Promise Me

by Nancy G. Brinker

  “So where are you headed with this?” asked Norman.

  “I think we should have a women’s sports day. A huge event with a 10K race, tennis tournament, horseback riding, track and field—and of course, we’d have an information fair, booths for support services, the traveling mammogram facility. And we’d come up with a great way to honor survivors in the opening ceremony. Maybe have them bring the torch! Oh, that’s perfect. We definitely need a torch.”

  “Hold on, Bruni,” said Norman. Not to be negative, just reeling in enough kite string to bring me back from dreamland. “I’m not saying don’t do it, but—well, for starters, I smell liability issues. And confusion.”

  “That’s dealt with all the time, though. Everybody has 5K or 10K races these days.”

  In fact, Cindy was organizing one for a children’s cancer charity at the time. Before I brought it up to my band of angels, I checked with her, just to make sure she wouldn’t feel like I was encroaching on her event, but she was enthusiastic about my idea. My band of angels was not. Halfway through an impassioned living room speech about the torch and all that, the two co-chairs of our upcoming luncheon gently but firmly dragged me into the powder room and closed the door.

  “Nancy, this isn’t a good idea. We don’t have the people to do this. We’ll end up complicating things and diverting resources and energy from doing the kind of events we do best. Events we know will bring in a lot of money.”

  “This wouldn’t be about the money. This is about getting out there on our feet with people in big numbers. The grassroots support we need is out there.” I pointed beyond the powder room door. “We can’t take this to the next level if we stay locked into this one particular group of people. A ticket to our luncheon event costs what some people pay for a month’s rent. They’re not going to come, and I don’t want to see them excluded.”

  “You’re risking the base we’ve been building, Nancy. Everything we’ve been working toward for the last year. Do you personally know any women who want to go out on a Saturday morning and tear around in the heat?”

  “Our base will be just fine. And I love to tear around on a Saturday morning.”

  But they made some good points, I had to admit.

  “What if we separate the two?” I said. “We’ll do the luncheon as planned, and maybe do a scaled-down version of the sports day—a 5K or a 10K race—a week or so later. But connect the two so we can capitalize on the visibility from the luncheon.”

  Like the song says: You can’t always get what you want. Sometimes you have to go for what you need, and I was convinced we needed this. There was no way we were going to get where we needed to be without the power of the people. On the other hand, we weren’t going to get anywhere at all if I alienated the angel band.

  One of Norman’s Brinker Principles: Involve your people in the planning process.

  It took me a few tries in life, but I eventually learned that you can’t bully people into believing. You win people over—or you don’t. And if you’re never willing to be won over, it’s a safe bet your supporters won’t be open to it either. It’s like a saloon door; it’s got to swing both ways.

  The powder room consensus: Focus on the luncheon first and foremost and follow it up with a little 5K “fun run” and information fair.

  Plans for our second annual luncheon proceeded like a freight train. Co-chairing this event is a Herculean, plate-spinning, champagne magnum–juggling feat of superwoman prowess, and over the years, we’ve been lucky enough to find the right women for the job. Laura Bush was our invitation chair that second year. (Her father-in-law, George H. W. Bush, was vice president then.) She had two little girls, a husband on his way up, and a lot on her plate in general, but she stepped up like a trouper and volunteered to stuff and address hundreds of envelopes by hand.

  Attire for the Annual Susan G. Komen Breast Cancer Foundation Awards Luncheon was not business casual. From the very first year, it was big hair, done-out dresses, designer suits. It was vintage, over-the-top Dallas, loaded with unapologetic emotion.

  “Create the place and take them there,” Stanley Marcus said, and that’s what we did.

  A darkened ballroom. A single spotlight on an American flag. Cue music. The light expands as the colors are advanced. On a giant screen, portraits of courage, beauty, and faith—women with breast cancer—our reason for being.

