Essays

A Personal Dictionary of Breast Surgery

When Erin Ollila went into hospital to have a lump in her breast removed, the words she focused on weren't necessarily the same ones her doctors were using.

Lobular

When you think of the lump you found in your breast, you think of a peanut M&M. But the ultrasound techs describes it as lobular. You don’t know exactly what lobular means, but you assume oval, and that is when you decide the foreign body inside of you is the identical twin to the yellow M&M in the commercials. You wonder if the lump has white eyes and white legs, too.

But what if lobular doesn’t mean oval? What if the lump isn’t shaped like a peanut “M&M”, but instead it is disc-shaped, like a Milk Dud? You like the way Milk Duds feel as you chew them and the caramel slaps and sticks to your teeth and the chocolate soaks up your saliva. Or maybe it’s curved, like a lima bean. You never liked lima beans; or most beans for that matter. Or maybe lobular means perfectly round in all directions, like a jawbreaker, or a gumball.

Or maybe lobular means none of those things; maybe lobular just suggests circular. Maybe lobular is like a chewed up piece of gum flattened under your shoe, taking the shape of whatever presses against it.

Slurp

The lady checking you in at Registration slurps her coffee from a small hole on the plastic lid. “Mmmm,” she says, “That’s good, but it’s too hot.” You think she is talking to you until a woman appears behind her slurping a Starbucks iced coffee up her own straw. “That’s why I always get mine iced,” the new woman says.

All you can think as you watch them is Slurp, slurp, slurp. It’s as if they’re mocking you.

The lady helping you shakes her Pandora bracelet so that it falls to where her wrist meets her hand, just as you do when it creeps up your arm. When you’re nervous, you roll your beads between your fingers, remembering the times Ryan gave you the charms.

You finger your left wrist, but it doesn’t make the bracelet appear. If your bracelet were on right now, you’d probably have the Together Forever charm or maybe the Best Friends charm or maybe the hearts rolling back and forth between your thumb and your finger. But you aren’t wearing your bracelet.

Cubbyhole

An elderly volunteer with a perfect pale-brown and gray French twist walks you to Prep-Op and points to the end of the hall. “You’ll be in room 15,” she says, “and Susan, who’s standing right there, will be your nurse.”

Room 15 is not a room; it is more like a preschool cubbyhole, where the children stash their blankets for naptime. The “walls” are made from pulled curtains—although you did luck out since you’re the last cubbyhole in the row. You have one solid wall of your own in Room 15.

Susan, your nurse, makes a list of everything you’re wearing and the items you brought with you: Black pants, gray shirt, purple sweatshirt, pink socks, black sneakers, multicolored messenger bag, two credit cards, a driver’s license, a notebook, two books, a cell phone, hair elastic, two bobby pins, a pen.

You ask her if she needs to know the color of your bra and underwear since she marked the color of the rest of your clothing and she says, “Oh, no. No one ever complains about lost undergarments,” and then writes down “undergarments” on the form before passing it to you for a signature.  Why does a pen or bobby pins get jotted down, but not your white bra and green undies?

She tells you to pack up your clothes and everything else in the two hospital-issued, plastic bags on the bed. She leaves so you can change into your gown, not the type you wear at a ball, but the kind that opens in the back and just about everywhere else as well. She returns with a Pepcid for your stomach. You take the pill with the smallest sip of water, even though your stomach feels just fine, as you don’t want to get the urge to pee before surgery.

Uncooked Spaghetti

Susan gets the IV ready to put in your hand. Why can’t she put it in your veins in the crook of your arm? You prefer the IV in your left hand, so you can write in the meantime, but she’d rather not do that because your surgery is on your left side. You expected the tip of the IV to be the same size as a normal needle, but it’s not. It’s much bigger. You have good veins, or so medical professionals have told you, so she shouldn’t have to dig around in your hand for an entry spot. You don’t want to watch the IV go in, so you look away, only to look back right as it punctures your skin. That is too big, you think, it’s like she’s stuffing uncooked spaghetti into your veins.

“What’s in this IV,” you ask Susan as she begins taping the needle and cord onto your hand. She loops the cord between your thumb and forefinger and tapes it tighter. Now that it’s not wobbling around, it is more comfortable than you expected.

You expected the tip of the IV to be the same size as a normal needle, but it’s not. It’s much bigger.

“Oh, just some antibiotics for the surgery,” she says and you begin to see a few drops move through the IV line and then it clears and is filled with liquid. It’s been almost a minute since the spaghetti-sized needle entered your hand at the bottom of your thumb and you feel a slow cool rush through your arm as the antibiotics enter your body. You hope the antibiotics don’t give you a yeast infection and make a mental note to take some acidophilus and eat more yogurt.

