While most people in my life have shown unquestioning support of my choice to undergo a preventative mastectomy, some have added, "But I don't know if I could've done that if I were you." Few have displayed outward disapproval and judgment. If there is anyone reading this who sees such a decision as radical and unnecessary, I say this to you -- gently, without anger:
You did not lose a parent to cancer before knowing her. You didn't wish for the chance to have known her and comforted her during a time of boundless agony. And you did not have that wish come true, with a spin you foolishly least expected when your sister, at the age of 30, was diagnosed with breast cancer.
Or maybe you don't know that when the pink ribbon is pulled off to the side, when all the heartfelt f*ck cancer hugs have been given, what is left is a woman sitting at her bedside. One by one, she takes six ugly pills that are made out of things she doesn't know about. But she takes them because her doctor prescribed them to her and they kinda just come along with the package that says: "This is scary and inconvenient but people survive this every day. You are one of many, you will survive, and at the end you'll pin a breast cancer ribbon on your handbag."
What you certainly do not understand is that underneath the familiar, commercial top coat of cancer struggle that subsides in margaritas with girlfriends, there is another layer. Only it is not a layer. It is exactly everything you're made up of, and it silently reminds you that this is the same death that marked its X through each portion of your heart so long ago. It is terror that does not speak in cafes, or at the gym or a birthday party, but rather lives in the black-hooded breath. It is blood that pumps with its fists closed tight. It is terror your friends and family do not get to touch or soothe because you pretend it's not there, and that is how you get dressed every day.
Perhaps you have never considered that when the novelty of becoming stunningly bald, of being a representation of the fight and a representative of courage wears away, that my sister was just a girl waking up in the starkness of morning without hair next to a husband who would soon divorce her. You never considered that when you have a mastectomy after a cancer diagnosis, not only do you lose your breast tissue and breast sensation, but it's also recommend that your nipples be removed too. And you go ahead and have a couple other smaller surgeries in order to construct new ones.
Lastly, you don't know what 25 sessions of chemotherapy and 29 treatments of radiation looks like. It is not just four-day spells of unrelenting nausea and hot red, blistering skin. It is there's more cancer in your lymph nodes after your margins were clear. It's please dear god let this be it. And then god doesn't answer back, but a doctor says to you on a Tuesday that you are not able to have children. It is a change that combs through every part of yourself, and it lasts in you forever.
And then, I took a blood test. And they said there is an almost 90 percent chance that this could be me.
When I was 22, I lived with my aunt Reggie and her 16-year-old daughter while my aunt was undergoing treatment for cancer that had spread throughout her body, throughout her blood. It was cancer that started in her breasts. Within a year, she passed away after what could be seen as a lifetime of treatments and unjustifiable pain. My aunt Mary-Anne has survived two breast cancer occurrences as well as ovarian cancer. These are both my mother's sisters. My mother passed away from breast cancer when she was 36. My aunt Mary-Anne is the only sister with cancer who had the chance to take the BRCA gene test, and she tested positive. My mom's third sister, Aunt Laurie, who has never had cancer, tested negative.
BRCA1 and BRCA2 are genes that ensure stable and controlled cell growth. Testing positive refers to a mutation of these genes that is linked especially to breast and ovarian cancer. Of me and my two sisters, only my oldest sister Amanda tested negative.
Recently, I found a diary I kept in sixth grade. One page read only this: "I'm not sure what cancer is but I think I know what it feels like." Just as in too many other families, the big "C word" in ours is laden with past and heavily adorned with heartache and rage.
Finding out I was BRCA1 positive after my sister's cancer diagnosis stirred a seemingly bottomless pot of unprocessed feelings. When I was encouraged to undergo a mastectomy with reconstructive surgery, I cried. And even though I told myself I had options, the part of me -- the part like my sister's with its X's marked -- that part already knew I didn't.
For three months, I pretended there was something to consider. I pretended that losing part of my natural femininity was not a smaller matter than the probability of developing a tumor. I wondered if I was doing my potential future children a disservice by rendering myself unequipped to breastfeed. And I told myself that any negative judgments made by potential future boyfriends were actually important.
When I was 19, most of my spine was fused with two titanium rods pinned to each side as a corrective result of severe spinal curvature I developed at 11. In spite of a successful surgery, I still identified myself as disfigured, unnatural, not normal. It seemed that having my breast tissue removed would only extend the long-going discomfort I had with my body. I Googled before and after pictures of women who had reconstructive surgery, while imagined bedroom scenarios of displeased men played in my mind. For so long, I wished to be in a regular body that hadn't needed to be tampered with and longed to feel at ease in my skin. It felt like another scar would only lead me further away from that.
In time, I accepted the reality of this hereditary mutation and scheduled my surgery with the same doctors who performed my sister's. The months after I returned from the hospital were still somewhat difficult; my chest was nearly as bizarre as I had imagined it would be. But a year later, my implants have settled and softened into my body and become a part of who I am. They are a new representation of my femininity, expressive of a woman's decision to care for herself. More and more, I appreciate my breasts for their phoniness, for their silicone mindlessness.
Because it means that they are too dumb to hurt me. They are my uncomplicated, pretty friends who look great in clothes and tell me life is short anyway and the only important thing is to have a good time. I've always wanted to feel that way. And as far as men are concerned, it is so simple. All I have to do is love my new body, and in turn, the right man will do the same.
Now, this is not just something I have accepted. I recognize it as an advantage that makes me incredibly lucky. It gave me an opportunity to grieve a past and also to defy the fate of repeating it. Although the work is not done -- an oophorectomy lies in the road ahead as a precautionary measure for ovarian cancer, which statistically develops later in life -- today, I am granted the immeasurable benefit of peace, of doing everything I can to live a healthy life.
As of last month my sister, Krista, has completed her treatments, and five scans in a row have come back clear. This blog will not possibly tell you how proud I am of her, or how much I look forward to having sleepovers until we're 100 years old. Or how grateful I am to be part of a family that reminds me how miraculous of a gift this really is, of this very delicate, beautiful life. There is a sweeping lightness in our family that I have not felt before. We have triumphed. For now, we have overcome. And that is all anyone ever really has the privilege of.
Each story and each woman who faces the possibility of a preventative mastectomy is wholly different. There are unique details to regard for every individual. Don't be afraid to process what comes along with this altogether complex and not to mention expensive and annoying circumstance of being given a choice between your breasts and your overall well-being and peace of mind. Sometimes, I felt like I was placed in a fear-mongering trap of the medical industry, but the evidence in my family's history is strong enough to know that the dangers are real. Ironically, surgery seemed the best way to remove myself from the questionable world of cancer treatment while still being proactive.
If this is a decision you are making, the only advice I could ever give is to trust yourself. Listen to yourself. You'll know what choice is best for you; discover it in your own time. I can't imagine that my mine will ever be one I regret.