by Sarah Price
“What did you think? That I was having an affair?” he whispered in an angry, hoarse voice.
“I . . . I just needed to see you, Nicholas,” she responded. It wasn’t a lie. She did need to see him. Even more importantly, she needed to know the truth. “You’re never home anymore.”
She was tempted to tell him about the test results having come back positive. At least it would justify the fact that she’d come to his office at this time of night. But wouldn’t that be a cop-out? Just as she decided to tell him, Nicholas interrupted her thoughts.
Running his fingers through his thinning hair in a familiar gesture of exasperation, he looked away from her and uttered, “It’s called work, Frances. Work. You know that word, right? It’s the word that puts food on the table and pays the bills. Work.”
“But I needed to talk to you about something.”
“Well, this certainly isn’t the time or the place, is it?” he snapped. “And who’s home with the kids? Obviously not you.” He stared at her. There was an intense emotion in his expression. Irritation? Annoyance? No, she thought. More like disgust. He glared as he shook his head. “You’re really something else, Frances. I can’t believe you drove all the way out here. That you have such little faith in me!”
She lowered her eyes, staring at the floor, her shoulders hunched forward. If her heart had felt as if it were in her throat before, she now knew it was in her chest, pounding hard. Shame washed over her, and she could barely talk as she whispered, “I’m so sorry.”
“You should be!” he replied sharply. “You know we have this big deal on the line, and I really don’t have time for your emotional theatrics right now. So go home, Frances. I’ll be there when I get there.” He looked up and saw the security guard standing at the end of the hallway. Motioning with his hand, Nicholas called out, “Would you mind escorting my wife back to her car?”
Without so much as another word, he turned and walked back to the conference room. She stared after him until the security guard approached. Her cheeks felt warm. She couldn’t hide her humiliation. Fortunately, the guard did not so much as look at her, providing the distance Frances needed as they walked back to the elevators.
During the drive home all she could think about was one thing: How could she possibly burden him now when he was so angry with her, thinking that she had suspected him of cheating when, in truth, she just needed to talk with him?
CHAPTER 6
“You do realize, Frances, that what you are suggesting is rather unconventional?”
During the course of the week, Frances had met with several doctors to better understand her cancer and her options. An MRI and a CT scan had preceded two reluctant meetings, first with a medical oncologist, then with a radiation oncologist. After she declined to schedule an appointment with a plastic surgeon, Dr. Graham requested another meeting.
Sitting across from him, his large mahogany desk littered with files and papers, Frances did her best to maintain her poker face. Despite the disorganized chaos that she witnessed, she knew from her research that he was, in fact, very organized. Not only had he attended the top medical school in the country, he’d also been listed as one of the top doctors in his field for five years in a row. Dr. Graham was clearly the best that Morristown Memorial had to offer when it came to treating breast cancer.
Which is why she needed to remain calm and focused.
“I do realize that, yes,” she said. “But my research has pointed to other options that I’d like to explore.”
“Your research?” Dr. Graham lifted his hand to his forehead, removing his glasses as he did so, in a gesture of disbelief. “That darn Internet.”
She laughed, the first time since their meeting the previous Friday. It felt good to laugh.
“That’s not it, Dr. Graham,” she said. “I’m not researching alternatives to be one of those patients who are afraid of chemo or chemicals or surgery. It’s just exactly what I told you last week: I don’t have time for cancer.”
“Well, it found time for you,” he replied.
Frances felt her spine straighten as she repeated his words to herself. Whether cancer had found her was not the issue. She knew she needed to remain strong and stoic to battle whatever lay ahead. But she also needed to maintain a balance in her life; she needed to maintain control.
“Well, too bad,” she said.
This time it was the doctor who smiled at her rebellious disregard of cancer’s grip on her life. It was the first time that she felt a connection with him. His smile enlightened her, allowing her to look at the situation through another set of eyes. Frances hadn’t felt this hopeful since her diagnosis, and she was depending on Dr. Graham to help her keep the faith. However, she had every intention of implementing her plan, with or without his support.
“Ah, Mrs. Snyder . . .”
“Call me Frances,” she said. “I think you and I should be on a first-name basis at this point.”
“OK, Frances,” he said, never offering his own first name. “So, what we are suggesting is a double mastectomy with chemotherapy and radiation to follow.”
But that was not part of her plan.
“No.”
He blinked his eyes. “No?”
“No.” She said it with such conviction and strength that he sat up straighter. “I don’t want a double mastectomy. Too many women are having that done. It’s overkill. In fact, lumpectomies have the same statistics for recurrence and survival rates as double mastectomies. So I say no to the double mastectomy. It’s not something I want to invest my time in, the recovery is just too long. And then there’s the reconstruction to think about, which can take twice as long to recover from.”
Dr. Graham made a disapproving noise that sounded like he was sucking air through his teeth. “Mrs. Snyder—”
“Frances!” she snapped. His patronizing tone had suddenly irritated her. She was tired of being doubted, of being second-guessed. She wasn’t an unintelligent woman. And it was, after all, her body.
“Frances,” he patiently corrected himself. “You are really taking a chance here.”
