Thomm Quackenbush, author

A Week in San Antonio | 2016 | Bryan's Engagement

11.22.16

We can only die in the future, I thought; right now we are always alive.  

-Amy Hempel



The Time I Didn't Die of Breast Cancer

Amber brought about this latest bout with death, while cuddled against me. "You have a bump," she said, jabbing at my chest.

"How do I have a bump?"

"Does it hurt?" she asked.

"Because you jabbed at it. Otherwise, no."

She poked it again. "Well, it's there."

"About how big is it, would you say?" I asked, trying to keep my voice even.

She directed my fingers to it. I feel a slight difference between the surrounding tissue and the bump, but then I want nothing more to do with it and do not want either one of us to touch it, as if it might subside if we just turn our backs on it.

Men are much more likely than women to die of breast cancer because we are just too stupidly manly to get it checked out. A quick visit to Doctor Google told me that the best case scenario is that I have a lipoma, a harmless but obnoxious lump of fatty tissue, treated by surgical removal if they pass a certain threshold of annoyance or size. Mine is invisible except to careful touch.

Still, I give it a week before I have Amber check it again. I am lying down at the time and, being stretched out, she can't find it.

"Maybe it's gone," she says. "Sit up."

When I do, she finds it immediately. "Still there. Same size."

I do not want her to cuddle against me so she doesn't come into contact with it, which is impossible given that I am dealing with Amber. In Texas, she attacks my side and then, to my horror, tries to find the bump with her lips.

I sleep fitfully, imagining I feel the lump aching.

The next day, pacing outside a breakfast restaurant, I call my doctor's office.

"What is this concerning?" the woman on the phone asks.

"I have a bump," I say. "A lump, I guess. On my left side. I mean, it's probably a lipoma." I want her to agree with me as to the innocuousness of the diagnosis. I can deal with a fatty bump.

Her job is not to reassure me. She schedules me for the Friday after I return to New York.

I alternate between panic and apparent serenity that is merely not looking at the panic. Amber is busy studying and taking tests online, so I cannot ask her to do the emotional labor of reassuring me that I am not dying of breast cancer. In deference to all she has in front of her, I tap her shoulder and tell her that I need a hug and a quick statement that I am not dying.

"You have a lipoma," she says. "You will be fine."

I go to the appointment straight from work, though I am nervous for half the day, knowing that I may get a diagnosis I do not want. But as least I will know.

The nurse ushers me into an examining room. "So, what's wrong?" she asks as she weighs me.

"I have a lump on my chest."

She nods. "And what do you think that is?"

"Lipoma," I say.

"Yeah, but what are you scared it is?" she asks bluntly.

I raise my eyebrows. "Breast cancer."

"Right," she says. "Can I see it? It's kind of my hobby."

"My chest or my weight?" I ask, motioning to the scale.

"Your chest."

She is a nurse and I am there for the lump, so I see no harm in showing her. "My wife put a little dot on it, so the doctor would be able to find it."

She nods, but doesn't give it a touch or much of a look. "Dermatology isn't actually my hobby," she says. "Wouldn't that be weird?"

We talk for another five minutes, about her hypochondria, about the medications I am on and why.

"Oh my god, you're anxious?" she asks. "This must be horrible for you."

"Yeah, I've been pretty panicked."

"I would be too," she says. "That's why I haven't been to the doctor in years."

She tells me how she thinks she will die before her husband and that she tells him this regularly, which he does not enjoy.

I feel at ease with this nurse as she confesses how her own insomnia drives her husband insane. In other circumstances, I think we would become friends - our neuroses match up so well - but I don't have a way to bridge the gap and ask for her name. Maybe I am just reaching for a life preserver so I don't have to think about the thing in my chest. She duped me into flashing her, so that has to count for something.

As she walks out of the examining room to speak to the doctor, she looks back at me and says, "Wouldn't it be funny if I didn't even work here?"

She comes back after a few minutes with a flu shot.

"I'll get one from work," I tell her.

"Or you can get one from me right now," she says. "What's the difference? You're here."

I shrug that this makes sense and she injects fire into my arm.

"I think you hit a nerve," I say.

The doctor is his usual soft-spoken, patient self. He feels the bump and notes that I have mild gynecomastia. He begins to explain, but I know Latin roots, even if I couldn't draw conclusions from context. This man is saying I have breasts. I look down. I assumed I just had nascent pecs. I'm definitely far from an A-cup. As far as I remember - which is to say "at least since 2005, when I lost about twenty five pounds in a couple of months and never gained it back" - my chest has looked roughly this way. Since then, I've seen a couple of doctors, slept with three women, and been shirtless an appropriate amount in public. No one accused me of having breasts before.

"A lot of times, it is caused by marijuana," he says in a fashion that suggests he thinks he has my number.

"I never smoke!" I pride myself on only taking drugs prescribed to me, which is of course the culprit he goes to next.

"What about the lump?" I ask, the whole reason I am here.

"Well," he said, hedging, "it's probably a lipoma, but I think you should have an ultrasound to be sure."

