Mastectomy - a husband's view
Malignant, invasive, an evil life form unto itself; if cancer has a colour it most surely must be black. Cancer is an emotive issue. Such words as tumour, or even growth, have horrific connotations for all of us. We know the high risk of death, we fear the inherent pain and suffering, and not altogether paradoxically, we fear the trauma associated with cancer treatment.
For one woman in every 11 living in Australia today, those fears cease to be fears as breast cancer becomes a reality which must be confronted, both by themselves and the people close to them.
Eighteen months ago, my wife, Sally, became aware of a lump in her right breast, along with some hardened swelling in the adjacent under arm area. Within days she had consulted her GP, undergone a mammogram and ultrasound, been referred to a specialist who conducted a needle biopsy and been booked into hospital for exploratory surgery. Even though these events occurred very quickly there still seemed to be more than enough time for considerable anxiety. I became aware that Sally was far more preoccupied with the thought of losing a breast than the possibility of having cancer.
At the time, I was too concerned with her general welfare to debate those priorities and agreed with her insistence that regardless of the outcome of the initial surgical tests no further decisions would be made without her full consent. She simply could not come to terms with the idea of surrendering to an anaesthetic without knowing whether she would awake minus one of her breasts.
This element of choice was, in the final analysis, not a choice at all. On the day of admission to hospital, her specialist joined me at her bedside and gently told us that the results of the needle biopsy showed beyond doubt that further tests were unnecessary. I sat and watched the last scraps of Sally's brave facade crumble while we listened to the medical logic which dictated why the surgery scheduled for the following morning would be radical mastectomy - the complete excision of her right breast.
The specialist suggested I come to talk to him in the hospital directly after surgery. I agreed, naturally enough and duly presented myself the next day. He came into the consulting room, still wearing his operating gown and looking very tired. It took a while for him to start talking and I had to work hard to contain my disquiet; he seemed to be choosing his words very carefully as he described the extent of the growth, its apparent spread to the lymphatic glands and their subsequent removal. He went on to explain that more tests were required before the exact nature of the post-operative treatment could be determined and began to outline some of the success to failure ratios associated with this type of case.
At this point I had to ask the inevitable melodramatic question: "Is there any possibility that Sally might actually die because of this?" As long as I live I will never forget his cautiously pessimistic reply: "Oh yes. She faces the very real prospect of a shortened lifespan."
He is a genuinely good man; very thoughtful and compassionate and I'm sure he would have given a more precise response if he'd known all the variables, but he didn't. That was the province of the pathologists, and not really his field. Shortly afterwards I blundered off home to ponder the meaning of it all.
Visits to Sally were a strain on her for a couple of days. She needed time to regain some vestige of equilibrium, no mean feat with tubes going in, tubes going out, a hospital routine to adjust to, and all manner of bossy professional attention which can be a bit much at times. Pethidine and Valium helped to ease her pain, and the reality, but made our communication seem odd at times. Certainly to my ear. It seemed a nail-biting eternity before the pathologists finished analysing all their tests and reported back to our specialist who had, it appeared, completely regained his professional composure and was offering a far more positive prognosis. "We are now looking at a total recovery."
At that point the proverbial grain of salt could possibly have been in order. When I woke up that morning I was convinced my wife was dying; by noon I was struggling to accept, without scepticism, that she was going to live.
There certainly was some scope for confusion, but I thrust the feeling aside for later scrutiny because it was time to go and share Sally's triumph. The last thing she needed was a Doubting Thomas at her elbow.
I didn't have to strain my powers of deduction to reach the obvious conclusion that Sally already knew the test results.
She was sitting up in bed with a very broad smile and for the first since the operation a hint of lipstick and make-up. Friends from overseas had fortuitously and unexpectedly visited earlier in the day, leaving their own special brand of therapy, while a letter from her mother provided yet more comfort.
In fact, it was the tone of that letter which prompted me to make some inane, tasteless remark which I considered amusing. For a split second I thought I had gone too far but to my intense relief she began to giggle, then to laugh to the point of having to clutch at the stitches in her chest.
The comment was merely a trigger, and her laughter provided a clear signal which helped to dispel my earlier doubts.
The frightened girl had been replaced by a woman resuming control of her body, and the healing process was underway.
I doubt that either of us would have been quite so sanguine had we known more about the bumpy track ahead of us. However, this abatement of my immediate fears meant I was free to consider some of the as yet unspoken questions I thought were coming close to the surface.
Was my wife now any less a woman than the one I had married? Did having only one breast reduce her femininity in any way? I knew that Sally was wrestling with these concepts from her own point of view; more than one reference had been made to the possibility of breast reconstruction.
I had also observed the reactions of her women friends who, almost without exception, were less than comfortable talking to me about it. This was undoubtedly due in no small part to a sense of "there but for the grace of God go I" but I began to interpret such remarks as "all this must be terribly hard on you as well" as probing for an insight into my attitude.
Did they see me as a reactionary? Someone who would cast aside his wife in favour of a whole woman?
Perhaps they were using my perceived behaviour as a yardstick to gauge their own partner's response should the same misfortune befall them at some stage? Probably not; or not entirely, but I felt quite sure my reaction was the focus of some fairly close scrutiny.
As it happens I now tend to regard the question of loss of femininity, or the cosmetic value of breasts, as one of our contemporary cultural cliches. To my way of thinking the real issue is nothing more nor less than the removal of cancer. In any practical sense the so-called mutilated woman is no less a woman, no less a person and there are many and varied options available when considering the cosmetic aspects.
A vicarious glimpse of mortality offers an ideal opportunity to develop these slightly facile male viewpoints. Sally was less than interested in the inherent philosophy of it all as she began to come to terms with her prescribed post-operative treatment: radiotherapy to kill any element of growth missed during surgery and chemotherapy to deal with the possibility of dormant cancer cells lurking elsewhere. Not unlike being partially cooked in a giant microwave oven, followed up with a couple of litres of weedkiller poured into the circulatory system.
It was, in short, a six month period of intensive hell. All things, good and bad, came to their eventual end and Sally's nightmare was no exception. Our lives have more or less drifted back into the old patterns. although there are some crucial differences. The bonds between us are undoubtedly stronger and I feel we are more tolerant of each other's foibles. We've both made a number of adjustments, some little, some large, but obviously Sally has had to make the lion's share.
That age old feminine catch cry "I've got nothing to wear" has a more plausible ring to it these days and is a new factor in the fashion equation. Once I would have pointed to a bulging wardrobe and poured scorn, now I bite my tongue and await the inevitable day when some tyrant of fashion bestows his blessing on the asymmetrical look and Sally can take up a new career modelling on the catwalks of Milan.
by R.B.
For current information on the incidence of breast cancer in Australia, refer to Australia's Breast Cancer Statistics.
Source: Ita, May 1991. Reprinted with permission and thanks to Ita Buttrose.
