The Old Man and the Sea

by Sheree Gaudet

I'll probably never forget the name of the surgeon who did my biopsy. Jamison. And it wasn't because he had white hair and tanned, lined skin that reminded me of the fisherman in Hemingway's, The Old Man and the Sea. It was because I became intimately familiar with the patch of blue embroidered letters on his lab coat during my hour-long procedure.

The pamphlet had been quite clear. I was not a candidate for a "fast food" biopsy. And as I lay chest down on the red padded table waiting for Dr. Jamison to begin, I felt a tinge of envy for my sister who, less than a year earlier, spent a mere ten minutes with her surgeon. But Sis had a lump that could be felt and seen clearly on her mammogram, and fortunately, she emerged from her ordeal with a cyst and a warning to cut out caffeine. In that moment, I vowed that I, too, would sacrifice my morning jolts of java. Just let me live.

Dr. Jamison had explained everything when I arrived for my appointment. First he pointed out the clusters of calcium that showed up as white spots on my mammogram. There had been changes in the last year, a potential indication of cancer. My case, he added, was complicated because I had extremely fibrous breasts which also showed up white on my x-ray.

If my films were a Rorschach test, I would have guessed they were snowstorms.

"But I see more white than black..." was all I could manage to whisper.

My surgeon responded with a sympathetic, grandfatherly shrug, and a reminder that 4 of 5 biopsies reveal no trace of cancer.

Soon I lay with my breast poking through a hole in a special table, and my eyes resting a few inches from the curved letters on Dr. Jamison's chest. Because the suspected region in my breast was large and diffuse with no defined lump, I would be treated to a state-of-the-art "stereotactic" biopsy. My surgeon would use an imaging device to guide his scalpel to those areas where the calcium was most pronounced.

I tried to ignore the pain when the nurse tugged at my breast and clamped it into something resembling the vise on my husband's work bench. Wincing, I craned my eyes toward Dr. Jamison's leathery face. He did not return my glance. I wanted him to know that I felt sorry for my squished breast and for everything that would follow. Instead of gutting fish, this old man would be extracting pieces of me.

I wondered how many thousands of breasts he had biopsied during his long years as a surgeon. Did the woman who preceded me this morning have so much snow in her breast? A few tears escaped from the corners of my eyes and rolled into the red vinyl tributaries of the table covering. The side of my face felt sticky, and I realized that there was no paper between me and the table. Had anyone wiped it down before me?

My nose plugged almost immediately and I tried to exchange shallow breaths of air through my mouth. I wondered if my breath was sour and if it lingered like a black cloud in Dr. Jamison's face. I wondered if the cloud would distract him from his task. I wondered if being neurotic causes cancer.

Dr. Jamison announced that he would be taking the first of several sections, and that I was to tell him if it hurt so he could squirt in more anesthetic. Thankfully, I was not positioned to view his hands as they dug deeper into my breast. I tried to focus on a wall poster of wildflowers as he removed corkscrew-shaped pieces of pink flesh and handed them off to the nurse who gingerly slid them into vials. After the ninth or tenth section, my breast began to ache and more silent tears rolled.

"Are you in pain?" Dr. Jamison asked when I could not help but sniffle.

"Yes, a little," I told him. "But that's not really why I'm crying." As he administered another numbing shot, I continued. "Mostly, I'm scared. The x-ray...there was so much..." Sniffle sniffle. "I have young children. A three year-old..."

"We'll, all I can do now is get the best samples possible," he said, gesturing to the nurse to hand me the tissue box. "Let's just hope it's benign."

That was not the reassurance for which I had been fishing. Suddenly I envisioned cancer cells. Armies of them gushing out of my mangled breast in search of new places in my body in which to spawn. I wondered if it was intuition or paranoia.

I asked to blow again and, after discarding the tissue, turned my head so I lay facing away from him. I tried to breathe more deeply and to envision myself floating. Dully, I watched the image on the screen as Dr. Jamison removed the rest of twenty-seven sections.

I don't know what I expected to see in the post-biopsy x-ray. Certainly not a breast full of little wormholes. I guess I thought the remaining tissue would instantly close up on itself and begin to heal. Half-jokingly, I asked Dr. Jamison if I had any breast left, and he told me quite seriously that the samples represented only about 5 percent of the affected area.

That was when I knew without a doubt that the best, the absolute best I could hope for if I had cancer was to lose my breast. I felt like a fish on the old man's line, gasping, desperate to be free.