Wednesday, March 30, 2011

Chapter 4~~Mother's Milk

Photo by Brendon Stuart
The mammogram Jo was able to schedule a few days later didn’t go well from the outset. When she checked in at the Women’s Center in the Sisters of Infinite Beneficence Hospital, the receptionist wanted paperwork she didn’t have.

“Do you have the referral from your primary care physician?” the receptionist asked cheerfully. She was young and blonde and wearing blue scrubs, as if she had just come from an operating room. Jo wondered with a twinge of revulsion if they were performing surgeries in back.

“No, I don’t,” Jo said just as cheerfully. “The person I made an appointment with said she would take care of that.”

“Who did you make the appointment with?”

“I don’t remember.” Jo scanned the room behind the small window which separated the receptionist’s domain from her own. There were three desks, but two were empty and the other held women busily talking on the phone. “She said since I was having this symptom,” Jo lowered her voice and poked her head through the window, “milk is coming out of my breast, that there would be no trouble getting the referral, that she could just call the office and they would fax it over.”

“Let’s see.” The receptionist looked at her computer screen. “Nope,” she said cheerfully again. “It says right here that the patient will get the referral.”

“Well, that’s not what she told me on the phone.” Jo said curtly, wondering if she could ask her boss Mandy, who was in the next building, to step on this annoying girl. “She said she would take care of it.”

“She wouldn’t have told you that.”

“But she did tell me that!” Jo raised her voice. “Does it say there whom I spoke to?” She used her imperious tone. “Is she here?”

“Unfortunately, she’s not here today.”

The receptionist wanted Jo to go away and come back another day, after she had made her appointment properly. But Jo didn’t want to do that. Jo mentioned her employment status at the hospital. Jo mentioned Mandy, the vice president of Planning and Marketing, and Jo’s personal friend. Jo said she didn’t want to wait another week to find out why, at 45 years of age, with no baby in sight, her body thought she was breastfeeding, and eventually, she was brought to a small office containing an aged woman with white hair piled high on her head like spun sugar. She wore a sickly-pink jumper over a long-sleeved white blouse: the uniform of the hospital volunteer. She allowed Jo to use her phone while she filed index cards in a small metal box—were they still using index cards for data storage? The woman's heavy gold bracelets and long, artificial fingernails tapped unnervingly on the desk as she worked with spotted, skeletal hands.

After several claustrophobic minutes in the small room with the silent old woman, Jo got ahold of someone in her doctor’s office who said she would fax over the necessary form, and soon the receptionist was once again cheerfully patronizing Jo, herding her into a back room where she was told to take off her shirt and put on a white and blue print hospital gown.

Once Jo was changed, she sat in a room with other gowned women, waiting. There was an air of camaraderie not present when men are in the mix. “I dodged the bullet on that one,” one elderly woman remarked to the room at large as she came back from her procedure. “I was worried about a lump in my breast, but he said there was nothing wrong.”

When her name was finally called, Jo found she liked the mammogram technician better than the receptionist. She had reddish-brown, shoulder length hair with bangs, and wore a white lab coat over black pants. When Jo told her about her symptom, she put Jo at ease, saying she had experienced the same thing, and even had to have a biopsy, but the results had turned out fine. “What color is your discharge?” she asked.

“I don’t know,” Jo admitted. “I haven’t seen it directly. I just noticed a few spots on my shirts.”

“You haven’t tried to express it?” the technician asked, using a breastfeeding term for squeezing a breast rhythmically to urge out the milk. Jo shook her head. But as the technician positioned Jo’s breast on the machine, squeezing it painfully between two plastic plates, a little liquid emerged. “Oh, there it is,” the technician said cheerfully. “It’s just milky white. I don’t think you have anything to worry about.”

The technician took several shots, repositioning Jo’s breast each time, placing her arm high and then low, tilting the massive machine this way and that, inserting new plates of film, and always remembering to step back behind a protective shield before pushing the button to take the picture. Then she asked Jo to sit and wait while she brought the plates to the radiologist to see if she had gotten good images. Jo sat in the darkened room, looking through a fashion magazine with beautiful women on every page.

When the technician came back, she said she needed two more shots. “I didn’t do it right,” she joked. Jo felt suddenly nauseous.

“Does that mean something’s wrong?”

“Not necessarily. I know it’s scary, but most of the time, it’s just that the patient moved, or the angle wasn’t right, so something isn’t clear.”

The technician took two more pictures, and Jo was sitting back on the chair reading when Dr. Brand came into the room with the technician close behind him.

“We’re seeing something suspicious on the film,” he said, standing before Jo in a pressed white shirt and tie. Jo felt at a disadvantage, seated, half-dressed, her upper body covered only by a flimsy hospital gown.

“What we’re seeing is a lot of calcification, which could be a normal result of aging, or it could be the by-product of a particular type of pre-cancerous condition.”

Jo started to cry. They all pretended not to notice.

“What you’ll need to do next is schedule a biopsy on the way out so we can determine exactly what is going on in the breast,” the doctor said.

The technician tried to comfort Jo, squeezing her arm gently as she walked her back to the lockers where her shirt and jacket were stored. The woman scheduling biopsies was also supportive. “Don’t worry,” she told Jo. “It’s probably nothing. Eighty percent of our biopsies turn out to be benign.”

But that particular number didn’t reassure Jo. Eighty percent. Since Jo’s Grandma had breast cancer, and her mother died of it, it seemed likely that one of her mother’s daughters would get it, too. And there were five of them. Five daughters. So Jo calculated that Jane, Jean, Claire, and Francine were the 80 percent who would have benign biopsies, while she was the chosen--the sacrificial sister. Jo was the 20 percent.

Cut Off will be published in June.


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