A few years ago one tiny detail of the Well Woman exam changed. I was asked if I wanted to get the BRCA blood test that would tell me if I was genetically predisposed to breast cancer. I told the doctor I didn’t need a test to know that. My mother had gotten estrogen induced breast cancer in her early 40’s so I assumed I was at risk. The doctor said I could “know for sure’ with the test. I asked her, “To what purpose? To live in fear? To wonder WHEN I’m going to get cancer, even though even a genetic predispositon does not mean it is certain. The fear itself could cause the cancer more than the genetics.”
The controlled her smile, which told me she agreed, at least at some level. She told me that new legal requirements said that with the predisposition I could choose preventative measures and reconstruction would be covered. She meant preemptive double mastectomies, meaning removing breasts WITHOUT cancer just in case one day you might get it. With that kind of reasoning, we could be left without anything real in our bodies. Anything COULD get cancer, we just don’t have the tests and the lobbyists yet to get it all covered for free and preemptively.
My response… “Well I guess if I wanted free boobs, that’s one way to get them! But I choose not to live in fear.” This time the doctor didn’t hold back her laugh!
Many years ago when my mother had breast cancer, reconstructive surgery was not automatic or immediate. I do believe the change that it must be covered (at the woman’s request/choice) is vital. And in time my mom did get reconstructive surgery after years of wearing a prosthetic in her bra.
There were times she struggled with identity. What does it mean to be a woman with only one breast (and for some women, no breasts)? But ultimately the answer lies not in the remaining or missing body parts but in history, identity, relationships and faith. Wholeness is in personhood not in physical perfection. To me and my brothers, that physical change was of little effect. She never stopped being “mother,” even when illness and complications kept her from fulfilling some of those roles temporarily.
But the acceptance of surgeries for women, whether needed or preemptive, go through cycles it seems. Almost none of the women in my mom’s generation still have their uteruses. They were taken out “willy nilly” for any complaint, or preventative for I don’t know what, to be honest. maybe birth control. But when I, a generation later, really needed one for pain that would at times drop me to the floor, it took 3 doctors and a consultation with my doctor (instead of me), to get one approved. Even after it was discovered I had external fibroids twisting in my abdominal cavity and in necrosis (meaning DEAD and rotting!, the surgeon decided to call my general practitioner to consult with (without my knowledge). I think he was trying to get ammunition to tell me he wouldn’t do the surgery. I just happened to be in the doctor’s office when the surgeon called. My doctor, who I had a long and respectful relationship with, put it on speaker phone (without the surgeon knowing I was there).
Surgeon: “We prefer not to do hysterectomies when the woman is still of child bearing age.”
Doctor: “What does Heather say?”
Surgeon: “That she doesn’t want children and that she is in horrible pain and wants a hysterectomy.”
Doctor: “Then what is the question?”
Surgeon: “She may not know that she will want children one day.”
Doctor: “Heather, do you want children one day?”
Doctor: “Give her the hysterectomy.”
Surgeon: “I didn’t know she was there.”
Doctor: “It’s not like she is getting it as birth control, she currently has necrosis and has a history of years of pain. Give her the hysterectomy.”
I have been blessed with some of the most amazing doctors. And a few not so much…but those get fired pretty quickly.
I got the hysterectomy, a partial – meaning they left my ovaries so that I would not start menopause at age 35. In my case that was an option, though for others the ovaries and hormonal imbalances are more of an issue. Menopause would still happen early for me, but the hormonal changes would not be as drastic.
And yet, even without the drastic hormonal changes, my emotional reaction to the surgery surprised even myself. Not that my desires had changed, but the question of what defines womanhood came to a sudden forefront. I resolved it quickly, through prayer and writing, but for others – especially those who have ovaries removed or do want children – the answers are not so easy.
I share with you my poem in all its vulnerability. I encourage you to pray, to write and to find amazing doctors who will ask what YOU want, support you, and laugh with you when you hit the nail on the head.
copyright Heather J. Kirk
not so much
for what it
remind myself –
even with a
I still am,
by the great
I AM …