The House

In May, I was still in Seattle. My real estate agent had set me up to receive listings as they became available that met my criteria. I would get several pings a day. I opened them up, one by one, and looked at the pictures. The vast majority of what was available in my price range and location was older, l980’s, run down, neglected, foreclosures or bank owned sad little houses that had not been maintained. I knew from my mother’s experience of house hunting in April, that one had to be ready to make a decision quickly if something came a long that was acceptable. Canadians and Brazilians, with cash in hand, were snapping up bargains in Florida within days of listing.

Early June, I opened up a listing for a property that looked promising. It was built in the 1990’s, small, 3 bedroom, 2 bath, 1500 square feet. I did not want anything bigger. I looked at it from Google maps and took a virtual walk down the street. I looked at the other houses around it. It was not a short sale, and it looked like it had been well taken care of. The kitchen and bathrooms were a little dated, but otherwise in good condition. At least the place had not been trashed, like some of the others I’d seen. It really was not much different from what I had just sold the year before in Washington, only this was a house and not a townhome.

I called the agent and he confirmed that it was in a good, safe area. “Let’s pull the trigger,” I said. I had him make the offer at full asking to give me more leverage against cash buyers. The price was not out of range. Then the waiting game began. That was on June 12. I already knew I had cancer then, but nothing was going to stop me. I had to get out of Washington and this was the opportunity to do it.

It took a while but finally they accepted my offer, contingent on my getting a loan and I mailed in my earnest money. I was already pre-approved by the bank; so I did not anticipate any problems. I arrived just in time to be present at the inspection, July 3, the day after I stepped off the plane. It was the first time I had seen the home I was purchasing in person.

It is a drab, plain little house, in a drab, plain little development. The neighborhood seems nice, all the yards are well kept. All the houses are close together, cheek by jowl, but the back yard is fenced and there is a green space behind the house with a stream running by, the perfect place for alligators to hunt small dogs. The streets all have names that were invented by developers, like “Fox Ridge”, “Eagle Drive” and “Weeping Willow Circle”.  The whole place lacks originality, character, and charm. I will be right in my comfort zone with the Jazzercise club nearby, the Starbucks, and Panera Bread.

This inspector was very thorough and gave the house high marks for having been well maintained. He only found some minor items like tears in the screens and cracks that needed caulked. The roof is only 2 years old and so is the HVAC which was a relief to me. It is also all on one floor, so my mom will be able to come and stay with me and not have to negotiate stairs.

The next step was to get the ball rolling the bank. We had a closing date of July 26^th, but my loan officer was on vacation until the 9^th. We had to ask for an extension until August 10^th. We spent a quiet 4^th of July watching the fireworks from Tim’s roof.

August 10^th did not seem like an impossible goal to meet, and then the battle with the bank began. Every since the economic debacle of a few years ago when anybody with a pulse could get a loan, the banks have gone 180° the other direction.

Some of the things they are asking for are:

Acceptable Hazard insurance policy and any applicable riders and addendums

Valuation of the subject property condition and value must be sufficient

A completed and signed Form 4506-T for all applicants

Satisfactory Pest Inspection Report

Verification of applicant’s identity to comply with the USA Patriot Act

Uniform Residential Loan Application

Borrower’s Certification & Authorization

Social Security Administration Authorization for the release of SSN verification

Notice to Applicant Regarding Title Company and Closing Agent

Florida Anti-Coercion Disclosure

Insurance Product Sales Discloure

Cancelled checks verifying satisfactory housing payments over the last 12 months.

A detailed letter of explanation for any credit report inquiries in the last 120 days

Explanation for unemployment in 2011

Income tax form 1040 for the years, 2010 & 2011

YTD employer paystub for the last 4 weeks.

Letter from employer that you are able to keep your current position and relocate to Florida

Seller’s relocation agreement

Explanation of deposits to bank account

All contract addendums, Lead Paint Disclosure, Radon and termite exposure

Explanation for moves for the last 20 years

Explanation for gaps in employment in 2010.

Complete Bank statements for the last two months.

W-2 form from 2010

Landlord information.

I jumped through all their hoops. I provided them with everything they asked for even though it meant making numerous phone calls to corporate headquarters of companies which no longer exist. Even though it cost me dearly to obtain those documents and paid to have them faxed to the loan processing center, I complied with every ridiculous thing they asked. (My originals are in a shoe box in storage in Renton, WA.) It was extremely stressful.

