Feminine, Fatal
The very thing that circumscribes my femininity could kill me.
I’ve been holding onto this one ever since I started republishing old work here last year, but I’ve revisited it recently and trust my community here to receive it with care. (Trigger warnings galore, folks: I talk about sexual harassment and assault, parental death, and cancer.) Thanks to my mom, my professors Kate Winkler Dawson and Kevin Robbins, Mary Shannon Tompson, and Elsa Rohm for being early readers of this piece.
The first time I was cat-called was on the Houston Metro riding home from HSPVA’s downtown campus my senior year. I was wearing a pale pink bodysuit that stretched tightly across the breasts that seemed to have only recently started to develop.
There was a younger girl across from me whom I vaguely recognized from school. Her footwear betrayed her innocence: tennis shoes with skinny jeans, or socks with sandals, I can’t remember exactly what. She hadn’t seen the two men in front of us with ogling eyes and scratchy, rumbled laughter, sizing us up. I was naïve enough to think for a moment that they knew each other and were discussing some inside joke, but it became clear that whatever joke it was, we were the butt of it. I never wore that bodysuit again.
In a perverse way, though, I was relieved to finally be worthy of attention. I was about to go to college, with nothing close to a serious romantic involvement in high school. I hadn’t even been kissed yet. We used to joke that we could count on one hand the straight guys at our magnet arts high school. When #MeToo started trending on my social media feeds, I felt left out of such a significant cultural conversation; then, I berated myself for being jealous of others’ suffering.
I love my breasts, though it can be difficult to try to separate what I think about them and what others have told me. From learning about my body as a preteen from the American Girl book The Care & Keeping of You, through the Accutane years, to getting dressed for fraternity mixers—I absorbed how, when, and why to accentuate my two best features. When I was at my most insecure, my breasts still got me noticed, for better or for worse.
Friends used to joke with me about how perky and pillowy they are. I don’t usually respond by explaining that dense breast tissue runs in my family—and with it, breast cancer. The very thing that circumscribes my femininity could kill me.
At my annual OBGYN checkup, my medical history goes something like this: breast cancer in both maternal great-grandmothers, maternal great-aunt, maternal grandmother, paternal grandmother, both maternal aunts, and mother. The processing nurse usually tries not to show her surprise, then recommends I get my first mammogram when I’m no later than 30 years old, or refers me to an oncologist.
I’ve accidentally referred in casual conversation to the fact that I’m going to get a preventative double mastectomy one day, and acquaintances have tried insisting that science may have progressed far enough by then to make treatment easier. My closest friends know better than to try to challenge me. I’m not torn up about it; I just hope I get some good use out of my boobs before I have to chop them off.
They’ve tested us for all the genetic markers, and our cancer isn’t considered “familial.” I do think science will progress: One day, they’ll find something in our DNA to prove the causal genetic connection. Until then, I’ll enter a high-risk clinic when I’m 25. My mom got her first mammogram at 28, despite doctors trying to tell her it wasn’t necessary yet.
In September 2016, she had missed two years of mammograms, when she finally scheduled an appointment. All it took was driving a few minutes down the street to Houston’s MD Anderson Cancer Center, the largest cancer center in the United States. She’d felt a rough patch in her right breast, but not the typical “pea” or “pearl” that doctors tell you to look out for when you keep up with regular self-examinations.
She’d had a few false alarms throughout the years that turned out to be calcifications when biopsied (dense breasts), so it wasn’t too unusual when they called her in the next week for more scans. When the sonogram tech started scanning her neck and underarms—to check her lymph nodes—my mom texted her sister Sarah that there might be a problem.
The doctor took two biopsies that night that my mom describes as one of the most painful parts of the whole cancer journey. The tech came back and asked if she could tell my mom some good news. This always implies that there’s bad news to come.
“There’s no indication that anything has spread to your lymph nodes. But the spot looks highly suspicious.” The biopsy results would come back in a week. When my mom walked back out into the waiting room, drained of tears, her sister was sitting there, having come without asking. They split a bottle of wine before my mom went home.
The next week, we were in the car together, driving back to visit her hometown in East Texas. I only learned this year that the call she took with me in the passenger seat was when she found out that the rough patch she’d felt was in fact a tumor, and that it was malignant. The nurse on the phone recommended that she not tell her children until her oncologists knew how bad it was and how they were going to treat it. Otherwise, her kids would just hear that she was dying. I still don’t know how she kept her composure, but that’s one of my mom’s best (and worst) traits: She’s always thinking of others first.
Her first meeting at MD Anderson after her diagnosis was on November 8, 2016. When they got home from the hospital, I was on the couch watching election night coverage, giddy to be living through the election of our country’s first female president, though I wasn’t yet old enough to vote. My dad called my brother downstairs and started to break the news. I yelled at him to speak faster; I could tell the news he was trying to break gently was dire. It didn’t matter that Mom had wanted to be the one to tell us.
