Julia lingers over her coffee, brought to her by a matronly and generous-bodied waitress. It’s stronger than she likes it, but, preoccupied by her thoughts about her mission for today, she drinks it mechanically, her awareness focussed internally. The fifties-style diner, where she has found a corner booth, provides a welcome retreat, and Julia is soothed by the quiet murmur of voices and the muffled sounds of food preparation coming from the kitchen. The atmosphere transports her briefly to a former time in her life, more carefree and spacious. She imagines riding in the pink Cadillac, sliced longitudinally from bumper to bumper and mounted on the wall above the row of booths that stretch out on her right. She sees her twenty-year-old self at the wheel, her long auburn hair streaming out behind her, a bright silk scarf knotted at her neck, out for a spin on a summer day with the sunlight winking on the chrome trim and lighting up the white-wall tires.
Bringing her awareness back to her current situation, Julia remembers with a jolt that this is her first visit to the store that she is here to explore. Earlier in the day, she had phoned to make an appointment and was told that she would be seen on a first-come, first-served basis. Knowing she will need the time and assistance of someone with expertise in order to complete her transaction, Julia now feels her anxiety mounting. So before it can paralyze her, she suddenly calls on her resolve to face her uneasiness, collects her jacket and purse and leaves the diner through the door that opens onto the mall.
The store she seeks is not far from the diner and on the opposite side of the mall. Her first impression is of a space cluttered with many racks, all overfull with clothing of every type and colour. She wends her way through the store, not seeing any sign of the service she believes is available here. Eventually she penetrates the deeper recesses of the store and finds a counter around which a group of women are gathered, chatting amiably.
As she approaches them, one of the group steps forward and asks, “How can I help you?”
Julia tells her what she has come to purchase and a stricken look passes fleetingly over the woman’s face. “I’ll get someone who can help you,” she says, and backs away from Julia, turning to approach the other assistants. She singles out one of them, an elegant woman of East Indian heritage. Her skin is the colour of burnished chestnuts and her hair shines with a blue-black sheen. There is about her an air of serenity as she moves fluidly towards Julia. It is settled like an invisible cloak around her slender shoulders and reflected in her tranquil face, a serenity that speaks of experience. She indicates that Julia should follow her to a fitting room at the rear of the store, and as they approach the door together, she turns her full gaze on Julia’s face, her eyes full of compassion.
“Is this your first?” she asks, her voice hushed, almost reverential.
“Yes it is,” is Julia’s simple reply. They enter a room larger than Julia expected. It is fitted out with large mirrors, framed in ornate gold. There is an upholstered bench along one wall and a counter on another on which stands a vase of silk flowers, white and yellow roses. The ambiance is one of studied care – care to create warmth, welcome and feminine beauty. Although still anxious about how experience in this place will unfold, the gentle presence of her companion has ignited hope for a good outcome, hope that grows as discussion about her requirements results in the departure of the sales assistant for the stock room.
Alone in the comfort of the fitting room, Julia’s mind drifts back over her journey of the past months, the journey that has led her to this time, this place. She remembers the sequence of events so clearly, beginning with an appointment with her family doctor, where her own perceptions were confirmed. What followed was a referral for further tests and then the call from the same doctor’s office requesting that she come in to the discuss the results in person. She knew then that the results would be hard to hear, and, when they met, one look at her GP’s face confirmed the gravity of the situation.
His words filled Julia with shock and fear: “You have breast cancer and you will need to be seen by a surgeon. I’m really sorry to tell you this news.”
Julia’s mind flashed to this first meeting with the man who would play such a pivotal role in her medical care. He was a kindly, soft-spoken older man and she immediately felt she could trust him to do his best for her. After his examination came his assessment, and then the shock of his verdict – a mastectomy of her left breast. To be sure of his ground, he arranged for her to have an MRI the following week, which confirmed his diagnosis. Within two weeks the surgery was done and Julia was home by 2:30 pm the same day, tired but hopeful. The pathology report would take two weeks to arrive at her surgeon’s office, two weeks of anxious waiting while she learned to manage the wound and the fluid drain and began to exercise the left arm to regain its full range of motion. She remembers the great need to sleep in order to recover from the physical shock of surgery and the effects of anesthesia on her body.
Julia finds herself smiling as she recalls the concern and support she felt from her family and friends in those early weeks. If she had ever wondered about her place in their hearts, the answer was made crystal clear by their actions and words. There were flowers, meals and many cards arriving daily at the house. The phone rang constantly with well-wishers and her parish priest made house calls to offer healing prayers and communion. It was an overwhelming, amazing infusion of loving care.
Two weeks later she met again with her surgeon and her memory of this meeting is one of ambivalence. The good news was that her incision was healing well, but with the dressings removed, she saw for the first time the scar where her left breast had been. The sense of loss was ferocious and brought her to tears as she took in the new asymmetry and the ugliness of the remaining breast tissue. She felt in that moment that she had been permanently disfigured as a woman.
A further shock awaited when her surgeon revealed the pathology results. The tissues that had been surgically removed showed that the cancer had affected the lobules in a large area of her breast and that it had also spread to the three lymph nodes that had been sampled. She then learned that a second surgery to excise more of the lymph nodes would be necessary. It would happen five weeks after the first.
Memories flooded back to Julia of the huge discouragement she felt about this news and about the post-surgery recovery, when she felt as though she was back at square one after having come through the first surgery so well. This time, she recalled, the physical recovery was quicker – for one thing, there were no staples to be removed. Two weeks later, though, the pathologist’s news was again quite devastating – 14 lymph nodes removed and all of them positive for breast cancer. This stunning news was shared at a meeting with a new member of Julia’s healthcare team, her radiation oncologist. The path report indicated the extent of the cancer’s spread, and was the basis for his decision to recommend 25 treatments to Julia’s chest wall and armpit once the surgery was healed.
