The Glass, Half Full

I don't believe I was born an optimist. I think I become one somewhere along the line. I don't know when, I just know that optimism is such a deeply ingrained part of my nature. On second thought, maybe I always have been an optimist. Just a realistic one, so sometimes I might just appear pessimistic, but it's only when there really is no hope. Some of the blog entries that were written on my darker days ended up with such positive responses. It amazed me that people would find something I didn't see or feel in those entries.

You'll notice that I said "darker" days. There are no blog entries from the darkest of days. Those are the days between when I had the mammogram and saw the breast surgeon. And again, the days between my first post-op visit and the realization that chemotherapy would be in my near future.

It's now a year from that first meeting with the breast surgeon. My first meeting as patient, that is. She had been my mentor for my 2 month elective in breast surgery, of all things, during my last year of residency.

I knew I was right about the diagnosis when I got the appointment. They received my mammo report on either Wednesday night or Thursday morning. First thing Thursday morning, there was a text message on my phone (not sure when it was sent) to call the office. She gave me an appointment for the very next day. My surgeon is a busy woman in a very busy practice. She triages appointments. Had she thought this was anything else other than cancer, my appointment would have been anywhere from days to weeks later.

You know it's never good news when the first thing that happens is the doctor walks into the room, gives you a hug and says "I'm so sorry." I probably could have left the room at that point. The diagnosis, albeit not official, was confirmed in that moment. I can still picture it. It was like a scene from a movie. I don't like that. You know how those movies end.

Back to my optimism. After that appointment, I focused on a few things. One was that she thought my nodes would be negative. I loved hearing that because it meant no chemo. Boy, would that one backfire. Small tumor, so lumpectomy is all that would be needed. I cut her off before she got more than a word or two into the mastectomy discussion. Looking back, I know I needed a lot more time to come to that decision. She was disappointed that I didn't bring anyone to that appointment. Yes, I went all alone. I knew what I had and thought I knew what I wanted. I wonder if I would have listened had she discussed a bilateral mastectomy at that opint.

The other concept that I clung to was that this was going to be stage 1 which has a 96% survival rate. I must have recited that number a million times. It became not just my favorite number in the whole world, but my own little mantra. 96% survival!

Of course, over time, I learned some of the above would not be so accurate. The tumor was grade 3 and a bit more aggressive than I had imagined. Funny, that I imagined my own tumor. I thought it should be well differentiated, moderately differentiated at worst. Didn't ever envision it would be poorly differentiated. I hate poorly differentiated tumors. They are bad news. They don't know how to behave like normal civilized cells. These are the tumors most likely to spread and cause havoc elsewhere.

Also, in my optimism, I completely ignored that the reported survival rates are just 5 year rates. I'll bet some of you didn't know that. A 96% survival rate is a beautiful thing. Don't get me wrong. But it doesn't mean as much as a 10 year or 20 year rate. It also lumps together a whole lot of disparate situations. A stage 1 tumor in a 60 year old woman is a different animal than a stage 1 tumor in a premenopausal woman. {sigh} I still like to ignore these things. 5 year survival is important, but it's not disease free survival either. Nor do these numbers look at recurrence. Nor do they look at something almost as bad, the chance of a new breast primary someday.

I do admit that once I had this appointment, it was a little bit easier to go on. I had a plan and a date. My surgery would be May 1. It could have been sooner, but I had to get in to see my internist for medical clearance. I also had to learn to say "I have cancer." Those words flow so easily now, but they were not only hard to say back then, they were hard to type. It made it real and I didn't want this to be real. It's a year later and now I say "I had cancer." And I still don't want it to be real. Sometimes, I even forget. Then, I catch a glimpse of myself in the mirror. I don't recognize this older woman with curly hair who looks back at me. And I certainly do not recognize this body. But, the forgetting is a good thing. A very good thing. It means that eventually, there will be longer and longer blocks of time when I forget this happened in my life. It means that Cancerville will be a place I used to live in. I won't be going back, not even for vacations! :P