Turns out, writing with an IV in your hand is not an easy feat. You decide that you’re going to try writing with your left hand—another hard feat. You write in your notebook “willing myself to write with my left hand,” as if the power of intention will suddenly turn you ambidextrous. Madden’s kindergarten handwriting is much better than what you just scratched along the paper. The sentence takes up about three lines on the page.

Grouch Sandwich

A man in blue scrubs walks into your room, doesn’t make any eye contact with you, and announces himself as Something Kearsavage. You assume, and hope, he said Doctor Kearsavage as he begins to talk to you—still looking at the floor—about what type of anesthesia he plans on giving you. He asks you when was the last time you ate something. “Around 8 or 9 last night,” you reply.

“What was it that you ate at 8 or 9p.m.,” he asks and sits in the chair on the side of your cot, staring with intent at the blank lines on your chart.

Does he really need to know what you ate last night? Your evening snack was quite a smorgasbord and every time you brought a new treat into the living room and noticed Ryan eyeing your selections, you proclaimed, “What? It might be the last snack I ever eat. I’ve got to have it all.”

There’s been a slight pause since he asked the question, so you finally answer: “Some Sour Patch Kids, a Rice Krispies treat, and a Popsicle.” For the first time since he’s entered your cubbyhole, he looks up at you blank-faced, blinks two times and then looks back at your chart to write those answers down.

Some Sour Patch Kids, a Rice Krispies treat, and a Popsicle… What? It might be the last snack I ever eat.

“What is THS Syndrome?” he asks you.

“I don’t know.”

“What do you mean you don’t know,” he asks, looks up at you for a second and then back down to the paper. “You have it. It’s written right here.”

You first urge is to take out your cell phone and Google THS Syndrome, but your cell phone is in your messenger bag, and your messenger bag is in the hospital plastic bag tucked underneath your cot. This information worries you. It is written in handwriting on a mostly printed chart, and you wonder if the results from the pre-admissions blood test indicated some new, horrible disease you may have.

“I have no clue what that is,” you reply, “but I’d really like someone to check on that before I go into surgery.” He nods, stands up and walks out of your cubbyhole. A few minutes later, her returns to tell you that it was TMJ Syndrome—temporomandibular joint disorder—which you do have, and you make a mental note to Google THS Syndrome when you get home.

You feel very uncomfortable with the fact that your anesthesiologist’s last name has the word savage in there. You aren’t sure you want a savage putting you in a dreamland. You’ve written in your scraggily, loose, right-handed handwriting, “he probably ate a Grouch Sandwich for breakfast.” You’re not sure what a Grouch Sandwich is, and why he’d eat it for breakfast and not lunch, but apparently that is what you’ve decided he devoured this morning.

Imaging

You’re worried about the “imaging” you need today. During all your phone calls yesterday, the receptionists and medical assistants and nurses you spoke to kept saying the word “mammogram.” You do not want a mammogram; your poor breast has suffered enough. Your nurse Susan wheels your cot around the hospital to Radiology, which seems quite strange seeing as you can walk there yourself, although everyone would see your backside. Susan parks your cart along the wall in Radiology and you hope she dropped you off at the right place because no one comes for you for two or three minutes.

A young ultrasound technician comes to get you and you realize it’s the same girl—is her name Brandy? —who was in the room during your biopsy. You’re worried less now; somehow this makes a difference. There is another female technician in the room, and they explain the procedure to you. You get an ultrasound. No mammogram! Unfortunately though, they plan on inserting a wire into your breast to mark the site of the lump for surgery. You didn’t plan on getting any new hardware today, but you prefer they take out the correct specimen, so wire it is.

You feel like an alien version of Madonna.

The doctor comes in who will be inserting the wire and he is relatively handsome. You don’t show your boob to that many people, and you feel strange having a slightly-handsome guy touching it—no less inserting a piece of metal into it—when you’re in a relationship, but apparently this is normal here because no one seems the least bit perturbed. Plus, he isn’t that handsome. It’s more just a mild handsome. Everyone else who’s touched your boob in the history of these lump appointments has either been an old male surgeon with minimal personality or women who seem the least bit phased over your mammary glands. Probably because they have their own boobs to manage.

After Minorly Handsome Doctor inserts a wire horizontally into your left breast he announces that he would like a plastic cup. Brandy, your new favorite ultrasound tech of all time, asks him to repeat himself, because she too seems confused about why he needs this. You look down. There is about three inches of wire just dangling out of your chest, bouncing a bit in the air. “You’ll see,” he says. She leaves the room and reappears a few minutes later with a plastic cup. He takes it, places it over the wire protruding from your breast and asks for tape. Both girls are looking at him blankly, and then the tech whose name you don’t remember—although it may have been Amanda—passes him the tape. He pulls out long strips and tapes the cup to your chest. “Tada!” he says. “Just in case you move your arm and knock it out of place.”

