In which I practice what I preach

Happy Monday. I'm having surgery next week.

Sometimes when I sit down to write these epics missives updates, I’m in a funny mood so I’m pretty sure it’s going to flow. This morning I am exceedingly stressed out and punchy so let’s see what this mental state produces, shall we? The writerly version of feeling cute; might delete.

When I went looking for a picture to share with this update, Photos inexplicably showed me this rare gem, captured by my friend Kayla Craig in Nashville. Pre-cancer, long hair, naive innocence, yet somehow strangely fitting?

Welcome, faithful Brigaders! Lo these many months ago (18 but who’s counting?)¹ you signed up for these rants sit-down comedy routines emails about My Cancer, and who knew you were climbing aboard for a strange mix of existential reflection and communal catharsis?² But here we are, a rag-tag band of compassionate folks, or at least compassion-curious, and I continue to be grateful because in the quagmire that is my head the news life in these chaotic times, you shine like gold. My not-so-secret goal is to turn the Compassion Brigade into something more delightful and less carcinogenic next year, but in order to do that, we need to do one more thing.

Another surgery

Whilst I would like to choose the route of what any good therapist would call Avoidance and Denial, the calendar confirms that I am indeed getting my mortal flesh cut open next week. Because I am annoyed about the existence of this surgery, I keep forgetting to mention it to people, which leads to alarmed looks and raised eyebrows and “is everything ok?” when I offhandedly toss out some reference to being out of work for a month in November.

So here we go.

When you get breast cancer, you get lots of choices. Actually you miss out on the most important choice, which is “do you want cancer?” because too late. But then you get an overwhelming Old Country Buffet’s worth of sub-par options. Standard course of treatment or a clinical trial (or essential oils from your long-lost second cousin)? Mastectomy or lumpectomy? Single mastectomy or double? Countless brilliant doctors lay out options and then tell you—utterly uninformed you, who barely scraped by in the “athlete” science classes you took to fulfill the College of Arts & Letters requirement—that the options are more or less equal, so you pick. I’m telling you, you realize once again that NO ONE SEEMS TO BE IN CHARGE IN ADULTHOOD.³

Because I am a thoughtful person with Google and (more importantly) a dear friend who did go to medical school, I muddled my way through the choices as best as I could. Clinical trial. Mastectomy. Double. I am quite satisfied with my decisions; I am still alive; I am not currently accepting input PLEASE DO NOT SEND ME BOOKS ABOUT CANCER DIETS.

But survival meant that I had one more choice to make, in the morass of non-choices that life-threatening diseases bring: do you want reconstruction after mastectomy, or do you want to go flat? I went back and forth, but ultimately chose reconstruction.⁴ Per my previous email:

Our management wishes to welcome two new employees: Replacement Right and Replacement Left, both of whom have been enthusiastically onboarded and taken their place among our ranks. Please make note that their current offices have moved one level above those formerly occupied by Right and Left Breast.

Sometimes my beloveds will remind me that my sense of humor is so snarky as to become oblique, so let me spell this out clearly for the people in the back: I chose breast reconstruction after my double mastectomy. This is a two-part process: within the mastectomy surgery, you get temporary expanders to keep your skin stretched as your body heals (from that good ol’ double amputation) over several months. Then you have a second “exchange” surgery to swap the expanders for the permanent implants. This is the surgery I am having next Thursday.

Funny story

When I was at a post-op appointment for my mastectomy, the nurse was talking to me about scheduling the exchange surgery. She explained how I’d likely be on the waiting list for a surgery date for many months. “Oh, so the surgeon must be really good, right?” I offered. Layup pass; couldn’t have been easier; clinic room small talk, what a great job you all do, I’m lucky to be here, etc.

She took a long look in my eyes.

“There’s a lot of cancer,” she finally replied, turning back to the computer screen.

THE WAY I HAD TO BITE MY ACTUAL TONGUE TO KEEP FROM SNORTING. No attempt to grab the low-hanging fruit. Just…“get in, loser, cancer’s an epidemic.”⁵

So here we are, 11 months post-mastectomy and I’m finally getting my final surgery. Next Thursday, 10/24, Mayo Clinic, not a sponsored post.⁶

Should be an easier recovery than the mastectomy, assures every nurse and doctor, which sounds great to my head but the rest of my traumatized body is screaming DO NOT GO BACK TO THAT PLACE, THEY KEEP SLICING US OPEN.

This statue was the original photo I was looking for. NOLI ME TANGERE.

A few important details

1. I can’t work for a month. No housework (huzzah!) but less delightfully, no writing. The number of times that the surgeon/nurses looked me straight in the face and said TYPING COUNTS AS REPETITIVE MOVEMENT was frankly a personal attack upon my profession, but fine.

2. I can’t drive for two weeks. Last month at a family wedding, I had the joy of catching up with cousins I hadn’t seen in years. When one fellow mother-of-many told me that upon learning of my diagnosis last year, she immediately thought, “But what are they going to do about the DRIVING?!” I must tell you I felt seen like perhaps never before.

3. It’s not the last surgery. Joke’s on me, when you choose reconstruction, you are signing up for a lifetime of fun! This “exchange surgery” (is it a white elephant gift swap? are we getting currency for a new country? did these breasts not fit like I thought they would from the catalog?) has to be repeated every 10 years. Breast implants are light years better than they were in the silicon scare of the 90s-00s. But they still have an expiration date. So fear not, if you stick around (and I do too, HAHAHAHA) you’ll get to hear me complain again in a decade. Lucky us!

