Lucy Q from the Breast Care Center calls one week after their radiologist informed me that I have breast cancer.

“How are you sweetie?” She sounds young and perky. “Sorry I did not call you earlier, I have been on vacation.” She pauses and I expect her to tell me about her vacation.

“How are you doing?”

“Fine I guess.”

“Just wanted to see what is happening.” Her choice of words was those of a college girl checking on Friday afternoon with a girlfriend. “Any frat parties to attend? ”

“Have you picked a surgeon?”

“I have.  At the Medical School.”

“Oh no, not the Medical School, we don’t want to loose you!” Maybe realizing her unfortunate choice of words, she quickly adds: “Oh, it is very good place, but we would like to keep you here at our breast-care center.”

She launches into her marketing spiel (reading from the teleprompter?) Largest breast-care center in the Southeast, etc.

“Please reconsider,” she pleads.  “We have two excellent surgeons with wide-open schedules that would be the best for you. We want what was best for you. “

They have an open surgery schedule with two expensive surgeons twiddling their thumbs. I imagine it would also be advantageous for them, should I choose to come there.

“My plates are already at the Medical School.”

“No problem. I can work miracles and get them back. Just call me in the morning and we will set it up.  We have two surgeons I want you to see: Dr. L. and Dr. R. , both with wide-open schedules.”

Her tone, her perkiness, her sale’s pitch leaves me feeling empty. But I write down her phone number.

“Call me in the morning.” She promises to put a “care package” in the very next day. “Look at everything carefully.”

Susie Q. sounds like of a kindergarten teacher with her cheerful tone and her simple instructions.

I never call her back.

The care package arrives ten days later and turns out to be quite informative and useful. A friend with a surgeon husband tells me Dr. R. actually has a good reputation, but he is a general surgeon, not specialized in breast surgery and reconstruction.

When you look for a surgeon you want someone who has, if possible, done hundreds of the kind of procedure you are about to have.

Anyway, I have formed a mental block against the Breast Care Center. It took them ten years to discover my cancer. I have no plans to ever return there — not even for a mammogram. Especially not for a mammogram.

“What are undifferentiated cells?” I ask my new gynecologist, Dr. Morte, as he reluctantly stumbles through my pathology report.

Undifferentiated cells sound pretty good to me. If cancer cells are no different from normal cells in my body, would that not be a good sign?

“You have to ask your oncologist. I don’t know the answer.” Dr. Morte slams the folder shut.

“You don’t know what that means?” I glare at him.

“You have to ask your oncologist.”

“I don’t have an oncologist.”

“Well, I am not an oncologist, so I cannot discuss this with you.”

We have clearly come to an impasse. My dislike for Dr. Morte is now intense.

“Why would I have an oncologist?”

I was proud to have found a surgeon already, but an oncologist? And what exactly do they do anyway? I assume they had something to do with chemotherapy.

Dr. Morte avoids eye contact. It scares me that he will not look at me and claims not to know anything about undifferentiated. His demeanor is weird and frightening.

Then he cleverly diverts my attention from the “undifferentiated” cells.

“Do you have a surgeon?” he asks. “If you don’t, I have someone I can recommend.”

“I already have a surgeon.” I cut him off, smug about being so resourceful.

“Who is your surgeon?”

“Dr. Guru at the Medical School.”

“Not familiar with him.” Dr. Morte shrugs. “Well, if you change your mind and need a name or referral, let me know.”

What is wrong with this man? He keeps talking about “my” oncologist, which I do not have, then he recommends a surgeon when I already have one. Why does he not give me the name of an oncologist? Why does he not explain some of the steps ahead? After all, he is a gynecologist and must run into patients with breast cancer all the time.

“Do you need me to fill any prescriptions?”

“Well, just the estrogen cream.”

He refuses, shakes that awkward head of his:

“No, now that you have breast cancer I cannot give it to you. You are at high risk for ovarian cancer, uterine cancer, and cancer of the colon,” he says.

“You have to make sure you take care of yourself now.”

“How do I do that? What do you suggest? ”

“Oh, you are doing it. You are arranging to have the breast cancer removed. Deal with that first.”

Before I leave, Dr. Morte reaches out to me, a hollow stiff arm, like a cardboard roll, slightly bent around my shoulder. He gives me an awkward pat.

“I hate doctor Morte,” I tell Marie. “First he will not tell me about undifferentiated cells. Then he scares me with bringing up ovarian, uterine and colon cancer. I am at risk for all of those.”

