Intro to Breast Surgery

12pm Dr. Carolyn Coombs-Skyles

Shaken from my earlier appointment, I’m turning inward and settling into numb shock. Food sounds revolting, though amber-colored liquor has a nice ring. But, I push on to my next appointment of the day. Cindy is repeating everything I mumble inaudibly to the receptionists in a louder, clearer voice. I’m handed another mountain of forms to fill out and sent to a chair that matches my mood in comfort. 

Name: Rachael Ahrens

Age: 35

I feel like I should put an exclamation mark behind that number since clearly I’m the youngest person on Earth to ever receive this diagnosis. Of course, I later found out that there are those younger than me. Jesus, the Universe can be a real asshole! 

I’m shuffled into another room and am asked to again take my top off. I’m wearing a sundress so this is an interesting request. I was handed what appeared to be half a medical gown, something more like a scarf or a large bib. Cindy giggles as I negotiate this new type of medical covering. I’m so inexperienced and braindead that I can in no way imagine how it would cover me so I give up and sit in my underwear on the table trying not to cry. With a chuckle, Cindy gets help from a passing nurse for a full gown. Apparently you’re supposed to wear pants to appointments with breast experts. There goes my whole wardrobe. 

As I get organized, in swoops Dr. Two-Names. Tiny with an impatient air and perfect black hair, this woman is all business. She’s a breast surgeon and therefore the “boss” of the overall treatment plan. She’s impeccably dressed under her tailored white doctor coat and, even though I assume she’s on her feet all day, whirling around to rooms like mine, she was wearing fierce stilettos that made me wonder if she was a masochist. 

She flips through the paperwork and some initial notes shared by Dr. G. “Ahhh, Allison,” she says out loud to herself after seeing my oncologist’s name. “Good.” I feel a little relieved that Dr. Two-Names approved of my oncology choice and then wondered why it mattered. I didn’t choose these people. They were given to me. And even if I had, do I need the approval of one doctor over another? 

In hindsight I realize the need to gain Dr. Two-Names’ approval is a result of who she is as a person. She is simply someone you want to please for reasons that aren’t immediately obvious, other than she’s very immediately intimidating. I imagine people step up to meet her extremely high expectations and avoid disappointing her at all costs. Asskissers stand no chance though. She can see right through the thickest layer of BS. There are probably support groups for her ex-boyfriends. Some people are just like this and I’m guessing many of them are surgeons. 

She turns her attention to me, long black eyelashes fluttering prettily. But, I don’t look long because this chick scares me. She gets right to the point. “Allison explained that you’ll be working with her first for chemo and, about a month after you finish chemo, I’ll perform your surgery.” She explains a lot of things I don’t remember and Cindy scribbles them all down. She tells me that we’ll see each other again halfway through chemo to begin deciding what sort of surgical options I have. There aren’t “ifs” in this conversation. Chemo is happening. Surgery is happening. My head is spinning as I begin to understand my sudden lack of input on what will happen to my own future, to my own body. 

As we wrap our discussion up, Dr. Two-Names helpfully reminds us of something Dr. G had also mentioned. I needed a port. I didn’t know what this was but I was very sure I didn’t want one. Dr. Two-Names explained a port-a-cath using a pharmaceutical diagram as an aid, noting they are placed on the opposite side of the cancerous breast in the upper chest region under the skin. It looked like an alien trying to escape someone’s chest cavity, right where my bathing suit or dance costume or sundress strap would go. I shook my head in protest and felt the tears coming. 

“No, that won’t really work for me. Where else can you put them?” I ask, trying unsuccessfully to keep from sounding like a fussy baby. “That’s where they put them,” she said firmly. “There are far more serious things to worry about.” Anxiety and grief are tailspinning over this discussion of butchery and I can no longer hide the fussy baby that is now me. I think she disguised an eye roll about as successfully as I disguised my grief. And then off she went, like she didn’t care if I came back to see her or not but knew that I would. She didn’t fake feeling bad for me once. 

Um, thanks for the hard truth, lady. But, can’t you see that I’m heartbroken and scared and that I’m not even sure I can do this? 

Yes, she could see all of that. She just didn’t have the time or patience to give many fucks about it. She’s a busy surgeon, after all. 

In the car, I tell Cindy I really don’t like her. We agree that someone a little softer around the edges might be better fit. I mean, did she miss the bedside manner lesson in surgery school? Who was this arrogant, scary, dark-haired mini-Barbie in a lab coat anyway?

In those early hours I didn’t understand this kind of tough and unfiltered delivery would be one of the most valuable things in my cancer treatment. I didn’t find another breast surgeon after all. Maybe that nifty subconscious lizard brain recognized she was the best surgeon for the job even though she scared me. I’m glad I stuck with her. Sure, I was fragile that day. But, like so many others before me, I eventually stepped up to her high expectations and toughened up enough to engage with her in a refreshing style of no bullshit problem solving. Pity was not invited to meetings with her. And I grew stronger because of it. 

Also, I didn’t know it at the time but having a whip-smart, unfuckwithable badass bitch as a surgeon meant that I had someone, well, whip-smart and unfuckwithable in my corner for this fight, which came in pretty handy over the next few months. Over our year together and ever since, I more and more appreciated my tiny, fierce surgeon in her tiny, fierce stilettos. She also softened a bit as she watched me meet challenges with grit and get stronger, just like she wanted me to. 

We’re comrades now. She called me boring at my last appointment. I didn’t take offense.

Thank you for sharing this post on social media to help me reach the next girl.

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