Girl Walks Into a Mammogram…

Through the calm eye of the window
everything is in its place
but so precariously
this day might be resting somehow
on the one before it,
all the days of the past stacked high
like the impossible tower of dishes
entertainers used to build on stage.
No wonder you find yourself
perched on the top of a tall ladder
hoping to add one more.
Just another Wednesday
you whisper,
then holding your breath,
place this cup on yesterday’s saucer
without the slightest clink.

“Days,” by Billy Collins

______________________

Two things I believe in – screening exams, and the  power of humor to defuse the most stressful situations – collided last week. 

Screening exams have just always made sense to me.  While I may not tend to getting our gutters cleaned before they clog, or finish Christmas shopping before the 24th, I somehow landed on this one precaution about which I am vigilant to a near obsession.  I don’t know too many women who at age 35 started casually hinting to their OBGYN that they wouldn’t mind getting a mammogram before 40.  No, no family history.  No, no particular risk factors, if you ignore a two decade unbroken string of lies to my primary care physician about weekly alcohol intake.  (I have it on good authority that the docs double what we tell them anyway). 

I am lucky not to have a genetic predisposition, but like so many people, that does not tell the full story of my history with breast cancer.  Like too many of us, I have friend history.  In both 2000, and 2008, my dearest friend Sylvia faced breast cancer in the face, spat back at it, and as best I could I spat right along with her.  You don’t sit in the chemo ward waiting for the next bag of clear liquid poison to be dispensed drip by agonizing drip into your best pal, and not form a history with breast cancer.  It’s personal.

Even aside from that history, I just think screening exams make overwhelming sense.  The way that not buying a house if you knew it was the subject of a satanic curse makes sense.  Here’s how I see it:  there’s something lurking out there that could kill you, but if you submit to a slightly uncomfortable procedure every year that said thing hasn’t arrived to try to kill you, you are karmically warning it that it better not f— with you, or that if it does, you are going to bring serious hell to rain down upon it.  Worst case scenario, the numbers on your side and it’s likely that, like Sylvia did, you will rip this thing limb from and spit one last time on its carcass for good measure.  OK, truly worst case scenario, everyone at your funeral is talking about how you did everything right, at least in this one small – or potentially enormous – regard.

This peculiar fixation of mine resulted in a prolonged and pitched battle to encourage, cajole and ultimately guilt Amit into having a colonoscopy at age 40.  Respecting both my husband and HIPAA as I do, I won’t detail the symptoms under which he has labored for many years.   But as I made abundantly clear to him, the somewhat uncomfortable ounce of prevention of a colonoscopy was certainly worth a pound of cure.  Of course, as I made this argument, I was fully dilated and in serious labor contractions two years ago, which meant he was goddamn well going to embrace that f—ing ounce of prevention given the 7 pound, 6 ounce innocent and helpless dependent I was about to force out of my chachi.  Not to mention the 560 ounce little person we already had at home.  These subtle pleas ultimately won the day, though it was over a year later that he resigned, drank 300 ounces of orange liquid, and submitted to an only slightly uncomfortable procedure confirming that – at least in the ass department – something wasn’t trying to kill him.

I thus arrived at the mammography center at Washington Radiology Associates last week with a self-satisfied, purposeful stride.  Written referral in hand, I served up my insurance card and checked the “No” circle on the lengthy list of prior health conditions (including my favorite:  “Do you have breast implants?”  To which I have long wanted to add a write-in response:  “Are you sighted?”).  Then I took my seat in the waiting area. 