  By this time, I’d been to a few Washington events, and if there’s one thing Washington knows, it’s how to get out the ceremony. There’s a reason for all that pomp and circumstance; I felt it as Suzy and I watched the Changing of the Guard at Buckingham Palace, but I didn’t know what it was then or why it created such a lump in my throat. It made me think about all the small and large rituals that lend structure to our lives. We formalize connection with handshakes and weddings. We mark beginnings with bar mitzvahs and ribbon cuttings. We honor the life of an individual with a christening or a funeral. We pause and direct our attention for a moment because the moment deserves that. Words are optional. Ceremonies give us a framework in which to express something bigger than words.

  We’ve gotten rather blasé about ceremony these days—we’re all so determinedly cool, so afraid to display schmaltzy emotion—but I think we feel the lack of it. If you’ve run yourself ragged to raise $50,000 for a good cause, just knowing that the check has been dropped in the mail is pretty anticlimactic. You want to celebrate. You want to hand that giant check to someone in front of a cheering crowd. That giant check is a big deal! It deserves a moment of “Wow! Big check!”—just like you deserve a cake with candles on your birthday.

  Our annual luncheons redefined big (and put a dent in “bigger”), honoring survivors and supporters, celebrating everything our scientists had accomplished, and setting the bar high for future efforts. If there was a dry eye in the house, I didn’t see it. People came away filled with gratitude for their lives, inspired to give and live and love, believing in their own capacity for heroism.

  This was the spirit I wanted to see at our little fun run, but truthfully, I wasn’t certain anyone would show up. I’d tried to hustle some corporate sponsorship, but that effort fell flat. Even companies that had sponsored similar events in the past didn’t want to attach their names to breast cancer. A few local businesses bravely ponied up a little money, and at the last minute American Airlines came through with a small grant. Some people would have been disheartened by that response; we were thrilled. We farmed out the task of creating a separate identity and some posters for the fun run to a small advertising firm in Dallas, and they came up with a name for the event: RACE FOR THE CURE.

  The moment I heard it, I said, “Yes! Yes, you got it exactly right.”

  Feeling more optimistic, I dared to think two or three hundred people would come. That would be a starting point for us to build on. More important, Mommy was going to be there, and I couldn’t stand the idea of her being disappointed.

  She wasn’t.

  That Saturday dawned drizzly and threatening, but the morning sun burned through the clouds, and about eight hundred people showed up to cheer on the runners. Everyone involved in the planning process was fairly stunned by the turnout.

  The atmosphere was positively buoyant—lighthearted, with a huge sense of yes, finally. The information fair was swarmed. You could feel the stories in the air, so many miles traveled, so many memories that never got a chance to happen. The hope was palpable. We tenderly passed armfuls of it back and forth the way sisters pass each other a newborn at a baby shower.

  I felt another frisson of Yes, exactly right.

  This was an event we could package and take to every city in America. This was how we would turn our little charity into a movement.

  At home in Dallas, Norman and I put in a full business week and then some. We bought a ranch in McKinney, Texas, and went there on weekends, all play. We rode horses and ate Mexican food. Norman pressed Eric into service baling hay and mucking out stalls, and the two of them spent
many hours shooting skeet and chauffeuring Cindy, Brenda, and me around with a horse and buggy. In Palm Beach, we played polo and went boating with Mom and Dad.

  Life was good, and as Norman and I grew together, I started thinking I’d like to have a baby with him. Norman wasn’t immediately on board with the idea. Brenda and Cindy were grown up and on their own. His relationship with Christina and Mark, his two children from his second marriage, was less than he would have liked it to be, and that was painful for him. (Later on, when they were older, he did become close to both of them, and it brought him a lot of joy.) He and Eric spent a lot of time together, working and playing. Norman took Eric with him to scope out new properties. They visited various restaurants in the company to meet the people who made it all happen. Norman was grateful for the bonus opportunity to be a good father, and he was a very, very good father to Eric. Norman was satisfied with that—for the moment, anyway—and I was satisfied with simply keeping the door open. (For the moment, anyway.) Most nights, I lay down next to my husband feeling completely weary and completely content with my beautiful son asleep down the hall and the beautiful baby I’d already created in my mind tucked snug and safe at the edge of my dreams.

