Something in Dr. R’s message does not add up. First I have an old pneumonia scar. Then it is radiation damage on the left lung lobe. But I had my right side radiated.  If anyone could solve this mystery, it would be my radiation oncologist, Dr. Alpha.

I call Dr. Alpha’s number, fully expecting to get his voice mail, but he picks up on the first ring.

No, he never took any x-rays of me, but I had a CAT scan before I started radiation. (How could I possibly have forgotten that?) He will look at it and call me back.

In less than an hour, Dr. Alpha is back on the phone. He has compared my  CAT scan from five months ago with the new one. The 8 mm granuloma on my lower left lobe does not worry him. It was there before I started radiation and has not changed at all.

“More worrisome,” Dr. Alpha tells me, “is the growth on the lymph node just below your heart.”

I try to steady my voice so it will not quiver. All my bluster and bravado from my days of radiation have  evaporated. I hear how meek and scared I sound. He must have heard it too.

“They never told me anything about a growth under my heart.”

“No, they wouldn’t. They try not to give you all the information. You want to come down and see?” offers Dr. Alpha. “I will show it to you and explain.”

I want to take him up on the offer and drive down and see for myself. But I also do not want to crash into his busy schedule. What do I know about x-ray images anyway? I did not even know you had lymph nodes under your heart. I will have to take Dr. Alpha on his word.

“You definitely need a PET scan,” Dr. Alpha says. “This needs to be fully investigated. I will schedule one for you.”

“But I have one scheduled for tomorrow at 1 PM. I guess I have to go ahead then?”

“Yes, you do. I will read it and get back to you as soon as it is done,” said Dr. Alpha.

I feel doomed. Dr. Alpha’s words – this definitely needs to be investigated – throb in my ears. “Investigated,” has a serious ring to it, like a grand jury inquiry or Senate investigation. And, yet, the idea that Dr. Alpha will get to read my PET scan calms me and reassures me. I know he will level with me no matter what the outcome.

Dr. Guru meets with my family in the waiting room. Big grin, face mask dangling around his neck, arms raised, two fingers on each hand formed into the V for victory signs.  No cancer in frozen lymph node section. So far everyone agrees. Big wide margins. Some  heard only “wide” margins, but not “big wide” margins. One thought he said only “good margins.”  Another does not recall anything about margins.

Whatever he said, everyone is jubilant. The cancer “episode” is over.  The drive home takes 20 minutes. We stop to fill a prescription: a small brown plastic container filled with — Wow — FIFTY Percocet!   Good bye pain I don’t have. Hello euphoria.

In the living room, the mantel above the fire place is filled with flower arrangements. Calla lilies, Gerber daisies, roses of all kinds, delphiniums, chrysanthemums,  hydrangeas, and freesias fill the air with their perfume, lots of get well cards.

Our family lounges in the sofas and chairs around the large coffee table. Snacks and munchies are brought in .  After all, it is dinner time. Wine is poured for everyone but me. (I get water. One indication that all is not fully back to normal.)  A couple of neighbors stop buy. The phone rings. A friend brings over a water melon salad and a chicken salad. My sister in law brings a bag of fresh bagels from Goldberg’s  along with various spreads. The atmosphere is that of a festive wake.

Normally, during casual family gatherings or Sunday dinners, people arrive late or leave early. Some excuse themselves to check emails, or make cell phone calls, turn on the TV  to catch the last few minutes of some game, or sneak away to play billiards downstairs. All signs of a certain restlessness, an eagerness to escape the tight family noose. Not today.

Like on  Christmas Eve, everyone remains seated: content and mellow, we bask in the glow of  togetherness.  I feel their warmth and concern, happiness about the outcome.  We even play a few hands of my favorite card game in a concession to my status as Queen for a Day. (Although they don’t let me win.)

At 11 PM, I go upstairs to prepare for bed. I am not particularly tired and I feel no discomfort. Dutifully I swallow a Percocet because my husband reminds me of the nurse’s wisdom: “Take them before you start to hurt. It is easier to prevent pain than to chase it away. ” Plus who wants to hear “I told you so” should I wake up wreathing in pain.

When I roll over on my side, I feel a tighness, tenderness, in my swollen, bruised  breast. A pleasant reminder that I still have that breast,  and that it is now tumor free. Post operative treatment options are completely off my radar screen as I drift off to a night of uninterupted, dreamless sleep.

Before my diagnosis, I paid no attention to pink bows, the symbol for breast cancer awareness.  But now that I have been initiated into the pink bow sisterhood, I see pink constantly and everywhere. It is obviously a powerful marketing tool.

Water bottles,  T-shirts, hats,  and slippers are decorated with pink bows. There are pink bows on candy such as Tic Tacs and M & Ms.

