Discovery

True, the older we become,  the less surprised we are by life's sudden turns.  But still, seven months after a normal mamogram, I was totally unprepared for the discovery that changed my life. I'm a teacher. It was late May.  The school term was ending.  Nights were warmer and I bought a pair of lime green shorts-and-skimpy-top pajamas for the summer, to take to Cape Cod, after my week in Washington, DC: two workshops, which is part of what teachers do in the summer.

I tried the pajamas on, and posed in front of my mirror although Heaven knows why, I never expected anyone to actually see me in my new short pajamas.  The bottoms fit fine.  The top didn't, it flattened me.  And I saw in the mirror a lump in my left breast below the nipple. What in Hell was that?  I had not seen it or felt it before. The moment I touched it, I knew.  I knew. Hello - you're finally here, aren't you? I've been afraid of you all my life - and, now you're here.  

There was no sleep that night.  I did not touch the place again - it had already given me its information. The next day I called my Internal Medicine doctor for an appointment - as soon as possible, I needed to know what I already felt I knew. I'm an American working in Germany. The health care system here is different - and you're going to be seeing those many differences.   

I was told to come in to see the doctor that same morning. He sonogrammed my breast, saw the lump, and also saw a lump in the left axillary. He said, "It's amazing how clearly I can see both lumps on the sonogram."  Ominous words. He referred me to the University of Heidelberg Brust Zentrum (Breast Center) at the Frauenklinik (Women's Hospital).   The haste I was passed on to specialists, confirmed my understanding of what was happening to me.  It also calmed me.  Already I had begun to make a transition from heathy independence to trusting patient. 

Though it was a long waiting-room time to see my assigned doctor at the Brust Zentrum, once I entered his office, things happened quickly.  He was calm, but funny; soothing, but realistic.  He spoke to me in English.  He examined my breast, and the other, and the swollen lymph node. He sent me downstairs for an immediate digital mamogram.  There was no wait.  When I returned to his office , my mamogram was already on his computer screen.  I have never seen a clearer, more detailed mamogram.  I told him even I could see the lump. He looked me straight in my eyes and nodded his head slowly up and down, twice.  He didn't say a word. He didn't need to.

He laid me out on his table and did a core biopsy.  First, of course, a local anesthetic was injected. I was surprised at the large bore size of the biopsy instrument. He pressed it against my breast in two locations. It sounded like a heavy duty stapler, or a lightweight nail gun. Pop, pop!  It didn't hurt.  He told me what to expect in bruising as after effects.  I would get the results in a return appointment the following week.  Then he said, "Prepare yourself. I believe this is a malignant tumor. If it is, as I suspect, it is small and we know exactly how to take care of it. Not to worry." 

His words freed me from fantacizing worst case scenarios. Worst Case was now sitting on my doorstep, and it wasn't that terrible. Small, he said.  Still, this doctor specialist who does breast examinations for cancer in the major medical University of Germany - could be wrong.  Nevertheless, I slept very well the following nights.  Thank you, Doctors.

I didn't wait as long for my appointment the following week. When I entered the doctor's office he and his nurse were sitting casually in chairs to the side of his desk, and I was offered a place between them.   I almost laughed.  I was told with the utmost kindness, that my breast tumor was invasive ductal carcinoma, and it appeared there was lymph node involvement.  I was sent to talk to an anesthetist, and to schedule surgery and hospital admission.  (more to come)