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.

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