It was all in the hopes of closing on August 10. If we closed on the 10^th, I could order my furniture to be shipped and it would arrive on the 24^th. I would schedule my surgery for the following day having done all of my research and interviews ahead of time, 3 months after my diagnosis. Then when I left the hospital, I would have a home with furniture and a bed in which to recuperate.

Then the bank wanted a pest inspection. A certified pest inspector went to the house and came back with good news and bad news. There were no live termites, but there was evidence of mold.

Now the bank wanted a mold inspection. The mold inspector reported that there was some water damage behind the dishwasher, under the sink in the master bath, and under the dining room window. It would cost $2000.00 to repair and the bank would not give me the loan until after the repairs were done.

Now, keep in mind, I do not own this home. I cannot order a contractor to enter and start replacing cabinets and dry wall. The sellers have to make the repairs, but are they willing to pay for it?  We have now missed the closing date and the whole deal may collapse. My cancer clock is ticking; I’m starting to freak out. Am I going to have to have surgery in Daytona and recover at my brother’s house? This is not what I want. But I may have no choice. I don’t want to be stupid a risk losing my lymph nodes, too.

I have my agent negotiate a deal with the sellers that I will pay them half the cost of the repairs at closing. It seems like it takes forever but finally they agree. Now we have another extension, until August 24^th. The only other hurdle we have to overcome is the bank’s final inspection of the repairs of the mold. The contractor is supposed to start on Monday and should have it done in two days.

But time has run out for me. I cannot wait for the furniture. I must take action. It causes me to have another terrible panic attack. But I make an appointment with an Oncologist at Florida Hospital Cancer Institute near Daytona. It was the first smart move I have made.

My Friends

Sometime around the third week of June the word of my diagnosis got out. And then the emails and the phone calls started coming. The email I received from my friend K was very sweet. She showed she was concerned but was not intrusive.

Then there was the phone call from R. She called during work hours and why I picked up, I will never know. She started out the conversation, “So is it true?” Yes, what did she think, it was, a joke? Then she said something to me I will never forget. “I don’t know what you’re so upset about, Amy. It’s only a boob.”

I couldn’t believe the utter and complete insensitivity of that statement. And coming from another woman! I lit into her.

“It is so much more than that! It is part of my identity; it is part of who I am. It is a source of sexual gratification for me. It is not just a useless body part, an appendage for decoration. I have had my breasts since I was ten years old. This is a big deal for me, it is huge!”

“Well, my mother had both of hers cut off and she didn’t seem to care.” “Really? How do you know? Did you ever ask her? Maybe she just never said.”

R told me she never really cared much about her own breasts. Losing one or two wouldn’t mean that much to her. I suppose some women do feel that way. But this was about ME! My breasts mean a great deal to me. Losing one is a huge deal! It is a life altering experience. I am devastated.

“Well, it’s nice to know you’re angry.” I just could not get over such callused indifference and insensitivity from one woman to another. I was furious.

Then there was F. I have already mentioned F as my angel. She was the first person I called and she was always ready to share with me her experience, and give me good advice. And she was always ready to listen to me wail. She was concerned when she called and she came to my rescue when I needed help getting out of my apartment.  She was sensitive to my feelings and did not share my diagnosis with anyone. Not that it was a secret, but she respected my right to privacy. She is a true friend.

But I think the unkindest cut of all came from someone who I have corresponded with for nearly a year now. I have shared with him my deepest most intimate thoughts and feelings, and he has shared with me. Our relationship has grown and broadened over time. I tried not to admit it, but I think I was falling in love with him, at least with the idea of him. To me he was hope for the future. In my mind he was everything I dreamed of smart, funny, handsome, well read, educated, and successful. He might have been a little stodgy and not as adventuresome as me; but most importantly he represented the possibility of a true partnership. Maybe it was all a fantasy, but it kept me going. He gave me something to look forward to everyday. Maybe we could meet again in Florida and make each other happy. At least that was my dream.

