She didn't panic. She was only 36 and healthy in a typical Northwest way—ate organic, biked 100 miles a week—and her annual breast exam had been blessedly lump-free only four months earlier. And when Valerie called her boyfriend over to cop a feel, he couldn't detect the lump. Neither could the nurse practitioner who examined her later that afternoon. Neither did the mammogram he ordered. It was an ultrasound that finally confirmed what Valerie had felt: a pebble-sized mass that turned out to be stage 2A, HER2+ invasive ductal carcinoma—in layman's terms, a rare, aggressive form of breast cancer that is notoriously difficult to treat.
The mass was so small, her doctor said it was a miracle she'd detected it at all. Then, "when he saw my lymph node, everything changed in the room," Valerie remembers. The cancer had already spread to her left arm. "He said, 'You have breast cancer, it's extremely aggressive, and you have an MRI scheduled for 4 p.m. today. Be there.'"
The following week was a blur of bone scans, blood tests, PET scans, and other tests and terminology that are all but indecipherable for those who aren't profoundly sick or working in medicine. It was a week spent calling relatives, crying long-distance, and adjusting to the abrupt new reality that she might die—soon. And, if she lived, it would be without breasts or the possibility of ever getting pregnant.
"That was probably the hardest to hear—that I could never have children," Valerie says. "I've always wanted to have children."
The bleak news was compounded by the fact that she'd been recently laid off from her job and that, as a relatively new Seattle transplant, most of her family and friends were across the country in South Carolina.
"I didn't have an immediate support system beyond my boyfriend and my cats," she says. "The isolation gets to you—you can't get a hug over the phone. It makes you dwell."
Which is why, two days after her diagnosis, Valerie began to blog about her battle with cancer. She wanted to keep her family abreast of her treatment and, hopefully, find support from someone going through the same physical and emotional struggle she was. She named her Tumblr blog CatsNotCancer because she loves cats (not cancer). Over the course of the next year, Valerie would bluntly document her daily ups and downs: How she named her breasts and the cancerous lymph node she would ultimately have chopped off; her ceremonious Viking boob funeral, where she lit boob-shaped candles and set them adrift in Lake Washington as guests snacked on boob-adorned cupcakes; the shaving of her beautiful red hair for Locks of Love ("I couldn't bear to watch it fall out"); her body's refusal to heal after her first radical mastectomy; how cat purrs help heal a mutinous body; the triumph of revealing her scarred, altered chest on Tumblr for its infamous "Topless Tuesday" shots.
"People see commercials and advertisements with cherubic bald women waving pink ribbons, but that's not talking about breast cancer and the realities of going through active treatment," Valerie explains. "After a few weeks, I discovered that I had a new mission: help people see the grim realities of cancer, so maybe they'd remember to cop a feel at their own breasts or book a checkup."
That mission began with a good-bye letter to her breasts:
"I looked at Mabel this morning (I named my left breast Mabel—my right one is Hazel) and I feel this weird mixture of anger and loss," Valerie wrote less than a month after her diagnosis. "And then I look at Hazel and feel sad too—she's being spared tomorrow but her day is coming very soon. And I wonder how I'm going to feel after the surgery when I see this void where my breasts once were. I have no idea... But I do know this. Tomorrow is the first real step toward defeating this dragon. And I have to view this as war—it is war. And tomorrow is the first battle. So for today, and just today, I'm going to allow myself a little self-pity. I may cry (and when I cry, I cry—think the Ben Stiller scene from Something About Mary. Seriously.) and I may pout. But come tomorrow morning, it's game on. I declare war. And I intend to win."
Valerie's posts were reposted, commented on, circulated around online cancer support groups. CatsNotCancer quickly gained more than 2,100 followers on Tumblr, partly because of her content and partly because Valerie took the time to respond to everyone who left messages on her blog looking for guidance, help, or empathy.
That's how she met Beth three months later, in December 2010.
"She was a fellow blogger who introduced herself and said she was going through treatment for lymphoma," Valerie recalls. "I had just undergone my fourth round of chemo and I was feeling really sick—I had no energy, and my mood was in the dumps. It was an accomplishment to put up a blog post during the day."
