in my time of dying

I found the lump on a Saturday, the day after Christmas.

I have to pause here a moment to spoil things and let everyone know that the mass turns out to be benign. My parents might be reading this, and all I need is a phone call from my frantic mother after she gets through the first and only the first paragraph. It is for this same reason that I will now state that I found the lump during a self-inspection in the shower, and that it was not discovered by my boyfriend as he felt me up in the kitchen.

Moving on.

I found the lump on a Saturday in December, the month in which I wrote my last examinations for the Personal Support Worker program. I had withdrawn from the program but committed to completing at least the biology courses and the one on professionalism and culture in the workplace – all of the courses where I was not faced with the wrath of a woman who insisted the rhythm was spelled “rythum” and stared down those who might attempt to correct her. I dare you, she said without saying. We have always been at war with Eurasia. In the lab, I didn’t know whether to walk out or break into riotous laughter when she stood over me and my mannequin while I practised peri-care and gave, with unnecessary force, the instruction, “Now, show me how you do the anus.”

This isn’t about that professor, though. It wasn’t her bullying behaviour that led me to withdraw from the program, though the villainous caricature I have drawn of her in my head would like to think so. It wasn’t the expense of tuition and textbooks and uniforms or the mad dash to get the kids to latchkey and then myself to school on time or the inherent lack of glamour in the profession I had found myself pursuing. It was my mind.

Throughout the course of a semester, my long dormant health anxiety had not only woken with a stretch, but bounded out of bed and gone on a tear, no caffeine required. What’s more, now with my expanded biological knowledge, I could recite the full names and symptom lists of the afflictions I was convinced now plagued me. Clostridium difficile. Methicillin-resistant staphylococcus aureus. Multiple sclerosis – remitting-relapsing. I went to two different clinics about a rash that developed in my underarms – axillae. Are you sure it isn’t MRSA? What makes you so sure? My stomach hurt. I analyzed and overanalyzed the pain, questioned the solidity of my bowel movements. My boyfriend came home on more than one occasion to find me in bed, hiding my head away under the blankets, trying to recall all of the potential pathogens with which I had come into contact that day, all of the times I washed my hands, and did I do it thoroughly enough? What if I made my children ill? The endless checking, questioning, searching for reassurance that accompanies this sort of anxiety.

Although I’d known fairly early on that being a personal support worker simply wasn’t for me, I had considered going on to nursing following my completion of the program, and had held somewhere safe and distant the faintest dream of perhaps one day teaching one or both of the biology courses with all the irreverence I could muster (or get away with). Behind the relief I had felt after signing my program withdrawal form, there was the unavoidable knowledge that my mind had defeated me again. When I handed in my pathophysiology final, my professor said, “Well, Miss, is it another perfect?” Then she chuckled and said, “My star.” And my heart broke.

My feared illnesses were fictions I wasn’t trying to create. (Unluckily, I tend to be most prolific when it comes to neuroses-fuelled manuscripts. Unsellable.) My doctor wrote a prescription for me for Celexa, generic name citalopram, following one visit during which I outlined my various nervous system symptoms and repeated frequently how many of these occurred concurrently with bouts of intense anxiety. Maybe the symptoms were really something, he said. He would keep an eye on them, but, in the meantime, I was suffering, and I had to work on getting better, he said. I took two half pill doses, and then I stopped, stating that I would start again after the holidays. The glasses of wine I wanted to enjoy in the sparkling glow of the season were hardly compatible with starting a brand new SSRI script. So.

The lump was undeniable. Non-fiction. The doctor felt it. A palpable three centimetre mass at approximately eleven o’clock on my right breast, mobile but firm. As I sat in the examination room that was more DC comics than Norman Rockwell with the paper towel blanket pressed to my breasts, I heard through my mounting distress the doctor’s theory that the growth was likely due to fibrocystic changes of the breast that are common in women my age. I heard “Cancer is uncommon in a 34 year old woman”, but I walked away with an order for a diagnostic mammogram and breast ultrasound. I walked away thinking “I have cancer, and I’m going to die.”

See, it didn’t take long for me to convince myself that, not only was the lump in my breast cancer, but it had to be metastatic cancer. That would explain the weird feeling I had been having in my right side, which I variably described as a pinching pain, a feeling of fullness, a feeling that I was being kicked in the ribs. These sensations I explained with my own diagnosis of secondary liver cancer.

 

I started taking the medication again.

 

The morning of December 27th, I woke trembling. I dressed in a daze, and, after kissing the kids goodbye, got in the car to go to the medical centre where I would be having my mammogram done. My boyfriend’s father drove me there without asking questions. I still wonder if perhaps he thought at the time that I might be pregnant, and I appreciate his discretion. (As certain as I was of my diagnosis, I did not want to make anyone worry until I heard it from a doctor.)

In the waiting room, I felt the world end repeatedly to a soundtrack of Whitney Houston and that awful Sheryl Crow-Kid Rock collaboration. This was the same place where I had learned the gender of my children during both of my pregnancies, where I had seen their fuzzy images on a screen for the last time before I held them in my arms, fully formed. It was this thought of them that ran through my mind as I held the blue gown close around me. I had worn a blue gown then as well, both times, around me and draped over my growing belly, but now a fear of my own body usurped what was once a sense of wonder at it. All the tears I tried to hold back fell just the same.

