“Little Wing” by Suzanne Stryk, 2005
Home Breast Exam
I handle my breasts in the shower more than an adolescent boy touches his penis. I pretend that I am just washing. I make a round sweep with soap from the outside of each breast to the center, a gentle squeeze of the nipple, up under the armpit and down the side. This is my version of a no-stress home-breast exam. I reason if I wash daily, I’ll notice any lumps, bumps, or changes. Will I?
Before awareness, there’s a dawning, a sliver of a line between not knowing and knowing—enough space for a dim light to seep in and expose a threat not yet seen, heard, smelled, or spoken. I can’t remember when I first heard the words breast cancer. I’m guessing that it was discussed in whispers before I had breasts or even breast buds. Maybe it was when Phyllis, a close family friend, died from metastatic breast disease when I was ten. I don’t remember anyone telling me that she was sick or that she was dying or that her sickness started in her breasts with a cluster of cells that turned into a lump; this was well before mammograms became a yearly event.
Odd, when you consider that I grew up with a one-breasted bubbie. My mother’s mother lived to a well-ripened age of 91 with a lone plump breast that dangled to her waist and sat opposite a red- and white-scarred flatland, and, yet, I never connected my grandmother’s missing breast with Phyllis’s death.
I recall my grandmother leaning over a white industrial bra and dropping her long breast into the deep cup and nonchalantly tucking a beige pad into the other side. I never asked after a second breast, and no one mentioned that she had once had two. Now, breast cancer would be obvious, but 45 years ago, there were no pink ribbons, pink rubber bracelets, breast cancer walks, postage-stamps, tins of tea, and bottled water screaming out grave statistics.
Back then, breast cancer wasn’t discussed in stages that sounded algebraic—Stage 0, 1, 2A, 2B, 3A, 3B, 3C, and 4, or more typically as Stage 0, 1, 2, 3, or 4. Stages are a shorthand way of discussing severity and survival with few words: Stage 0-1: Very good odds. Stage 2: A little worse but very doable odds. Stage 3: Serious. Stage 4: A life sentence with no cure possible.
I wonder if my grandmother’s cancer was staged as doctors refer to the process now. Would she have been a Stage 1 or a Stage 2? Before the mid-60s, mammograms didn’t exist; any lump or bump was biopsied. Clusters of abnormal cells were studied under the microscope. My 84-year-old mother wonders if her mother had cancer at all.
When I was eight or nine, I had a Barbie doll, a Stacey doll, my namesake, or so I wanted to believe. She was a top-heavy straight-haired platinum blonde who couldn’t have been further from my Russian-Jewish genes. Stacey, like Barbie, was sexy if you were into plastic. She was manufactured from 1968 to 1971, which coincided with my infatuation with top-heavy dolls, and measured an impossible 39-18-33—a body that appears naturally only once in every 100 000 women. It’s hard to believe that Barbie, the ultimate shiksa, was created by a Jewish woman, Ruth Handler. (Handler had breast cancer and invented right and left prosthetic breasts. Makes sense. We wouldn’t wear our left shoe on our right foot. Yeah, Ruth!)
Alas, my physical blueprint is closer to a matryoshka, a Russian stacking doll, than to a Barbie. I wonder if dolls will ever be made with a single breast to reflect the reality that some little girls and boys will see when their mothers or grandmothers disrobe in front of them.
Once Upon a Time
In Egypt around 1600 bce, breast cancer, described as ulcers of the breast or tumors, was first detected. Centuries later, doctors began to understand the circulatory system and linked breast cancer to the lymphatic system, the sprawling super-highway of lymph nodes (key agents for infection control), which runs throughout the body. In the 18th century, scientists discovered that this super-highway could also spread disease like a reversible lane on a modern freeway. William Stewart Halstead performed the first radical mastectomy, termed the Halstead radical mastectomy, which involved the removal of the pectoral muscles, all breast tissue, and the underarm lymph nodes; this was supposed to reduce the risk of the cancer spreading. Halstead radical mastectomies were routinely performed until the 1970s, when Rose Kushner was diagnosed with breast cancer and refused the one-stop biopsy and mastectomy surgery that had become standard practice. The journalist challenged the invasive, disfiguring surgery, which had been used for 70 years with no scientific evidence to back up the practice. She made breast cancer into a political issue and pushed for legislation that would offer women choices in treatment. She pushed for coverage of annual mammography by Medicare. She pushed for more dollars for breast cancer research. Her work lead to the change in protocol from the Halstead radical mastectomy to the modified radical mastectomy
Kushner figured out that not all breast cancers are equal. Could my bubbie’s breast have been spared? Was this a matter of your breast or your life, ma’am?
