EIGHT YEARS AND STILL IN REMISSION (YAY) – Marilyn Armstrong

Eight years ago today I had a bilateral mastectomy for cancer. I had malignant tumors in both breasts. Two different kinds of cancer. Which, I was told, is extremely rare. One in a million.

I’m always that one in a million.

The much better news was that both tumors were small and non-aggressive, as cancer goes. I also had the wits to find the best cancer doctor in Boston and the only plastic surgeon who was sure she could manage to create breasts for me. I’d had five (six?) previous abdominal surgeries, so there wasn’t any undamaged skin for her to work with … so she literally salvaged the skin from my breasts and reused it over the implants.

Recently – Photo: Garry Armstrong

I had four surgeons working on me at the same time because there were two breasts to be removed, followed by two “new ones” to be implanted. I was a total mess when I came out of surgery … but I had breasts. I didn’t have to go through the horrible stage where suddenly, you’re a woman with no breasts. I remember how much my mother hated losing first one, then the other breast. How they made her feel “unwomanly.”

It’s a surgery that changes you.

Mind you I had been told conclusively by at least three previous plastic surgeons that it was impossible. It couldn’t be done. That was when a friend (a doctor type friend) stepped in and introduced me to the good surgeons. The head honcho and her lead plastic surgeon. So I got them and their top assistants because they didn’t want to extend the surgery any longer than necessary and this way, they could work on both sides of me at the same time.

And that’s what they did.

That surgery changed me in a lot of ways I haven’t even begun to address despite the eight years that have passed. The heart surgery — a mere three years later — didn’t change me as much as losing both breasts.

It’s hard to explain how important breasts are to a woman. It doesn’t make any logical sense. Unless you are nursing — and I was way past the nursing phase of my life — they are secondary sexual characteristics. Yet from early on, one’s breasts define femininity. Size, shape, all of that stuff. The fake ones look more or less normal under clothing … but they don’t feel real.

Also, I have no nipples. I could have gotten pretend nipples, but it would have involved more surgery and more weeks of recovery. I realized fake nipples weren’t going to make me feel more female. They would feel as fake as the implanted breasts.

Make no mistake: I’m glad to have the fake breasts. I can look in the mirror and see a woman even though she has significant replacement parts.

I have to wonder about women who have breast surgery for “cosmetic” purposes. This is serious surgery. To do it voluntarily?

So, eight years later, I’m alive. My body changed enormously after that surgery. I went from being extremely thin to quite plump, probably because of the drugs they kept giving me to suppress production of estrogen. The drugs made me terribly sick and eventually, the oncologist suggested I stop taking them, that they were making me miserable and I had no quality of life left. I asked what percentage of difference not taking the drugs would make … and he said “less than 10%.”

I stopped taking them.

I still wonder if those drugs had something to do with how my heart disintegrated immediately thereafter. I can’t prove it, but still … those were some powerful drugs.

Climb every mountain – Photo: Ben Taylor

Meanwhile, it is eight years and there’s no sign of anything (new) wrong. It doesn’t mean I can’t get cancer somewhere else, mind you. It just takes one random floating cell to take root somewhere, but so far, so good.

Where cancer is concerned, that’s as good as any of us can ever say. You are never cured … just remitted. For now.

NOT ORIGINAL ISSUE – CANCER ISN’T “A DISEASE”

Anyone who has had cancer, no matter how many years have passed, knows you are never “cured.” The best anyone can say is “so far, so good.” Cancer isn’t a “disease.” It is many diseases characterized by a common thread, that they are a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. But cancers are different for each organ they invade … which is why I doubt there will never be “a cure” for cancer. There may be a cure for this or that cancer, but a cure for all cancers? For every part of the body? Not likely.

Moreover, there is no test to tell you if  your body is free of cancer cells.

This is, of course, true of everyone from birth till death, but when you’ve had a run in with cancer, it stops being theoretical and morphs into something more sinister and personal. In 2010, I had a double mastectomy, losing both breasts to cancer. It wasn’t a prophylactic double mastectomy. I had cancer in both breasts. Two unrelated tumors at the same time. The odds against getting breast cancer in both breasts simultaneously are incredibly small. I seem to be one of the those people who manages to beat normal odds.

After the mastectomies, I got instant reconstruction. Two silicon implants replaced my breasts. They do not, as people imagine, look like real breasts. When you are in the tunnel through breast cancer to (hopefully) recovery, you find yourself answering weird questions. Like “how large do you want them to be?” Do you want nipples? Saline or silicon?