When I told him about my diagnosis, he wrote me an email. An email. He said how sorry he was. What kind of heartless, empty shell of a man writes a woman an email when hearing this kind of news? How impersonal! Why not pick up the phone, let her hear the sympathy in your voice? Tell her personally how you feel about her and her body. It would mean so much more. Send flowers, or a handwritten card. Or just call her. Emails are so cold.

I couldn’t get over it. I ended our correspondence and our relationship. It was never going to develop beyond that anyway. I miss him terribly, but it is for the best. If you really care for someone you have to be willing to take the risk and show it. Otherwise, it is all lip service.

The Descent

Sunday, June 24^th I experienced my first Anxiety Attack. I never knew these things were real. I always thought it was just an expression, a phrase used to describe some celebrity diva throwing a tantrum. But they are real as I found out. Very real.

I awoke at 4 in the morning. I had not been sleeping well since I learned that I might have cancer. I lay in bed at night, wide awake in the dark, thinking, “what if”, unable to sleep because the sound of blood pulsing in my ears was so loud. Once I do fall asleep, I invariably wake up at 4 AM, regardless of what time zone I am in.

The first time it happened, it started with a sob and short, shallow breathing, making me light headed from hyperventilation. My chest was heaving, my heart was pounding and I could not stop crying. I got up out of bed. My muscles were all contracted, my arms were frozen in a bent position, my hands like claws. My shoulders were shrugged up by my ears. My neck was tight and I was hunched over. My whole body was convulsed with shaking. Barely able to shuffle my way down the hall to where A was sleeping on the couch, I stood next to him and was barely able to speak above a whisper. Once he woke up he could immediately tell I was in distress. All I could say was, “I’m so scared, I’m so scared.” I was in a complete state of terror.  

He sat me down and tried to calm me down by talking to me. I could not stop my chest from heaving and the crying. He tired to give me alcohol, but I could not swallow. I don’t know how long it went on, but it was completely terrifying.

I finally convinced him to come to bed with me, to lie down next to me and hold me firmly. That worked. I was finally able to stop the shaking, and the trembling.

The next morning we went about our normal Sunday business and did some shopping. But I felt odd, disconnected, not well. I called Dr. Crossland, the oncologist I had just seen 4 days earlier. I hoped she would be on call. I got her partner, who I had never met. I tried to explain how I felt and that I needed help, trying to control the emotion in my voice, and failing. He was sympathetic but said, “I’m sorry I can’t help you. I can’t prescribe anything for your anxiety over the phone. You have to go to the ER.” That afternoon I told A I was not feeling well and he said, “You are going to the ER.” I needed help and did not resist.

Once we arrived I told the registrar why I was there. They were not very busy. She took some information and got me into a room. I laid on the bed with a thin blanket over me. The first person to come in to evaluate me was the social worker. An older lady she seemed sympathetic, professional and competent. It was her job to document my story. She stood before a rolling computer stand with a screen on top and a keyboard on the shelf. She never took her eyes off the screen and entered everything I said; only occasionally asking a question.

I started at the beginning and I told her everything, about my mom, my move to Florida, my breakup with my partner, my pending house purchase, my leaving Washington, and my diagnosis of breast cancer. As I recounted the list, I became more and more agitated until I was in a full blown panic attack. These things come over you like a tsunami and they are completely uncontrollable. Shaking, trembling, sobbing, crying, wailing, and unable to take a deep breath, I pulled the thin sheet over my head and hid from everyone. I would not come out from under the blanket, I did not want to be seen and I was too scared. I felt safer that way.

The ER doc came in to ask me questions and I spoke to him through the blanket, only occasionally peaking out at him with one eye. “I’m sorry I can’t help you,”, he said, “You have to agree to be admitted.” He wanted me to be admitted to the psych ward for 5 days. “THAT IS INSANE!” I wailed, “I am moving to Florida in 8 days! I can’t afford to miss any work!”

“Well, I’m not going to write you a prescription for Ativan and send you on your way. You have to be seen by the psychiatrist.”  He had me. I had no choice. There was no way I would be able to walk out of there. I reluctantly signed myself in.

They checked me in and went through all my things. They took away anything with a string on it so I could not hang myself. They took away my cell phone. They put in a cold, sparse room, with very little furniture only a hard bed with a thin blanket. Then they turned out the lights and left me alone in the cold and the dark.

