BREAST CANCER
BIOPSY
CHEMO
DEATH
My apologies. A ‘spike’ – this is to say, an unwanted, obtrusive thought – just erupted into the text there. Any mention of breast cancer will bring one on, and I’m compelled, first, to follow all the strands of thought which radiate out from the node BREAST CANCER through to their worst possible ends, and then to ruminate for a while to see if I can’t think myself back to safety again. That eruption represents the lost three-quarters of an hour I spent sitting in a kind of trance at my desk, ruminating, chewing my cheeks, and picking at my skin.
None of this made me feel any better – it never does. Rumination only ever leads to further rumination, so if I really want to snap out of it I have to make the effort to do something else, go somewhere else, or contact someone else. With half the afternoon gone already, I phoned my mother and asked her why she hated the phrase ‘battling with cancer’ so much. She thought aloud for a minute or two: ‘Because in a battle you can see your enemy – you know who they are, what they are, how many of them there are . . . Because you don’t “battle” – you just do what you have to do to make the cancer go away and leave you to get on with your life . . . Because it makes it sound like you have control, and you haven’t.’ She said she didn’t recall doing any battling when she had breast cancer, but she remembered how angry she felt. How had she seemed to me when she was ill? I thought for a moment. ‘Distant,’ I said. ‘Laid out flat.’
I couldn’t remember any dates, or even which year it had been. My mother told me that she’d found the lump towards the end of April 1983, not long after my thirteenth birthday; she’d had the mastectomy on 6 May. Before she went in for the biopsy, my brother and I were told as much as we needed to know at that point, which was that our mother was going in ‘for a little operation’, and nothing more. When I arrived home from school the following day, it was my grandmother who opened the door. She didn’t smile when she saw me, which was unusual; she just told me that my mum was upstairs. Mum was lying on the double bed with an unfamiliar, woozy look on her face. She explained what the surgeon had found, that she was going back to hospital in a couple of days, and what they were going to have to do when she got there. She did not sound like herself when she talked.
It never occurred to me that she might die. I must have been enough of a child still to accept things as they happened, and to assume that they would work out. In retrospect, I realize how lucky we were. Breast cancer treatment has advanced a great deal in the last twenty-five years; if Mum had been diagnosed more recently, perhaps she would have got away with less extensive surgery, and lower doses of radiation. Even so, she has never regretted her mastectomy, never felt, as some women have, that in surrendering a breast she was somehow losing part of her identity. Like her daughter, what she fears losing most are her marbles. Cogito, ergo sum.
As I could remember so little, I asked my mother to email me the relevant dates, and anything else she felt able to tell me. She sent me a long, detailed message, and at the end she wrote: ‘Looking back now I am surprised at how many years it took me to acknowledge that there might issues for you, maybe I was not prepared to face up to that. I focused on surviving and getting the most out of life for myself and my family.’ The ‘issues’ are partly psychological, partly genetic. In recent years my mother’s genome has been checked for the breast cancer genes: BRCA1, BRCA2, and a third gene specific to Ashkenazi Jews, which confers the advantage of protection from TB along with the distinct disadvantage of a higher risk of breast cancer. Thankfully, they found none of these, but the geneticist she saw took a family history, saw that two of her maternal aunts had died of the disease and advised her that, just because they hadn’t been able to identify a culpable gene, it didn’t mean that none was there. I was given the option of going into an early screening programme at thirty-five, which I took. Once a year now I go to the local breast unit for a mammogram, and spend the next two weeks waiting for the results, and wondering if I would cope as well as my mother had if the results turn out to be bad. I hope that I would be able to ‘focus on surviving’ too.