Science and medicine march forward at an unnervingly slow pace, and we wait, holding our breath, having few other options.
Patti was my best friend from age 12 on. Sex-crazed boys at the Turkish synagogue where we hung out on Saturday afternoons teased her mercilessly for her large breasts. She wore high-neck t-shirts and sweaters, careful never to show cleavage until she was nearly a middle-aged woman. She refused to hide behind frumpy blouses like the other girls with unseasonably large breasts. Behind her back, the boys came up with a long list of breast terminology—twins, tits, sisters, headlights, hooters, coconuts, casabas, cantaloupes, boulders, berthas, melons, and knockers—while they made smacking sounds with their mouths and squeezing gestures with their hands. “Vavavavooom!” They’d explode when Patti or another amply developed girl came into view.
Who knew then what her future would hold?
On the same day that my younger son, Shiah, was born, my friend Bobbie’s sister, Tina, died of breast cancer. Tina had offered up both breasts to the stainless-steel surgical altar a few years earlier to no avail.
At three-days old, Shiah was the color of a watery-yellow bruise. He was diagnosed with severe jaundice, which required another hospital stay for treatment in the neonatal intensive care unit. While he was laid out like a plant in a light box until his bilirubin count dropped to a normal level, he drank far less milk than I produced.
I pumped my breasts every few hours, placed the bottles of milk in the pockets of a flimsy hospital robe, and smuggled the liquid gold into the maternity ward where I skirted around the nurses on my way to visit my friend Johanna who had just given birth to her fifth child. Smiling, I pulled out my still-warm milk and offered it to her. Johanna had had a bi-lateral mastectomy, both breasts removed, four years earlier during pregnancy. Her third son was delivered early a few months later, so Johanna could undergo aggressive treatment for aggressive breast cancer.
Five days after Shiah was born, Patti’s mom called. Patti, of large-breasted fame, at age 42, was on her deathbed in Manhattan. She had been diagnosed with Stage 4 breast cancer in her late 30s. Her medical team had urged her to have a complete mastectomy. She had opted to have one breast removed and take her chances.
A few days later, Patti’s mom called. Patti had died. I was sitting cross-legged on the couch, nursing Shiah, talking to my in-laws and my husband. Noah was next to me, his shirt flipped-up while he nursed his doll named Baby. I shook and sobbed uncontrollably. I wiped my nose with my sleeve and tried to pass Shiah to Steve, but Shiah was clamped to my nipple, not yet finished with his afternoon tea.
Who Knew that We knew?
Rachel Carson began writing Silent Spring, her epic environmental book, in the late 1950s. It traced the path of the chemical agent DDT through the food chain to humans via land, air, and water. She concluded that DDT was causing cancer and genetic damage. Her book was serialized in the New Yorker in 1962, a year after I was born, two years after Patti was born. Initially, no one was interested in Carson’s work despite the fact that she was a highly respected author. Her ideas were so out of line with the prevailing knowledge that they were dismissed as if Carson had lost her way, if not her mind.
Shortly after Silent Spring came out, Monsanto, the multinational agriculture biotech corporation, and the producer of the herbicide Roundup, published a parody of Silent Spring called Desolate Winter, which aimed to discredit Carson’s work. Monsanto asked what would happen in a world where bugs, famine, and disease ran amok because of the elimination of DDT and other pesticides. Did anyone in the Press question Monsanto’s motives? Where were all of the other scientists who knew better? Was there other conflicting research that was hidden or stifled? Did money change hands? Was the threat of cancer so little known back then that it didn’t ring any alarms? How many times has the same scenario unfolded since then? How many dissenters, like latter-day prophets, have tried to get our attention and failed? Rachel Carson died at age 57 in 1964 after a long battle with breast cancer.
From 1960 to 2003, the rate of breast cancer rose 181%. According to a 1993 study by the National Cancer Institute, “breast cancer is strongly associated with DDE (a form of DDT) in the blood.” In the early 70s, DDT was banned in the US; decades later, traces are still found in the environment, the bloodstream, and breast milk.
