When Cancer Smells Love

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The damp, silty smell fills my nostrils. I turn my head but can’t escape the smell. It emanates from me, this nauseating perfume of illness and abandonment.

It has been five days since the operation, five days since my right breast and several lymph nodes were removed. I can’t bathe or shower. The bandages on my chest must remain dry; so, too, the surgical drains hanging from my chest. Last week’s sweat is pungent, locked under the arm pressed tightly and protectively against my side.

I stand in front of the bathroom sink, carefully trying to pull my right arm away from my body. I just want to put a wet washcloth under my armpit. By eliminating the smell, I feel that I will reclaim myself. But my right arm remains stubbornly pressed against my side; neither Percocet nor Vicodin attenuates the pain sufficiently to allow such movement.

My husband stands a few steps behind me, understanding my bare back as a signal not to approach. He simply said, “Can I help?

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At this point, I realize that I cannot wield the washcloth with my left arm across the front of my body; the slight weight of this arm pressed against my flattened chest is too much. But I want to protect my husband from an unsavory task, to protect his image of me – my image of myself – as whole and clean, competent and capable.

“No, thank you,” I said without turning my head. “I’m fine.”

I was alone when I first felt the intuition that something was very wrong. The lump had, of course, caused some anxiety, but my gynecologist assured me that it was probably just a cyst. A mammogram just three months earlier had shown nothing; how could this mass, suddenly palpable under my fingers, be a problem?

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But when, after another mammogram, the technician came back and said, “The doctor wants to do an ultrasound,” my stomach tightened. When the radiologist came into the room, I knew. The radiologist is not supposed to enter the room. The radiologist is supposed to remain anonymous, carrying on routine activity in the invisible background, allowing the technician to emerge and say brightly, “You’re good to go; See you in a year!”

As the radiologist spoke to me—about contacting a surgeon, about urgently needing a biopsy—I felt what would become an unpleasantly familiar sense of disconnect. As I struggled to pay attention, the only thought that registered was a distant realization that I had broken out in a sweat.

Leaving the office, my first call was to my husband. During our 20 years of marriage, we had been lucky as our partnership had not been challenged by illness or serious illness. But now together down the rabbit hole we have gone.

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Our first visit was to a surgeon for another ultrasound. As I watched the image appear on the screen, the doctor gently but clinically pointing shadowy fingers at a cellular structure that had gone wrong, my mind jumped back. For a while, I was on a different table, in a different doctor’s office, where my husband and I looked at a different picture, amazed and convinced that the little throbbing shadow was our baby’s heart.

I want this ultrasound, I thought. I do not want this ultrasound.

I went back to the surgeon for a lumpectomy, which was considered the most sensible biopsy technique for me. My husband waited while I, at least, had the brief respite of being asleep. A few days later, we returned to the surgeon’s office to find out the results.

My husband joined me in an exam room where, after checking my incision, the surgeon was direct. Although the tumor was small, it was malignant and fast growing, and it had started to spread.

“Go ahead and get dressed,” he said, “We’ll talk in my office.” My husband and I did not speak while I took off the medical sheet and put my clothes back on.

By joining the surgeon in his office, we indeed enter a strange new world. A world of “invasive ductal carcinoma“, of” no clear margins “. A world in which having options suddenly meant a choice between a second, substantially disfiguring lumpectomy or the removal of one or both breasts. Thinking of my two children, my husband, my family, I chose the mastectomy.

Our parallel universe expanded with our next visit to a plastic surgeon. He was nice, but I felt like a piece of meat as he drew on my body with a purple marker, illustrating my breast reconstruction options. TRAM component? Horizontal purple lines above my pubic bone, an oval around the potentially useful flesh of my belly. Tissue expander followed by an implant? Purple lines bisecting my chest, then encircling the targeted breast. Upon returning home, I discovered that, contrary to the doctor’s assurances, the purple marker did not come off easily with soap and water.

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It has now been five days since the mastectomy and the insertion of the tissue expander pressing hard against my chest wall. The yellow-orange stain from the surgical antiseptic is yellowish on my skin, accentuated by the remnants of purple felt-tip marks that aren’t hypothetical indicators this time.

We still have a journey ahead, of chemotherapy and exhaustion, of work calls being taken while relieving clumps of hair from my itchy scalp, of endless doctor’s appointments, of a brutal and unceremonious admission at menopause. But right now, at my sink, I don’t know any of that. All I know is that I feel disgusting, helpless, weak, and don’t recognize this version of myself.

Washcloth unnecessarily in hand, I turn to my husband, who is waiting patiently. I don’t want him to see me like this. I don’t want him to wash the sweat and stench off me. I don’t want to need help.

Yet I am touched by the intimacy of this moment, by the tenderness of my husband. He loves me and wants to do this for me.

I love him, so I let him.

Catherine Moseley Clark is senior vice president and general counsel for the Henry M. Jackson Foundation for the Advancement of Military Medicine, a nonprofit organization dedicated to medical research and public health. This article was first published in Pulse: voices from the heart of medicine.


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