4. It’s great timing. Like most of this Substack, the previous phrase is dripping with sarcasm. For those of you smarties who did the math, you might have figured out that I will be in bed/at home resting and recovering for the 2 weeks immediately before and after the dumpster fire hellscape election. Impeccable timing to have nothing to do but scroll! Luckily I’m immersed in the read-everything phase of book writing, so I have 17 stacks of library requests to devour instead. But if you’re in my closest circle, consider this your warning as to why my meme-texting will increase substantially as I stave off our deepest fears for democracy.

Can you help?

Darlings. If I ever find the time, energy, and postage stamps to eek out a word of thanks to humanity for every good and gracious gift that has been bestowed upon me and my family over the past 18 months, you will top my list. Your prayers. Your generous support. Your meal trains, your gift cards, your doorstep dinners, your texts, your emails, your comments, your calls, your conversations in which you did not try to fix my cancer or cheer me up or invoke God’s plan or tell me I was too much—

I could truly, madly, deeply never repay it all.

So please just pray for me and mine, if you can. Good thoughts and hope happily accepted if you are not a praying kind. Please pray for a smooth surgery and an easy recovery. For good doctors and nurses.⁷ For me to be patient with myself (and for my caregivers to be patient with me; bless him again for saying yes “in sickness and in health”). For my kids who are not looking forward to the prospect of their mom in bed again for weeks. For my poor book that just wants to be written but has to wait longer. For all that I simply cannot do. For all that is beyond our collective control.

Friends, in the not-so-secret interest of full disclosure, I am in the anger stage of grieving my cancer. You might find this puzzling or ironic, since, you know, I survived it and all. But if I haven’t done so yet, let me inform you that grief is a tricky beast. Most of us have to wrestle with her during our earthly days, and she follows no neat timeline. I spent so much of the first year of treatment focused on pure survival, so my body had no time or space to get angry about what happened. But now that the existential threat has slunk back into the scary woods? A surprising bitterness is left in its wake. I am furious that I got cancer, furious that it will forever shape my life, furious that other people didn’t get it, furious that I’ve endured far more than my fair share of suffering. I am looking for exactly zero advice on how to manage this; prayer, poetry, exercise, swearing, laughter, and good friends are helping enormously.⁸ I only share this to encourage you to let your own body express the fullness of what it has experienced, because grief will come out sideways if you don’t meet it face on.

Which brings me to my final point/story/sermon:

This summer I went to an incredible nature writing course at the biological field station at Itasca State Park. One of the women in the workshop was a cancer survivor, and she and I got to talking about our journeys. She told me about a colleague of hers who drew her aside at a holiday party, pulled her into her office, locked the door, and whispered that she’d had cancer, too. But she hadn’t told anyone, because she just wanted to deal with it on her own.

Both of us went slack-jawed at the story, she in the telling and me in the hearing. Because we both agreed, in body and spirit, that there was no way we could have gotten through cancer without the support of others.

I am never, ever saying that you have to start a snarky Substack about your medical maladies. But when I hear about people who soldier through suffering, as if keeping quiet or keeping up appearances will fix things? My heart aches. The world is too much for us, and far too much to bear on our own. So my deep desire for you is that whatever Terrible Thing you are going through (and most of us have at least one), you share about it with someone else. A trusted friend or an anonymous stranger, someone who can help you feel the lightness of letting the fear step out of your body, even for a moment. When readers tell me you put into words something inside of me that I never knew how to name, it is better than 10,000 five-star Amazon reviews. It is the point and privilege of being a person on this planet, to help each other bear the darkness.

So there you have it, folks. In a riff on Psalm 30, you have turned my bitter snark into something beautiful today. Your silent, steady presence pulled me out of my anger and resentment again, and reminded me that being human is a long road, walked better together. I shall not delete this post, but shall fling it wide into the world, on behalf on my breasts that have borne so much (this is what happens when you read Wordsworth in the morning) and yet have more to bear, but so it is with all of us.

Here’s to the sacrament of surrender, the communion of community, and every hard and glorious lesson God keeps inviting me to relearn over and over and over.

And here’s to my new bosom buddies, ready to hang around for the next decade.

Vision board for 2025: “Striding Into A New Era.” Would you believe that both of these statues are from the same mini golf course? Minnesota forever.

1. Me. I am always internally counting. Telling anyone “don’t think about it” is as effective as yelling at a crying kid STOP CRYING, so let’s cease trying to control things that make us uncomfortable, eh?

2. Also me. This was my not-so-secret plan all along, muah hah hah.

3. The divine Love that created the cosmos notwithstanding.

4. I feel zero need to explain my decision, but am deeply grateful that modern medicine gives women this choice.

5. Because we are destroying the planet. Which includes ourselves.

6. Lucky me, I get to keep paying for this privilege. Actually now would be a fitting time to shout out my husband’s incredible employer whose support, flexibility, and amazing health insurance rank high among the true heroes of the past 2 years.

7. Even if their skill isn’t the reason I had to wait so long to schedule surgery.

8. Also those compilations of invisible danger pranks (language warning). Can I confess that I laugh to tears at these, ironic since my family knows I startle at the slightest interruption. Please don’t analyze what this says about my psyche.