Beth Israel Hospital in Boston.

I went with smallish and no nipples (they require two extra surgeries and they are entirely for appearance), and silicon, which feels more “real” than saline. I suppose it’s all for appearance, really. It is the appearance of womanhood which matters when the original parts have been replaced. And yet, appearance matters more than we might think and in ways we never imagined.

Everything went well — or as well as these things ever go. I hoped I was done with cancer. Imagine my surprise when I realized there was something hard underneath the scar across my right implant. Flat, hard. My first reaction was “What the hell?” Could I get breast cancer without breasts?

I hit the Internet to discover it is probably scar tissue. Or (unlikely but not impossible) a very rare form of skin cancer that grows directly under the mastectomy scar. Rare isn’t impossible. Not in my world, so reluctantly, I made an appointment at the Dana-Farber. It is the only dedicated cancer facility in Worcester County and has been where I’ve done all my follow-up since the surgery.

I had my surgery and reconstruction at the Faulkner Hospital in Boston. My surgeon and plastic reconstruction surgeon were the best. Anywhere. Literally described by my local oncologist as “the dream team,” If you have breast cancer, this is as good as it gets and if life throws this at you, I strongly advise you to find the best surgeons, even if they aren’t convenient. This is something you want to get right the first time.

My oncologist thinks, as I do, that it’s nothing to get excited about, but we’ll watch it. I had been on an annual checkup, but now I’m back on a 3-month schedule. It may not be a big deal, but you don’t fool around with cancer. And you never, ever take for granted that you are fine, no matter what anyone tells you — including your doctors.


As all this was going on, I have been reading. Most of the books have been lackluster, but this one: Life and Other Near-Death Experiences: A Novel by Camille Pagan, grabbed me from the first page and kept me engaged to the end. I wished it wouldn’t end which is unusual for me to say, especially because it’s a book is about a young woman who discovers she has a rare, aggressive form of cancer while simultaneously discovering her marriage has come unglued. Literally, both things hitting her on the same day within a couple of hours.

life-and-other-near-death-experiences-coverWhat makes this book different from other books that deal with life and death, is it never takes the easy way out. There are no cheap, easy fixes for life’s ugly problems. It confronts real decisions people have to make and does so with humor, wit, and realism.

The main character of the story freaks out when her life falls apart. She doesn’t take it calmly. She completely loses it. She needs time to think — plus a huge amount of support from family and friends to face her new reality. It was the most realistic story about dealing with cancer I’ve read and it wasn’t depressing.

Not a light-hearted romp or a vale of tears, it reminded me that how we react to appalling news varies, but we all react. You cannot fail to be changed by facing death, especially when you know there’s no surety you’ll beat it.

Once you’ve had any medical crisis that will kill you left untreated and might kill you anyway, even with treatment, you never look at life the same way. You don’t take life as a given. None of us should take life for granted, but we do. Until we come upon our dark angel — and he’s holding our number.

What made this one special was its lack of sentimentality. No mawkishness. Not a cliché in sight … you I cannot tell you how grateful I was for that. I’ve had cancer. I have (had) (still have) (will have) heart disease. If there is a cliché about disease I haven’t heard, I’d be surprised.

This is a good book. I hope it will get some attention. It got lumped into the category of “humor” where it doesn’t exactly fit. I’m not sure where it would fit, so maybe humor is as good as any other placement. Occasionally, it made me laugh or at least chuckle in recognition.

Regardless, any book that can make you laugh in the face of death is worth a read.

STAYING ALIVE

In 2010, I discovered I had cancer in both breasts. Two tumors, unrelated to each other. Just twice lucky. They removed the tumors and the associated breasts, gave me very attractive fake replacements. Much perkier than the old ones in an artificial implant sort of way. I have a little ID card for my breasts, like they have their own personae. Maybe they do. Thus, a little more than seven years after the siege began, I’m officially a survivor. Almost but not quite.

My mother died of metastasized breast cancer. My brother died of pancreatic cancer 10 years ago, having never gotten as old as I am. This is not a reassuring family history.

All chronic illnesses make you paranoid. The thing that’s so insidious about cancer is its absence of symptoms. The possibility that it is growing somewhere in your body and you won’t know it’s there until it’s too late, is about as scary as disease gets. Nor is it a baseless fear. I had no idea I had cancer — much less in both breasts — until it was diagnosed twice during a two-week period. One diagnosis of cancer is hard to handle. A second diagnosis a week later is like getting whacked over the head with a bat. It leaves you stunned, scrambling to find someplace to stand where the earth isn’t falling out from under you.