  But on a particularly chilly night during the winter of 1984, as I lay down and pulled the comforter over us, my hand brushed across my left breast, and everything changed.

  The next moment I was on my feet again, trembling, fighting panic. It was as if I’d touched a tarantula in the bed.

  “Oh, my God … oh, God …”

  Norman was instantly standing beside me. “What’s wrong? Calm down. Talk to me.”

  “It’s a lump. I felt a lump. Right here. Feel. Do you feel it?”

  I took his hand and moved it to the side of my breast, watching his face. His expression remained square and calm except for the smallest tick at the side of his mouth as his thumb located the small, pebble-hard lump.

  “It’s different, Norman. It’s hard. It’s—it’s like Suzy said—not like before.”

  “All right. Let’s just stay calm,” Norman said evenly. “First thing in the morning, we’ll call M. D. Anderson and get you on a flight to Houston.”

  “Yes. Okay. I’ll call Fred Ames. He has my baseline mammograms. And I know he’s the best. They don’t get any better than him.”

  Norman coaxed me to lie down again and locked his arms around me. We both lay awake for a long time, and for a long time after his breathing relaxed to a slow, deep rumble, I lay there listening to my own heart pounding: Not this, not now, not this, not now.

  Dr. Ames was a terrific surgeon who’d been monitoring my breasts, both for my own sanity and as part of that ongoing study of the female relatives of breast cancer patients. His hands were always sure and warm, like the man himself. Sitting on edge of the exam table in his office, I exhaled and inhaled, feeling calmer.

  “Nancy, I don’t think it’s anything to worry about.” Dr. Ames smiled and patted my hand. “Feels like another benign tumor to me.”

  “No. This feels different. I know what my breasts feel like. The other tumors were kind of rubbery. This is hard as a rock.”

  “That doesn’t mean it’s malignant,” he said patiently.

  “I know that, but I want to be sure.”

  “I’m not recommending another biopsy, Nancy. You’ve had this breast biopsied three times already. Even with a needle biopsy, which isn’t always accurate, we keep building scar tissue. It makes the mammograms even harder to read—and that’s already an inexact science. Let’s watch it for a little while and see if it changes.”

  I nodded. That was a logical response. Good medical reasoning. Wait and see.

  I went home to Dallas. I had things to do. SGK was sponsoring a seminar on breast cancer detection the next day, and there were a million details to keep me occupied the rest of the afternoon. One of the display tables featured an array of lifelike prosthetic breasts with lumps in them, and the next morning, as I welcomed our guests, I watched the women stand there, brows knit, palpating the different types of tumors. I don’t know why I’d never felt those breast forms before, but that day I did. One of them felt chillingly familiar.

  As I stood there, talking to our audience that day, the knot in my heart tightened.

  “A biopsy entails the excision of a lump, from which thin samples are mounted on slides for microscopic examination. The ‘permanent section’ takes several days to analyze. Results from the frozen section are available within minutes. If a tumor is malignant, a test—the hormone receptor assay—is done to determine if the cancer’s growth is influenced by hormones. There’s a lot of important research being done right now in the field of hormone therapy, and you’ll be helping to support that with your donations.”

  The women gathered there looked up at me, trusting what I was telling them, making notes on little yellow pads as I explained the difference between a mastectomy and the new lumpectomy surgery that had now gained wide acceptance.

  “If you refer to your handout, you’ll see the statistical differences in … in survival … with the various forms of adjuvant therapy. These decisions are deeply personal, and it’s imperative that we get all the information before …” I cleared my throat, thumbed through my notes. “It’s our responsibility to be vigilant about our own breast health. We can’t just take a physician’s word for it, even when it’s a physician we know and like—a physician we respect and trust. You are the CEO of your own body. Just as a business hires consultants, you look to your physicians to provide you with an expert opinion, but ultimately the decision is yours.”