Because of the many changes that must occur to make healthy cells cancerous, breast cancer can take up to 30 years to develop. Why did it take science decades to conclude what Carson knew in the early 60s? Who knew that we knew so much back then?
My personal list of breast cancer tolls and loses rolls continuously like credits at the end of a movie. My mother-in-law had ductal carcinoma in situ a few years after Shiah was born. In April 2007, two friends, Anna and Little C, were diagnosed with breast cancer. Three more breasts removed. In 2008, my friend Sarah got a call after her mammogram. She had calcification sites. A biopsy followed. Thank God no breast cancer, but because she has dense breast tissue, she will likely repeat this cycle many more times. In 2011, my friend Em was diagnosed with HER2, an aggressive form of breast cancer. Soon after it was my friend Ren. Now, my dear friend Gee is recovering from a lumpectomy. My friend Maggie is waiting for the results from her surgical biopsy after having 2 mammograms, an ultrasound, an MRI, a needle biopsy and then the surgical biopsy. She waits. We wait.
Consciously and unconsciously, I recite the Hebrew phrase from my childhood, b’li ayin hora, literally translated as “without an evil eye,” an incantation that I use to protect my two small breasts and all breasts. I know far too many women whose shirts lie against flat chests, dented chests, foam, silicon, or saline. I wonder who declared this war on women.
No Matter what You Call It
Four years ago, Jules, one of my favorite students, came to a yoga class I was teaching for cancer patients, survivors and their caregivers. She wore a pin that said, “Not yet dead,” from Monty Python’s show Spamalot, which she had seen in Las Vegas with a group of women who were living with metastasized breast cancer.
Many of my students have or have had breast cancer. The stages and diagnostic names sound industrial and mechanical, as if named by an engineer in a steel plant: ductal carcinomas in situ, lobular carcinomas in situ, Paget’s disease, ductal and lobular carcinomas, inflammatory breast cancer, angiosarcoma and cystosarcoma phyllodes, estrogen-negative cancers and triple-negative cancers. Breast cancer, the catchall phrase, oversimplifies the highly variable disease, the treatment options, the side-effects, the variety of outcomes and chances for survival, recovery, and recurrence.
Jules has lived with metastasized breast disease for ten years. In 1999, she was diagnosed with Stage 2, a diagnosis that she thought meant she’d be fine after treatment, but it didn’t work out that way. Three years later, she had a sore leg, which felt like a pulled muscle. An x-ray showed extensive bone metastases in both of her femurs. An MRI revealed she had metastases in her skull.
When Jules arrived to class with her Monty Python pin, we wanted to laugh and cry in the same moment. Jules spoke our fears when she said, “I sometimes wonder when the other shoe will drop.”
Reaping and Sowing
Washington State is known for apples, asparagus, airplanes, wheat, timber, coffee, computer genius, marijuana, and BREAST CANCER. According to the Center for Disease Control, women in Washington State (me) have the highest rate of breast cancer in the nation. Typically, we delay childbearing (me) or skip having children altogether. We drink more alcohol (not me). We absorb less vitamin D due to lack of sunshine, and more of us use hormone replacement therapy to beat back the effects of menopause—all of these factors are known or thought to increase the risk of breast cancer.
Ashkenazic (Eastern European) Jewish women (me) have a higher rate of breast cancer than the general population. Five to ten percent of all women with breast cancer have a gene-line mutation gene. The genes BRCA1 and BRCA2 when normal and healthy protect breast and ovarian cells by being tumor suppressors and ensuring genomic integrity. Genes, made up of thousands of DNA letters that run down the DNA double helix, can become delinquent, dangerous, and deadly with the deletion of a single DNA letter.
Long, long ago, when Jews were called Hebrews and wandered in tribes through ancient Israel, DNA letter 185delAG was accidentally dropped; but unlike a stitch in knitting, we’ve not been able to pick it up, and it’s been a deadly error. Translation: Women with the BRCA1or BRCA2 gene have up to an 82-percent chance of developing breast cancer by the age of 70.
A few months ago, I went to the doctor for a sinus infection, and for a dreaded round of antibiotics. My doctor rifled through my chart as though looking for something she had lost.