As usual, I woke up at 4 AM and found myself in a strange, cold, dark, scary place all alone. I was too scared to stay in there alone. I wrapped myself up in the thin blanket and padded down the hall toward the light and voices.

The talking stopped when I arrived.  All eyes looked at me. “What are you doing up?”. “I can’t sleep”. “Well, we can’t give you any Ambien after midnight. You have to see the psychiatrist”. They gave me an Ativan, an anti-anxiety medication and I went back to my room where I laid awake staring at the walls until morning.

Learning to navigate the hospital’s rules and systems proved to be a challenge. I had to call my work from a phone in the hall. Then I had to figure out how to order food. The other patients seemed to have the knack, but they ignored me. I was not there to make friends.

I spent the first day forced to attend classes where we would talk about our “feelings” and how to take care of ourselves. Yes, I know I have to eat, yes, I know I have to sleep, I know I have to take a shower. There was no place to exercise. I paced the halls. No sign of the psychiatrist. Everyone else wanted to see him, too.

The second day was much like the first. They started giving me Ativan on a regular basis, and I lurched from side to side as I walked down the halls. Finally, the psychiatrist came to see me. I tried really, really hard to act sane. I told him I could not stay in the hospital, that it was a waste of my time and that I was leaving town. He disagreed with me. He wanted me to stay another 3 days.

He signed me out because I was there voluntarily but he wrote that it was, “against doctor’s orders.” Dr. Mathieson, is a tall, gangly, bearded older gentleman; he seemed kind, but strict. “I am only going to give you a prescription for 2 weeks worth of medication, and that’s it!” You have to visit your family physician before you leave and you have to find a psychiatrist once you are in Florida. Ok, fine.

They unlocked the door and let me out.

I went back to work the following day and later saw the family doctor who has been treating me for years. I told her the whole story. The anti-anxiety medication was working but now the depression set in. I cried and cried as I spoke. She wrote me a prescription for Bupropion, an anti-depressant. Four weeks later I would be reading on line that Bupropion interferes with the effectiveness of Tamoxifen, the cancer drug I was taking. None of the doctors, or pharmacists caught it, but I did.

Thursday, at the end of my shift, I disconnected all the company equipment I had at home, the computer, the phone, the headsets, the wires, modem, router, etc. I packed it all up to take to the office the next day. My supervisor was going to ship it to my brother’s house in Daytona where I was going to live and work temporarily until my escrow closed in 30 days. Friday, the 29^th I worked from the office. It was my last day working in the state of Washington.

That weekend was devoted to moving all of my furniture and household items  into storage. I ordered two big containers to be delivered to the apartment and they left them in the parking lot in front. A hired two laborers to help move the big stuff. It was unbelievable how they packed everything into those two containers. But there was one big problem, the kitchen. The two days I spent in on the psych ward in the hospital and all of my emotional problems had really set me back. I did not have the kitchen packed.

Then an angel appeared. My dear friend F who had advised me from the beginning on her experiences with breast cancer arrived on the scene. If she had sprouted wings and a halo, she could not have looked more like an angel to me. I was emotionally distraught, a mental wreck, drugged and confused. I was upset, crying, could not focus and could not make a decision. F came in, started assembling boxes, grabbed some wrapping paper and packed my whole kitchen! She worked all day. I could not have done it without her. I will be forever grateful.

Sunday, A and I packed the few remaining things in the storage containers, I packed my clothes to take on the flight and it was done. The following morning, Monday the 2^nd of July, I boarded a plane for Orlando, with my little dog in his crate, never to return again. I cried quietly the whole way hoping the young couple sitting next to me would not notice. But I am sure the flight attendant did.

No One Ever Said

No one ever said to me, "Don't worry, Amy. We'll take good care of you."

There was no one at home to wrap his big, strong arms around me, pull me into his chest and say, "You don't have to bear this alone. You can lean on me."

The Doctors In Bellevue

The Doctors in Bellevue

When I heard Dr. Te say I had breast cancer, I wasn’t really all that surprised. I knew something was going on after all the mammograms and the painful and humiliating drilling called a “biopsy” they did in my right breast which left it scarred. I also have a family history. My maternal grandmother died of it and my maternal aunt. But neither my mom, nor any of her other 5 sisters had it.