At my first mammogram last year, I left with a good set of riffs on the whole process.  Without consciously trying to summon them, funny things just sprung into my head as I was pushed into the machine.  No woman would say this is a pleasant test, but for the small-breasted, it is painfully funny.  To get a B (or, if they came in that size, B+) cup breast sufficiently splayed on the proper area for this exam, one’s face, neck and clavicle are essentially flush with the machine.  It’s really more of a clavicle exam for us.  My head felt like it was being pulled backward by a giant rubber band, and my face and neck hurt far more than the modest amount of flesh compressed between the plates.    As I strained to answer the humorless tech’s questions, the breath from my nose fogged the surface of the machine, and I had this vision: if this is the technology we have to live with, then you could certainly make the process a little more enjoyable.  I recalled a street fair on Church Street in Burlington back when I was at UVM.  There was this Velcro wall, and for a few bucks you could make a running jump onto a trampoline and splay yourself face-first onto it.  You could combine these technologies, having the tech ready to take the image right at the moment you hit the wall.  The end result might be just as painful, but it would be a hell of a lot more fun.  Beer would be served.  And your college roommates could be standing there laughing their asses off, waiting their turn. 

Letting these and other wacky ideas bounce against the sides of my brain got me through the test, out the door, and back to the land of immortal-til-proven-otherwise.

This year was different. 

For one thing, the waiting room was especially crowded.  Out of the corner of my eye, I could see a young couple, the man’s arm on the woman’s shoulder, her head buried a little into his neck.  To my immediate left was a woman studying the pamphlet we were each given about a new 3D mammography technique that, while FDA approved, is not covered by standard insurance.  The brochure was gripped so tightly in her hand that it was crumpling, and her finger was following every line of text.  She sighed every minute or so.  The chairs were set up theater-style, and I was in the second row.  But I didn’t look behind me.  After a moment I stopped looking around me and stared straight ahead. 

All of a sudden, this seemed like the last place on earth where levity or jokes should course freely, even if only in my head.  I had to acknowledge that some subset of my fellow waiting room sisters had not gotten the form letter three days after the exam.  They’d gotten the phone call. There is nothing funny about this, I thought, and I’m deluding myself trying to pull humor into this place.  Breast cancer is a nightmare.  It’s awful and scary and unfair and has to stop.  I could get it any day.  Why should I be immune?  I’ve still enough Irish Catholic in me to feel with dreaded certainty that every peaceful day with my family and friends is not just tempting fate, it’s sending it an engraved invitation. 

Then, as if the good people at Washington Radiology were reading my mind, the TV screen at the front of the room alit, and there we all were, listening to the opening music of the Cosby Show.  The first episode was an old favorite:  Theo buys an expensive designer shirt by “Gordon Gartrell,” to impress his date Christine.  Cliff makes him take it back, but gives him $30 to buy a substitute.  Denise promises Theo that for $30, she can make an exact replica of the Gordon Gartrell.  Hilarity ensues. 

 

The shirt is a wreck, Theo unwittingly lets Christine see him in it, and Christine assures him that the shirt is even better than the designer one, because it’s unique.  Cliff and Claire preside over the whole affair with their knowing smirks, their firm but wise parenting. The closing music is like a balm being rubbed into my temples.

 No doubt, the Cosby Show is funny.  Bill Cosby’s face is a national treasure; he needs almost no spoken lines at all.  The ones he speaks –   “No fourteen year old boy should have a $95 shirt unless he’s onstage with his four brothers.” – are made pure genius by his deadpan expression.  I laughed.  The woman cliutching the 3D brochure laughed. 

In the end, the folks at Washington Radiology let me forgive myself a little. The right kind of humor belongs everywhere, is needed everywhere. I could either choose to think about whether it’s my turn to get that phone call, or I could let my mind travel to that beautiful brownstone in New York, where a doctor and lawyer appear never to actually go to work, but do orchestrate inspired responses to their children’s self-inflicted messes. 

 Halfway through the second episode (Cliff’s parents 50th anniversary; family lip-synchs to “Night and Day” – another classic), they finally called my name.  The tech was nicer this year, and, having opted to pay out of pocket for the new 3D technology, I was treated to a digitized image of some fairly perfect looking boobs (really, those are mine?) looming over the room like they were part of a national security briefing.  My snort fogged up the machine.  Just like that, there were more riffs to take away, more laughter taking its rightful place here, on this particular Wednesday.   May it grace all the others I am lucky enough to have.

 And I still think the Velcro wall idea has legs.

What I Wish I’d Known: The Newborn Edition.

