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Miranda Sweeney's white paper gown rustled as she shifted her weight on the exam table and pulled the edges together to cover herself. "Just like that, it's over?"
Dr. Turabian closed the metal-covered chart with a decisive snap. "Well," he said, "if you want to call twenty-five rounds of radiation, nine months of chemo and two surgeries 'just like that.'" He took off his glasses and slid them into the pocket of his lab coat."I couldn't be happier with your tests. Everything's where we'd hoped and planned for it to be, right on schedule. Other than taking your immunotoxin every day, there's nothing more you have to do."
Miranda blinked, overwhelmed by the news. "I'm
I don't know what to say." Was there a rule of etiquette in this situation? Thank you, Doctor? I love you?
"You don't have to say anything. I think you'll find getting better is a lot easier than being sick." He grinned. "Go. Grow your hair. Come back in three months and tell me you feel like a million bucks."
He left her alone, the heavy door of the exam room closing with a sigh. Miranda went through the motions of getting dressed, all the while mulling over her conversation with the doctor.
Stick a fork in her, she's done.
After a year of this, Miranda didn't believe you could ever really be done with cancer. It could be done with you, though, as you lay on the medical examiner's table like a waxy victim in a crime show.
Snap out of it, she told herself. For once, the doctor's advice didn't make her skin crawlno precautions about nausea meds and gels and post-op limitations. Nothing like that. His advice was so simple it was scary. Get dressed and get on with your life.
She tore off the crinkly paper smock and wadded it up, crunching it into a small, tight ball between the palms of her hands and then making a rim shot to the wastebasket. Take that.
As she reached up to pull her bra off a hook, a familiar, unpleasant twinge shot up her right arm. The post-op sensations never seemed to end, although her doctor and surgeon assured her the tingling and numbness would eventually go away.
Which wasas of a few minutes agoover.
She told herself she ought to be laughing aloud, singing "I Will Survive" at the top of her lungs, dancing down the corridors of the clinic and kissing everyone she passed. Unfortunately, that was the last thing she felt like doing. Maybe the news hadn't quite sunk in, because at the moment, she simply felt hollow and exhausted, like a shipwreck victim who'd had to swim ashore. She was alive, but the fight for survival had taken everything from her. It had changed her from the inside out, and this new woman, this gritty survivor, didn't quite know what to make of herself.
She turned to face the mirror,studying a body that didn't feel like her own anymore. A year ago, she'd been a reasonably attractive thirty-eight-year-old, comfortable in her size-10 body andall right, she might as well admit itdownright vain about her long, auburn hair. During the months of treatment, however, she had learned to avoid mirrors. Despite the earnest reassurances of her friends, family, treatment team and support group, she never did learn to love what she saw there.
Some would say she'd lost her right breast and all her hair, but Miranda considered the term lost to be a misnomer. She knew exactly where her hair had goneall over the bed pillows, down the drain of the shower, in the teeth of her comb, all over the car and the sofa. Shedding hair had followed in her wake wherever she went. Her husband, Jacob, had actually woken up one day with strands of her wavy auburn hair in his mouth. Over the course of a few days, her scalp had started to tingle. Then it stung and all her hair had come out and it wasn't lost at all. It had simply become detached from her. She collected it in a Nordstrom's bag and put it in the trash.
As for the other thing she'd "lost"her breastwell, she knew darn well where that had gone, too. During the surgery, the tissue had been ever so carefully bagged and tagged and sent to the hospital pathology lab for analysis. Her diagnosis was made by someone she'd never met, someone she would never know. Someone who had typed her fate onto a neat form: infiltrating ductal carcinoma, stage one, tumor size 1.5 cm, nodes 15 negative.
She was considered lucky because she was a candidate for TRAM flap breast reconstruction, which took place immediately following her mastectomy. A separate surgical team came in and created a new breast, using tissue from her stomach. She'd struggled to be matter-of-fact about her reconstructed breast, figuring that if she didn't make a big deal of it, then it wouldn't be a big deal. Even though her counselor and support group encouraged her to acknowledge that an important, defining part of her was gone, that her body was permanently altered, she had resisted. She claimed she hadn't been that enamored of her breasts in the first place. They simply
were there. Size 34B. And after surgery, they still were, only the right one had been created with body fat from her stomach, something she didn't exactly mind losing. And the tattooed-on nipple was something of a novelty. How many women could boast about that?
Miranda knew she should be weeping with relief and gratitude just about now, but she still didn't like looking at herself in the mirror. The reconstructed breast seemed slightly offkilter, and although the skin tone and temperature were exactly the same as her other breast, she couldn't feel a thing there. Nothing,nada. And her belly button was pulled a bit to one side.
According to the members of her support group, she was supposed to look in the mirror and see a survivor. A phenomenal woman whose beauty shone from within. A woman who was glad to be alive.
Miranda leaned forward, looked carefully. Where was that woman?
Still in hiding, she thought. Her gorgeous self didn't want to come out to play.
After an agony of baldness, she was getting her hair back. Her brows and eyelashes. Unfortunately, the fledgling fuzz of hair on her head was just plain weird. She had a terrible feeling that it was coming in whitish gray. But it was her real actual hair, growing in strangely soft and baby fine, as though she had just hatched from an egg. Her skin was sallow, and new lines fanned outward from the corners of her eyes. The whites of her eyes were yellow. She still hid beneath hats, scarves and wigs. She didn't like looking like a cancer patient even though that was exactly what she was. Correction, she told herself. Cancer survivor, no longer a patient.
