The loss that seems unendurable

Fay Lande

August 20, 1993|By Fay Lande

IN 1987 I had two mastectomies, leaving me, as one of my children said, "without boobs." Several years later, the feelings of grief and loss finally surfaced for me in a form I could understand.

Neither doctors nor hospital staff spoke to me about these feelings before or after the surgery and, for a long time, I was embar rassed to acknowledge having them. After all, it seemed like petty carping when I was still alive and others I knew had died.

If each of us is meant to sing our own song, this, I thought, is part of mine. I grew up with my mother's fear and grief over the loss of her breasts to cancer surgery. This engendered in me a terror of cancer surrounded by a foggy sense of impending doom. I remember the day of my mother's return from the hospital: her blue coat with its soft fur collar and the mysterious awkwardness her arms. She said only three magic words about this new phase of our lives, "Don't tell anybody," but I lived and breathed and ate and slept her grief.

Of course as a child I told everybody I knew, passing on the magic words, "Please don't tell!" and now, so many years after her death, I am telling everybody there is to tell, at least in &L Baltimore.

At 8 years old, I thought my mother a freak who could never go swimming again or wear short sleeves. Who would ever want her? And in puberty, when breasts came so easily to me, I lorded it over her without ever saying a word.

My mother's surgeon, Frank Adair, had a reputation as a man who healed. Others were not so successful with the same surgery. A prominent breast surgeon who knew him in the old days told me, "He was a great man with the ladies." My mother used to say that Dr. Adair had saved her life. In spite of the hollowed-out armpits, the stretched skin, the terrible scars of those earlier mastectomies, she loved him. Did that account, in part, for his extraordinary success rate? Dr. Adair's successor told me, "We believe that surgery itself is therapeutic." Was that belief based, in part, on the evidence of my mother's survival?

Even so, having once survived the cancer, my mother questioned the necessity for the operations that put an end, she felt, to her chances of finding love. Perhaps it had not really been cancer after all. Perhaps it was a dreadful mistake.

"They cut me," she used to say to me in Yiddish, as if to say, "You can't know what that means."

Indeed, I couldn't know until I made my own descent into darkness many years later. I entered the hospital with mixed relief and terror. In the enormous waiting room filled with people of every age and nationality, it came to me that we were all facing death, separately and together; that at last I had fully joined the human race.

I remember the clatter of jitneys going up and down the corridors to the operating rooms, the women strolling in ones and twos (each with a drain bottle under the long bathrobe), the terror, the laughter. A man blew me a kiss as we waited on parallel gurneys outside the operating rooms.

When later I read in Solzhenitsyn's book, "Cancer Ward," a description of an imaginary mountain of breasts piled up over days and years of operations, I said, "Yes, I know."

Before the surgery, well-meaning friends said, "At least it's not an essential part of your self. It's external. Your body will remain whole, intact." And after the surgery, I wanted to be the bravest one in the hospital, the one who answered the daily question, "Have you looked yet?" with "Yes and "It's OK." Now I'm ready to move on with the rest of my life.

Perhaps there are such women -- women for whom the practical is just that, who turn aside longings and memories as they put one foot in front of the other. I envy them.

But for me, the missed opportunity to grieve for my breasts covered a volcano. No one told me that I might not be able to bear my beloved husband's eyes or hands on my smooth scarred chest. The shame was overwhelming. The unacknowledged fear and grief could only be expressed in actions. I drew back from him because I couldn't speak the words.

"Tell me you don't mind." Of course he did, but how could I believe him? Was it this fearful and even lovingly meant silence that led us, each on the advice of our separate therapists, to take refuge in self-fulfillment and separateness? "Live your life," Bernie Siegel had said, "and you might just get to live." I dismissed my husband's anger and, beneath it, his fear and love, and ran off to a trailer in the woods, leaving behind an abyss of misunderstanding and a broken marriage.

Only in grieving that second unendurable loss was I able to put mind and body together and painfully, with hope and sorrow, begin to untangle the threads of life.

As the ideas of holistic medicine trickle into the mainstream, we might begin to ask what part of the intricate psyche, the deepest self resides in the physical breast? The eye sees, the tongue speaks and the breast gives. It is our connectedness, our nurturance, our love. To lose a breast is to be deeply wounded.

After my surgery I came across a 16th-century woodcut in a contemporary medical text. It depicted a woman being treated for breast cancer, body distorted by agony and awkward draughtsmanship, by the three methods that we still know for "killing" cancer: cutting, burning and poisoning. "Although incidence rates are increasing," says the American Cancer Society, "early detection and improved treatment have kept mortality rates fairly stable over the last 50 years." With all our high technology, we have not moved very far along.

Where are the truly new therapies for this illness that grows in epidemic proportions in our time? In what form, from what faith, wisdom or love of heart and mind they will come and be recognized, I don't know. But I know that I am their advocate.

Fay Lande writes from Baltimore.

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