  By the time I left the podium, my face was burning with shame and fear, and I’d decided to practice what I preached. What kind of hypocrite could tell these women to do one thing, then go home and do another? I went home and called the surgeon who’d done my three previous biopsies in Dallas.

  “Dr. Fogleman, it’s Nancy Goodman Brinker. I need a second opinion.”

  Sitting on the edge of his exam table the next day, I felt considerably less calm.

  “This doesn’t feel good to me, Nancy. It’s small, but …” He shook his head and thought for a moment. “If I were you, I’d get it out.”

  I nodded. That was a logical response. Good medical reasoning. Get it out.

  Okay, Suzy. I pushed my palms together in my lap. Now what do I do?

  “Let’s head upstairs and do a transillumination,” said Dr. Fogleman.

  “Maybe,” I said. “Let me think about it while I get dressed.”

  He left the room, and I put my blouse on and combed my hair, calmly instructing myself not to overreact. Dr. Fogelman had said the same thing about the other three lumps. Everything I’d learned in the last three years was very much in keeping with Dr. Ames’s solid advice. I also knew from my research that this test, which illuminates the interior of the breast (it’s also called diaphanography), was probably not going to shed any light, as it were. I never considered those three biopsies that came back benign to be “unnecessary”; there was a question that needed to be answered. The only unnecessary test is one that tells you what you already know, and unfortunately, this particular test has a history of doing that, but it might reveal something about the size and shape of the tumor. I opted to do it.

  Reading the results on an infrared-sensitive camera, the radiologist reported a solid round tumor with a clearly defined exterior. Like a little candy-coated gumball.

  “There’s definitely something there,” said Fogelman.

  No kidding. I bit my lip, tried to swallow my frustration.

  “The radiologist thinks it’s benign.” He shrugged. “That well-defined border is a very good sign. Maybe watch and wait is the way to go.”

  I forced myself to go about my business for the next ten days, pretending to the best of my ability that everything was fine. I didn’t want Norman to look at me with that somber tick at the side of his mouth. I couldn’t bear to drag Mom and Daddy through this whole thing again. I wanted
Eric to feel happy and secure, knowing he was loved by an invincible mommy who’d always be there for him. I went riding with Norman on the weekend, wrote thank-you letters in the evening, fixed Eric’s lunch, attended board meetings and moderated discussions, and spoke pleasantly with Mommy on the phone, even though she kept asking, “Are you sure you’re all right? You sound tired.”

  It took every ounce of self-control to keep my hands away from my breast. Every moment I was alone, I prodded and poked it, thinking, No. It’s not growing. Or … is it my imagination or …

  Something was off. It was changing.

  “I think it’s getting bigger,” I told Fogelman.

  He moved my paper gown aside and ran his fingertips across it. “I think so too.”

  I immediately called Dr. Ames. “I don’t care what this is. I want it out. Now.”

  “All right. No problem,” he said, trying to soothe me, but I was no longer in a mood to be soothed.

  “If you don’t want to do it, that’s fine. I can go elsewhere, but I’ve made my decision.”

  “Nancy, I’m as confident as I can be that this thing is benign, but if it’s troubling you this much, then sure, let’s take it out.”

  “Immediately? Tomorrow?”

  He sighed, good-natured, patient with the impatient patient.

  “Sure. Come on down. I’ll give you a local and do it right here in the office.”

  Norman was out of town on business, and I didn’t want to wait for him to come back.

  “I’m not worried,” I lied to him that night on the phone. “I’d rather just go by myself and get it out of the way.”

  I told Mommy the same thing, then called my friend Sandy and asked if she could go to the hospital with me. Doris Bechtold, the wonderful patient care coordinator who’d taken me and my family under her wing that first day we brought Suzy in to M. D. Anderson, greeted me at the door and took me to meet Dr. Ames, who walked with me to the day surgery room.