Back in the spring and summer of 1983, when I was still the child who assumed that my mother would survive, I certainly never caught myself thinking, Oh no, Mum’s got breast cancer – that means I have an increased risk, nor did I consciously register the message, ‘Female body parts are life-threatening.’ On the other hand, I do remember how much my developing breasts disturbed me in those early adolescent years. Sometimes in my bed at night I would take one or other of them in my hand and dig my fingers under it, so that I could feel the lower edge of the gland sitting inside its envelope of skin and fat. It always felt as if I could have lifted it up and away from myself, a separable thing.
If I could have left my body behind and still somehow remained alive, I think I would have done. It was letting me down in so many different ways. Not only was it a female body, which was humiliation enough in itself, but it did not even seem to be developing into one of the better ones. My hair, which had been blonde in early childhood, had turned middling brown, a most uninteresting colour. My early puberty meant that my growth, which had been pretty close to the mean up till then, stopped at twelve or so. I watched as most of my contemporaries overtook me, leaving me behind along with the other ‘petite’ girls, or ‘shortarses’ as I prefer to call us. I wasn’t going to be elegant; I wasn’t going to be willowy; I certainly wasn’t going to be boyish; I was going to be entering adult life with short legs, and they were the wrong kind.
Increasingly, the sight of my body in the mirror or in photographs became offensive to me. Its proportions were not quite right, and this was irritating to the eye and mind alike. I would fantasize about rubbing my legs out and redrawing them, just that bit longer, or imagine myself having plastic surgery in which my legs would be broken and reset so that they could be artificially extended. Any other set of female legs I encountered would be abstracted from the body and compared with my own abstracted pair. In order that nobody at school should notice my two damning signs of physical inferiority, I took to sitting on the edge of chairs and stretching my legs out so that my feet peeped out from under the desk.
My face was just as displeasing. For a start, one of my front teeth was broken. The accident had happened when I was eight years old, as a consequence of scientific curiosity. We were on a pebble beach on the coast of Scotland. My father picked up a piece of rose quartz, about the size of a fist, that had been worn smooth by the sea. He said he would break the stone open to show me the crystal structure inside, and told me to stand well back. I did, but not far back enough: the stone bounced off the rock he threw it at and straight into my mouth. Screams flew up from the beach like startled birds. I realized with astonishment that they were coming out of me. My mother ran up yelling at my father. I got a trip to the dentist and three Famous Five books to cheer me up. But that tooth, a snaggle right at the front of my smile, went on to make a nuisance of itself for nearly twenty years. It could not be built up into the semblance of a full tooth until I was fourteen: it was a young tooth, with its nerve still exposed. A first temporary correction, in which the missing part was replaced by a kind of cement, soon turned yellow. Its replacement was held to the tooth stump by a steel pin, which gave it a dirty, greyish tinge. The tooth wouldn’t be mature enough for a proper crown until I was in my mid-twenties. In the meantime, I would have to live with the certain knowledge that people were saying things.
Did I ever say things myself? Almost certainly, but my most vivid memories are of life on the receiving end. Conventional girlish bitchiness, about weight or breasts or dress sense, was not really my thing. This made sense, of course, because body, whether as an aesthetic object or a vehicle for sporting prowess, was never my thing. I was mind, mind all the way. It was both my treasure and my weapon. While I had been so miserable in primary school, I had been encouraged by some to comfort myself with the idea that my br
ain was something special, and if people were mean to me, that was just because they were jealous. When I arrived at my secondary school, where the floors strained under the weight of so much feminine brilliance, I risked losing both my claim to uniqueness and my best excuse for being awkward. For the first year I didn’t know quite where to put myself, but in the second year I started Latin together with all the other girls who had taken it as an option; everybody in the class was a complete novice, and this gave me the perfect opportunity to make my mark. I took to reading ahead of the rest of the class under my desk, translating with the help of the glossary at the back of the book, so that when it was my turn to be chosen I could turn in an apparently effortless performance. My work paid off, and I became an acclaimed Latin genius. I’d declared my territory, found my perch again at the top of the tallest tree, by myself.
