Scar Tissue

The brain heals memories like scar tissue. Little pockets of betrayal, oozing pustules of heartbreak, shards of anger encapsulated, slowly covered up by a thin layer of skin and hardened there. If you’re lucky, if you massage the memory just a little but not too much, you’ll end up with a scar you can live with. Sometimes the memory is still too fresh, the membranes of remembrance barely fused together, leaving obvious traces still hot to the touch. Just a wrong look from the wrong person at the wrong time causes the seam of it to weep and there I go getting undone again.

I clutch my hand to my chest to steady myself and hope to hold back the fever. This one is too soon to even remember, a baby of a memory, threatening to break me open and take all my insides out with it. I can’t sing myself a lullaby of denial and go back to sleep. An unspoken part of me wishes I were an alcoholic, so maybe the bottle could keep this under wraps. But I’m not, so here it comes again. These words will undo me and maybe do me in.

The too soon time of which I speak, the one I hope to fade to memory is that of my surgery. My double mastectomy with immediate reconstruction that took place last July left wounds that are healing far faster on the outside than in. “Give it time,” a rational person will counsel. But a memory, just like a wound is breeched if you get too close and you rub it the wrong way. Thanks to mass media and Angelina Jolie, most people by now have heard of the BRCA gene mutation, which is the culprit behind hereditary breast cancer. Discovery of that lump in my left breast a year ago soon led to genetic testing, and the revelation that my mother too caries the BRCA 1 gene mutation. My soon to be 57 year old Mom, who has never had cancer, is about to undergo a prophylactic double mastectomy.

At this point, the universe is just messing with me. My mother’s surgery has been rescheduled twice now. The first time, I was at her house dog sitting and she was at the hospital about to meet with the anesthesiologist when the surgeon came in and canceled the whole thing. He sent her home that day because he said he had been up all night thinking about the complications that I had, and wanted to take an entirely different approach than what was planned for that day. The second time the surgery was rescheduled because my Mom had to have a non-elective surgery first, to remove a bile duct stone.  Each time the date is set, a countdown begins inside of me. Now a third date has been set, and on the outside I am steady and supportive, upbeat and positive when I speak with her. We talk about practical things, like button up shirts and rearranging her shelves so she doesn’t have to reach for things. Like me, she wears a good mask of efficiency and organization. Like me, is she scared shitless inside?

There is no way to really prepare yourself for a major surgery like this. Doctors and nurses will gloss over your concern with a gentle smile and tell you it won’t be that bad. (They tell you this because, A. They have to, and B. They just don’t know, and C. They want to comfort themselves and won’t you please stop asking the hard unanswerable questions.) You can read all the pamphlets, books, blogs, websites and forums you like but in the end the outcome is the same. You will be on the table facing the blade, your skin will be cut, nerves will be severed, tissue removed. You will be sewn back together. Anesthesia will make you groggy, grievously sick and later constipated. Drains will awkwardly protrude from under your arms and collect bloody fluid for you to measure, record and dump twice a day.

It is the searing pain that I am most afraid of… even afraid to tell of because it hurts to remember and write about. Waking up, with the anesthesia wearing off, even fully loaded with morphine, it was like a Mack truck smashed into my chest and I was left with a load of cement on top of me, pushing against each breath. The nurses were eager to get me out of bed to walk to the bathroom or stroll down the hall. I thought they were completely insane. It took so much effort and another morphine drip just to sit up and leverage myself against the bed. You can’t use your arms to push up off with or steady yourself. I remember teetering towards the bathroom and then came the challenge of wiping myself. The first week, I could take care of #1, but really couldn’t reach my backside. There goes privacy and dignity. Hopefully someone loves you enough to know you in this more than biblical sense.

I spent less than 22 hours at the hospital from admission to release. It seemed the sweet and doting night nurse had been replaced with a hard, cold and unfeeling morning nurse whose job it was to make my stay so unpleasant, that I would be eager to get in that wheelchair and scoot my agonized self out the door. It was the longest 45 minute car ride of my life, as I could feel every little bump and turn in spite of being padded with a fortress of pillows. My long, unpaved and potholed driveway had just received an emergency last minute load of gravel by the landscaping company my step-brother worked for. It was a crazy scramble to make happen on short notice, but after I threatened to walk up the ¼ mile driveway, everyone knew it had to get done.

I vomited every last bit of anesthesia out of my body the first night home. With nothing able to stay in my system, every wretch wracked my body with hot searing nerve pain, and I felt every bit of it. I remember my husband saying, “This is fucking insane. How could they send you home like this?” Those first few days are hazy to me, but my husband says that everyone was falling apart. Our four year old son had to be barricaded out of the bedroom and could only visit me with careful supervision. Everyone was worried and regressing. Both the cat and our son were shitting everywhere. My husband’s neck and back had seized up so bad, that I thought I would have to call my Mom to come stay with me because he was falling apart. I pray we will never have to live through something that hard again.

Think of how delectably sensitive your nipples are, then imagine having them cut out along with all the nerves and tender tissues below. Every time I was caught in a slight breeze, or touched a certain way, stabbing nerve pain would radiate from my phantom nipples. I was having phantom milk “let-down” feelings again, where a nursing mom feels her milk ducts release. It was a knife in the heart to have to hold tender memories of nursing my baby at a time like that.

Sleep could only happen in 3-4 hour windows while the narcotic pain relievers did their job. I would escape to dreamless sleep in a semi reclined position, my back and arms fully supported. My preferred method of side-sleeping was not possible until about two months later. I was sewn up tight and fragile and walked that way too, my shoulders sort of hunched up and frozen like a turtle caught without it’s shell. For about the first 3 weeks, I learned to manage with a regular 4 hour dosage of oxycodone or hydrocodone, then I was cut off. The doctor felt I could manage with Tylenol, which didn’t even come close to touching the pain. I had to learn to feel the pain in a whole new unmedicated way.

I suppose surgery is like childbirth in the way the body can go through such a shock, such profound pain, and find a way to heal, to bounce back in some respect. I didn’t have a beautiful bundle of joy to take home at the end of this excursion though. I was the helpless baby, crying and inconsolable, until I found that it hurt too much to cry, that I was too dehydrated to cry. No one could hug or hold me anyway.

I want to comfort my Mother. She has seen my nippleless breasts, and the meandering snake of a scar on my left, the horizontal crescent moon on my right. On a braver, happier day I have proclaimed that I am more comfortable in my skin than I have ever been since the day of the surgery and that she too will one day get to this place, with time and healing. We try to make light by rejoicing at the miracles of plastic surgery, to be able to have your boobs on your chest again, rather than lugging around saggy, tired “Nat-Geo” breasts that droop down towards your navel.

I just don’t want to face this surgery again. I want to save my Mother from the pain she will endure. A very small childish part of my brain thinks this is happening because of me, because of the lump that I found. I’m sure she had to face that same demon, to see her little girl suffer because of a genetic trait passed down. Really this is no fault of our own. Still, could someone please put me to sleep and wake me 6 months later? Logical brain knows that this is the best choice… the right choice. Those breasts that had nourished me as an infant, just might kill my mother. If she chose not to have surgery, intensive screening every 6 months might be the thing to kick that cancer gene into action.

Each time this is rescheduled, we play with time, we play the odds game. There was no one to save me from facing this surgery. The countdown continues. Tick… Tick… Tick…