I also knew it had to be very small and very early. I had no symptoms, no lumps, no pain, nothing looked abnormal. Both of my breasts looked normal, beautiful and like each other. No difference.

“And you have to see a surgeon right away.”, she said. “Cant this wait? I’m leaving the state for good in 4 weeks. I’m getting on a plane and moving to Florida in 4 weeks.” “NO, YOU HAVE TO DO THIS NOW! IT CANNOT WAIT!” her voiced sounded so alarming.

So, I stepped on the conveyor belt and entered “the system”, the disassembly plant, the meat processing plant. I became cancerous breast number 99,999, a statistic, and a faceless, nameless, insignificant middle aged white woman like so many before me.

The first surgeon I saw was Dr. Kristi Harrington at Overlake Medical Clinics Breast Surgery. That is where they send you next. But before I saw the doctor, I quickly made a call to my dear friend, F. I knew she had breast cancer 7 years ago, and was treated for it. She was the closest person I knew who had it, I trust her. She was the first person I called.

F. explained that her breast cancer was in one place and was DCIS, not invasive. She opted for lumpectomy and as a result had a small indentation and a small scar. She also had a small scar under her arm where they had taken a sample lymph node, known as a “sentinel node”.

This was all new to me. F also steered me to a reliable website where I could read more. It was breastcancer.org. I was completely clueless. Its not that I never believed it could happen to me. It’s just that the thought of having it was so horrific to me I never thought about it. I couldn’t.

The site was very helpful and answered many questions. It seemed conservative and reasonable. I learned how common this is. 100,000 women a year are diagnosed before the age of 59. I in 8! I never felt more like a statistic, more insignificant.

 I made up my mind that I would have what F had, a lumpectomy. They would go in, use a melon baller, scoop out the cancer, I would have a small scar and go on my way. Radiology may or may not be needed to follow up but that was not a given. It is controversial, but it did not seem so bad. I knew what I had was small and it was early.

I saw Dr. Harrington on June 11. She is an older woman, slight of build, and probably one of the best in her business, since breast surgery is her specialty. She is a dispassionate, matter of fact, no nonsense, dry factual kind of person. She rarely looked me in the eye and concentrated on my reports. I really liked her no nonsense style, emotionless. I wanted the facts. I did not want anything held back. Dr. Harrington treated me like cancerous breast 99,999, faceless, nameless, which just happened to have a middle aged white woman attached to it. Like so many she had seen before. Nothing special. No different. A cipher. A blip.

She very patiently took her time to show me my images. She took out the teaching materials, the flip charts, worn out from so much use and explained what I had. She showed me the cross sections of the cancerous cells  and the artist’s drawings of the invasive ones (kinda squiggly). She drew diagrams. She seemed tolerant but bored.

I followed along. I am not stupid. It seemed very understandable the way she explained it in layman’s terms. I had come alone. I really did not think I needed anyone with me. I am a competent adult.

Then she showed me my images. There is cancer, it looks like grains of sand scattered all along the milk duct, in two places. They are very small, like grains of sand. It took a trained radiologist to read these images.

Then she took an electronic pen and drew a line on the images showing me the tissue she would have to take out. She drew a big circle around one spot and then continued the line to encircle the other. There, that is what we would be removing. I looked at the image of my beautiful little breast, all flattened out and the lower ¾ of it would be missing. They have to take healthy tissue, along with the cancerous tissue to obtain a “clean margin”.

Suddenly my throat went very dry and the air in the room became heavy and hard to breath. The blood in my ears began to pound and it became hard to hear. “That is most of my breast,” I said, “there would be almost nothing left. My breasts are small.” “Yes,” she said matter of factly, “and your nipple would be pointing at your toes”. My heart began to pound. I could feel the muscles in my neck stiffen. “What is left would have to be irradiated to prevent reoccurrence and no plastic surgeon would touch it to reconstruct it.”

That did not sound like a good option to me, destroying my breast. What was left would not even fill a bra cup. What else could I do? She is not suggesting removing my breast is she? I asked her what she would do. She said if she wanted reconstruction, the most successful approach would be a complete mastectomy. Now I really couldn’t breath. I felt light headed and faint. I could not speak but only nodded. My worst fear, my worst nightmare had just come true.