I don’t think most of us are afraid of dying per se. We are afraid of the journey we will have taken to get there. We’re afraid of pain, suffering, the humiliation of dependence and gradual loss of control of our own bodies. After having one or more close encounters with the dark angel, no one is eager to feel the brush of those wings again.

We are called survivors, which means that we aren’t dead yet. The term is meaningless. Put into perspective, we are all survivors. Anyone could be felled by a heart attack or run over by an out-of-control beer truck tomorrow. The end of the road is identical for all living creatures; it’s only a matter of when it will be and what cause will be assigned. Everyone is in the same boat. If you’ve been very sick, you are more aware of your mortality than those who who’ve been blessed with uneventful health, but no one gets a free pass. The odds of death are 100% for everyone.

Recovering from serious illness is a bumpy road. Each of us has a particular “thing” we find especially bothersome. For me, it’s dealing with well-wishers who ask “How are you?” If they wanted an answer, it might not be so aggravating, but they don’t want to hear about my health or my feelings about my health — which are often as much the issue than anything physical.

They are being polite. So, I give them what they want. I smile brightly and say “Just fine thank you.”

I have no idea how I am. All I know — all I can possibly know — is that for the time being, I am here. To the best of my knowledge, nothing is growing anywhere it’s not supposed to be.  Six-and-a-half years after a double mastectomy, I am in remission. That’s as good as it gets.

The real answer for those of us who have had cancer, heart attacks, and other potentially lethal and chronic ailments is “So far, so good.”

That is not what anyone wants to hear. We are supposed to be positive. Upbeat. You are not supposed to suffer from emotional discomfort. Why not? Because if you aren’t fine, maybe they aren’t, either. They have a bizarre and annoying need for you to be bright-eyed and bushy-tailed no matter how you actually feel. It’s their version of a vaccine.

Since cancer, I’ve gone through major heart surgery and having survived that, I figure I’m good to go for a while. None of us are forever, but I’m alive. Presumably I’ll continue to stay that way.

Welcome to surviving. It’s imperfect, but it beats the hell out of the alternative.

SYMPTOM | THE DAILY PROMPT

ONCOLOGY AND AN INTERESTING BOOK

REPLACEMENT BREASTS – NOT QUITE ORIGINAL ISSUE


Anyone who has had cancer, no matter how many years have passed, knows you are never “cured.” The best anyone can say is “so far, so good.” Cancer isn’t a single disease. There is no test to tell you your body is free of cancer cells.

This is, of course, true of everyone from birth till death, but when you have had a run in with cancer, it stops being theoretical and morphs into something more sinister and personal. In 2010, I had a double mastectomy, losing both breasts to cancer. It wasn’t a prophylactic double mastectomy. I actually had cancer in both breasts. Two unrelated tumors at the same time. The odds against getting breast cancer in both breasts simultaneously are incredibly small. I seem to be one of the those people who manages to beat normal odds — not in a good way.

180-view-dana-farber-270117_04

After the mastectomies, I got instant reconstruction. Two silicon implants replaced my breasts. They do not, as people imagine, look like real breasts. When you are in the tunnel through breast cancer to (hopefully) recovery, you find yourself answering weird questions. Like “how large do you want them to be?” Do you want nipples? Saline or silicon?

I went with smallish and no nipples (they require two extra surgeries and they are entirely for appearance), and silicon, which feels more real. I suppose it’s all for appearance, really — the appearance of womanhood matters when the parts have been replaced with something that isn’t real flesh.

Everything went well — or as well as these things ever go. I hoped I was done with cancer. Imagine my surprise when I realized there was something hard underneath the scar across my right implant. Flat, hard. My first reaction was “What the hell?” Can I get breast cancer without breasts?

180-exam-room-dana-farber-270117_23

I hit the Internet to discover it is probably scar tissue. Or (unlikely but not impossible) a very rare form of skin cancer that grows directly under the mastectomy scar. Rare isn’t impossible. Not in my world, so reluctantly, I made an appointment at the Dana-Farber. It is the only dedicated cancer facility in Worcester County and has been where I’ve done all my follow-up since the surgery.

I had my surgery and reconstruction at the Faulkner Hospital in Boston. My surgeon and plastic reconstruction surgeon are the best. Anywhere. Literally described by my local oncologist calls “the dream team,” If you have breast cancer, this is as good as it gets and if life throws this at you, I strongly advise you to find the best surgeons, even if they aren’t convenient. You want to get this right the first time.