Here, my brain splits into factions. The sensible part hears the diagnosis I expected and tells me to stop worrying. The rest decides that he is lying to me, that he thinks I have cancer but doesn't want to have to tell me yet, that he would not have suggested an ultrasound unless he suspected that this irritating little bump was something considerably worse than a bit of fat. This latter faction becomes louder and louder with each step to the imagining office across the hall.

"I'm here to get an ultrasound," I say, the question in my voice.

The secretary glances at her colleague, then looks me up and down. "Excuse me?"

"An ultrasound. The doctor said-"

"Date of birth," she prompts.

I give her the information, repressing my urge to fidget.

"Yes, you're in the computer for a mammogram and an ultrasound," she says as though she doesn't believe it either. "We can't do it today. When can you come back?"

A mammogram? screams the dire faction. Not only does the doctor think I have breasts, but now I have to have them squished in a machine?

Increasing certainty I have cancer drowns out the sensible part of me. Amber is too young to be a widow. Will it be especially tragic that we were only married a few years? How many years does she need under her belt until it isn't as tragic?

I make the appointment for Tuesday, which might as well be a year from now for all the help it gives me in the moment.

"I'm a man," I tell the secretary, in case that is no longer clear, "so I've never had to have a mammogram before. How much do they hurt?"

"I've had them," she says, seeming human instead of an impersonal aspect of this experience. "They aren't comfortable, but they are nothing you can't handle."

I tell Amber everything. She refuses to state anything one way or another. To her, nothing changed. To me, my doctor was too much of a coward to tell me I am dying of aggressive, terminal, metastasizing cancer that is filling up my ribs and lungs, on its way to my heart. I've seen too many people suffer through cancers. I've known four who died from it.

We go out to Panera to eat, so she can do homework and I can work on my latest novel project. I restrain myself from googling too much. I cannot really focus on the book, though I plug away and add a couple thousand words out of obligation. I want to prevent something in my life from going awry, even if I cannot control what is happening in my body.

The flu shot begins to take hold of me, not truly making me sick, but weaker and thus less able to fight off errant thoughts.

"Even if it is cancer," Amber says, "and it is not cancer, we caught it early. We'll get it cut out of you and you won't ever have to worry again. But it is not cancer."

"And why is that?" I prompt her.

She rolls her eyes, because I have already given her the script from what I have researched. "Because on the list of male breast cancer symptoms, you have only one of five. You aren't leaky or sore. You just have a bump, which could be a cyst or a lipoma. Anyway, mammograms are much more successful for men, since you have so little breast tissue to get in the way."

I alternate again through the weekend, panicked and then the sort of calm where I am sure the fear is going to come back. Amber gives me hugs when I need them, but she cannot chase away my terror of what may happen Tuesday.

I fall to superstition. If I can transcend my word count for the day, the doctor will not find cancer. It I get above thirteen thousand steps for the day on my Fitbit, the doctor will not find cancer. If I rinse all the dishes, the doctor will not find cancer. If I wash all the laundry, the doctor will not find cancer. It doesn't matter that it doesn't make sense, that there is no correlation between my chores and what is in my chest. I want the illusion of control so I can keep myself composed enough to continue functioning until the mammogram.

At the same time, I think of all the things I won't be able to do once I am undergoing chemotherapy, how I won't be able to take long walks at night or taste the teriyaki salmon Amber makes for me. How I will miss going on road trips. How I never fully appreciated what I had because none of us ever do. I don't want to mourn myself, but the pessimistic faction has been winning the week.

Monday, I acquired a twitch. It starts in the pinky and ring finger of my left hand before occupying my left pectoral muscle for the next twenty-four hours. Its lodging there cannot be a coincidence. It woke me early Tuesday morning and would not abate long enough to let me go back to sleep.

I am fine through morning classes, in that I show my students Charlie Brown's Thanksgiving and am sufficiently mentally distracted. In the afternoon, we have a report card ceremony that gives me too much free time in which to worry. One of my coworkers tells me I am pacing as though my wife were about to go into labor, so I restrain myself until it is time to leave.

I pick Amber up, because I do not want to face this appointment alone. "If I get a clean bill of health, we will get Indian buffet. If I am dying, Subway."

"Why are you going to make us eat Subway?" she whines.

"To punish my body for doing this to me."

When we get there, I ask the receptionist, "Will someone tell me what is wrong? I won't have to wait to find out the results, right?" I don't think I can wait again, not as nervous as I am.

She assures me that a doctor will speak to me.

The paperwork I fill out asks me how often I have had breast cancer and which of my family members (men included) have had breast cancer. I don't even have the energy to comment on this, just mark as many "never" boxes as I can and incline it Amber's way.

The nurse leads me to a cubby half covered by a curtain. I wouldn't trust this as a dressing room, but I am asked to strip from the waist up and they will come for me.

"Do you have deodorant on?" she asks.

"Yes?" I'm a civilized person in North America. It's polite to wear deodorant. Or is it that deodorant causes cancer? I'm sure I saw a headline to that effect...

She hands me a moistened wipe to remove it. "It shows up on the machine."

