I can assure you that the pathetic fallacy occurs only within the pages of fictional narrative. If ever I’ve had something truly unpleasant to do, it has always taken place in lovely weather. My appointment was for 9am on a Monday morning and I left at twenty to eight because getting across town in rush hour traffic is an unpredictable business. Naturally it was not long past eight as I came in sight of Addenbrooks hospital, a collection of towering buildings that all give the impression of having no doors into them. I am not fond of hospitals and this one merges in my mind with a kind of futuristic concentration camp. It used to be said that the smoking chimneys indicated the furnace where the unwanted body parts were incinerated but I don’t know about that; I try not to look closely at any of the buildings or speculate about what goes on inside them.
So I had a long wait in an empty waiting room. By sheer chance I chose a seat from which I could activate some nearby double doors by moving my head a few inches forward and couldn’t decide whether this was entertaining or annoying. Finally, we got going. I had a mammogram in a nasty, scruffy room with a cold machine and an efficient but not exactly sympathetic nurse. I dressed again. Then I was called for a meeting with a doctor. Another multi-purpose room that didn’t seem to fit any purpose particularly. I was told to undress again and to use one of the blankets to wrap around me. These turned out to be the size of a (small) baby’s cot blanket and the edges only just met as I held it about my ribcage. Now I am on the thin side, so what more generous women are supposed to do, I have no idea. Perhaps it is a form of distraction for them to figure out how to weave two or three into a decent covering whilst waiting for the doctor to finally arrive. When he came the doctor asked a few basic questions and made an examination. ‘Well, you’ve got a lump,’ he said, ‘Did you notice when it first appeared?’ I was answering him but he spoke over the top of me, ‘It’s probably been there for months. It feels benign, and the mammogram looks fine, but we won’t know until we biopsy.’ He shook his head at me slightly. ‘Cancer at 39, well….we wouldn’t want that.’ As he said this I was uncomfortably aware of my mind receiving the word like the crash barriers in the middle of the motorway receive articulated lorries. And then, the internal police force were suggesting everyone move along please, nothing to see here, no, no, no terrifying words had been spoken. The doctor whipped out a black marker pen and drew a circle on my breast. I had a mad desire to take the pen from him and add a cross on the other side. ‘You’ll be called for an ultrasound in a little while,’ the nurse said. ‘In the meantime you had better go back to the waiting room.’ She gave me an information sheet on biopsies, which I folded and put straight in my bag, hoping I might not notice myself do it. This time when I took a seat the receptionist came over. ‘Have you not been seen yet?’ she asked anxiously. ‘Only you came in early this morning and you’ve been here for ages.’ I explained that I was waiting for an ultrasound and she made a little ‘o’ with her mouth and walked away backwards to the safe rampart of her desk.
Once again I was called, once again I undressed in a chilly room and lay shivering and inadequately wrapped on a cool couch. This one at least had the benefit of being dimly lit. Another doctor appeared, a more genial and comforting one, and a smiley nurse. They took seats on either side of me and I felt rather unwillingly like a sick child being visited by its parents. The doctor eyed my marker pen bullseye. ‘Excuse me,’ he said, ‘but I make it a little further south than that. There it is,’ he declared, pointing at the screen. ‘Looks quite innocent to me, but of course it’s impossible to tell. It’s standard practice at this point to offer you a biopsy.’ It is fair to say that by now I was in what my mother would have termed ‘a state’. No one had mentioned anything to me about biopsies before, but it seemed as if the whole horrible morning had been one long, slow conveyor belt ride towards its inevitability. I had been dressed and undressed, I was cold and terrified and misinformed, I had been promised an answer and no one could give it to me without, it seemed, cutting me open. I’ve been made to wonder in the past what the point of ultrasound is. As a teenager being diagnosed with polycystic ovary syndrome, I had my fair share of them and every doctor complained that they couldn’t see clearly into my internal mechanics. I wanted to scream, have you actually looked at me? If you held me up to the light, you could probably see right through me! But of all the things I felt, anger, frustration, horror and fear, fear was by far and away the strongest. ‘Do I have to?’ I blurted out. ‘Must I have a biopsy?’ The doctor looked vaguely taken aback. ‘Oh no, not at all.’ He put his head on one side, considering. ‘The latest research from America suggests you have a slightly less than 2% chance of anything being wrong. The alternative I would suggest is to have you monitored. Back here in six months time for a further check up.’ I hesitated; going through the whole morning’s process again was far from appealing. ‘This is not an easy decision,’ I said. ‘Tell me what the biopsy is.’ ‘Well,’ replied the doctor, getting into his stride, ‘we make a small nick in your breast and insert a needle which will take a sample of flesh. We’ll need to do this two, or even three times. And then the nurse and I will lean very heavily on your chest to stop the bleeding.’ He said this with some vigor. ‘There will be bruising, I’m afraid.’ ‘I really don’t care about the bruising,’ I replied. ‘It’s just that I’m so scared and I’m here on my own. I hate to admit to being a coward when you see people dealing with much worse every day, but I’m not sure I can go through with it.’ The doctor held my hand very kindly and waited for my decision. In all honesty, there wasn’t much of a contest. I took the appointment amid flurries of promises to keep a close eye on the reviled lump. ‘Wait and watch, wait and watch, that’s what we will do in this case,’ the doctor declared, getting out of his seat and stretching luxuriously. ‘But you can come back at any time and we’ll fit you in for a biopsy. After all, cancer at your age….’ And his voice trailed off, whether out of horror or uncertainty as to how the sentence should finish was impossible to tell. Out in the corridor I watched another young woman waiting to go in, her ribs rising and falling erratically with fear of what lay ahead. The nurse appeared with an appointment card. ‘Some people need a little time to get used to the idea, I suppose,’ she said kindly, but not without some latent anxiety.