My oncologist thinks, as I do, that it’s nothing to get excited about, but we’ll watch it. If it seems to be growing, or starts hurting, we’ll move on to testing. In the meantime, I take a deep breath and can return to worrying about the lunatic pretending to be President who seems intent on making my personal angst irrelevant by blowing up the world.


As this was going on, I have been reading. A lot. Most of the books have been lackluster, to put it kindly. Life and Other Near-Death Experiences: A Novel by Camille Pagan grabbed me from the first page and kept me engaged to the end, wishing that it wouldn’t end. Which is a pretty unusual thing to say considering the book is about a young woman who discovers she has a very rare, aggressive form of cancer and her marriage comes unglued — at the same time. Literally, both things hitting her on the same day.

life-and-other-near-death-experiences-coverWhat takes the book out of the ordinary from other books that deal with life and death, is it never takes the easy way out. No cheap or easy solutions. It confronts real-life decisions that people in major life crises are forced to make. It does so with humor, wit, and realism.

The main character of the story freaks out when her life falls apart and needs time plus substantial support from family and friends to face her new reality. It’s the most realistic story about dealing with cancer I’ve read and it wasn’t depressing. Not a guffaw filled romp or a vale of tears. It reminded me that how we react to appalling news varies, but we all react. You cannot fail to be changed by facing death while realizing there’s no guarantee you’ll beat it, no matter what you do.

Once you’ve had any medical crisis that will kill you left untreated and might kill you anyway, even with treatment, you never look at life the same way. You don’t take life as a given. None of us should ever take life for granted, but most of us do. Until we come face to face with the dark angel and he’s holding our number.

This is a good book. A surprisingly good book. I hope it will get some attention. It is lumped into the category of “humor” where it doesn’t exactly fit … but I’m not sure where it would fit. Maybe humor is as good as any other placement.

Regardless, any book that can make you laugh in the face of death is worth a read.

MR. COFFEE AND BREAST CANCER

It was the best of times, it was the worst of times. I was just out of the hospital having had a bi-lateral mastectomy. I came home in pain, shock, full of drains and swathed in bandages. I felt I had been bludgeoned and the world was upside down.

coffee vanilla

My best friend was staying with me. She had stayed with me in the hospital too. The very definition of friendship is that one person who will sleep in a chair in your hospital room for three nights to make sure you’re okay. They don’t give medals for it, but they should.

coffee

I didn’t recover quickly. It wasn’t just the physical changes or pain. Breast cancer requires a revision of a woman’s sense of self and womanhood. There’s no such thing as “simple healing” when one loses significant pieces of ones body, especially those pieces which are specifically identified as “feminine” and without which … well … it’s different.

I was not a happy camper, but I was alive. I had a family, my friend, and a few good computers. There was food to eat, coffee to drink. More slowly than I imagined possible, I got better.

72-Kitchen Floor_01

Until the coffee machine died. One morning, I slunk into the kitchen and there was water everywhere. The Mellita machine we’d had for a  few years sprung a leak. Its life ended in a giant puddle on the kitchen floor. It’s actually quite remarkable how much more water 12 cups is when it escapes its carafe and takes up residence on the floor.

We tossed the Melitta in the trash and realized we were in the midst of a major life crisis. We most urgently, desperately and immediately needed a new coffee machine.

Garry and Cherrie went to the local Walmart — literally the only shop in town and it isn’t even our town, it’s two towns over — and ended up buying a Black and Decker. It was a 12-cup machine and came with a reusable filter. It seemed a sensible choice. Without further ado, the new machine was set up and put into service. We were saved. There would be coffee.

72-cups_021

We are a coffee-loving family. Coffee is the start of the day. No coffee? No way! The household went into emergency mode.

Within 48 hours of getting the new coffee machine, we all began to lose our taste for coffee. No one wanted a second cup. We weren’t even finishing the first cup. A 12-cup machine was previously not big enough for all of us and we had to make a second batch. Now, one pot was more than adequate. We had leftover coffee.

One morning, Cherrie said she thought maybe she’d like some tea. Garry decided he didn’t really need coffee and I didn’t want any either.

Suddenly, I knew. It had to be the coffee machine. Until we’d gotten the Black and Decker, everyone loved coffee. A week later, no one was interested. Cherrie wanted tea? Cherrie?

I sent Garry out with instructions to come back with a Mr. Coffee. It may not be the best machine on the market, but it makes consistently good coffee.