But it wasn’t supposed to be like that any more. I had imagined my new school as a non-boarding version of St Clare’s or Malory Towers, an ideal polity where clever girls and sporty girls and horsey girls and musical girls and shy girls could all find their social niches, while the spoiled or superficial or flibbertigibbety would come to learn the error of their ways. Unfortunately, the school wasn’t fictional and neither was I. Enid Blyton would never have been up to constructing a back-story as convoluted as mine, or working out its consequences for character and plot development. I would have been better prepared had I chucked out the school stories for girls and studied the various overlapping literatures on childhood depression, childhood anxiety, the longer-term effects of peer rejection, loneliness in childhood and the social and emotional problems faced by gifted children. These are rather light on lacrosse matches and midnight feasts but rich in descriptions of the pathology of children who are both unhappy and hard to like.
Difficulties with social relationships appear to accompany depression in young people. Interestingly, it seems that social problems reflect in part the depressed youth’s perception of others as critical and rejecting; which in turn may spark critical and defensive behaviour on their part, which puts peers off, and this leads to isolation. [p. 65]6
Kovacs et al. described ‘dysthymia’ as predominantly characterized by gloomy and depressed mood, brooding about feeling unloved and additional manifestations of affective dysregulation, including irritability and anger. The other predominant feature is the ‘cognitive’ symptom of self-deprecation or negative self-esteem. [p. 121]
It wasn’t that I was friendless exactly in my first three years at secondary school – more that my friendships, more often than not, did not quite take. This was partly down to sheer bad luck. Girls who had been friends in the school’s junior wing were allowed to stay together, within reason, but as they made up only one third of the senior year, there had to be a different method for sifting the new intake. The school had a huge catchment, extending south as far as the West End and north into Hertfordshire; each new senior cohort was sorted geographically into three separate forms, all the better to help girls pal up with other girls they might like to travel home with. It made no less sense than any other sorting system, and a lot more than most, but it could not take account of girls’ differing interests, abilities, personalities, levels of maturity or any of those other qualities by which girls spontaneously sort themselves.
For the first couple of days it was fine: new upper thirds were seated, two by two, in alphabetical order, so for that short time I was able to cling to another girl whose surname began with L. But she soon found someone more to her liking, and two weeks on, when we were allowed to select our new seating partners, I had nobody to choose, and had to be paired with the only other awkward singleton. I managed to make a couple of friends in other classes, girls I had encountered in my French group or at break-times, but this was no help in class before register, in class between lessons, or at lunch when we sat in form groups. The school had extensive grounds, which meant that it was possible to be less conspicuously alone than I had been at the other place, but most of the time I would rather not have been alone at all. Not at school.
There were cliques, usually made up of pairs of best friends, and there were periods when I would hang about hopefully on the outside of some clique or other, pulling on its collective skirt and trying as hard as I could to copy, quip, laugh and flatter myself in. This got me a birthday invite or two, but also led to just accusations that I tried too hard to please people. Whatever the reason, I was unable to follow the rhythms of group interaction; it was all of a piece with being out of step in dance classes and hopeless at netball. Trying to join in one of these conversations was for me the adolescent equivalent of trying to jump over a moving skipping rope while two other girls were twirling it. Almost always I would make the wrong judgement and bring the rope or flow of talk to an awkward standstill.
It came more naturally to me to form one-to-one friendships and spend my lunchtimes with my one friend pacing around the grounds, usually up and down the walkway lined with lime trees which marked the boundary between two large sports fields, having intense discussions. Sometimes we talked about music, about what we’d seen on Top of the Pops, or what we’d read in Smash Hits or No. 1 magazine, or about how ridiculous Spandau Ballet’s lyrics were but how at least they weren’t as irritating as Duran Duran. We talked about Comic Strip Presents and The Young Ones, Nighteen Eighty-Four and The Catcher in the Rye. (I still haven’t found my way back to George Orwell, despite his celebrated translucent prose; there’s something about finding an author incredibly profound when you’re fourteen that ruins them for you later.)