“What about those cases where they get chemo and radiation first?” She leaned forward in her seat and poked her finger against the top of his desk. “Those women don’t get their breasts chopped off!”
“It’s not chopping—” he started to argue.
“Please!” She leaned back and ran her fingers through her hair. She almost laughed at the doctor but didn’t want to upset him. After all, he was her medical savior. “Will I lose my hair?” she asked.
“I . . . uh . . .”
“I’ll take that for a yes.” When she said the words out loud, it suddenly didn’t feel as bad as she had imagined over the past forty-eight hours. “So what do I do? Shave my head?”
“That’s a little drastic,” he managed to say.
“Not any more drastic than removing both of my breasts.”
He conceded with a simple “Touché.”
His stone-faced expression told her all that she needed to know. Dr. Graham had his own ideas about what she needed to do to beat the invader in her life, and she had her own. Unfortunately for him, they were both very different.
“I need the least disruptive way to get rid of the cancer, Dr. Graham.”
Pushing back his chair, he stood up while shaking his head. “That’s not the way it works here, Frances.”
“So how, exactly, does it work? Every cancer is different. I learned that from my research. For some women, their cancer is genetic. For others, it’s environmental or even caused by stress. Hormones can influence its growth. Cancers are all different: different types, stages, and causes. So if it’s true that there are different causes and even types, then tell me, Dr. Graham, why are all of the treatments the same? Why aren’t treatments tailored for the woman?”
He took a deep breath and walked toward her. Gently, he placed his hand on her arm and stared into her face. He wore an expression of compassion that, sh
e could sense, also included a tinge of superiority.
“Frances, I know you think I don’t understand how you feel, but I do. Even though I’ve never had breast cancer, I certainly can understand your frustration.” He gave her an empathetic smile. “These cures, these treatments, however drastic they may seem . . . they are the best the medical field has to offer right now, and statistically, they give you the best chance of living a long, healthy life.”
She lifted her chin and stared at him. For a week, she’d studied everything she could about lumpectomies and mastectomies. There was no way that she could go through either of those surgeries without Nicholas and the children finding out. Hospital stays, drains, and painkillers would not mask the truth. And she needed to mask the truth. Just for a little while longer until Nicholas forgave her. Besides, more than anything, she didn’t want to be that woman who became the focal point of pity within the family. She didn’t want to interfere with their lives. And she already understood the psychological ramifications of breast cancer for herself, so she could imagine how her children might feel if they knew about her illness.
Dr. Graham sighed and rubbed the bridge of his nose. She felt sorry for putting him through the stress of keeping her secret, but it was only to protect her family.
“Chemotherapy will shrink the tumor, I’m sure. But you’ll need surgery, Frances. Without it, the cancer will grow stronger.” He leaned against the edge of his desk. “To try and avoid surgery is simply not an option.”
Frances digested his words. Surgery. They wouldn’t know whether she would need a lumpectomy or a mastectomy until after chemotherapy. The idea of losing her breast—one or even both!—made her feel like running away.
An image came to her mind of a red sleigh on a snowy day. Mrs. Bentley had had a double mastectomy with no reconstruction. Frances could now see her face as if it were just yesterday, and not thirty-some-odd years ago. Mrs. Bentley had been matter-of-fact about dying. She’d answered Frances’s questions on that snowy day when they posed for that photo. Mrs. Bentley had seemed to appreciate Frances’s innocent candor, a rare treat when most people avoided the subject entirely.
Frances’s mother, however, felt only pity for the woman. Even though her mother had smiled to Mrs. Bentley’s face, she had also talked about what a pathetically frail creature she was to anyone who would listen. Her mother had organized food drives to help with meals, but never contributed any time herself. Instead, she made quite a lot of fanfare over delivering the meals to the Bentley home as if she, and not others, had cooked the meals. Frances often wondered if her mother organized the food drives to help Mrs. Bentley or merely to appear like a good Catholic woman among her social circles.
Unlike candor, pity was an ugly gift.
Frances shuddered at the memory. She didn’t want to be pitied by anyone, especially by her own family.
“How soon does all this begin?”
“I want you to start your first round of chemo on Thursday. It will be a two-week cycle: one week on, one week off. So every other Thursday you’ll come to the chemotherapy center.”
“But Thanksgiving is coming up.”
Dr. Graham glanced at the calendar on his desk. He flipped over the page to look at November. “You should be fine, Frances. Your chemo will start October 20 and then again on November 3, November 17, and December 1. Perfect planning to avoid Thanksgiving!”
He sounded quite pleased, as if she’d purposefully scheduled her cancer diagnosis to avoid the upcoming holiday. Now, however, she had to figure out how and when to tell Nicholas. She knew she couldn’t go through chemotherapy alone. And while she was certain he would be upset she hadn’t told him already, he would understand once she explained that she hadn’t wanted to distract him from work.
“You will need to come in next week to have your Port-a-Cath inserted,” he added, switching back into doctor mode. “And I want you to have a tour of the chemotherapy center. My assistant will get all of this scheduled for you.”
“Port-a . . . ?”