75-KitchenWindows-404

Out went the Black and Decker, in came Mr. Coffee … and coffee was back. I eventually surmised that the Black and Decker fed the water through the grounds too fast to produce the right flavor … and there was something weird about that metal basket (we went back to paper filters). Also, the water was the wrong temperature.

The years have come and gone and we are one more Mr. Coffee down the road.

We are happy. There is coffee. It is good and hot. It is the smell and taste of morning, the one single thing I can’t imagine giving up. Take away everything, but do not take away my coffee. Or Mr. Coffee. When you have a good thing going, you don’t mess with it.

Mr. Coffee. Accept no substitute.

I’M JUST FINE. THANKS FOR ASKING.

BLAST FROM THE PAST:

A mere two years after a double mastectomy, I’m facing another medical crisis. I’m not handling it gracefully. Too many crises. Dozens of surgeries. I can’t bore you with details; I have, thankfully, forgotten them.

Fake breasts

I’ve spent more time in the hospital than most interns. I’m a professional patient with the scars to prove it. When I die, they should stuff me. Put me in some kind of museum proving with enough medical attention, even the totally unfit can survive. Each doctor who redesigned some portion of me can tattoo his signature along the appropriate scar, assuming all the doctors are still alive. Probably they aren’t because I started my career on the wrong side of medicine while still a teenager and apparently am not due for retirement anytime soon.

I need a new mitral valve. I used to joke and laugh, saying the only major system in my body that continues to work is my heart. I laughed too soon. Probably jinxed myself.

I go into each surgery with fear and resignation. I know how I’m going to feel when I wake up from the anaesthesia. I will hurt. I will be sick and disoriented. I will realize I must have survived because I’m aware how totally miserable I am. Again.

Last time I woke up and the first thing I did was look down at my chest to see if I had a semblance of breasts. I did. Lumpy, not flat. Though I knew they weren’t original equipment, I was comforted by the familiarity of the landscape. With all the pain, drains and anger at my body for betraying me, it was nice to know I would at least appear — on the surface — female.

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View of Boston and Fenway Park from the Baptist Hospital

That was when I said: “Never again. I’m never going through this again.”

I should just shut up. How stupid am I? I can’t remember how many times I’ve woken from that weird deathlike anaesthesia sleep and have fought my way back up to the light. Each time, just a little weaker, a bit less sure of the future — but alive. Hanging on.

Lobby of the Dana-Farber in Milford
Lobby of the Dana-Farber in Milford

It’s too soon. I’m not ready. Maybe this time the magic won’t work. My first husband died following complications of mitral valve replacement surgery. I watched him die. After the surgical accident that killed his brain, he remained technically alive, but in a vegetative state for 9 long months. I took care of something that looked like him, but whose eyes were empty. When finally he passed completely, I and the rest of his friends gratefully wished him well on a journey he should have taken nearly a year before.

Probably no surprise that this particular surgery holds a special terror for me.

Less than two years since I vowed “Never again,”  again has come. I suppose I’ve already made the choice to let them fix me, or try anyhow (does “or die trying” sound too ghoulish?). The alternative — slowly dying while my heart becomes less and less able to pump blood — doesn’t sound attractive. An attractive option does not seem to be available. But, there’s no advantage in waiting. I won’t get younger or healthier. The older I get, the more dangerous surgery is.

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Glass shaft at the Dana-Farber.

I gave myself a little gift of time. I put off my appointment with the surgeon until the beginning of September. I need to get my head into a better space, to settle down emotionally. A few weeks of denial before I tackle another scary reality.

So for the next three weeks If you ask me, I will tell you. I’m just fine. Thanks for asking.

Prompts for the Promptless – Ep. 9 – Gallows Humor: Dying Is Easy (Comedy Is Hard)

After I was told I had cancer in not one, but both breasts — they were having a two-for-one special at the Dana-Farber — I had them removed and replaced by silicon Hollywood quality implants. I stopped short of adding the fake nipples. Previous surgeries had left me with no naval, so now lacking both naval and nipples, I think maybe I’m an alien walking the earth.

I have a tee-shirt that says “Yes, they are FAKE. My real ones tried to kill me.” It makes people laugh. It’s the high point of my cancer experience.

Unfortunately, cancer tends to enter your life and like a guest that long over-stays his or her welcome, you just can’t get rid of it. After I gave up my Medigap policy and signed on with Fallon Senior Medicare Advantage plan, it took me five months to get an appointment with an oncologist. It began last November and isn’t over yet.

