An Intimate Life

by Cheryl T. Cohen Greene

  My mother and I vowed to put aside the rancor and resentment and forge a new relationship. When we talked we would stay in the present and not relive past hurts, slights, and traumas. We would sidestep topics that we knew would ignite arguments. I had gripes with her as a mother, and she was never shy when it came to her complaints about me as a daughter, but we were both adults now. It was time to see if we could transcend the bitterness and become friends.

  To my great surprise and delight, my mother and I were able to begin again. We found that we actually enjoyed each other’s company and our bond grew and deepened over the last seven years of her life. She even opened up to me about her sex life. Turns out my father was a wonderful lover, who always made sure she was “satisfied.” Sure, it was more information than I wanted, but it was also a yardstick that measured just how much our relationship had changed.

  Incredibly, there was only one time when mom brought up the past by mentioning her anger at Michael. When I asked her to let it go and stay in the present, she did without an argument. I was grateful to my mother for her efforts and willingness to change. Anger had become a habit for both of us, and it was difficult to break away from the old patterns and the familiar dynamic, but she did it. When I lost her in 2002, I lost a friend.

  By 2006, Bob and I had shared our lives for twenty-seven years. There had been many good times and a few bad, and we delighted in the former and weathered the latter as a team. In the winter of that year, life would throw us yet another curve ball. It had been almost thirteen years since my brush with cancer and, to my shock, it was now back. This time it was in my breast.

  I had a small lump on my right areola that my radiologist initially speculated was a blocked milk duct. A mammogram picked up a number of tiny, suspicious-looking spots, but no one used the c-word yet. I was told to have another mammogram in six months. “We’ll keep an eye on it,” the radiologist said. I trusted her judgment and left the hospital relieved. Six months later when I dutifully returned for the follow-up screening, I was advised that nothing had changed and that the best course would be to remain vigilant and continue with semi-annual mammograms. Once again, I went about my life confident that I was in no imminent danger. Coincidentally, a few days after my second test, my old pal Barbara, a fellow surrogate, called to tell me that our mutual friend, another Barbara, had undergone a lumpectomy after being diagnosed with breast cancer. As soon as we hung up I called the other Barbara to see how she was recovering. We chatted for a bit and I asked what her symptoms were. “Well, at first they told me I had a blocked milk duct,” she said.

  The next call I made was to Evelyn, another surrogate, who had had a mastectomy several years earlier. I explained my situation, and she gave me what in retrospect was the best advice I could have received. “Tell them you want a stereotactic biopsy.” Within a week I had an appointment for one, and for a biopsy of the lump on my areola.

  When Dr. Whitney walked into the exam room she had a serious look on her narrow face.

  “I have breast cancer, don’t I?” I said.

  “Yes, you do.”

  I had infiltrating ductal carcinoma. She sat down and spread out the results from the stereotactic biopsy across her lap.

  I felt like I was hovering above my body as I watched the scene play out.

  “I’m going to take the biopsy of the lump. I’ll have the lab analyze it and we’ll get the results in about twenty minutes. Lie down and relax and I’ll be back soon.”

  “I’m fine,” I said in disbelief.

  “Cheryl, you’re in shock. Lie down and when I have the results we’ll take all the time we need to go over them and decide what to do,” Dr. Whitney said.

  I lay down, but as soon as the door closed I jumped up and pulled my phone out of my purse.

  I dialed my friend Joanne’s number. “I have cancer. I have cancer—again,” I told her, trembling.

  “Come over here as soon as you can,” she said.

  Then I phoned the nutritionist I had worked with when I had lymphoma.

  “Have them send me all of your lab work. I’ll put together a plan for you. We’ll work together like we did before,” she told me, concerned but firm.

  I was instinctively, immediately reaching out to my support system. Once again, I resolved to do everything I could to survive. I put away my phone and eased back on the exam table, crinkling the paper that lay over it. I took slow, deep breaths until Dr. Whitney returned.