Alongside these usual Penguin Modern Classics, I liked to read whatever popular psychology books I could find at the local library or the second-hand bookshop in Edgware. I remember being particularly impressed by ‘Sibyl’ and her multiple personalities, but what fascinated me most were dreams and their interpretations. I liked to collect my own and those of my friends too, if they could remember any, and if they were willing to share. I also had a way of turning the conversation round to what I thought my own problems might be – was I, for example, a ‘manic depressive’? Did you need to be to be a writer? What did they think of my latest story for English? Did they think it was funny? And didn’t they agree that I was still quite thin really, not actually that ‘developed’ yet? I needed my fix of reassurance and fished for it daily.
Camilla arrived in the third term of the first year. She had just been made to leave her specialist performing arts school, which had a cruel policy of winnowing its student body down, term by term. To have been rejected in this way at twelve years old can only have been devastating, and her new school with its staid curriculum and ordinary girls must have seemed like the most dreary comedown ever to be inflicted on anyone. To me, though, she was different and glamorous, a real-life Noel Streatfeild character, a prize of a friend whom no one else had claimed. I spent a term’s worth of lunch breaks listening raptly to her stories about the school and what she had done there and how girls with far less talent had mystifyingly been kept on. She would also listen to monologues on my favourite subjects, and on this basis we managed to remain bosom friends for several months. Then in the second year another new girl arrived, and Camilla moved in on her. I liked the new girl too, and continued to spend my break-times with the other two, but I couldn’t help noticing that, more and more, Camilla was making fun of me, or cutting across me when I talked, or just ignoring me altogether. One lunchtime, when the other girl was off sick, and for want of anything more sophisticated to do, Camilla and I were playing hide-and-seek in the formal garden next to a Georgian building we called ‘the Old School’. When it was my turn to hide, I crouched behind a shrub. Camilla looked for me for a minute or so, then she got bored and called to me to come out. I stood up and yelled, ‘Boo!’ We both laughed. Then I stopped laughing, but she carried on.
‘You looked so funny!’ she explained. ‘You just jumped up, and I saw this grin and these two small evil eyes.’
I was stunn
ed. ‘I do not have small evil eyes!’
Camilla stopped laughing. ‘You do! They’re just like—’ [Here she made an unflattering reference to the eyes of a third party.]
‘They are not!’
‘They are!’
We stared at each other for a moment. It dawned on me that I could only continue as her friend on condition that I threw up my hands and conceded that I was indeed risibly ugly. This was impossible; we both knew that.
‘Goodbye, Camilla.’
‘Goodbye, Joanne.’
That afternoon, during gym, Camilla spent a happy forty minutes sitting next to me on an exercise mat, trashing me to the girls on the neighbouring one: ‘. . . and she bored me for hours up and down Lime Walk going on and on about how thin she is, and how flat chested – and look at her, the great, ugly brick!’
This was nothing exceptionally wicked. It was common practice, after a nasty ‘break-up’ like ours, for two former best friends to do each other down to their new mates, preferably within earshot. It was normal, healthy bitching for normal, healthy girls. Looking back, I don’t think she can have expected me to sit there and take it, as I did. It seems obvious now that what I was supposed to do was to grab a new friend of my own and retaliate, but I could no more do this than I could catch a flying rounders ball. I sat quietly on the mat, hoping at least that I looked the more dignified, and let her words soak in. I didn’t want it all to be true but maybe it was. The notion that I could well be a great, fat brick with small evil eyes stuck with me. It was another breed of thoughtworm, and over the next few years it would be joined by others of its kind. Some to do with my teeth, my dress sense or my resemblance to Neil out of The Young Ones came courtesy of other girls, but others, like the ones about the unacceptable shortness of my legs or the hideousness of my nose, were truths I’d discovered myself.
Woman Who Thought too Much, The Page 5