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The Hungry Soul: Food for the Heart

The Mammogram
by Patricia A. Burke

It's 8:40 am. I can barely keep my eyelids off the dark circles on my cheeks. My brain usually doesn't start to function until ten. I walk into the patient waiting area. I'm just awake enough to notice a girl fidgeting and sliding around one of the plush grey waiting room chairs. She's alone. I think, how odd to see a child here, maybe her mother is getting hers done now.

The radiology technician shows me to one of two dressing rooms and instructs me to remove all of my clothes from the waist up and slip on a multicolored robe. "This one closes in the front," she reassures.

The waiting area of the RDC Diagnostic Center is pleasant enough. Subtle tones. Off-white walls trimmed in that lovely soft mauve that is so comforting and plush grey carpet to match the chairs. And the staff leaves nothing to chance. There is no need to wonder if the robe ties in the front or the back.

I find a vacant seat across the room from the fidgety body. Easy enough. It's just me and the girl. She must be about ten. Her shoulder length auburn waves of hair tumble over her face with each jerk and spin, slide and stretch. The radiology technician hands me a clipboard. "Here, fill out this history form while you're waiting. Thanks. I'll be back soon."

I always aced multiple choice tests in high school. I think it's because I spent enormous amounts of time and energy analyzing the motivation of the invisible test creator. What's he getting at here? What does she mean by frequently? In graduate school I had to ask myself these same questions as I developed a lengthy questionnaire for my research thesis: "Bar Use and Alienation Among Alcoholic and Non-Alcoholic Women."

Most research questionnaires and medical history forms are poorly designed. Do you ever have headaches? What does that really mean? Does it mean ever, ever or does it mean often? I might be too picky, but I had to submit my research questionnaire four times before my advisor would accept it. I hate filling out forms.

As I focus my attention I realize that this medical history form, however, is straight forward. Are you currently on hormone replacement therapy? Any female members of your family ever had breast cancer? If yes, before the age of forty, between the ages of forty and fifty, or after the age of fifty?

I check off my mother. No name required, just check off the box labeled mother. I struggle with the age. Was she in her forties or fifties. I have to count backwards in my mind. I remember the graduation picture. Mom and Dad drove all the way from Maryland to Boston to attend my college graduation. My roommate, Jamie, offered to take a picture of the three of us in front of the campus library. That was the last time I saw my mother when she still had both of her breasts. A few weeks later she received the diagnosis. Cancer. Within days she was no longer the same woman. . . no longer the same mother. I still have that picture. It's buried somewhere in a mountain of old photos I keep meaning to sort through.

She was forty eight. I count backward to the year of my graduation. She was forty eight. Is that the right answer? I can never remember if the daughter is at higher risk if the mother is under fifty or over fifty at the first occurrence.

I look up from my form and notice the girl's mother. She has returned. She sits down next to her daughter. I wonder why she hasn't slipped into the dressing room to change back into her street clothes. Our eyes meet for a moment. Silence. Then she gives out a sharp sigh tinged with nervous laughter, "One of the joys of being a woman." There is sarcasm in her voice, but the anguish in her eyes nibbles at my bones like a piranha that has devoured layers of flesh and muscle, hoping to steal the last bits of meat off my skeleton until there is nothing left.

The woman glances furtively at her daughter, then back at me. I respond with the resignation of one who knows, "Yeah, it's gotta be done." Silence. I turn back to my form. There's something else. I feel it in the air, something unspoken.

"I have a lump." I hear the tremble in her voice, the shallow breath, and a light choking sound as if she wants to say, "I take it back," but can't. The girl squirms in her chair. I don't know what to say.

I hear Dad's voice over the crackling phone line. "She's just gotten out of surgery. She's had a radical mastectomy. She's going to need chemo and radiation therapy." Pause. I hear the tremble in his voice, the shallow breath, the choking back. "They took her left breast and a lot of muscle tissue in her chest and from under her arm. We'll just have to wait and see." Pause. The discomfort mounts. "Gotta go. Talk to you soon." Click.

I want to tell this stranger. . . this woman. . . my story, my mother's story, the story of all women. I want to tell her that I know. But I don't. Instead, I say, "Gee, I hope it's nothing. I am surprised by the detachment in my voice. Silence.

What do I say? The discomfort fills the room like a thick greyness, a weight that bares down steadily on my chest. My stomach turns. I look over toward the girl. "It's school vacation week isn't it? Done anything fun?" The mother smiles and sighs as if to say, Yes, this is safe. We can talk about this. She speaks for her little girl, "Unfortunately, she's been sick all week."

"Not fun," I respond. "It's not much fun to be sick on your vacation." The little girl raises her eyes shyly and offers me a half-hearted smile.