For anyone who might be reading this and who has never experienced a mammogram before, I can only tell you that, for me, it felt very much as though the technician was attempting to make a panini with my breast meat. (I’m terribly sorry, technician lady. You were very nice and comforting, and you were only doing your job, and I know you did it well and that I was supposed to feel like my boobs were becoming sandwiches. I totally get it. I am just trying to prepare all of my uninitiated breast-having readers so no one comments and says “Why didn’t you tell me it was going to be like that?” I’m telling you now, all. You’re welcome.) After taking eight pictures, she let me go, but not before telling me that I didn’t hear it from her, but nothing was jumping out at her. As in, nothing that looked like cancer. “You just looked like you could use some peace of mind”, she said, showing a warm sense of humanity I should not have anticipated in all of the technicians I was soon to encounter. I felt relieved by this for all of the 20 minute walk back to my boyfriend’s parents’ house. I’m sure I sobbed that night. I’m sure I cuddled close to my son and imagined him and his sister growing up without me, maybe even forgetting me. I’m sure of this because that is how I spent many of the next eleven days – crying, not eating, rehearsing death in my imagination. I would marry my boyfriend in a white tea-length dress like the one Audrey Hepburn wears in Funny Face, and then I would be buried in it. In my more irreverent moments, I envisioned my friend, C., playing and singing, “Only the Good Die Young” ironically at the funeral. (I still kind of want this to happen, C., many many years in the future, when I am old and through with raging against the dying of the light – a message implying I was never a saint in life, which is accurate for even the best of us, I would tend to think. Make a note.)

Fixated on the pain in my side, I went to see my long-suffering doctor on December 28th. He shook his head when I asked about metastatic cancer, but he gave me a referral form so that I could have my abdomen examined via ultrasound. I went for the ultrasound on the 29th, in the morning. I remember than an old man with a cane in the waiting room said to me, “Young woman, you were in the walk-in clinic yesterday. Are you feeling any better?”

After the abdominal scan, I made the mistake of asking the technician if she had seen anything strange. “Well, I’m not really supposed to say anything,” she said. “The radiologist is the expert. He makes an evaluation. I just take the pictures.”

Naturally, my mind translated this as, “You are fucked, but it isn’t my job to tell you that. Have a good day!”

The final test was the breast ultrasound. I can’t remember if I started worrying about my lungs before or after this, but, at some point, I started having pains in my upper back and occasionally my chest, and I maintained that my breathing “felt weird”. These symptoms I attributed to the cancer having spread to my lungs. Breast, liver, lungs. I monitored every hiccup and cough and read articles on the Internet about stage four breast cancer. I hoped I didn’t have it, but believed that I did. All of my health worries until now had been unfounded, but now there was something solid. A solid mass. Just because you’re paranoid doesn’t mean they’re not out to get you.

I was afraid to look at myself in the mirror when I got undressed.

“Did you find the lump?” I asked the woman who performed my breast ultrasound.
“Oh, we don’t do that for you. We just do the scan, and the doctor makes any comment.”

New Year’s came and went. My boyfriend and I slept two hours of the night away and woke to the sound of fireworks. I braced myself for my dad’s upcoming weekend visit. How would I smile through it? Time only dallies when you don’t want it to, much like a child. Or your period.

I don’t want to spend a lot of time talking about how that weekend went. I made it through without revealing my mind state, I thought, though my dad told me later he had thought I seemed down, and he believed it had to do with the fact that I was having a hard time finding a job. Also, the news that I was having back pain, discovered when questions were asked about my boyfriend giving me a massage, traveled quickly from my sister to my mother, who threw out her own set of questions.

The news finally came on January 6th, which was a Wednesday. One of my doctor’s nurses or administrative staff called me and said, “Dr. ________________ wanted me to call you and let you know that the results of all the tests came back, and you’re fine.” There was no cancer. Indeed, I had not let myself believe it, but when my boyfriend and I had gone looking for the lump to see if it had changed at all in the days before I got the phone call, we had been unable to locate it. The initial trace of my demise had vanished, and, in the days and weeks that followed, so did the dark self-diagnoses that had come from it. The side pain almost instantly disappeared. My breathing became more normal. I started running again.

I continued taking the Celexa.

Medication was something I resisted even considering for many years, even in the face of the crying fits my now ex-husband endured during my first pregnancy. My first-born came into this world screaming holy hell and pooping everywhere. In other words, healthy. Yet, during my pregnancy I could barely believe she would make it out alive and normal, not anencephalic or premature or with cerebral palsy. I resisted considering it even after the first neurologist told me I did not have amyotrophic lateral sclerosis and after the second one told me I did not have Parkinson’s.

My resistance finally faltered a little when a friend suggested I seek help after I told her my intention to withdraw from the Personal Support Worker program, and my true main reason for doing so. It faltered a little when she told me there was no shame in mental illness, or seeking help, or taking medication, and, finally, when I emerged honest from 11 lost days to a world still standing, it fell away forever.

 

in my time of dying