Dying is easy 1

To get started on the wrong foot, the customer service person who signed me up in the beginning gave me incorrect information, having assured me Dana-Farber in Milford was covered by Fallon. This turned out to be untrue and left me without an oncologist. I was annoyed, but they said I could see my Dana-Farber oncologist once more and I figured I’d get a referral from him.

My oncologist didn’t know anyone at UMass in Worcester which is Fallon’s only cancer care facility in Worcester County. I remained calm. I’m past surgery and chemo, in the maintenance phase of care, the part where they do their best to ignore you. Failing that, they do the least they can. Unless you obviously grow a new cancer in a location they can see and feel, they tell you you’re fine. Not to worry. Smile. It’s just cancer.

At Dana-Farber, I had been going for quarterly check-ups, feeling for lumps, taking blood, checking for weird symptoms that could indicate something growing somewhere it shouldn’t. Annually they run a scan to take a look around the property, aka my body. I’d had to go to war for the scan. Their plan was to do nothing at all unless I had symptoms. Does death count? I felt their plan was insufficient while they felt running a scan was a frivolous waste of taxpayer’s money. My life didn’t come into the equation.

My former oncologist couldn’t help me find a new doctor. He suggested I call the HMO and ask them to refer me to a medical oncologist with a speciality in breast cancer. I knew my PCP wouldn’t be able to refer me because she had already said so. She had suggested I get the referral from my oncologist. Full circle.

I called Fallon Senior Heath Plan.

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The customer service rep sounded about 12-years-old, but knew even less than her years suggested. She didn’t understand the concept of different kinds of oncologists. After explaining for perhaps the dozenth time, I began to sink into the slough of despond. It was like talking to a smiling plastic doll who will recite one of 3 pre-recorded phrases. Pull the string, get an answer.

I got transferred to a supervisor and retold the story. She said she would “research the problem” and get back to me. Research the problem? Sounded like a kiss-off to me.

I called my doctor’s office, explained I hadn’t been able to get a referral from my oncologist or from Fallon where they kept saying my family doctor should send me to the right doctor even though I told them Dr. S. didn’t know the doctors in oncology at UMass, Worcester.

HELP, I said. Please!

I did my little song and dance, explaining I needed a Medical Oncologist with a specialty in Breast Cancer. Since breast cancer is frightfully common, it shouldn’t be that hard to find someone.

A few hours later, my doctor’s office called back, gave me a name, an appointment, a phone number. The appointment was for a few days hence, also my birthday. I didn’t want an oncology appointment on my birthday. Nor did I need an appointment immediately. I had just had my annual scan. So I called the doctor’s number to change the appointment to something more sensible.

I got transferred, transferred, and wound up talking to Lisa, the administrator for the Breast Care department. The doctor with whom I’d was booked is a surgeon and they need my medical records before they can continue. The records are all over the Commonwealth, scattered between 4 hospitals.

Lisa said not to worry, she would take care of it. She did. She changed the appointment, booked me with an appropriate doctor, called the various offices and ordered my records. Said if I had any kind of problem, give her a call and she’d fix it because women with cancer shouldn’t have additional problems because they already had quite enough. My feeling precisely!

Shortly thereafter, my doctor’s assistant called asking why I’d cancelled the appointment she had made for me. She was furious. After all the effort she’d made making that phone call on my behalf, I’d had the gall to CANCEL the appointment. I explained she’d booked me with a surgeon — pointless since I’ve already been thoroughly surged. I needed a different doctor.

She was pissed because it hadn’t been easy to get that wrong appointment and seemed unable to grasp the difference between a medical oncologist and a surgeon. I explained — again — that a surgeon would not be able to help me because I don’t need breast surgery. I have no breasts. But I do need my medical records sent to UMass. She said Lisa from UMass had called about it but she wasn’t sure where to send them.

“Did Lisa tell you where to send them?” I asked.

“Yes,” she said.

“Then … why don’t you send them there?” Duh.

“But you cancelled the appointment I made!” she whined, still pissed off.

“I changed the appointment. To be accurate, Lisa changed it because the doctor to which you were sending me was the wrong doctor. NOW I have an appointment with the right doctor.” We went back and forth for a while until she grudgingly accepted my apology for not needing a breast surgeon. I assured her that I truly appreciated her futile efforts.

“I’m so sorry to upset you,” I repeated.

Yesterday I got a note in the mail (not email, the regular mail) from UMass cancelling my appointment with the oncologist and suggesting I call to make a new one.

Maybe I don’t really need an oncologist. Dying is easy; comedy is hard.

Dying is easy