She clearly remembers her fearful reaction to this prospect, despite assurances that the procedure would reduce the chances of a local recurrence by 80%. Her fear had to do with being alone, vulnerable and exposed in the treatment room, under the focussed beam of the radiation rays while the technicians remained behind a protective wall.
There are a few things Julia knows have helped her navigate this leg of the journey, the five weeks of daily treatment from Monday to Friday that started five weeks after her second surgery. Always with her, at every treatment, was a small copy of a picture of Jesus, “Prince of Peace,” drawn by a little girl called Akiane Kremarik. Akiane’s inspiration came from ongoing visions of Jesus which came to her repeatedly, despite having no prior knowledge of His story or teachings. Smuggling that picture into the treatment room in her pants pocket reminded Julia that she was in fact never alone and that she could ask for divine presence to help her remain calm and still, and to guide the hands of the technical staff in their work of directing the rays. It was like touching the hem of Jesus’ garment in the knowledge that He had the power to heal her. She smiles as she remembers the kindness of the staff, who never failed to treat her with respect in this strange new country of cancer treatment, where she felt exposed and so vulnerable among strangers. As the weeks passed, the process and the staff became familiar to her and she was able to relax and visualize the demise of the cancer cells during treatment.
Support also came from another source – a community founded and led by a gifted and spiritually aware psychologist named Peter. On a number of occasions he had led her through visualizations to encourage relaxation – a prerequisite for healing – and the release of fear, especially the fear of the radiation treatment. Gratitude welled up in Julia as memories of his compassionate phone calls came back to her. Peter also requested her permission to inform the larger community about her situation and when she agreed, a group of women offered to drive her to her treatments. This gift of time and presence each day made the whole process so much more manageable. Julia and her family were relieved of the responsibility for travel arrangements and Julia looked forward to visiting with each one of these women on the days of her treatments.
The five weeks of radiation treatment seemed to pass quite quickly, and on the last day of treatment, as on the first, she drove herself and her husband to the cancer centre. As she left the treatment suite for the last time, the radiation therapists blew bubbles around her. Then she was invited to ring the bell kept on the reception desk to signal to the whole floor that she was officially DONE! These were moments to savour!! So many memories, so many emotions, and through it all, she had experienced being held up by the loving care of her family and many friends from every part of her life. Her sister Pam had travelled from Europe to be by her side, bringing her unique brand of energy and the reminder that survival of breast cancer is doable! They were bonded by the same diagnosis, and Julia had been at her sister’s side in 2011, when Pam had gone through surgery and radiation treatment.
Many people had told Julia how exhausted they had been during radiation treatment, but that had not been her experience. She had certainly benefited from a nap here and there, which had restored her energy. However, the credit for her new-found energy she attributed to the generosity of Jess, a faithful friend who showed up on Julia’s doorstep twice a week to go for a walk – whatever the weather! Julia recalls that at the beginning it had been a struggle to walk around the block, but with patient encouragement from Jess, her stamina had improved week by week.
Julia’s kaleidoscope of vivid memories suddenly comes to an abrupt halt as the sales assistant returns to the fitting room, carrying boxes large and small. She invites Julia to examine the contents.
The larger box attracts her attention first because of its appearance. It resembles a small suitcase, about ten inches square, fabric-covered and opened by a zipper running around three sides of the lid. Julia opens it and lifts the lid to reveal a breast-form or prosthesis cradled in a depression into which it fits perfectly. The breast-form is a fascinating facsimile of a breast in terms of its soft, skin-like surface, its fluid texture and its weight. It certainly has gravitas and it impresses Julia as an amazing example of German engineering, the Volkswagen of breast prostheses!
The smaller boxes contain mastectomy bras in a variety of sizes, designed to accommodate the breast-form.
Once the breast-form is inserted into the bra, the combination can be tried on and Julia’s anticipation rises as her companion assists her. It has been hard for Julia to anticipate her size, partially because measuring her bust is challenging when one breast is missing and partly because Julia has been losing weight on her anti-cancer good regime of reduced sugar and grains.
The first attempt is good but not perfect. With her companion’s expertise, though, it is not long before the right combination of bra and prosthesis is found. For Julia the result is nothing less than spectacular and she examines the effect, turning to look at her profile in the large mirror from various angles. It’s hard to tell that she is wearing a prosthesis, and it feels so good to be symmetrical!
“How does it feel?” asks her attendant.
“Unbelievable! It feels like it’s part of me! It’s the first time in all these months that I look and feel like myself again!” Julia replies.
“Would you like to wear it home?” Julia is asked.
“Yes, that would be marvelous,” she replies. Her satisfaction grows as she puts on her blouse, noticing that it fits so much better than when she arrived and that she looks normal again. “Thank you so much for your help!”
These are Julia’s heartfelt, parting words to the woman who has facilitated her transformation. As she walks out of the store, she feels restored and grateful, eager to walk through the front door of her home and see her husband’s reaction to her new shape.
It is several weeks later, and Julia has adapted to her new routine. Each morning, as she puts on her bra, complete with its left breast, she feels as though she is strapping on a layer of protection and rebalancing her depleted body in readiness for the new day.
Her most recent accomplishment has been to complete the five kilometer Walk for a Cure in her hometown with her daughter by her side. She feels thrilled and overwhelmed to have been part of the 7,000-strong crowd of participants that together raised one million dollars for breast cancer research. Reaching this first-time personal fitness goal has been so satisfying for Julia. It is a statement that she is fighting back to full participation in her life, for however much time she has left to enjoy.
Now that is worth a celebration!