“I don’t see your last mammogram here.”
“I had one last year with my annual.”
She turned a few more pages and said, “You haven’t had one since two thousand and eight.”
“Shit! Are you sure?” I was stunned. How could I of all people have missed even a single mammogram? I looked at my doctor thinking she had misread my chart.
“Really” I asked again.
She nodded. “Really, two thousand and eight.”
Women and some men will continue to be diagnosed with breast cancer each and every day and each and every year. I see breast cancer in part as a collective karmic return for environmental misuse, arrogance, lack of awareness, and greed, but it’s also an opportunity for change. As we pollute and defile our world or watch others do it, and pass it off as an unavoidable complication of modern life, we suffer and rack up negative karma. Karma is the cause and result of our actions. Think of it as a self-perpetuating loop that can be stopped if we take action. To believe that things have to be the way they are, to believe that we have no choice, to believe that we are stuck with what we have, is to live without hope.
Stacy Lawson is a yoga instructor and writer living in Seattle with her husband, two sons, and dog. She is the founder of Red Square Yoga, a by-donation studio focusing on therapeutic yoga. Stacy’s work has appeared in Under the Sun, Drash Northwest Mosaic, The Seattle Star, and Sunday Ink: Works by the Uptown Writers.
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Very well done.
Thank you! I appreciate the support!
well done , enjoy your trip.
Nice. Insightful and personal and appreciated. II was (am) moved. So…let’s talk editorials.
Clean, powerful piece with sharp writing.
Thank you for your ever-present support, humor and friendship on the path.
I like the way you weave together the personal elements with the science of breast cancer. And the images of women and their breasts all around the family are gorgeous, poignant and elegant. Thank you for a heartfelt piece.
So appreciative of your support, your ideas, your writing, your thoughtfulness.
Typically, as a reader (particularly of online material), I skim, or bookmark for later, or make reading-type gestures, straining to pay attention. This essay defied that pattern. The back and forth between memoir and the informational was skillfully done; the passion behind both, contagious. I am a breast cancer survivor, and I still have trouble accessing, and understanding, my experience. Thank you to Stacy for giving me an opportunity to make meaning out of . . . disease.
Thanks Hollis for taking the time to read my piece.
Thanks to Stacy for writing this very interesting and informative article. I know so many people who have had breast cancer, some survived and some did not. It is a very frightening disease.
I became part of a study over 40 years ago to have an annual mammogram. I continue to go for my annual.
wonderful piece — emotional, intelligent, informative. A very good read on an important topic
Thank you Randy!
These are beautiful and piercing words– an essay rich with fact,memory, awakening and tenderness. Stacy has written a vulnerable , wise and redemptive narrative, inviting us to understand and to hope.
Thank you B…. you’ve been with me and writing the whole time! Miss you.
Great article. I especially felt combining the personal along with the factual a more interesting read. You are amazing.
Thank you Jeanie!
Poignant, powerful and brutally honest. Thank you.
Thanks Shelley! I will miss you a lot this next weekend. Need to write together soon!
What a remarkable piece, Stacy. Thank you! Beautifully written and, as others have commented on, the weaving together of personal and scientific is powerful. I will share this with many women in my life.
Thank you my dear! The support of my friends means a lot!
Fantastic piece. Having been on both sides of the bed as a breast cancer survivor and oncology nurse, i can attest to its authenticity, but its the honesty, craft and sheer power of the writing that held me. Brava!
It was a pleasure, Stacy. I wanted to make more solid comments, actually, such as: your information, clearly structured and presented, enabled me to learn and retain. The material on Rachel Carlson, for example, is very moving, and made me vow, as I do each year, to read “Silent Spring,” as clearly those dynamics are still at play. I relate, as a writer, to the interweaving of memoir and “fact,” reflection and history.
Beautifully written – insightful, thoughtful, and thought provoking!
You are a gifted writer.
It is not often, in fact I can’t remember a time I have read a piece I learned so much from AND I was so deeply touched by… at the same time..
Thank you for sharing something so personal Stacy. Cancer can elicit such strong emotions;
your fear, grief (and denial) are palpable in this essay. I was touched by the image of you sharing your breast milk with a friend who lost her breasts to cancer and of you grieving the loss of another friend while nursing Shiah (I must add the vision of Noah nursing a baby doll made me grin). Such an honest, powerful piece!