Nora Ephron, a powerful chronicler of our human experience, wrote a compilation of things she’d wish she had known earlier in her life.  One of them certainly resonates with me these days:   Write everything down.  In the aftermath of her passing, Frank Rich wrote a wrenching and beautiful tribute to her, in which he offered a few additions to Nora’s list.  My favorite is:  There is no closure.  He wrote it as a friend grieving a friend, but I think it applies to our beginnings and middles as much as our ends.

 Closure is the furthest thing from your mind in the first days and weeks of becoming a parent.  Nearly everything about the journey to that pink and blue striped nursery hat has been about openness.  By choice, albeit an imperfectly informed one, you’ve decided to open your minds, hearts and bank accounts to create this child.  Every new mother has just endured the ride of her life, and the pride at what you’ve accomplished is mixed with some measure of shock at how this body that was previously very much yours has been opened to a fair amount of indignities. 

 We recently had two sets of dear friends welcome their first babies.  Alexander Jacob (AJ) was born on August 30, and Katherine Amelia (Katie) arrived on September 11.  This post is a love letter to their parents, and a humble codicil to Nora’s legendary list. 

 You are already doing a great job.

 These tiny little nuggets of love have just emerged from what is apparently a warm and delightful place, the dreamiest bouncy castle known to mankind.  That their very first experiences through the exit turnstile have been snuggling in your adoring and slightly trembling arms means they are getting exactly what they need:  you, the only parents they will ever know.  You have a tremendous, built-in advantage and have walked into this job with unique qualifications.  Katie and AJ have been hearing your voices for months, and they can’t believe their luck at who they got as a mommy and daddy.  Soon, they’ll connect that voice with a less blurry version of your face, and you will have that greatest of staring contests where each of you marvels:  It’s You.  In the more bewildering moments, try to remember that in the eyes of that baby returning your stare, you’re already the best parent that ever was.  In some ways, it’s a low bar of course, but take comfort from it anyway.

 You’ve just begun a new relationship … with fear. 

 You know how, for at least the last decade or two, you never really worried about whether you would arrive safely at work, get back home again, find a way to feed yourself, board a plane without having it crash, and generally be ok?  Guess what:  your parents still did.  Even yesterday, in some part of their brain they worried.  So trust me, at the moment that you are least physically and emotionally prepared to process the infinite affronts, you are about to loathe in a whole new way:  people who run red lights; people who curse loudly in public; people who impose demeaning punishment on their children; big dogs that seem sort of unpredictable, and their owners who have them off leash.  Also, in no particular order:  sneezing; dirty bathrooms; any bathroom without a changing station; busy parking lots; e. coli;  large, festival-type events featuring several of the aforementioned things; global warming; uneven pavement; BPA; balconies; glass shards; carnies…

 More fundamentally, you will fear that this world can’t be trusted with its newest member.  You will never, ever be able to process harm coming to a child, even in a bad made for TV movie, much less very real suffering being beamed at you from that world you no longer trust.  Sooner or later you will be up at an ungodly hour for a feeding, and you will see the commercial, sob uncontrollably, and start giving to St. Jude’s.  You may as well just do it now.

 http://www.stjude.org/stjude/v/index.jsp?vgnextoid=f87d4c2a71fca210VgnVCM1000001e0215acRCRD

 What could you possibly have been afraid of before now?  Turns out it was all chicken shit.  This is fear.  The bad news is there is no escape from it.  The good news is that you are in good company, and you have just redefined your citizenship in the human family.  That which levels us is by definition equalizing.

 Get out and stay out.

 You had babies at a glorious time of year.  As soon as your pediatrician gives the go-ahead, I beg you to get yourselves and that kid outside.  It is one of the only antidotes to that fear, because with each excursion you are subconsciously rebuilding a bit of trust that the idiot with the big dog isn’t about to sneeze e.coli on your baby.  And one day someone will sneeze on her, and she’ll be fine.  (Doesn’t mean that person isn’t a complete asshole).  Moreover – and I know you can’t believe this right now – your newborn is not going to provide enough sensory stimulation to counter the exhaustion, random crying jags (yours, not the baby’s), anxiety, and the creeping, guilt-inducing sense of displacement you are working hard to deny.  Get out.  It is just plain weird to spend that much time inside your home, the place you typically thrill to see at the end of long work days and on lazy Sunday mornings.  You also need sun and oxygen and to force yourself to regroup on the personal grooming front.  You won’t do it to impress your spouse, who looks as bad as you do, but for some reason you’ll put a brush through your hair for the undifferentiated public, even the dog owning idiot.  Either way, you’ll feel better for it. 