  She did a needle biopsy on the lump and soon we were discussing how we would treat the now undeniable cancer in my breast. The cancer in the lump was the same as that in my breast, which is not always the case. I learned that there are over forty different kinds of breast cancer and women can have more than one type simultaneously. Infiltrating ductal carcinoma is one of the most treatable, especially when caught in stage one, as was the case for me.

  “I would recommend a mastectomy, given the number of small tumors,” Dr. Whitney said.

  The mysterious spots that the mammograms had picked up were actually tiny, one-millimeter tumors clustered together in one quadrant of my breast. They were so small that at first Dr. Whitney could barely make them out.

  “Fine. Should I let you take the other breast too?”

  I wanted the cancer gone and I wanted any chance of cancer in my other breast to go along with it. I didn’t like the prospect of losing both breasts, but I liked the possibility of having to undergo treatment again even less, and in that moment my suggestion seemed logical.

  Dr. Whitney assured me that I had a relatively low chance of developing cancer in my left breast and that only the right needed to be removed. When they performed the mastectomy, they would take out a few of my lymph nodes to be sure the cancer had not spread to them.

  I asked her if this cancer was related to the lymphoma I had survived years earlier and she answered with an emphatic no.

  One of the first things I did when I got home was find a breast cancer support group. I had joined a group after my lymphoma diagnosis and had found it to be a powerful adjunct to my treatment.

  I had my mastectomy in February 2006. Luckily, the cancer had not spread to my lymph nodes and I wouldn’t need chemotherapy or radiation. I was sent home with two drainage bulbs dangling from my right side, below my armpit. I had to measure the amount of fluid in them every day so they could see that it was diminishing. I also had a fluid-filled flexible plastic expander in my chest to prepare my skin for reconstructive surgery, which would take place in April. Once a week I visited the reconstructive surgeon to have fluid added to the expander so that my skin wouldn’t contract. Most of the time I was uncomfortable, but I was rarely in pain. Apart from the first day or two after the surgery, I didn’t even take the Percocet that had been prescribed for me.

  The mastectomy impacted my body image significantly. I’d grown to accept and love my breasts, even though they weren’t the perky mounds I had always wanted. I loved having my nipples sucked and played with during sex. The reconstruction would bring my shape back into balance, but I knew that the sensitivity in my right side would be much less than what I was accustomed to feeling.

  I had to remind myself that I was more than my breasts. When I finally said it out loud to a friend it seemed so obvious that I hardly had to repeat it to myself or anyone else. In a way I had to relearn what I had discovered in my modeling days: An imperfect body could still be a sexy body. True, I would have to accept a loss of sensation, but I still had plenty of ways to receive pleasure.

  Fortunately, Bob, once again, proved to be a supportive and devoted partner. When he learned that the cancer hadn’t spread into my lymph nodes his relief was on par with mine. He nursed me throughout my recovery, and our intimate life stayed strong. He often told me that all he wanted was for me to regain my health and that the worst thing he could imagine was that I would feel that I was somehow less appealing to him.

  As I looked forward to the reconstruction, I began to think more about how t
he change in my body would affect my work. My greatest concern was that it would shift the focus of my interaction with a client to me, when it should be on him. I believed that clients needed to know about the mastectomy because my right breast would look and feel different from my left, and I didn’t want them to be distracted by that. One day I brought up my fear in my support group. Dr. Renaldi, one of two psychotherapists who led the group, asked me how I thought I should address the issue with clients. Having the opportunity to talk out a plan was exactly what I needed at this time. I decided that I wouldn’t mention it in the earliest part of the work when I was interviewing the client about his history, issues, and goals. I would reveal it only when we moved to the bedroom, and I would discuss it matter-of-factly. No great announcements, just another item on the checklist of need-to-know information. If I didn’t want a client to overly focus on my mastectomy, I had to be sure I kept it in perspective too.

