Read an Excerpt
On September 30, 1974, an NBC News correspondent reporting from the Guttman Breast Diagnostic Institute in New York told of the nationwide reaction to the mastectomy of the wife of the President of the United States, how women everywhere were rushing to their nearest mammographer, how suddenly afraid women were. The report emphasized that the fear was productive, because so many women were acting on it.
On camera, the correspondent said, “The terror that women feel about breast cancer is not unreasonable. What is unreasonable is that women still turn their terror inward. They think if they avoid investigating the possibility that they have the disease, they'll avoid the disease. But as cases of such prominent women as Betty Ford become known, other women are turning their fear into the kind of action that can save their lives.”
The correspondent had done her homework. She knew that early detection was important, that most lumps were benign. She knew all about the different kinds of mastectomies -- radical, simple, and so on -- and the controversies about them. She knew a lot. But as the correspondent spoke to the camera, telling the nation what she knew about breast cancer, there was one thing she did not know. She did not know that she had it herself...
Chapter One
I had a lump for a year. At least a year. It was a hard little thing -- about the size of a yellow grape -- and it resided, imperceptible except to the touch, on the far left side of my left breast, due west of the nipple. I knew it was there, my (ex-) husband knew it was there, and my (ex-) internist knew it was there, and my (ex-) mammographer knew it was there. Of the four, onlyone of us was worried about it. That was Arthur Herzog, the husband, who had found it on a spring evening in 1974 during a routine sexual feel.
“What's that?” he said. “I don't know,” I said. “It's a lump,” he said. “Mmmm,” I said, wanting to sleep. “Will you get it looked at?” he said. “Sure,” I said, and went to sleep.
I got it looked at. “It's nothing to worry about,” said my internist on Central Park West, whom I'll call Dr. Smith. “Feels like a cyst. A lot of women have them. But we'll send you for some mammograms.”
I went for some mammograms. “This doesn't worry me a bit,” said my mammographer on East Ninetieth Street, whom I'll call Dr. Ellby. He held up his pictures of my lump to the light. “Come back in a year and we'll have another look.”
Whew. Not that I had been worried, either. Well, maybe just a little. Anyway, I was glad to be out of there.
Mammograms -- low-radiation X-rays that show the inner structure of the breast and can, theoretically, pinpoint the location of even the smallest abnormality -- are not pleasant things to have. The experience is often likened to having a chest X-ray, but it's not like that at all. When you have a chest X-ray, you stand, shoulders forward, against a machine, and the machine performs. Mammograms require a different kind of participation. Before the picture-taking even begins, one has to tolerate the sensible and essential but unnerving business of being “palpated” (medically felt up) by the mammographer. Then, holding your paper gown together with one hand, and grabbing your purse, bra, and blouse with the other, you are bustled off to another room where topless and chilly, you sit on a small stool before a large machine. A technician -- a young woman, usually, who moves fast and doesn't talk much -- takes your breast in her hand and puts it, as if it were a slab of beef, on a slab of steel. Then her arm shoots up and she cranks down another slab of steel, thereby creating a sort of breast sandwich.
Your flattened breast is the filling. “Say when it hurts,” says the young woman, who has become part of the machine. “Ouch,” you say, and she stops cranking. “Don't breathe,” she says, as if you could. Bam, slam. Click, slam. “Breathe,” she says. Then, like ballet exercises, repeat on the other side. (Crank, crank. “Don't breathe.” Bam, slam. Click, slam. “Breathe.”) And that's it. But you can't go home. Not yet. You go out to the waiting room filled with women on mahogany chairs and aqua settees reading House Beautifuls and old Newsweeks or not reading at all, and there you wait -- either to be dismissed (no cancer) or called back for more pictures (maybe cancer). Not that that word is spoken either out here or in there. It is as silent as the g in sign. But, like the g in sign, it is there.
It was there in my head as I waited in Ellby's dreary waiting room on that day in June. But it was there the way “rape” was there. A buried terror, far, far under the ground. My remote fear of breast cancer virtually ended when Ellby said he wasn't worried, and the fear was entirely finished off a week later when, after seeing the mammograms, Smith said he wasn't worried. Ellby was the mammogram emperor of the greater New York area (“Surgeons send their wives to him,” a doctor friend had told me); Dr. Smith was my trusted (impeccably reputed) internist of eight years. If they weren't worried, why should I be?