I looked at her and I said,” if you had told me that this thing was so far advanced there was nothing you could do, that it was going to kill me, I would be grateful. I would be glad.” She looked at me for the first time in shock, leaned back and said. “In all my years of practice, I have never heard anyone say that!” I guess I was just the first one to admit it out loud.

Then she said something you almost never hear a doctor say. She said that with the stage I am at, by lopping off my breast entirely, no radiation required, it would be virtually 100% curable. What a choice! And I don’t even look or feel sick.

Dr. Harrington was done with me now and hustled off to speak to cancerous breast number 100,000. Before she left she arranged for me to have an MRI the following day. I made the appointment with her surly staff. Finally she said admonished not wait. Most women have their breasts lopped off right away. “I can do you next Monday.” She said. That would be 2 weeks before I boarded the plane for Orlando.

I left the office alone, armed with notes. Nobody was in the waiting room for me. Nobody drove me home. Nobody was home when I got there.

The next day I reported to the MRI station on the disassembly line, like a dutiful lamb. I went alone. I did not think I would need anyone with me. The waiting room was full and the staff were busy. The lady who signed me in told me she was a breast cancer “survivor”, too. I told her I was a breast cancer victim. She thought I had a bad attitude.

I was told by a young technician to undress and put on a gown. She was petite and perky and completely lacking in sincerity. She did not look me in the eye, or smile. I was just another cancerous breast with a middle aged, white woman who happened to be attached to it to be processed. Ho-hum, I wonder when is lunch? And she called me Amy.

I was made to lay face down on a hard slab with two holes in it for my breasts to fall through. The plates pressed in on either of of each breast making them flat. I was humiliated, scared, uncomfortable, sad, and mad all at the same time. It was like a nightmare, or torture. Then I was rolled into a huge machine which made loud noises over my head, like explosions. It went on for 20 minutes. The perky little technician came on the speaker, “Are you OK, Amy?”, completely without sincerity. Of course, I’m not ok . I’m hanging upside down with my breasts hanging out while you are shooting guns over my head. I’m scared and humiliated. What do you think? Should I be Ok with this?

She did not smile when I left. She thought I had a bad attitude. Cancer victims are supposed to be brave. Besides, it was time for lunch.

Dr. Harrington called me the next day with the results. The left breast was free and clear. No signs of anything. The right breast, in addition to the two known spots was found to have a third spot at 8 o’clock which looked suspicious. (There we go again making my body part into an inanimate object, a clock).

I did further research to find out about reconstruction after mastectomy. This was truly my worst nightmare come true. I always pitied women who had mastectomies. It seemed like a cruel, drastic, barbaric thing to do to a women. The thought was unbearable. And now it was happening to me.

I learned that reconstruction could be done at the same time as the breast removal. But it was not recommended. Higher risk of complications and infection. I looked at before and after pictures of women who had reconstruction. None of them looked symmetrical, or natural, And they all had massively huge scars going horizontally across their breast. Then I learned the worst. A reconstructed breast is a lifeless object attached to a woman’s chest. All of the nerves are severed in the process of removal and the fake will NEVER have any sensation! That is the most horrific thought of all.

The next day I went to see Dr. Minami, a soft spoken gentleman, a general surgeon. He reviewed my reports and confirmed everything I had heard from Dr. Harrington. There was no choice. I had no choice. I asked him about reconstruction and he confirmed that too, with one addition.  The remaining breast will grow old and age naturally, the reconstructed one never will. They will look more asymmetrical as the years go by. Wow, more good news!

When I called Dr. Harrington and asked her about doing a double mastectomy,she practically yelled at me, “         YOU JUST TOLD ME YOU WERE CONCERNED ABOUT LOSING SENSATION! WHY WOULD YOU WANT TO DO THAT?” “I don’t know, “I said meekly, “for prophylactic reasons.” “Your left breast is completely free and clear. There is no more chance of it developing cancer than any other breast in the world.” Well, she had a point.  

Before I left Dr. Minami, I had one other question. What about the “do nothing” option? What if we leave it alone, let it run it’s natural course and let me die a natural death. He stroked his chin thoughtfully and said, “Well, maybe if you were 80 years old you could consider that.” (There we go with statistics again, forget about the individual).