“I warned you, he is pretty thorough,” she says.

I disagree. Dr Morte personifies many traits of a bad physician:  He is steeped in his narrow specialty, ignorant or indifferent to anything outside his box. Pathetic communication skills.  An ass.

Doctor Morte, my new gynecologist, looks ascetic, with a largish, oval head on a thin neck stem. Thick accent. Is he Persian? I cannot place the accent, and it bothers me. I used to be good at identifying foreign accents and nationalities.

He sits on a chair across from the awful examination table with the steely stirrups. I feel fragile and vulnerable, draped in the paper gown — my legs dangle over the edge of the table, freshly shaved for the occasion.

For a while, maybe seconds, but it seems like minutes, Dr. Morte just sits there on his stool with my file in his lap, knees together, like a schoolboy holding his homework before presenting it to his teacher. Then he suddenly he looks up and blurts out:

“I meant to call you. But since you were coming in anyway, I wanted to tell you in person. You have cancer.”

After the words flew out, he looked relieved. A bit surprised, also, as if he were thinking: “Wow, I had been dreading this all morning, but it was pretty easy after all.” I still struggled with his accent. Armenian? Greek?

“I know.” I say.

He looks shocked.

“You know you have cancer?”

“Yes, they told me”

“Who told you?” His feathers seem ruffled.

“They called from radiology at the Breast Care Center.”

“They did?” He looks a bit confused still, but quite content. At least nobody on his staff had spilled the beans. Was that why he was upset? He thought someone on his staff had spilled the beans.

“You take it well.”

“Do I have a choice?”

I am proud of “taking it well” but of course I am not the least bit stoic, only woefully ignorant.

Despite a brief and scary Google search, I rely heavily on the mumbo-jumbo crutch given to me by the radiologist: slow growth and good prognosis.

Dr. Morte opens the thin folder in his lap and leafs through the papers.

“Tell me about my pathology report, please.” He hesitates.

“Oh, I don’t know.”

He doesn’t know? Why can he not share MY pathology report with ME?

“Please read the pathology report!” I say. But he keeps leafing through the thin ream of papers without looking up.

“Read!” I tell him, a lot firmer this time.

“Read it to me!”

The whole scene reminds me of my oldest daughter, the bookworm. When she was little she would climb up in my lap, shove a book into my hands and say: “Read, Mommy! Read!”

Doctor Morte starts to read barely audibly, mumbles. He is confused. Uncomfortable. He stumbles over the words as if it were the first pathology report he has ever seen, unfamiliar with every term and phrase.

“Infiltrating ductal carcinoma”

I am jubilant. Finally a label on the hard lump in the right breast at the twelve-o’clock position.

“Is the tumor 1.5 cm?”

Dr. Morte looks down, shuffles the papers again.

“Well… Yes.

“No…

“Yes.”

“Well, no.”

“It’s 0.9 cm.”

“No, it’s 2 cm.”

He looks clueless and appears to want to give up.

But I will not let him. I stare at him intently and do not say a word, waiting for him to continue.

He looks at the page again and mumbles something about “undifferentiated cells.”

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.

Just before his office closes, I get an appointment for two weeks later with Dr. Guru, an oncology surgeon.

“First available? Are you sure?”

“Yes, that is the earliest. We want your x-rays from the Breast Care Center brought over here well before that, and we want your biopsy results faxed over right away. Then we need the actual glass slides sent over by courier.”

She doesn’t say how I will find a courier who can be trusted with original glass slides. Is there a medical courier service? A movie scene flashes through my mind: a helicopter lands on the hospital roof, a transplant team hitting the ground running with a cooler between them. Clearly that’s not how glass slides are delivered.

“Don’t you have an earlier appointment?” I whine “Two weeks is a very long time to wait.”

“Breast cancer is never an emergency, Mrs. V.  A few weeks makes no difference. You will be fine,” says Dr. Guru’s assistant.

“You have had it for years,” I tell myself, echoing the radiologist. But a two week wait seems like an eternity. (And of course I choose to ignore that I myself have waited months to schedule a mammogram after I felt the lump.)

I check Dr. Guru’s CV on the internet. He appears to be accomplished: educated and trained at top institutions, he teaches at the medical school, does research and has published numerous articles. He serves on boards. He and his wife have founded a cancer camp for kids. His specialty seems to be breast reconstruction, as well as melanoma.  Perhaps my lump will be a coffee break procedure for him. Something he would have time to do between the important – scarier – procedures. The thought is oddly comforting.

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.