The radiology technician breaks the tension as she pokes her head in the door and nods at the woman. "You're free to go. The lump is nothing. Your breasts are just really fleshy. The doctor didn't find anything significant."

The woman turns toward her daughter and reaches out for a hug. She stands up, smiles at me. I say, "You must be relieved. I'm glad for you." I don't say, I'm glad for all women.

She walks toward the dressing room, just as she crosses over the threshold turns back toward me and nearly shouts, as if she wants to prove it to us both, or perhaps the world, "There is a God. Just remember if this ever happens to you, if you ever find a lump it can still be nothing." I nod and smile but I'm thinking, Yes, there is a God, but God doesn't always work that way.

As she closes the dressing room door I hear my parents' bedroom door shut behind me. "Mom, I know this may sound strange, but I'd really like to see your scar. I want to see what they did to your body." It was about six months after the surgery. I'd come home to see how she was doing.

Mom shakes her head vigorously. "No! I don't want you to see me like this. I can't. I'm too ashamed. I'm so disgusting. I'm a freak." I'm shocked by her reaction. It had never occurred to me that she would imagine herself to be any less of a person, any less of a woman because she'd lost a breast. I was naive.

I try to imagine what it must be like for her. I want her to know that I can accept whatever I see. "No matter what happens, Mom, no matter how your body has changed, I will always love you. Your appearance is not important to me. What's important to me is that you're my mother and I want to see you as you are now."

We simultaneously burst into tears. I reach out with my arms open. We embrace. She steps back, unbuttons her powder blue blouse with the Peter Pan collar, slowly slips it over her shoulders, then unfastens the prosthetic bra which holds a foam pad in a specially designed pocket to fill in the space where her left breast used to be.

The scar is massive. The left side of my mother's chest is gone. There is a hollow bowl where flesh and muscle used to be. I stand before the feminine frame from which I came, the woman who nursed me, whose breasts where offered up so freely to nourish me, and I am the one who stands exposed. An uncontested wave of sorrow reaches up from my belly, washes over my lungs, and forces its way through my clenched jaw which must give way to the sheer power of what sounds like an infant's wail.

The woman emerges from the dressing room, takes her child by the hand, turns one last time toward me and says, "Good luck," as she hurries out the door. I am jolted back into the off-white room trimmed in mauve.

The radiology technician pokes her head through the door, "Ms. Jenkins, come this way." By reflex, I stand when I hear my name. I follow the tech to the mammogram room. "Step up to the machine, please, and take your right arm out from your sleeve." She grabs my breast and kneads it like a piece of bread dough until it is mashed into the right shape. I wonder if my mother's surgeon was as impersonal when he carved her diseased flesh and threw it into a biohazard container for disposal.

The x-ray plates are cold. They flatten my breast like a slice of bologna between two pieces of Wonderbread. The tech admonishes me, "Don't breathe!" The buzz of radiation penetrates my skin. I wonder if it is the daughters' whose mothers are under fifty or over fifty who are at higher risk. I wonder if the physicians who recommend that women over forty should have yearly mammograms are right or those who say too much radiation can increase the risk of cancer. All research is biased. It depends on how you set up your methodology, how you construct your questionnaires, how you interpret your data. I know. I wanted the alcoholic women in my graduate thesis to show more signs of alienation than the non-alcoholic women. They did. But was it because that's true or because I wanted my data to confirm my hypothesis? I wonder what's real. I wonder if the buzz of radiation is simply taking a picture of my breast or causing my cells to mutate, to run wild, to grow into an unimaginable monster.

"Wait right here," the technician instructs after the last buzz.

"Right here?" I'm dazed.

"Yes. You can have a seat right here."

The technician takes the plates with her. I wait. The room is darkened by fully drawn vertical blinds on the room length picture window. I wonder what the point is of having such a large window. I notice that the computer the technician input my medical history data into is still on and running the same screen saver I use on my PC. I stare, mesmerized, as the multicolored angled lines dance across the black screen.

After about five minutes, which seems like an eternity, the tech pokes her head through the door. "You're all set. Have a nice day." I am liberated. My cells have not mutated. Not this time.

I walk down the hallway to retrieve my clothes. In the waiting area two other woman, wearing robes that tie in the front, eye me nervously as I enter, then return to their magazines. I slip into the dressing room, throw on my sweater and rain jacket and hurry myself out the front door of the medical arts building. A sigh of relief squeezes through my lips. I think, Yes, there is a God, but God doesn't always work that way. Today, she did.

The Mammogram was published in Mobius: The Journal of Social Change, Volume 9, Number 4, Fall, 1998 and is reprinted here with permission of the author.

Copyright, 1997 Patricia A. Burke


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