[ed. For Anna, in admiration.]
About a month ago, I had surgery. I am not sick, but the surgery was to reduce my risk of becoming sick in the future: a double mastectomy, a significant procedure for an otherwise healthy 31-year-old woman.
I’d been struggling with whether to do it for nearly two years, ever since I learned I carry the BRCA1 genetic mutation that predisposes me to early-onset reproductive cancers. My sister and I both inherited it from our mother. Typing the percentages of cancer risk for those with the mutation makes me cringe, as much for us women as for the simple, intractable nature of the human genome: The risk of breast cancer is as high as 90 percent, and 50 percent for ovarian. Breast cancer typically appears first. Thus, if you have not already developed cancer and been forced into decisions, as my sister has, doctors often recommend the prophylactic removal of one’s breasts and, eventually, ovaries, where the cancer is far more difficult to detect but whose removal is far more physically and existentially complicated.
I’ve always considered myself physically sturdy, the product of determined Irish, Swedish, and German farming stock. I’ve never sprained an ankle. The only bone I’ve ever broken is the forefinger of my left hand; it eventually healed, crooked but perfectly functional. I am not allergic to anything. Lately, though, I’ve thought about how much sturdier genes are than bodies: Bodies break and fall apart but the genes that comprise them remain steadfast, titanium double helixes. Bodies, it could even be said, break most often under the implacable weight of their genes, and will continue to do so forever, or at least until we truly master how to manipulate the genes, an eventuality that of course inspires ambivalence.
I know I am fortunate to have had the privilege and opportunity to make this decision that could help save my life. I am lucky that, when the pathology reports returned from the lab, the news was that my doctors had gotten to me before the cancer had. That said, this shit—testing positive for the gene, facing the decisions it forces, this surgery, recuperation, and whatever comes next—has been difficult. I choose those words—“difficult” and “shit”—carefully: Difficult is all this is. All the time, worse things happen, things that can’t, eventually and with effort, be scraped off the sole of the boot.
Meanwhile, the months have been dwindling during which I can claim (translation: buy) comprehensive health insurance through my graduate program. I am technically still a student, yet actually just unemployed, so the possibility of getting cancer while uninsured has grown increasingly real and distinct. This is why I went ahead and did it now, while I can bask in the dual luxuries of coverage and time. That said, I’m not bouncing back the way I’d planned on or hoped for when I hoisted myself onto and under the lights of the operating table and stared up at the anesthesiologist’s surgical cap covered in smiley faces. Nearly four weeks out, and I still can’t shave my armpits properly. Pulling a shirt over my head requires a mental pep talk and I can barely lift a gallon of milk from the fridge.
As a result, all I’ve craved are suburban comforts. Chief among these: my dog, a television with decent cable, a car and a place to park it, and gas enough to get me with a short drive to someplace pretty in the country where my dog and I can both take a walk off-leash. These are some of the reasons why I am writing this not from Brooklyn, which has been home for the past four and a half years, but from my parents’ house in Virginia. Here, I migrate between my old bedroom, lined from floor to ceiling with books, and my parents’ library downstairs.
by
Illustration: Emil Robinson, Pink Book, 2011. Courtesy the artist and Waterhouse & Dodd.
About a month ago, I had surgery. I am not sick, but the surgery was to reduce my risk of becoming sick in the future: a double mastectomy, a significant procedure for an otherwise healthy 31-year-old woman.
I’d been struggling with whether to do it for nearly two years, ever since I learned I carry the BRCA1 genetic mutation that predisposes me to early-onset reproductive cancers. My sister and I both inherited it from our mother. Typing the percentages of cancer risk for those with the mutation makes me cringe, as much for us women as for the simple, intractable nature of the human genome: The risk of breast cancer is as high as 90 percent, and 50 percent for ovarian. Breast cancer typically appears first. Thus, if you have not already developed cancer and been forced into decisions, as my sister has, doctors often recommend the prophylactic removal of one’s breasts and, eventually, ovaries, where the cancer is far more difficult to detect but whose removal is far more physically and existentially complicated. I’ve always considered myself physically sturdy, the product of determined Irish, Swedish, and German farming stock. I’ve never sprained an ankle. The only bone I’ve ever broken is the forefinger of my left hand; it eventually healed, crooked but perfectly functional. I am not allergic to anything. Lately, though, I’ve thought about how much sturdier genes are than bodies: Bodies break and fall apart but the genes that comprise them remain steadfast, titanium double helixes. Bodies, it could even be said, break most often under the implacable weight of their genes, and will continue to do so forever, or at least until we truly master how to manipulate the genes, an eventuality that of course inspires ambivalence.
I know I am fortunate to have had the privilege and opportunity to make this decision that could help save my life. I am lucky that, when the pathology reports returned from the lab, the news was that my doctors had gotten to me before the cancer had. That said, this shit—testing positive for the gene, facing the decisions it forces, this surgery, recuperation, and whatever comes next—has been difficult. I choose those words—“difficult” and “shit”—carefully: Difficult is all this is. All the time, worse things happen, things that can’t, eventually and with effort, be scraped off the sole of the boot.
Meanwhile, the months have been dwindling during which I can claim (translation: buy) comprehensive health insurance through my graduate program. I am technically still a student, yet actually just unemployed, so the possibility of getting cancer while uninsured has grown increasingly real and distinct. This is why I went ahead and did it now, while I can bask in the dual luxuries of coverage and time. That said, I’m not bouncing back the way I’d planned on or hoped for when I hoisted myself onto and under the lights of the operating table and stared up at the anesthesiologist’s surgical cap covered in smiley faces. Nearly four weeks out, and I still can’t shave my armpits properly. Pulling a shirt over my head requires a mental pep talk and I can barely lift a gallon of milk from the fridge.
As a result, all I’ve craved are suburban comforts. Chief among these: my dog, a television with decent cable, a car and a place to park it, and gas enough to get me with a short drive to someplace pretty in the country where my dog and I can both take a walk off-leash. These are some of the reasons why I am writing this not from Brooklyn, which has been home for the past four and a half years, but from my parents’ house in Virginia. Here, I migrate between my old bedroom, lined from floor to ceiling with books, and my parents’ library downstairs.
by
Illustration: Emil Robinson, Pink Book, 2011. Courtesy the artist and Waterhouse & Dodd.