 There is also a new world of possibilities you can grasp right now, for a limited time.  You may have noticed that AJ and Katie sleep all day long, and that they don’t weigh very much yet.  Make haste for the hottest new restaurant in town, because they have a table for you at 5:15 p.m., and the car seat will fit right next to you on that plush banquette.  But Caro, you say, what if he wakes up?  What if he cries?  Surely you aren’t telling me to be that kid-toting ambience wrecker I’ve been cursing lo these 38 years!  Like I said, you’ve got a limited window.  An infant’s cry is about as shrill as the coo of a turtle dove, particularly amidst the din of a restaurant.  Devan hit up Hank’s Oyster Bar at the age of three weeks, and we only lifted her out of her car seat to show her off a bit to the waiter. 

On that note, you should show that baby off.  The way people respond may feel off-putting at first, because the three of you have been happy shut-ins for a while.  You certainly don’t need to let anyone touch him, but 99% of people are just happy to breathe in the sight of a joyful new presence.  They’ll be especially happy to meet parents like you, because babies born to smart and thoughtful people who have their act together are sort of like carbon offsets.  This planet needs Katie and AJ, for countless reasons, but one is that while you’ve been waiting for the ideal alignment of professional stability, financial security, and emotional maturity, a whole bunch of morons have cut to the chase and procreated willy-nilly.  We can’t lose that battle, and so for all the other wonderful things they will offer to this world, AJ and Katie also offset….let’s see…how about those twins Charlie Sheen had with the crackhead.  I think their names are Bob and Bob.

 Embrace the Shitstorm

 You will not believe how much of your time, money and energy is about to be consumed by poop. On an intellectual level, you know that all those little expulsions mean that AJ and Katie are healthy and growing.  They are doing just what they should.  That doesn’t mean it’s any easier to watch that pile of adorable onesies and embroidered burp cloths become covered in crap, often to the point of being irredeemable.  I remember my horror when I finally got to break in my silk (?!) Petunia Picklebottom diaper bag and realized I’d be depositing wet and putrid items into it, day in and day out.  

 Some five years into parenthood, I still hate some of the sheer grubbiness of it.  Just a few weeks ago, there was a purple popsicle situation that sent Amit into orbit.  But looking back on the infant days, I also realize that all that poop flying around was serving another purpose:  slowly but surely, we were having to loosen our grip on the wheel of our previously tidy lives. 

 By the time Kian came along, we thought we were pretty battle-tested on the poop front, but these kids sometimes find a way to up their game.  This boy’s butt sphincters were just mighty, and he loved to eat, and this led to some outrageously horrible outcomes.  In what has come to be known as the Cafe Divan Incident, Amit and I had Kian out with us for brunch when he was about 6 months old.  Detecting the familiar smell from the stroller, I looked down at him and thought I could see – yep, oh sweet Jesus – shit that had blown all the way up to his neck, just below his hairline.  I don’t know how Amit ended up being the one, but he hoisted Kian and headed down to the basement level restroom.  Twenty, thirty minutes must have passed before they emerged, and I will never forget the sight of the two of them coming up the stairs.  Amit had a full trash bag in one hand, our son – naked, but for a new diaper – in his other arm, and a look of shell shock worthy of a WWII movie.  For all that we throw the phrase around, you never really think you will witness shit hitting a fan. 

 We thought of that story the other day and laughed til our stomachs hurt.  Like much else in life, you can’t always see at the time that this day is going to be the one you’ll remember.  It was just another day where sweet Kian was doing just what he should.  But in giving in to the astonishing and unending mess, so were we.

  H, S, B and C:  We love you guys.