  I had another question that wouldn’t be answered so easily. I struggled with how I would talk about my breasts in the mirror exercise. Cancer would become part of the story of my body. Lymphoma may have been a more frightening diagnosis and a more grueling recovery, but my body had remained externally intact after it. Now, when I stood before a full-length mirror with a client following along, I would have to address the differences in my breasts. The new vocabulary I would need for this was nowhere in sight, but I had a feeling it would come in time, as I healed.

  The reconstructive surgery didn’t even keep me in the hospital overnight. To help me look more even, the surgeon lifted my left breast and moved the nipple slightly upward. A silicone implant went into my right side.

  It didn’t take long to realize that the surgery was a success. Under a bra and blouse my breasts looked even and unremarkable. When I undressed the difference between the two was evident, but not startling. What was more complicated was coming to terms with the loss of sensation. My new right breast had some faint sensitivity, but that was it. Once it healed I had to decide if I wanted, for aesthetic reasons, to have a nipple constructed from surrounding tissue. The appearance of my new breast sans nipple was fine with me, so I opted to pass on it.

  One of the many lessons I have learned from working with disabled people is the importance of focusing on what you can feel and experience, as opposed to dwelling on limitations. Doing away with preconceived notions about how and where you should feel pleasure and training your attention on where you do feel it can sometimes make you forget that you have nonreactive areas. I’d seen disabled clients awaken to sexual feelings and often be surprised and delighted by it. It was time for me to apply this bit of wisdom to myself. So, I no longer had two sensitive breasts. I still had one, and a partner who never shied away from reimagining our life in the bedroom. And that was plenty.

  Scott was the first client I saw after returning to work, five months after my diagnosis. He was coping with an overriding fear that his penis was too small, and he had gone to drastic measures to enlarge it. A doctor had given him injections, which, instead of growing his penis, slightly misshaped it. The last thing he needed was my body image issues spilling over into our work together.

  I held to my plan not to mention my mastectomy right away. From the outset, it had to be clear that he came first in our work together. When we undressed, I told him about my surgery, and invited him to feel my breasts. Scott cupped my right breast in his hand and lightly squeezed it. He did the same to the left. “The right one feels harder,” he said. “Yup, they still haven’t perfected reconstruction.” Then we set about tackling his issues and the topic of my mastectomy didn’t return.

  Once again, I had learned the value of simple, straightforward communication and of appreciating the full breadth of sexuality. When a client finally comes to see a surrogate he is ready to work on himself, and a slightly lopsided bust has yet to prove a problem in my work.

  In the third session with Scott, when it came time to do the mirror exercise, the new narrative of my breasts, which I had only begun to formulate, unveiled itself to me. As I looked at my reflection I said, simply, “I have had breast cancer, but was lucky that it was caught early. I had to have my right breast removed and reconstructed. Now it’s not nearly as sensitive as my left. Even so, I like it to get equal attention.”

  My practice continued to thrive, even though ordinary aging presented certain physical challenges. I was no longer as flexible or as nimble as I was when I first started as a surrogate. On the other hand, I had nearly four decades of experience to draw on and a level of expertise, sensitivity, and insight that I couldn’t have had as a younger woman. My reputation in the field was established, and I had a coterie of therapists in the Bay Area, and even other parts of the country, who referred clients to me. Between my standing in the community and the dearth of surrogates, the work continued to roll in. In the wake of AIDS, surrogates left the practice in droves. I sometimes wonder how my profession would look today if the disease hadn’t changed the course of it.

  I could look back on a rich and rewarding career, and I was still in demand. In all of my years in this profession, my age has only been an issue for one client who referred to me as “no spring chicken.” He and I actually wound up working well together after I explained to him that if he expected to be a hit with any woman, he should keep that kind of comment to himself—especially since he was hardly a young man himself.