How long would it take to kill me? We don’t know. We don’t know how fast it is growing. It could take 5 years, 10 years, 15 years, 20 years. Most likely I would die of something else. The only thing we know for sure is that one day I will die, by whatever means. We all will. Now I had another choice to consider. I left his office by myself, his grumpy staff did not look up or say goodbye.

Dr. Harrington said she could “do me” on Monday, the 18^th, 2 weeks before I was due to board an airline, to leave my home of 20 years, go to a place where I did not know a soul, never to return again. Somehow I could not picture myself doing that, flying cross country, stitches and a huge gash in my chest where my breast once was, drains coming out of my body, on pain medication, no one to help me, and a rolled up sock in the empty cup of my bra carrying a small, neurotic dog in a crate.

Once I got to my destination, there would be no follow up with my surgeon. I knew of no doctors in Florida. Who would take care of me post op? What if there were complications? What about plastic surgery? Would there be time to interview and find a plastic surgeon to put me back together again in two weeks time? I still had to put my furniture in storage, pack the kitchen, etc. I called around trying to book an appointment with a plastic surgeon to find out about immediate reconstruction, if that would be an option. I spoke with Dr. Stephens in Bellevue and he only took the call because he knows me. He did not do reconstructive surgery, but did not highly recommend doing it immediately. I could not get appointments with the other doctors I called. There was no time to research and interview them.

I was encouraged to scrape my plans indefinitely, to stay in Seattle and have my breast removed. But I did not like the doctors in Seattle. They were cold, impersonal, and did not offer me any hope or help. I did not have a rapport with any one of them. They worked in silos, they were very segmented. I wanted a team approach. I wanted everyone working together for me. I decided to wait until I got to Orlando. I would start over and find a team. They had to have good plastic surgeons in Florida, right?

I had come too far. Everything was in place. The lease on the apartment was up, my employer had been informed, I had an offer in on a house, and I had my airline ticket. I did not want to stay in Seattle in that toxic situation.

I remembered something my friend, F told me about and I read about on BreastCancer.org. It was Tamoxifen, a drug which has been effective in slowing down cancer which is hormone receptive, like mine. It is an estrogen blocker which deprives the cancer of the hormone which makes it grow. The side effects are hot flashes and mimics menopause. Taking it would plunge me over the cliff of menopause, into the abyss of no libido and being the dried up old crone I was always  destined to be.

I took the initiative, picked up the phone and made an appointment with the oncologist, Dr. Katherine Crossland the next stop on the disassembly line. I saw her on June 20^th, 13 days before my departure.

There is a term I learned by reading BreastCancer.org. The term is “newly diagnosed.” The advantage of using this term is that when you say it you are immediately labeled. The label, “newly diagnosed” is slapped across your forehead. This is a great time saver because everyone knows about the newly diagnosed. They are all the same. No need to ask questions. You can assume you know everything about them at the outset. Forget about whether she has a personality, has an opinion, and thoughts or feelings. They are all alike.

I met Dr. Crossland and I told her I was newly diagnosed. She nodded knowingly. She patiently explained my pathology report, showed me the teaching materials, and explained what I had. Then I launched into my story. In a high, tight voice I told her everything, from the story of my mom, to the move to Florida in 2 weeks, buying the house, to the breakup. I told her I was going to wait until I got to Florida to find a doctor. “But don’t you think I should be on Tamoxifen?” I asked her. “Yes!”, she immediately whipped out her pad and wrote me a prescription.

She was kind and sympathetic, not like the surgeon. I told her how I have been through surgery before in my long life. I do not handle it well and the recovery is long and slow. I was shocked when she said, “It is just like removing a lump of fat.” I looked at her in horror and shook my head, “Oh no, it is so much more than that.” Before I left, I confided in her that if I could find a doctor who would care for me throughout, and keep me comfortable, it would be my choice to let this thing run its course and die a natural death.

“It is not a pretty way to die, Amy,” she said. I wonder what is, I thought. Growing old and forgotten in some nursing home, dying of pneumonia? Being killed in a car accident? Heart attack? At least this way I get to choose.

As I was leaving she said, “You seem like you are under a lot of turmoil.” Duh! I looked at her with a wild look in my eyes and laughed in a high pitched, hysterical, insane sounding giggle. That was the end of my experience with “the cancer system” in Bellevue.