“Port-a-Cath,” he repeated as he pushed his chair backward and reached into his file cabinet for something. What he withdrew was a shiny piece of laminated cardboard with a medical diagram. He set it on the edge of his desk and reached around the side to point to different illustrations of parts of the body. “It’s a catheter connected to a portal—this round device with a silicone septum here—that gets inserted into your chest.”
“My . . . my chest?”
He pointed to his own body, just under the collarbone. “Here, Frances. And the catheter will run up a vein and into your neck.”
Instinctively, her hand fluttered to her throat.
“It sounds worse than it is, trust me.”
She grimaced at his words. “Have you ever had one?”
“No. No, I haven’t.”
“Then please don’t tell me that it sounds worse than it is.”
He bit his lower lip and slowly nodded his head. “Fair enough. How about this? I’ve dealt with hundreds, maybe even thousands of patients who’ve had this device installed. They all say it’s not as bad as it sounds.”
She could accept that.
“Why do I need it?”
He nodded his head once. “Good question. When chemotherapy is administered, the nurse will puncture your skin with a needle here.” He pointed to the circular silicone part of the portal. “It doesn’t hurt at all.” Before she could comment, he quickly added, “Or so my thousands of patients have told me.”
She couldn’t keep herself from smiling. Despite the circumstances, she was beginning to appreciate this Dr. Graham.
“The reason you have it, Frances, is because the chemotherapy is too strong for your veins. There have been instances where veins have collapsed and shut down. The port provides a more direct pathway, thus allowing us to get the drugs into the main artery in a safer manner by lowering the risk of damage to the veins, skin, and muscles.”
“Wow,” she said drily. “Sounds like a party, doesn’t it?”
This time he smiled. “I can assure you that it’s no party, but it’s the best treatment we have. I will not try to sugarcoat it, Frances. Sometimes the treatment will feel far worse than the disease. But in the long run, chemotherapy can give you back your life, the very thing the cancer wants to rob from you.”
“If the treatment doesn’t kill me.”
“And that will not happen.” He set down the diagram and folded his hands on top of it. “I promise you that.”
There was a moment of silence that befell them while Frances stared at his folded hands. He wasn’t wearing a wedding ring, and she wondered if that was by chance or by choice.
He cleared his throat. “How did your family take the news?”
“I . . .” She averted her eyes, too embarrassed to admit the truth. She hadn’t told her husband, because he had been too busy to spare the time for a discussion, a simple conversation that revolved around her for once, and not him. It was far too painful to acknowledge. So she chose the lesser of the two evils, which was to tell Dr. Graham a lie. “They were concerned, of course. But I reassured them everything would be fine.”
“And you believe that, don’t you?”
For a moment she was confused, wondering whether he meant that they were concerned (or would be, anyway, if she had told them) or that everything would be fine. She decided on the latter. “Yes, Dr. Graham. I do.”
He gave her a broad smile, in acknowledgment. “That’s what I like to hear. You know, a positive, upbeat attitude does wonders when going through treatment. With a good attitude and a good support team, you’ll be amazed at how strong a fighter you truly are. While I haven’t personally experienced it,” he added with a soft smile, “I have seen it over and over again.”
“A thousand times?” she asked in a slightly teasing tone.
He laughed. “Yes, at least.”
Dr. Graham stood up and motioned toward the door of his office. “Now, let me get you s
cheduled for the tour of the chemo floor as well as the Port-a-Cath surgery. It’s an outpatient procedure, Frances, so your husband should be prepared to take you home and let you rest until the anesthesia wears off. No driving and no strenuous activities, understood?”
She nodded, barely listening when he introduced her to his assistant. Her mind reeled as she came to the realization that now she would have no choice; she would have to tell Nicholas. After what she’d heard, she knew she would need the support of her husband during the upcoming months. This time, there was simply no way that he could avoid being by her side. And once she told him what was going on with her health, surely things would finally change and he would want to put his family before anything else.
CHAPTER 7
The second floor of the Carol G. Simon Cancer Center was more intimidating than Frances had imagined. A young man took her on a short tour of the chemotherapy center, pausing to explain the different areas. But Thomas’s explanations fell on deaf ears. Frances stared at everything and nothing at the same time, his words simply not registering with her. The conflicting emotions that welled up inside of her hindered her ability to comprehend anything.
She had a “welcome” folder pressed against her chest as she followed her “tour guide,” which was a horrible way to think of him. Tour guides were supposed to show people historic sites or take them on adventures through exotic attractions, not through the institutional wing of a cancer center. In all her years, Frances had never put chemotherapy center and tour guide in the same sentence. The former brought fear along with visions of death, while the latter sparked dreams of curiosity and exploration of exotic locations, none of which she had in regard to her upcoming cancer treatment.
Surely, this was going to cause an upheaval in her otherwise well-organized routine and methodical approach to her roles as wife, mother, and homemaker. She had embraced those roles since way back when, after the birth of her first child, and as with other aspects of her life, had always approached them with poise and conviction. While she often liked to initiate changes in her home life, such as redecorating, organizing, and gardening, she was adamant about not making changes to her personal life, especially when these changes might disrupt the routine of her family life.