I ran downstairs and slammed my door shut, while my brother threw himself on her lap and asked if she was going to lose her hair. Despite her best efforts to keep the secret until she could tell us that the cancer was Stage 2B and not at all terminal, I thought for months that it was Stage 4. I must have convinced myself it was worse than it was because of how fully my world felt like it had shattered. I texted a few friends the news but went to bed early. I wouldn’t discover until the next morning that Hillary Clinton had lost.
Another thing I learned belatedly: My mom says I put up a wall between us almost immediately. I was cruel to her. I just remember spiraling even deeper into my own depression. I know that I didn’t like her wigs, especially the blonde one, and I didn’t want to see her looking so frail and hurting. I no longer recognized my best friend, and I took my grief out on her.
My brother was only 13 at the time, but we didn’t lean on each other through the cancer—or the divorce. That February, only four months after her diagnosis, my mom told my brother and I separately that she had asked my dad for a separation. She knew she couldn’t heal if she was also trying to heal their marriage. When my dad wouldn’t leave the house, she took a bag to our grandmother’s extra room.
That night, she developed a neutropenic fever from the stress or because chemotherapy had killed all of her white blood cells, and she checked into a walk-in clinic in the middle of the night. My godmother called me the next morning to tell me, and I was so angry that I had had to hear it from someone else that I didn’t want to see or speak to my mom. When I left for the weekend on a church retreat, I didn’t know how bad things had gotten. My brother, on the other hand, rode with her in the ambulance when they decided to transfer her from the clinic to the emergency room.
I got home to find her discharged from the hospital, and my dad holding his boxes in our driveway. She says the last thing my dad said to her before he left was, “Don’t spend too much money.”
After 12 weeks of Taxol and four treatments of Doxorubicin (nicknamed the Red Devil for its shade and infamous toxicity), she had a 100 percent pathological response to the chemo. She got a double mastectomy in April 2017. She didn’t know if I would visit her in post-op, but I crawled up in bed with her and put my head on her shoulder, like some switch in me had flipped.
I don’t remember this either. Later, a therapist would to her explain that it’s common for children to act as if a sick parent is already dead, to start practicing how to live on their own as a coping mechanism, until they know the threat has passed.
She was declared cancer-free almost exactly a year to the day after her diagnosis. Now, her hair is even longer than it was before it fell out. She’s remarried to her high school sweetheart, incidentally another cancer survivor. They say that cancer saved their lives, in giving them the courage to leave unhealthy marriages and make the lifestyle changes they needed in order to not just survive, but thrive.
For me, however, the threat hasn’t exactly passed. Since my mom entered remission, both of my aunts were diagnosed. Sarah didn’t have to do chemotherapy or radiation, and Claire’s was only Stage 0, which was thankfully enough for her insurance to cover a preventative double mastectomy.
That’s what I’ll do sometime in the future, but I don’t know when or whether it’ll be too late. One of our close family friends had a mammogram only six months before she was diagnosed with HER2-positive breast cancer, which means she is the one of every five patients whose cancer cells replicate even more quickly than my mom’s did. Even the most careful timing falls at cancer’s feet.
Mom still takes estrogen-blocking medicine, despite the plentiful side effects, so that her cancer won’t recur in whatever remains of her breast tissue, her lymph nodes, or the most common areas of metastasis: brain, bones, lungs, or liver. But every time her head hurts or her bones ache, she has to decide whether it’s the premature menopause, run-of-the-mill exhaustion, or cancer.
Every time my breasts feel sore, I panic that I’m pregnant—a huge burden in Texas as reproductive rights are systematically eliminated—or that cancer has come for me even earlier than anyone expected. Even if these worst-case scenarios are either impossible or else highly unlikely, my feelings about my breasts and their fraught symbolism are complicated by political and medical concerns.
I’m bargaining against time, see. I don’t want to change my body prematurely and irrevocably. But if I wait too long, I could develop cancer before I can take any preventative action. These are decisions that will affect my partner, as well, whomever they may eventually be.
Though I’ve sometimes gone back and forth about whether I want to have kids, I know I would hope to at least have the option to breastfeed my children. I don’t buy into the overly simplistic narrative that “breast is best,” but part of my desire to have children comes from a primal curiosity about my body’s capabilities as a woman. If I had to literally cut myself off from this one possibility, I think I’d always wonder. Some irrational part of me would always fear that I had somehow deprived my child out of single-minded worry.
Beyond the biological function of breasts, I will have to think about if and how I’ll have reconstructive surgery. Preventative mastectomies are often the best candidates for nipple-areola sparing mastectomies because, for one, patients tend to be younger and less ill. There are even surgical techniques now that use fat from the stomach to replace the removed breast tissue, giving the patient a boob job and a tummy tuck in one fell swoop, though recovery obviously takes longer.
Some women have prophylactic hysterectomies (removal of the uterus) or bilateral salpingo-oophorectomies (removal of both ovaries and fallopian tubes) in addition to mastectomies. But no preventative gynecological surgery can bring one’s cancer risk to a total zero, and each surgery is expensive and invasive. These are things that most other 23-year-olds know nothing about.
I don’t get to exist in my body today without imagining its reduced, future form, like a foreboding shadow only I can see. I am always both myself and less than myself. I am resolute, if unresolved.