You feel like an alien version of Madonna.

Alone

You miss Ryan; you feel uncomfortable in the silence of your cubbyhole where you can watch all these people. A woman walks by with her husband, or maybe it’s her brother. She is holding the back of his hospital gown closed as he walks in front of her. She looks into your cubbyhole, notices you are alone, and smiles with that sympathetic, pity kind of smile. You did this to yourself. Ryan would have been here waiting with you if you weren’t so adamant he stay at work. “It’s just a small procedure,” you said to him. “There’s no need to take the whole day off when you’re probably going to only be allowed in the pre-op area for a half hour or so.” You always need to be the strong one; you always end up alone.

Contestant

It must be all the Jeopardy you watched with your grandmother as a child. When someone asks a question, you pull the relevant words out and feel the urge to answer as quickly as possible. It’s as if you’re listening closely, with a buzzer in your hand waiting to respond with your answer—just not in the form of a question.

Your doctor walks into your cubbyhole in Pre-Op with your chart in his hand. “How are ya doing,” he says with about as much enthusiasm as you’ve ever seen him muster. He must be excited to cut. You’ve heard it’s like a drug—cutting that is—that some surgeons get high off the rush.

You’ve heard it’s like a drug—cutting that is—that some surgeons get high off the rush.

“So, you still in a lot of pain?” he asks, and your contestant-like brain kicks into gear as you nod your head and answer, “Yep,” at the exact same time that he says, “back there,” and points toward his rear end.

Hold up.

Back Where?

Did you just acknowledge that your ass was in pain? Does this man even know what surgery he’s doing?

You don’t say anything, partially because you just don’t know what to say at a time like this, and partially because you don’t want to embarrass your doctor. If he mentions your ass again, you’ll remind him your surgery is on your breasts, not your derriere.

Notes to Self

You’ve watched every season of Grey’s Anatomy except the current one. You know all the things that happen in hospitals. Your anesthesiologist could be drunk. A gunman could go on a killing spree while you’re in dreamland. Doctors could perform the wrong surgery on the wrong patient. You watch a lot of movies. You read the news. People go under anesthesia all the time and wake up with a case of amnesia. With your luck, this is bound to be you in a few hours. You’ve learned that writing with your left hand is no longer an option, but you can maneuver the pen around the page if you grip it very loosely with your right hand. You write in your notebook:

“If you (and you write “Erin” on top of the word you, just in case you don’t remember your own name) wake up from surgery and don’t remember anything like in the movies—I just want you to know that you love Ryan with all your heart and Madden and your parents, brothers, and best friends. Just in case. ☺” You neglect to mention your sisters-in-law and nieces and nephew. And even more importantly, your own dog, Fenway.

V-Drug

When it is time, a woman whose shoes and hair is covered with blue surgery caps comes into your cubbyhole. She has kind eyes and while pulling your IV line out from behind your back, informs you that she is the nurse anesthesiologist and that she was going to give you a sedative and bring you into surgery. She says the name of the drug, something that started with a V and was similar to Valium, but you forgot about as quickly as she told you. The only think you remember her telling you was that some patients say they feel a mild burning sensation once the V-Drug gets into their system. Then she begins to wheel you away.

High

Here are the thoughts you remember thinking from the time you leave your cubbyhole until you fully go under from the anesthesia:

Where is the burning feeling? Didn’t she say I’d feel a burning sensation?

These people must be so strong to wheel around the patients all on their own.

I feel the same as I did ten seconds ago.

This is the operating room?

Where is everybody?

Ohhh, I feel a warm sensation. It’s definitely not burning, but I do feel all warm in my veins.

What are they putting on my lower legs? Is that massaging my legs? Is someone massaging my legs?

I kindaaaaaa get the whole addiction thing now. This doesn’t feel so bad.

You feel a big bit high, and a tiny bit nervous. The nervousness is catching up real quickly with the high, and you realize that in a few moments you will be in a dreamland. The same dreamland you’re afraid you won’t wake up from, and that is what scares you. Look around, you think, feeling a sudden urge to take everything in. The items in this room might be the last things you ever see. Everything in this room is disappointing. Sterile. You’re on your back, buzzed off the anesthesia high, staring at the ceiling fan—or was it just the lights on the ceiling—when you notice the initials on what you appear to think is a fan: ALM.

ALM. You twist those words around in your mouth even though you don’t open it to speak. ALM feels familiar. You floating deeper in your buzz and the fan—or light—starts to get blurred and fuzzy. Aaaaaa Llllllll Mmmmmm, you think. ALM stands for Amy Louise Melo, your best friend since kindergarten.

This is how you know you’ll be okay.


Top photo by Mike Licht, used under Creative Commons license.