Even Fleischman’s yeast packages and Morton’s salt display pink bows. The pink bows are usually accompanied by statements like: “Each purchase helps fight breast cancer” or “Purchasing this package will support efforts to find a cure for breast cancer.” Valerie, a consumer relation’s representative for Fleischman’s Yeast writes that me: “Our donation will range from a minimum of $100,000 to a maximum of $200,000 depending on the amount of registered products.” This is certainly a good contribution although she does not specify which organization that gets the donation or what the profits are on yeast envelopes sold because of the pink bow. Morton’s salt does not respond to my inquiry regarding their support of breast cancer.

I find heads of cauliflower at the grocery store – and not in the organic section, either – each wrapped in cellophane with small pink bow and a link to a web site where you can learn what the cauliflower does for the “cure.” (Presumably it contributes more than antioxidants.) Heads of broccoli come with a pink bow printed on the cellophane wraps and an assurance that Andy Boy, the grower in Salinas, CA, is in “Proud Support of The Breast Cancer Research Foundation.”

7 Eleven sells boxes of donuts with pink ribbon sprinkles and 15 cents per donut goes to Susan G. Komen for breast cancer research. How much goes to diabetes prevention programs?

Delta Airlines sold $2 cans of pink lemonade on their transcontinental flight from Atlanta to San Francisco “in honor of breast cancer.” (How much did the near-bankrupt airline donate to the cause?)

The breast cancer awareness postal stamp was the nation’s first fund-raising stamp, according to the U.S. Postal Service. It cost more than the normal First-Class stamp so that net proceeds could go to the cause. Thirty percent of of the net proceeds went to the Medical Research program of the Department of Defense. Does WMD stand for Women Massively Deceived?

Well, the defense department did use the money for breast cancer research. But why the Department of Defense?   What could possibly be the link between the defense department and breast cancer? Is the defense department really the ideal department to decide who gets grants to research such an important health issue for women? Yes, there are women in our armed forces. But please, I don’t think funds from the breast cancer stamp had anything to do with women soldiers.

Once you are aware of the pink bow mania, you can not escape all the products and organizations involved in rooting for “the cure”and their promotion of  “awareness.”  You have to ask yourself, how much money is really contributed to breast cancer research, and who gets the money for doing what?

Join “Think Before You Pink” and support the fight for breast cancer prevention.  If shopping were the solution, we would already have a cure.  http://www.thinkbeforeyoupink.org/

Thursday, I only have one thing on my mind, one thought circling my brain like a  hungry wolf.  I want to go under Dr. Guru’s scalpel, I need for him to get rid of my nasty, ugly tumor. Now.

Not a word from Dr. Guru’s office.  Not a word about the MRI results.  Not a word about a surgery date. Yet another week-end of uncertainty looms before me.

I can only assume now that my surgery will not be on Tuesday. Annoyed at being in limbo, I call Dr. Guru’s office. His assistant, Joy, has left although it is only 4.15 P.M.  Of course, I left my own office at 1.15 P.M., three hours earlier than Joy left hers. But I am not an oncologist or surgeon. My job is only about money, not about  life or death, not about anxiety and worry.  And my territory is Europe where 1 P.M. Eastern standard time means 6-7 P.M. : Happy hour in London and Paris.

Yet there is an upside to breast cancer: people care more than I could have imagined. Six friends call me in the evening to ask about my MRI result and about a surgery date. They, too, get huffy and annoyed when they hear that I don’t know.

One friend, who calls me from Sweden  to check up on me, says:”We love you!”  before she hangs up. We have been friends for more than 40 years. She has shown me in a million different ways how much she and her whole family cares, but for the first time she says:  We love you.

A perfect day to hang out in our wonderful pool, the one extravagant purchase we do not regret. It is large and deep, filled with cool turquoise,  mildly salty, water, soothing to both body and soul. My friend Cecilia comes over and gives me “The Complete Guide to Breast Cancer.” (Winner of the Ross Kushner Award for American Medical Writing.) It feels surreal to look down at the 36 pt. blue typeface against a pale yellow background and realize that I have breast cancer and the book is for me and about me. Flipping through the pages, I discover the complexity of breast cancer: There are so many different kinds, different stages, different phases, different grades, everyone with a different outcome. The outcome depends on — what? I need to figure this out.

I glance at the statistics for my cohort. Five year survival looks good: First five years 96% still alive.

Ten years looks less promising. Best case seemed to be 75% alive after 10 years.  Worst case was 54%. That is, according to my math impaired mind, 50-50: a coin toss.

Twenty years looks a bit scary: 40% of all women diagnosed with breast cancer will die from the disease. Could that really be right? But I will be 80 years old. You have to let go sometime, especially if you dread assisted living. But from what little I have gleaned from my research so far: dying from cancer is not the ideal way to depart.

