‘SUMMARY: CORE BIOPSY RIGHT BREAST – INVASIVE CARCINOMA.’
Our eight-month old son cooed happily on the floor in the GP’s room. He held a colourful piece of plastic in his chubby hands, turning it. Eva, my wife, sat beside the GP’s desk. One arm was folded across her chest, the other hand supported her chin. There was silence.
I’m trying to remember if I knew what the result was going to be as soon as he directed us into his room. He stood quietly, with a kind smile, motioning us inside. I had never met him before but had spoken to him on the phone during which he was more jovial. He sounded South American; a gentle, lisping curve to his syllables. He had cared for my wife eighteen months before when she had stumbled into the surgery after a sudden increase in her two days of abdominal pain; a ruptured ectopic pregnancy. He had listened to us and spoken to me after the practice nurse inadvertently gave my four year-old daughter an unnecessary vaccination. He is a good doctor, because he listens.
‘It’s not the news we hoped for, I’m afraid.’
Eva had come to him about three weeks before about an enlarging breast lump. She noticed a pea-sized hard lump in June 2015, seventeen months before, one month after the ruptured ectopic pregnancy. A different GP sent her for an ultrasound, which showed no ‘sonographic abnormality.’ A month later she was pregnant again. Her breasts went through the changes of pregnancy, and then of lactation. I don’t know when we started talking about the lump; some months ago. Eva was intermittently anxious about it as it was growing in size. We relaxed every time we remembered the ‘normal’ ultrasound, and rationalised the massive hormonal changes she was going through. The day she noticed a change in the angle of her nipple in the mirror, she made an appointment with the GP. He thought probably a milk collection (galactocele), but ordered ultrasound, +/- mammography due to its increase in size.
Last Monday (six days ago), she had an ultrasound. After the ultrasound she could sense the ultrasonographer’s unease. She left to speak to the radiologist, who said that she should have the mammogram, and that she should return two days later for the core biopsy and fine needle aspiration (FNA). The reason she was given was because ‘it doesn’t fit into any category neatly.’ On Wednesday she returned, by herself, as we presumed this was our over-cautious western medical system that wanted to ensure the lump was benign in the tragically young, beautiful mother with two young children, one of whom she was still breastfeeding. I mean how twisted would that be, right?
Before the biopsy we welcomed her brother and sister-in-law who just arrived from Germany via travelling in Asia. There plan was to spend ten days with us, and especially to meet their nephew, Luca. At lunchtime we had to attend a pre-admission interview at the local state school which our daughter, Mia, had been enrolled to begin in two months’ time. We both came away from the interview (which was an informal getting to know Mia and her family chat, really) glowing having watched this incredible little girl talk with the head of prep with confidence, openness and genuineness, traits of which we were so proud to see in her.
We had some chat before the biopsy. Could this actually be bad news? We doubted it.
After Eva returned, she was her usual matter-fact-self – annoyed at the poor communication skills of the doctor. Whilst she lay on the table, right arm above her head and partially naked from the waist up, the interventional radiologist dropped in phrases such as ‘worrying’, ‘don’t beat yourself up for not coming sooner’, ‘98% of women beat it’, ‘hang in there’, ‘do something nice for yourself.’
I left shortly after to attend night shift as a psychiatry registrar. I blurted out to my two colleagues what he had said, and they told me to go home immediately. I decided to stay, partly as I knew there was nothing I could do, and my wife had my brother-in-law and his wife with her. The shift was a blur, but by the end of it I had settled back into the disbelief that this could be a bad outcome.
How could this beautiful woman, a 36 year-old devoted mother of a 4 year-old and an 8 month-old, an outstanding English literature teacher (her second language), living in this dreamy beach-side town in Australia, pursuing the life which we had been hoping for and creating for the last eighteen years together as best of friends, with no maternal family history of any cancer, and absent father who’s family history we knew nothing of, possibly receive a diagnosis of cancer?
We booked an appointment for the Friday morning, two days after the biopsy, to receive the results. On a whim, Eva phoned the surgery on the Thursday, and we were surprised to hear the result was already there.
I remember the cold of the air conditioning in the waiting room, a stark contrast to the Queensland spring day outside. The quietness of the place; the tap of the receptionist’s fingers on keys and her polite voice on the phone.
The rest of the consultation was a blur. I remember saying ‘fuck’ under my breath, and then walking over to Eva and cradling her head. She desperately tried to extract more information from the GP. As a doctor, I knew that he was very limited with what he could tell us at this early stage. The FNA was not back. The hormone receptor status was not back. The cancer typing had not even been performed. Eva asked him to repeat things, and I could see her analytical mind whirring to try and calculate what would happen in the days ahead. He recommended a private breast surgeon, but we said that we could not afford to go private due to our minimal private health insurance. He seemed somewhat surprised, and emphasised that it would be the fastest option, but he would also refer us through the public system.
He printed off the pathology report for me, and we left. I waved blindly at the receptionist, and we stepped out of the icy coolness into the humid, blanketing air.
Luca was on my left arm. I pulled Eva into me and she laid her face into my neck. I’ve seen her cry often, but these tears were different. These were the tears of a woman who had been hurt many times in her life, and now was being hurt on so many levels; a horrific diagnosis; an unknown future; and mostly, her role as a mother to her two children was suddenly precarious.
We took the elevator downstairs. I could feel my heart racing and the breathlessness rising. I could feel a hollowness opening up inside me that felt as if it contained the coming months of uncertainty. It was heaviness and lightness at once, a lack of substance and an anchor pulling me down from the middle of my abdomen.
I sent a message to a friend at work stating that I couldn’t do my next two night shifts. And then the sobs came. I was facing a cafe and a barber shop. I could feel my face scrunch and I realised I had been holding my breath. In that first reaching out to a friend and colleague, not caring about anything else but my family, I felt how much we were going to need others. I gasped and pulled my sunglasses over my eyes, and we walked towards the sea.