Nevertheless, she responded to Beth's overture of friendship, and for the first week, their communication was benign. The 19-year-old Wisconsin native, who appeared physically healthy in photographs, talked about her daily struggles with balancing lymphoma treatments and college classes (she wanted to become a psychologist), and the two talked companionably about their favorite TV show, Lost.
Then one day, Valerie received a note from Beth via Tumblr that simply read, "Can you get pregnant while on chemo?"
It struck a chord.
"I wrote her back and said, 'Well, I can't get pregnant while on chemo...' but I admitted that I didn't know her treatment and couldn't know what she was going through," Valerie says. "I did think that chemo would be really, really bad for a fetus. I mean, it's poison." She urged Beth to contact her oncologist immediately.
Instead, Beth messaged her again, intimating that she'd gotten pregnant after being raped by her uncle.
"I immediately sent her my phone number and personal e-mail address and urged her to call me," Valerie says. Beth called within minutes, and the two had their first phone conversation, during which Beth haltingly explained that her uncle had abused both her and her 6-year-old cousin (his daughter). Over the phone, Beth sounded very young and painfully shy, and yet: "She was almost casual about the whole thing," Valerie recalls. "She was hesitant to even call what happened rape."
E-mails forwarded to me by Valerie confirm her account. "Well, I guess its rape then because I did not want that at all," Beth wrote in an e-mail sent the day after their phone conversation, on December 30, 2010. "That word is so gross sounding to me. It makes me so angry. Like the whole thing is just gross, but secondly, I could have gotten really sick from that! Inconsiderate."
Beth ended the e-mail "Blah, blah, rant over lol :)."
It put Valerie on alert. "I kept thinking 'inconsiderate' is one of the last words I'd use to describe rape," Valerie says. Her skepticism grew when she received a follow-up e-mail from Beth on December 31 that read, "Well...I am officially pregnant. This is my worst nightmare. Horrible. I want to die. I am mortified :("
Mortified?
Despite her suspicions, she continued to e-mail Beth.
"I was trying to keep an open mind," Valerie says. "I'd only known this girl a few weeks, and it sounded like she had people in her life mistreating her. I just wanted to offer what support I could."
And who was she to judge the coping mechanisms of a 19-year-old cancer patient and struggling full-time student who spent Christmas being raped by her uncle?
But while Beth e-mailed daily updates on her mortifying pregnancy—"Aborting it is what [my doctor] would recommend his daughter to do. He doesn't think I could handle it mentally or physically. Blah blah."—Valerie contacted her own oncologist about the content she'd read on Beth's blog. She remembers one about Beth throwing up blood between classes at school, then skipping to the hospital to get a five-unit blood transfusion. "My doc was like, 'There's no way in hell that's happening,'" Valerie says. An adult has 11 to 13 units of blood in their body, total, and from the pictures she'd posted, Beth was a petite woman. If she'd lost half the blood in her body, she'd die, not be home in time to blog about it before dinner.
Nor would the average lymphoma patient have the energy to be a full-time student while undergoing treatment, or risk exposing herself to hundreds of germy students while actively being treated for cancer of the immune system.
But Valerie didn't confront Beth with suspicions that she was faking her sickness. Instead, to preserve her own health and sanity, she abruptly stopped answering Beth's e-mails, texts, and phone calls. "Her lying was so alien as a concept, the idea of outing her horrified me," she says. "Part of me thought, 'There's something horribly wrong with her, and if she is being abused, I don't want to make life harder on her.'"
In response, Valerie says Beth went "totally apeshit."
Munchausen syndrome takes its name from an 18th-century German baron who was famous for embellishing tales of his military exploits to anyone who'd listen. But it wasn't until 1951 that Baron Munchausen became widely associated with another crop of pathological liars: people who go to incredible lengths to fake illness or psychological trauma for the express purpose of attracting medical attention and sympathy from other people. Munchausen sufferers don't just shave their heads and say, "Look! Cancer!" They alter their medical records, starve themselves, install catheters and chemo ports, even convince doctors to perform unnecessary surgeries on them—anything to legitimize the fantasy of their sickness.