  Sometimes clients call me after our work is completed to get a confidence boost, or with questions that arise for them. They also often send me cards or emails thanking me or reflecting on our time together. In 1990, Mark O’Brien published the essay “On Seeing a Sex Surrogate” in The Sun magazine. He detailed how our work together unfolded in a way that only someone with his talents as a journalist and poet could have. I was moved by it, and so was Ben Lewin, a Los Angeles–based screenwriter and filmmaker.

  In 2007, Ben visited me with an old friend of his who was also his chief financial backer. Like Mark, Ben had been afflicted with polio as a child and he walked with forearm crutches and a leg brace. I’m sure this was a primary reason Mark’s story resonated so deeply with him. Between other projects, Ben started working on a screenplay based on Mark’s article and our interview. He would send me drafts to review and check in occasionally, but long periods went by without any contact.

  With Ben’s busy schedule and the vagaries of the film world, it sometimes seemed that the project would languish. Then, in 2010, when I returned home from a trip to Boston to visit family, I found an oversized envelope in the stack of mail waiting for me on the dining room table. The screenplay was finished and it was tentatively titled The Surrogate.

  From there an incredible cascade of good fortune began. The film received more financing and Ben secured three talented actors to appear in it. John Hawkes had been cast as Mark. I was thrilled. I had admired him in Deadwood, Winter’s Bone, The Perfect Storm, and other movies, and I couldn’t wait to see the chameleon-like actor turn into my erstwhile client. The inestimable William H. Macy was set to play Mark’s priest and confidant. Several actresses were considered for the role of the surrogate.

  When I learned who would be the onscreen version of me I was in my car. “Helen Hunt is going to play you.” My heart sped up; I must have taken my foot off the gas because I soon realized my car was nearly at a stop. I was so stunned that I almost forgot I was driving. Pull over before you cause an accident, I thought and veered to the roadside. “Helen Hunt,” I stammered into the cell phone. “That’s right,” said Ben. Academy Award–winning Helen Hunt, a bona fide star and a beautiful and respected actor, was going to play me. Was this really happening?

  Ben also asked if I would serve as a consultant on the film, which would start shooting in May 2011. This would entail working with the two primary actors, and being on set for some of the filming. I made plans to fly to Los Angeles as soon as I got home.

  I’ve always loved movies. Growing up in the ’50s I went to our hometown theater a
lmost every Saturday. That was before you could log on to the Internet or buy a book about filmmaking, so the workings of the Hollywood dream factory were opaque and mysterious to the general public. Even as an adult, I lost myself in onscreen magic, having little sense of what it took to create it. Being on the set with the cast and crew of the movie changed that. The amount of time, work, and energy that goes into a film is staggering. One thing I learned immediately is how much curiosity and thought underlies a great acting performance. Both Helen and John asked a number of smart questions about me, my work, and Mark. They honed in on the tiniest details and immersed themselves in the story.

  Helen Hunt invited me to have lunch with her on one of the first days I was in Los Angeles. We met in Santa Monica, and as I sat at a table waiting, I saw her walk past the restaurant window, and, once again, felt like I was dreaming. Helen had so much genuine interest in me and my work that I quickly lost my anxiety about sitting across the table from an accomplished and celebrated actor. She taped much of our conversation and paid careful attention to the cadence and rhythm of my speech. The next day I went to her home and demonstrated Sensual Touch on her partner, who remained fully clothed.

  By the time John Hawkes and I met, he had seen Breathing Lessons , an Academy Award–winning short documentary about Mark O’Brien, close to twenty times. One of the first things John said to me was how impressed and inspired he was by the courage Mark had shown throughout his life. He wanted his performance to honor him. John was in the process of reading every piece of Mark’s writing he could get his hands on, and he had even learned how to type with a mouth stick, the way Mark had. I’ll never forget the first time I saw John on set playing Mark. It was overwhelming. It was as if he had dissolved into Mark. As I sat there with my headphones listening to John deliver his lines in Mark’s wheezy voice, I got chills.