A gorgeous, moving, and profound piece. I saw it in earlier stages and now see it is a realized work of art. Many thanks Stacy. You did it.
Thank you Priscilla, could not have done it without you and our fantastic class.
You approached BC from many angles, up close and far away, like the way I watch you knit at the table, building and eliminating stitches. BC sucks, its history is harrowing and here you help add to Rachel Carson’s detection of its ugly hand on women and the environment. Nice piece.
Thank you G… for your love and support and for showing us how to put cancer in its place. I love being with you, PK, and Alex. You much come back and claim your place at the seder.
Thank you Stacy for gifting me with such a riveting story from beginning to end. Your heartfelt, compassionate writing, without a doubt, will deeply touch the soul of every reader. You have blessed us with a Mitzva. I also thank your sister Nance who enabled me the opportunity to read your story. It is truly masterful. Mazol Tov
Wow – what a wonderful piece of writing. Being Stacy’s sister, reading about my Bubbie was emotional and made me remember the feelings of seeing her disfigured chest as a child. And there was remembering Phyllis’s death and hearing the story for the first time of her friend that received Stacy’s breast milk after Shiah was born. And being a nurse, previously an oncology nurse, reading the science was great too. I love a really good writer and Stacy has proven to be one. Thank you Stacy.
Thank you for writing this Stacy. I don’t know you personally, but I came across your piece through facebook.
I love how you explained breast cancer by weaving together the concepts of feminine self-image, personal health, the health of family and friends, science, and history.
I am in my late 20s, and much of what you wrote rings true to my families experience with breast cancer – my Aunt died of breast cancer at the young age of 38. We knew it was because of the DDT she was exposed to as a child. Cancer in not otherwise present in that side of the family, and for the nearly 200 years back that we can trace our genes our ancestors have lived into their early 90s. My Aunt should have too.
My mom often feels guilt about this exposure to DDT. How could they – my mother and her sister, and their community, and the world – not known that DDT and other pesticides, which are poison, would poison humans too? My mom asks herself why she and her sister didn’t run inside and cover their mouths when the fields were being sprayed. Why did it seems harmless to literally breath it in? Now, I try to ease her thoughts by pointing to history and by reminding her that even if they more aptly avoided the spray they still were exposed to a DDT saturated environment.
But, my mom still feels a betrayal to her feminine instincts, which I think is an undertone to your piece. Women of my mom’s generation felt uncomfortable with the idea of rebelling against pesticides and DDT, even if their instincts whispered to them that something wasn’t right. Women of my grandmother’s generation felt uncomfortable with the idea of keeping their breast, even if their instincts whispered to them that science might be wrong and the procedure more harmful than good. Their experiences remind me that regardless of what science tells me, I need to listen to my inner voice and make a reasoned, cautious opinion about my health and my life.
The details in this piece is written in an interesting and intimate way that pulls you in to continue reading. Thanks, Stacy, for giving such a human touch to this horrific disease.
Thank you for everything. You are so real and genuine that you bring fresh air into a room. See you soon. S
I am so honored that you read my piece. It took me many years to write it. I am trying to make sense out of the breast cancer epidemic that we are facing. I do know that we need to treat ourselves with love and compassion and this will lead us to strength. I think we have all have heard whispers or had feelings that we ignored. I see this as a game of building trust with myself. I need to have an on going dialogue with myself, one that is deeply honest, and one where I drop pretense. Then, when I hear the voice, I won’t have to wonder. I’ll know what to do.
Thank you Laura! I wanted to respond to you personally, because I think the louder our voices are, the better chances we have of being heard. Breast cancer is one of those things that is genetic, environmental, and influenced by the choices we make. I can’t help but think that the more people are touched by it, power brokers, decision makers, scientists, doctors, will have to tell the truth! Breast cancer is a beast. Too many young and old women dying because of unconscious decision making. Wake up people! We have choices to make.
Thanks again for reading and commenting!
A wonderful piece of almost stream-of-consciousness writing. I loved the weaving together of memory, physical experience and observation.
I so miss you! Thank you for your kind words. I need my Laura fix now!
I loved how you weaved together an intricate fabric of science, history, personal vignettes, and your reaction to them. Very powerful piece; skillfully written. I couldn’t pull away!