I cheer myself up: pioneer women had an average life expectancy of 38 years. Women in Sudan….Women in India…Women living in all under developed countries, their numbers are dismal even now in the 21^st century, a lot more dismal than my life expectancy with cancer.

I close the book and put The Complete Guide to Breast Cancer up-side down on the table beside me. I don’t want the title to stare me in the face while I am trying to relax.

At lunch before my doctor’s appointment, Marie gives me a care package: one of the presents is a blue vinyl journal with a cheerful green flap to close under a pink loop (I do not connect the pink loop with the pink cancer bow. Somehow I am still able to ignore the pink breast cancer symbol.)

“Write down everything,” Marie says. “When something really bad happens,” she continues, “It is so hard to understand or remember what they say. Everything is confusing, and you don’t realize how important something is, until after wards. And if you scribble down things in note pads or on pieces of paper, you will loose them. Or you don’t date them. It is a mess when you try to go back and piece things together. In a journal, you have it all in order. I picked the book because the cheerful covers.”

“I will write down everything,” I promise her. “Maybe I will write the Cancer Comedy. To match the cheerful covers.”

Marie also gives me bookmark that she herself has made on Photoshop. It is a photo of me during our Florida vacation. I am standing inside an inner tube in the waist high turquoise water, holding up both arms, my fingers shaped like Vs for victory as if I am about to conquer the Mexican Gulf. In the photo there are no waves, just perfectly clear and smooth aqua water.

“In my next incarnation,” I tell Marie, “I will be a dolphin.”

Before my scheduled check-up with my new gynecologist, I have lunch at my friend Marie’s invitation. She picks Anise, one of my favorite lunch places, one with so many memories of earlier, happier, days when Marie and I both had sons and our sons were both in the International School, a few hundred yards away.

As always Anise is crowded at lunch time. As always, there is a smattering of French coming from a table somewhere, and from the staff as they weave in and out between the small rickety tables bringing water, wine, and bread baskets. We sit outside in the court yard. The sunlight ripples through the wisteria leaves. It’s all a bit funky and run down. Paper table cloths. Café chairs. Wildflowers in large terracotta pots.

It is such a reminder of the days when misfortunes were only future abstractions, not present realities. I can not count how many lunches I have spent here with friends worrying mostly about others, especially the kids. About grades, about college, SAT scores, about drinking and driving. About the boys being accused of doing things to girls they never did or meant to do. About my girls being taken advantage of by boys like our sons, or worse, by older men.

Not once, as I recall, did we ever talk about anyone getting sick. If we ever talked illness it was with a shudder at the thought of having elderly parents far away, or at the possibility of Alzheimer’s. “That would be the worst,” we’d all say almost in unison. But mostly we talked about books, politics, food and the kids, their prospects for the future, and what we would do when they went to college and we were “free.”

“Dr. Morte is rather glum,” Marie warns. “Glass definitely half empty, and don’t expect small talk. But he seems thorough.”

“Thorough is good,” I acknowledge “at least when you deal with a doctor and not an IRS auditor.”

On my drive home from the office mulling over my new diagnosis, I try to think of names of doctors I can ask. My friend B’s husband is a vascular surgeon, he ought to know. But they have left for some medical conference on Corsica. My friend Elise’s husband Dan is a doctor. He teaches at the medical school. I have some hazy notion he works in OR which would have to mean he is either a surgeon or an anesthesiologist, what else does one do in an operating room? I realize I am woefully illiterate about anything medicine.

One person I do not call is my husband.  He is still in San Francisco and will not land till midnight. There is no point to frighten him just before he boards a cross-country flight. Could there be anything worse than sitting trapped in an airplane for 4 hours to mull over one’s wife’s cancer diagnosis?

I also don’t give any consideration to what might be the best hospital or which hospital is in my “network.” In fact, I don’t give insurance or benefits or out of pocket costs a thought.  I only have one bee in my bonnet: I want a surgeon to remove my cancerous hazelnut right NOW. I scroll my cell phone for my friend Elise’s phone number.  Her husband answers and tells me they are both about to board a flight for Ireland.

“But Elise is standing right by my side.”

“I actually I am calling you,” I tell him. “I need some advice. I need the name of a good surgeon. I was just diagnosed with breast cancer.”

The last sentence sounds surreal as the words tumble out. I feel as if I am acting in some drama where my only line is: “I was just diagnosed with breast cancer.”

Dan calmly says: “Oh Elise had that experience, I don’t know if you were aware.”

Really? No, I had no idea. How long had I known her? Seven years? Longer?

“The first person who comes to my mind,” Dan continues, “is Dr. Guru. When I am back in a week, I’ll help you cut through the hospital bureaucracy and red tape. I will let you talk to Elise now.”

“I had cancer when I was in law school.” she tells me. “My two children were still in elementary school. I waited for weeks to have her surgery so the kids could be in summer camp during my convalescence. This is the worst time you know,” Elise assures me. “This time of waiting, not knowing what they will find and what will happen. But you will be just fine.”