And so after this debacle, I found myself, if possible, feeling worse than ever. My odds of a clean bill of health had improved, but the route to getting it had suddenly turned even more arduous. I cannot express to you how much I loathed the idea of the biopsy. I am horribly squeamish, and the thought of having this procedure done under my nose, while I was conscious, with my consent, seemed as outrageous as it was impossible. But without it I knew there would always be this relentless niggling in the back of my mind. And now I didn’t know what to do, didn’t know who to tell. I had taken the decision to keep quiet about it initially as I didn’t want to worry people. I’d taken a blogging break because I didn’t feel able to write about it and knew I could not talk honestly about anything else. And there was another reason why I’d only told a couple of people, and that was that I realized how touchy I was about their responses. I couldn’t bear the thought of anyone freaking out on me when I was freaking out about myself, and all I could tolerate was a reply along the lines of: I know someone this happened to/this happened to me and I/they am/are fine. I have to say that my blogging friends were marvelous – a couple had emailed me unwittingly and received more news than they bargained for, but their responses were quite perfect. And I must say a special thank you to JB who was by now holding me together across virtual space, and who would continue to do so, daily, until the end. Those in real life were sometime less than helpful. One friend I rang that morning when I returned weary and upset from my inconclusive tests let me get as far as saying I had chickened out of the biopsy before starting to yell at me ‘You are SO stupid…!’ I was more shocked and hurt than I can say, but then I shouldn’t have been surprised. Long association with chronic fatigue had taught me that people’s responses to illness and the threat of disease are often fierce and emotional. I had become very practiced at not complaining, at downplaying anything I felt or feared because illness is like grief – so often you end up comforting the people who are supposed to be comforting you. It’s just human nature and I am the first to need comfort when my loved ones are ill. But my heart sank at the thought of six months of pretending I was fine.
For a week I suffered a kind of extreme anxiety, riding the waves of constant, bubbling panic. And then, time passed and I began to take myself in hand. I have often thought that anxiety arises in situations where a part of you longs for comfort, needs it quite desperately, but your mind refuses to permit it. I began to see that the way I respond to fearful situations is not at all skillful. My tendency is to batter myself with a whole range of worst-case scenarios with the vague intention that I should somehow then be prepared for them. Of course this is nonsense; the gulf between speculating on something and actually knowing it is insurmountable. But I could not inhabit the position where I was comfortably sure I would be all right. This seemed like tempting fate. And so, when I most needed to soothe my inflamed imagination, I was incapable of doing so for fear of being subsequently clubbed around the head with an unexpected disaster. There was so much superstition in the way I approached the outcome of this problem, already I had fallen into regressive childish habits of trying to wear only ‘lucky’ clothes, and making bargains with the gods. It was nothing more than a last-ditch attempt for control in a situation where there was none to be had, much in the way that people will more readily bet on dice before they have been thrown than after; we find it so hard to believe that the force of our desire cannot really influence the outcome. And I had to recognize how hard it was for me to prevent that 2% chance from sliding out of its category of science and into the wholly different causality of narrative. In science, a 2% chance is minimal, but in a story, the same degree of chance becomes something else altogether. The less numerically likely something is, the more likely it is to happen, because that’s how events gain maximum impact in a narrative setting. If this were a story then the question of my health would be decided by completely different factors – the moral universe of the novel, irony, the power of poignancy, the dead woman, as Edgar Allen Poe declared, being the most poetic of all subjects.
I didn’t think I was going to die, but I wondered how much I was going to suffer. Still, it was undoubtedly true that the greatest torture was being done to myself already inside my head. I knew, with a great undertow of dread, that I would have to find a way to face that biopsy and so I set about trying to alter the way I was framing the event in my mind.
I will do a further part tomorrow – many apologies for the length of this but it’s been going round and round in my mind for weeks now and this is the only way I know of getting it out and laying the ghouls to rest. Thank you for your patience, blogging friends, the book reviews will return!