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.

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.

I am reading in the garden, pool side, when I notice the gathering clouds and hear the rumble in the distance, so I dart inside the house to lie down on the living room sofa. My husband is already napping upstairs.

Claps of thunder before rain begins to drum against the tall windows as I drift off to sleep, a rare occurrence. I seldom take naps. When I slowly come to, the clouds have dispersed and the sun has moved from my field of view. It is pre-dusk on a clear summer evening. Suspended between sleep and  consciousness, I hear the children in the neighborhood across  the pond laugh and shriek. Then their shrieks get shriller,  the kind of shrieks that come not from joy but from fear or conflict. Quickly, their squeals  turn back to merriment and laughter.

I try to orient myself in space and time, drifting between the here and now, and previous places and decades. I am back in my own childhood, resting in bed, perhaps with a mild fever. The neighborhood children play kick the can, race across the lawns, hide behind the sloan hedges and among lilac bushes. These sounds from five decades ago  mingle in my mind, not only with the present shrieks, but with shrieks and laughter from my own children, two decades earlier, in a state 1500 miles from here. The same joyful shrieks, the same quick swings between  fear and  laughter.  As I rest on my sofa, the scent of those lilacs from far away and long ago is so intense that  I half expect my mother to enter the room with a glass of lemonade or a comic book, or my three children to come crashing through the back door.

I get up from the sofa to retire up stairs. I continue re-reading Joan Didion’s The Year of Magical Thinking. (I read it already in January, months before I knew, now I have the strong urge to re-visit her experience.)

“Life changes fast” she writes. Life changes in an instant. You sit down to dinner and life as you know it ends. The question of self-pity.”

Only, I don’t feel self-pity, I just feel amazed. I am amazed that this happens to a person, who on the maternal side, descends from a long line of women with dour expressions and whose gloomy longevity allowed them to reach  87, 92, 97, 99 years of age.  Could it be my newly discovered paternal grandmother , Carolina Jansdotter, dead at 39 , who is the culprit, the poison in my gene pool?

Or did the environment throw a wrench into my DNA machinery? After all, what does it matter if your food is cooked from scratch if there are hormones and antibiotics in the meats, mercury and PCB in the fish, pesticides on the vegetables, estrogen in your water, genetic manipulation of grain and fruits, chemicals in your cosmetics and lotions, detergent and soaps. Formaldehyde fumes  in your floors, ceilings and walls.

According to cancer.org you get cancer one of three ways:  inherited,  environmental damage to DNA,  or a combination of both. So, no self-pity -  yet. Just amazement and anxiety, and a great deal of curiosity: how did I get it? Want went wrong inside my breast? The more I learned about the cancer, the more I realize that this disease is highly unpredictable. A Stage I can accelerate without warning and against all odds.   A Stage III can be beaten back , also against all odds. Cancer is still deadly, not much progress has been made towards finding a cure. And it is clear that  a lot of unpleasantness and expense is involved in trying to beat it back.

Sunday dinner with extended family: Sister- and brother-in-law celebrating the return of a lost son. He is now home after two years in Japan, teaching and one year in Vietnam, doing what? We are about to find out. Luke is sensitive, intelligent, and well-informed, I can’t wait to hear about his Asian adventures. Yet on the 10-minute car ride over to their house I feel restless and “antsy.”  My mind is pre-occupied with cancer.

After dinner, we linger around the long dining room table and contemplate Luke’s travel stories while we watch the candles burn down and  sip the last of the wine. I glance at Ellen’s enamel painting of the fruit blossoms, and wonder if the enamel- and paint fumes were what brought on the breast cancer that killed her. She left behind a middle school child and a high school student. I, if it comes to that, will leave behind three college educated, adult children, all gainfully employed with their own health-insurance, cars, and homes.

Still, I feel I have to tell everyone. It would be too awkward to call around the next day, or, God forbid, send a group email. I assume, my cancer announcement will no longer ruin the evening.

Every one reacts calmly and appropriately. They show concern, but don’t seem spooked. Nobody tries to gloss over or dismiss it. Even the family member who seems to most enjoy  “organ recitals” does not share her archive of maladies, not even those with favorable outcomes.

Yet, that night I feel anxious. I sleep poorly in a mix of sugar high from the dessert and the angst of what my diagnosis, now four days old, really means. I am awake at 2.30 A.M; I listen to the steam whistle blow as the train rumbles through the city of Smyrna, or was the train down in Vinings?  I am awake at 3.30 A.M, then again at 4.30 A.M. The alarm goes off at 5.30 A.M. and rescues me from my insomnia, but I am so exhausted I can barely toss the covers aside to climb out of bed.

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.”

My friends Cecilia and Marie email me names of surgeons and oncologists. All of them are affiliated with the hospital closest to me. But this hospital is in a feud with Blue Cross Blue Shield, my insurance company. The news is all over the local papers. Given the insurance issue and Dr. Guru’s excellent CV, I will stick with him and not look further even though I have to wait two weeks to see him .

For the first time since my diagnosis, I Google breast cancer and a zillion entries take my breath away. Cancer looks scarier, deadlier, than I ever knew. I thought the “problem” was practically solved. Two people I knew, friends of friends, died from it, but those had been aberrations in my mind. Now my head is definitely out of the sand.

I don’t have enough specifics on my lump to be able to do basic research. For that I need a pathology report which nobody has shared with me. All the radiologist said was: Any questions?

How could I have questions when I had never heard of bio-markers, stages, phases, hormone receptors, Comedo cells, necrosis, and anuploids? The list of incomprehensible things goes on and on. Are they all in my lump and in which proportions?

Surfing the net about cancer feels like being thrown into a stormy sea with a cork to hold on to. From what I can glean breast cancer is light years away from a “cure.” I click to close my internet connection. I feel my pulse beat in my ears, my heart is pounding.

Away from the computer, I feel restless. I go outside to check the pool baskets and to skim off the water’s surface with the net. I go back inside and pick up around the house. I empty the dishwasher. I fold a load of laundry. I water the plants: Mundane, repetitive tasks that require a certain focus, but no exertion.

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.