Elise tells me she had a mastectomy, no chemo. She sounds so calm and reasonable that I become calm too. Clearly Elise has made it – it’s been 20 years since her harrowing experience. I thank her and wished them both a great vacation.

My own vacation plans just evaporated. My “vacation” will be spent waiting – waiting for schedules, waiting for procedures, waiting for test results, waiting for phone calls, waiting in waiting rooms. Crap!

Thirty minutes earlier, I was told I have breast cancer. It is at moments like this you turn to your friends.

I throw myself on the phone to call Marie and Cecilia. Normally, I don’t like to talk about anything personal on my office phone. I am in an office landscape and everyone hears and knows everything. Especially such matters you don’t want anyone to hear and know. I often wish people around me would be more discrete when discussing their health, finances or week-ends. But I feel a great urge to tell someone and I can talk Swedish with my friends, so nobody understands as long as I don’t use the universal words “cancer” or “tumor.”

Marie wants me to come over right away. When she hears my husband is in California, she begs me to at least have dinner with them so I won’t be alone. But I am too restless, too keyed up. I need to be alone so I can pace, wring my hands, and wrap my head around the cancerous lump.

“I will help you find someone,” says Marie.

“Someone who won’t stab my heart.”

“What side is your tumor?”

“On the right side.”

“Your heart is on the left.”

Marie  promises to jump on the internet and help me in my research.

Cecilia, too, immediately volunteers to plug into her network of doctors. Strange, we have known each other for twenty years and this is the first time I realize that the reason Cecilia knows a lot of doctors is that she has health issues. Yet she never talks about them.

Driving home I wish I had done something to prepare for the possibility of a cancer diagnosis.   But instead I have kept my head in the sand and now my mind feels kind of dusty and gritty. My only thought is: How fast can I get rid of my lump. I have about an hour to find a reputable surgeon.

Although the possibility that I may have cancer has loomed for weeks, months if you include the time I wasted after I discovered the lump, my diagnosis takes me by such a surprise that I do not have a single question for the radiologist when she calls and gives me the biopsy result. And she doesn’t tell me what to do. Just hangs up, thrilled to get off the phone so easily, I imagine.

I have done nothing to research breast cancer. I have not sought the advice from anyone. I have not told anyone about the biopsy, other than my two best friends who know as little as I do. My whole strategy has been: It can’t be cancer. No worries.  And yet, this whole time,  I knew deep down there was something wrong.

I swing my chair around to look out over the city from my 16th floor office window.  I watch the steady stream of traffic on the 75/285 interchange.  From Paces Ferry Road a green canopy of trees stretches for miles, and beyond the trees, in the distance, I can see the skyscrapers of Midtown shimmering in the clear, sunny light. I suck on the words “slow growing” and “good prognosis” as if they were bonbons.

Good candidate for lumpectomy? What is that? Just removing the lump? It sounds pretty easy. I can probably deal with that. Lumpectomy rhymes with vasectomy.  It has to be a piece of cake if men voluntarily submit to it. Lumpectomy also rhymes with appendectomy. I had one of those , years back, and barely remember the details.

Then I take out a ruler from my desk drawer and measure 1.5 cm. It does not look all that small. In fact, it looks eerily big. And what if it the lump is 2 cm? That looks even bigger. Two centimeters is ALMOST an inch. Is it really possible they did not see my lump on last year’s mammogram. Or did they forgot to tell me? What about the year before? Or the year before that? Dr. Dork said my cancer is so slow growing I may have had it for a decade. That would mean I have had ten mammograms without anyone discovering my cancer. My heart starts to beat fast and hard.

I am getting pretty angry with the Breast “Care” Center. Why put me through the trouble, expense, and unnecessary radiation of annual mammograms when they have so much trouble seeing what is on the films?

I asked Doctor Dork during my biopsy about the previous year’s mammogram and all she said was: “Oh, we saw something then. But only with 20-20 did we realize what it was when we compared it with this year’s x-rays.” She was unapologetic. Unsentimental. ”It is what it is” was the radiologist’s attitude. Last year we didn’t notice a lump and this year we did. No big deal. But the longer I stare at my ruler, the bigger the deal becomes. Clearly, it is better to see a tumor when it is 1 cm, or even better at 0.5 cm.   And what about discovering cancer at an even earlier stage, as micro-calcifications? They noticed  milky streaks inside me before when they turned out to be nothing at all. And now they have not seen a cancerous lump as big as a hazelnut.

Reluctantly, I look down at my right breast.  The lump needs to come out. For that I need a scalpel, and a surgeon to guide it. My watch says 2.30 P.M. When do doctors’ offices close? Four? Five? I have less than a couple of hours to find a surgeon and to make an appointment.