She turned away, grabbed her bra and finished dressing, pulling on her khaki twill pants and a front-button shirt. She disliked the twinges she felt whenever she pulled a shirt over her head. It was as though her body kept wanting to remind her that she'd been nipped, tucked and rearranged, and there wasn't a darn thing she could do about it. She slung her butter-yellow sweater around her shoulders and loosely tied it by the sleeves, knowing the morning chill would be gone by now. With a deliberate tug, she put on her hat. Today's accessory was a sun hat made of cotton duck, which she'd chosen for comfort rather than style.
She finished putting herself togetherhandbag, cell phone, keysand walked through the now-familiar putty-colored hallway of the clinic.There was soothing Native American–style artwork on the walls and soothing New Age music drifting from speakers in the ceiling. As usual, everyone here was busy, hurrying somewhere with a chart or heading into one of the exam rooms. And as usual, everyone she passed offered a distracted but sincere smile of encouragement.
The waiting room was a different story. There, patients seemed almost furtive as they studied magazines or checked the inboxes of their BlackBerries. It was almost as if they didn't want to make eye contact for fear of seeing something they shouldn'thope or despair or some combination of bothin the eyes of another patient.
Miranda realized none of the people in the waiting room could know she was leaving the place for good. She wouldn't be back for three whole months, and then only for a checkup. Still, she felt an odd flicker of survivor guilt as she passed through the room, past the burbling tabletop fountain, the aspidistra plant that had doubled in size since she'd been coming here, the magazine rack, for the last time.
She stepped out into the dazzling sunshine of an Indian summer afternoon. For a moment it was so bright Miranda felt disoriented, as if she had lost her bearings. Then she blinked, dug out her sunglasses and put them on. The world came into view. Seattle in September was a place of matchless beauty, a time of warm, golden days, incredibly clear skies and crisp nights that held the snap of autumn in the air. Today had been graced with the kind of weather that made normally industrious people sit out on the patios of urban cafés, sipping granitas and tilting their faces up to the sun.
From the hospital on First Hillalso known as Pill Hill, thanks to the abundance of hospitals and medical centers in the areashe could look toward the waterfront and see the bustle of downtown, with its disorganized tangle of freeways and the distinctive spike of the Space Needle rising above Elliott Bay. Farther in the distance lay Seattle's signature defining view deep blue Puget Sound lined by evergreen-clad islands and inlets, the horizon edged by mountains that appeared to be topped with blue-white whipped cream. It didn't matter whether you'd been born hereas Miranda hador if you were a newcomer, Puget Sound dazzled the eye every time you looked at it.
A car horn blasted, causing her to jump back onto the curb. Whoops. She'd been so busy admiring the scenery that she hadn't been paying attention to the signals. She dutifully waited for the little green pedestrian man to tell her when it was safe to move forward. It would be incredibly ironic to survive cancer, only to get squashed by a bakery truck.
She hiked half a block to the bus stop and checked the schedule. The ride that would take her home to Queen Anne, the area where she lived, wouldn't be here for another thirty minutes.
She sat down on a bench and dialed Jacob on her cell phone.
"Hey, gorgeous," her husband said by way of greeting.
"I bet you say that to all the girls."
"Only when I hear your special ring, babe."
"You're using your driving voice," she remarked. "What's that?"
She smiled a little."Your driving voice. I can always tell when you're on the road."
He laughed. "What's up?"
"I just came from Dr. Turabian's."
"Are you all right?" This, of course, was his knee-jerk reaction these days. Jacob found the whole cancer business terrifying, and to be fair, most guys his age didn't expect to find themselves helping a young wife through a life-threatening disease. Jacob even seemed afraid of her, scarcely daring to touch her, as if he feared she might break. At first, he had accompanied Miranda to all her appointmentsthe tests and treatments, the follow-up visits. He was wonderful, trying to mask his near panic, yet Miranda found his efforts so painful to watch that it actually added to her stress. In time, she found it simpler to go on her own or with one of her girlfriends. At first Jacob had fought herI'm coming with you, and you can't stop mebut eventually, he accepted her wishes with a sort of shamefaced relief.
"It was my last visit," she reminded him. "And it went just as we'd hoped. All the counts and markers checked out the way Dr. Turabian wanted them to." She took a deep breath. The air was so sharp and clean, it hurt her lungs. "I'm done."
"What do you mean, done?"
"Like, done done." She laughed briefly, and her own laughter sounded strange, like the rusty hinge to a door that rarely opened."He doesn't want to see me again for three months. And it's unexpectedly weird. I don't know what to do with myself. It's as if I've forgotten what I used to do before I had cancer."
"Well." Jacob sounded as though he was at a loss, too. Afraid to say the wrong thing. "How do you feel?"
She knew what he was really asking: "When can you start back to work?" Her sabbatical from her job had definitely taken a toll on the family finances. Though she felt a pinch of annoyance, she didn't blame him. Throughout this whole ordeal, he had kept the family afloat, juggling work and extra household responsibilities so she could focus on getting on with her treatment, which touched off an exhaustion so crippling she couldn't work. His job, in beverage sales to large grocery chains, kept him constantly on the road. He earned a commission only, no base salary, so every sale mattered. And Lord knew, the bank account needed all the help it could get. They had budgeted for their house on the assumption that they'd be a two-income family.
"I feel all right, I think." Actually she felt as if she had run a marathon and crossed the finish line with no one around to see her do it. The world looked the same. Traffic still flowed up and down the hills, boats and barges still steamed back and forth across the Sound, and pedestrians still strolled past, oblivious to the fact that she'd just completed cancer treatment and had lived to tell the tale.
"Good," said Jacob. "I'm glad."
She watched a pigeon stroll along the sidewalk, poking its beak at crumbs."Me,too.I'd better let you go.See you tonight?"
"I'll try not to be too late. Love you, babe."