twinkling dots of molecules on a dark background, a starry sky of her mortality, of her disease.
After the bone scan she lay on a narrow slab under a thick plastic tunnel, unmoving, holding her breath while other pictures segmented her body even more, into tiny slices, a biopsy without a knife, each a photograph of the fiber of her being.
“It hasn’t shown up anywhere else,” Dr. Beddowes told her happily. “When Dr. Fink does the mastectomy we’ll do a lymph node sampling to see if it’s spread to any other nodes. I want you to have a plastic surgeon there at the operation so you can have an expander put in at the same time to start the reconstruction.”