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Operation Shake and Bake

My idea of relaxation is certainly not staring at a crooked poster on the ceiling of a hospital room with heavy radiation equipment around me. I don’t think the hole at the center of the poster through which the red laser is peeking can convince me or another patient that they are  looking at a scenic island with clear water and waterfalls. I ponder, if everyone believed in the same God, it could have been possible to have a heavenly image up there and then when a beam comes out of this hole, it would be more believable as a divine intervention and healing. I have no idea what is coming through here. Chemotherapy is something I saw and felt, had side effects to so felt more real. This, I just need to have faith.

Laying on the radiation machine with both hands up and breast exposed is not the most comforting positions. “Hands up” always evokes feeling of fear and unpredictability, and anxiety of what may happen. Our brain is fascinating at making associations and the association of both hands being up is that of being vulnerable. I am here to get radiation treatment with the desire to get any stubborn cancer cells that may have survived the surgeries and chemotherapies.

The ladies at the reception seem familiar with the crowd in the small tightly packed waiting area. They should be since radiation treatment is given five days a week for several weeks. They know patients by their first name and usually their accompanying friend or relative. When I declare, I am here for my shake and bake, they crack up. (My radiation oncologist is Dr. Sheikh). They are not used to chirpy cancer patients, and I notice that the chairs in the waiting room are occupied by humans with very depressed affect and sickly demeanor.

Radiation Oncology is a topic not much discussed in medical school unless you inherently are interested in finding more about it. It is usually a department tucked away in the basement of a medical center or in an area that many don’t pass through. So despite being a physician, I had no idea what goes on in there until I arrived there as a patient. The presence of equipment seems to have had some robotic effect on the staff too. Or is it that the principles of physics that over-arch the principles of empathy that is so prevalent in my world of psychiatric medicine. The appointment begins with changing into a gown…ah the dreaded hospital gown. This will be the routine for another 32 days. Being a sucker for unique products, I have acquired the “radiant wrap” which is a designer radiation gown for breast cancer patients. However that doesn’t really make the ordeal any better. I am neither more radiant nor more covered.

I walk into the radiation room, and its cold and dark. There is soft music from a radio channel that doesn’t add much to the ambiance. There are women in lab coats, i.e the technicians who quickly line you up in the right position. Of course the black marking on my chest with markers help them align the machine. Reminds me of the old embroidery machines that I used to watch with fascination at the street corner as a child. How the craftsman would line up the needle on the careful drawn on design and give the machine a whirl. Well, now facing me is a round disc attached to a huge machine arm emitting rays that intersect right at the spot where the “x” is on my chest. I can see my image in the glass. I also see, the machinery inside opening tiny metal doors with a disturbing screeching sound. I lay still, with my chin up since I don’t want my chin to get the radiation. Then I breathe. After few seconds the machine moves and now its angled to my side and I can see the darn poster again.

I am quite skilled at imagery and have taught it to my patients many times. But now as the radiation equipment moves around me,  I just can’t summon the power to imagine that I am basking in sun light on this island full of water falls. What I have gotten good at though, is believing that the little energy bundles that come out of the machine are hitting my skin and making sure that all rogue DNA is blasted away one by one. 32 more treatments to go, I softly pray, and hope for the healing rays to make me disease free. Then perhaps soon, I will vacation at a real island and won’t have an “x” mark on my chest.

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A Case Of Breast Envy

As a psychiatrist, I have read about penis envy in girls as proposed by Freud. What I had never experienced until recently was  “breast envy.” Yes, envy of other women who have two breasts. My recent trip to a water park uncovered this psychological issue.

I have to say that going to a water park right after chemotherapy ended was a bit of a challenge. From buying a swim prosthesis to finding water proof eye brow pencil, it was a quest but I am happy to report that it ended up being a rather cathartic and relaxing.

The first day arriving at the water park resort, I used my wig as an excuse to not get in the water. Chlorine will ruin it, I claimed. I was unsure of getting in the water and losing my hand drawn eye brows. I had also read that all prostheses absorb and expand in water. I was nervous of this expanding proposition. So I spent most time staring at other women and their breasts curled in the lounge chair. Creepy, may be… but I was more like a kid who is watching others eat ice cream when his fell on the ground – envious and wistful, thinking, “I once had two of those too”.

Women walking around in swimsuits, women with two breasts, women without “ports” in the chest, women with hair, women with pony tails, women with eye brows, women with eye lashes, women with toned abs. One woman in her cheetah print swim suit was mammarily gifted, I thought, “how would she react if I walked up to her and complemented her?” Cancer gives you courage, but also the wisdom to not use said courage on all occasions. I kept the complement to myself. Then, I suddenly realized… I was checking out other women’s boobs. What is wrong with me? Perhaps this phenomenon is breast envy. Nothing unconscious about it though!

The toughest thing about the grief of the loss of a breast is that one never gets a chance to mourn it fully before the whirlwind of treatment starts to blow you away. When someone dies, there is a proper service, then the family gets a chance to gather and regroup , comforted by loved ones. When your breast dies, the postmortem report, i.e the pathology report is handed to you, usually with more disturbing information than the demise itself. Then instead of a quiet period of mourning, you are sent off to deal with the harsh reality of chemotherapy drugs. No break, no memorial, no time to grieve. So as you recover from chemo, you get moments here and there to work through the grief and therefore, it isn’t unusual that for some, this grief ends up lasting a life time.Complicated grief usually does linger for long.

Having had a few patchy moments of working through my grief, I felt ill equipped to handle the boob fest around me. I envied the women in their two piece bikinis. Being a modest woman, I would never be caught dead in one, but just knowing that I couldn’t rock one like some of them bothered me. I could never buy a regular swim suit anymore and will always have to get a “mastectomy” suit with high neck. Again,not big on exposing but just saying! I had to keep reminding myself to take the prosthesis out of the suit before throwing it in the water extractor.I couldn’t get myself to use the shower in the women’s locker room. I imagined being talked about in hushed tones by the teenagers with body piercing and dark hair.

The next day, I decided I wanted to have fun, so I put my cap on (instead of the wig) and got in the water. It felt nice. The statistic of one in eight women in US having breast cancer was weirdly reassuring that I perhaps, wasn’t the only one here in this huge water park and that there must be others here struggling, just like me. I took the ride on the lazy river, the only thing that I usually do at the water park. I am not the one to do the slides, for one I don’t know how to swim and secondly I was always too scared. My kids on the other hand are little dare devils. So my husband asked the kids if they wanted to go down the big slide in the family raft and they happily started following him, then he said to me, “You can stand over there and you can see us come out.” He knows very well, I don’t do rides.

I looked at him and asked, “Can I come too?”

He looked at me puzzled, “You mean on the ride?”

“Yes,” I said, explaining, “I thought to myself, for the last few months, I have endured a lot of pain and suffering, how bad can this ride really be? No more than a long day in the ICU getting chemotherapy? Am I really afraid of coming down a slide in a water raft that lasts barely a minute?”

I joined them in the line.

Three times over, I came down the slide in the raft screaming at the top of my lungs, completely ignoring the sinking feeling I got as the raft plunged from the height, twisting and turning. Completely ignoring the fact that I can’t swim, I embraced that moment of thrill, the here and now.

I am no longer afraid! Cancer does that to you. And during the ride it didn’t really matter if I had one breast or two.