For an eternity, I sit, chilled, and play on my phone to try to distract myself. If I can catch a Pokémon, then I won't have cancer. No Pokémon are spawning in the office.

A nurse comes in and puts what look like miniature Band-Aids on my nipples. In the center of each is a little stud. She also asks where the lump is. I haven't felt it in a week, but I remember where Amber's dot was. She applies another marker there.

A nurse brings a woman, gray haired and confident, into the other cubby. I want to ask her how she is, to not be so alone in this experience, but I know I have no right to disturb her. The sound of my voice alone would be enough, since men should not be here.

The nurse brings me into the room with the machine. It does not look like much, but it doesn't have to. All it has to do is mash my chest between two plates, which it does in short order. The nurse tells me to stop breathing. I feel panic every time she says this, as though she will never again tell me I can breathe. My muscles are not twitching, but having to stand still while the machine loudly scans me reminds me of this fact.

The whole process of the mammogram takes maybe ten minutes. Aside from having a strange, late middle age woman roughly getting to second base with me, it is not particularly uncomfortable or at all painful, though I do feel that the machine would have lifted me off my feet by my chest hair had I not obeyed it.

She leads me back to the cubby to wait. "Do you have a t-shirt?" she asks.

"Yeah. Does that mean I can take off the..." I want to call them pasties, but don't think this would go over well. "The little bandages?"

"No, those are landmarks. Leave them on in case the doctor needs more pictures."

If the doctor needs more pictures, that probably means I have cancer. At the very least, it means that what I thought was a lipoma is something more complex. Complexity is the last thing I want in my body.

I sit in my booth, nestled next to my work shirt and jacket, in my t-shirt so I don't feel so chilly. After several minutes, she tells me I can take off the landmarks for the ultrasound. After several more, another nurse comes to collect me.

She offers me a robe that has no front.

"No thank you," I say. "I'm not really modest about my chest."

She continues to hold out the robe until I put it on and lie down on the examining table.

The ultrasound goo is warm almost to the point of discomfort. I do not think about how strange this is, how I will definitely need a shower. She is slow and methodical, seemingly going over each angle a half-dozen times. She scans my right side first, the unaffected side. I cannot make myself look at the screen. While I appreciate the idea that she has to be thorough - what if the real cancer was hiding there the whole time? - I want her to get to my lump and dismiss me.

She finally finishes that side and tells me to use a hand towel to wipe off. Once I have done this to the best of my ability, she squirts more goo and undoes all my work.

I can hardly breathe. I don't want to disturb her work and she barely seems to acknowledge me as a person, just something she needs to scan. I don't mind, as I wouldn't want to make idle conversation with someone worried they are about to get terrible news.

She hands me the towel again and tells me I can put on a shirt. She is gone for some minutes before returning and saying that the doctor will speak with me now. The doctor, in this case, is telecommuting in from an office across the river. He has seen the scans and tells me nothing I do not highly suspect: I have a lipoma.

"How much do you drink?" he asks.

"Alcohol? None at all. I am not supposed to with the medication I'm on and-"

"What medication is that?" he interrupts.

I was under the apparently misconception that anyone treating me could see a file of everything I am taking, if not every past inoculation and childhood malady. I tell him the medications.

"Yes, that's probably why you have gynecomastia."

"Well, I don't actually think-"

"You'll come back in six months and we'll see." The phone disconnects and the nurse directs me how to leave the office.

As I exit, a woman passes by me, her belly swollen with new life. It all feels a little heavy-handed.

I look at Amber and tell her that I have a lipoma, but I still have this dread. I expected to feel a great weight lifted off my chest, but I as numb for a good forty-five minutes as I watch the imagined timeline drift off to be mentally recycled into future plotlines.

I hoped the Indian buffet would taste as nothing had before, like the freedom from worry for a while, but it tastes only of curry and not much else.

"Will you write about this?" Amber asks.

"I don't know," I say. "I don't think my family would be kind if they found this out. My mother already refers to me as the daughter she never had. Now that I have breasts..."

"You don't have breasts!" she says, smirking. "Any more than your brothers do. And it might help someone else going through this. Wouldn't you have been reassured to read someone else's story?"

"Yes," I say, biting into a dosa, "but I don't know that I owe this hypothetical stranger my embarrassment just for his peace of mind."

Soon in Xenology: Faces. Engagement.

last watched: Star Trek Beyond
reading: The Martian
listening: Tori Amos

A Week in San Antonio | 2016 | Bryan's Engagement

Thomm Quackenbush is an author and teacher in the Hudson Valley. Double Dragon publishes four novels in his Night's Dream series (We Shadows, Danse Macabre, and Artificial Gods, and Flies to Wanton Boys). He has sold jewelry in Victorian England, confused children as a mad scientist, filed away more books than anyone has ever read, and tried to inspire the learning disabled and gifted. He is capable of crossing one eye, raising one eyebrow, and once accidentally groped a ghost. When not writing, he can be found biking, hiking the Adirondacks, grazing on snacks at art openings, and keeping a straight face when listening to people tell him they are in touch with 164 species of interstellar beings. He likes when you comment.



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