Yes, she knew she ought to have had it looked at immediately, she ought not to have waited the three weeks until her trip, but she'd found a doctor in New York who wouldn't make her consent to a one-step, who wouldn't insist on doing an immediate mastectomy while she was still under anesthesia from the biopsy.
“I couldn't face that again,” she said. “I did that last time, going under knowing I might come out with . . .” She looked away to the empty playground, to the jungle gym where Anna Page had hung upside down that day all those years ago now, her sandy dress falling over her face. “With no breasts at all,” she said. “With no chest muscles. With arms that might be swollen and achy the rest of my life. And I couldn't tell Jeff until I knew what we were dealing with. I just couldn't put him through that again.” Turning to Kath now, her eyes searching. “Every doctor in this whole town knows Jeff. Word would have gotten back to him, you know it would have, Kath.
“I wanted to make the decision myself. I couldn't imagine leaving it up to some man I'd never met before, who would have no idea what it would feel like to . . .” She swallowed hard. “To lose a breast.”
She'd read the same McCall's piece we'd all read about Shirley Temple Black, who'd refused to consent to a mastectomy before she knew what the biopsy showed: I wouldn't have it that way—that's what she'd written, and that's how Linda had felt, too.
“And I couldn't know for sure what I'd want to do until I knew how bad it was,” Linda said.
She'd read that most doctors thought any woman who had anything less than a radical mastectomy was being unforgivably foolish. Unless they took out the whole breast and the surrounding muscles and lymph nodes, they couldn't be sure they'd gotten all the cancer. But she'd read, too, about a doctor in Cleveland who thought a lumpectomy—cutting out only the lump and leaving the rest of the breast alone—was as effective as a radical for some women. “More effective, even, because he thinks the lymph nodes help your immune system fight the disease.”
“Dr. George Crile,” Brett said. “There was a piece on him in Reader's Digest, about studies in Finland and Canada showing five-year survival rates for lumpectomies equaled those for radicals. It discussed a new study just beginning here in the U.S., twenty-two hospitals participating in randomized pools.”
“I think I saw that fella on the Today show,” Kath added nervously.
“Randomized?” Ally whispered.
“You're blindly assigned to one of the treatment groups,” Brett explained.
I looked off to the palm tree still standing in the old mansion yard, wanting to say Don't do that, Linda, don't let your treatment be decided randomly, luck of the draw. Wanting to say this couldn't be helping Linda, all this talk. But they were talking at least, while I sat mutely imagining Linda in that coffin for real, Jamie and Julie and J.J. in the front pew, having no idea that dead meant they'd never see their mommy again.
Linda had gone to Memorial Sloan-Kettering on the Upper East Side of Manhattan, not far from where her brother and sister-in-law lived. Her sister-in-law kept J.J. and the twins while she went to the hospital for the preliminary tests: X-rays and blood samples, an electrocardiogram, a lung-capacity test. She was evaluated by a surgeon, a radiologist, and a chemotherapist. They agreed to go in and do the biopsy, tell her what they found, and let her participate in the decision about what to do about whatever it turned out to be.
“One lump,” she said. Like the first one, but not.
She'd been saying no to herself all along: No, it's not a lump I'm feeling, it's just fibroid tissue or something, like the last time. No, I'm fine, really, even if it is a lump; look how well I'm running. When they said yes, it was malignant, she wanted to say no again, but she was all out of denial.
“I had them”—she waved a hand in front of her chest—“take out the whole thing. But not the muscles, not the nodes.”
She couldn't tell Jeff about the lump at first. She didn't tell him until the night before the biopsy. He was in Boston, but she called him that morning from her brother's apartment and told him he had to come to see her in New York. She couldn't even say why over the phone, but he hadn't questioned her. He'd been up all night at the hospital, and still he didn't hesitate. “I have a gunshot wound in post-op, but I can get someone else to cover,” he'd said, and she'd told him if he could get there that evening, that would be soon enough.
“It's just a breast, right?” she told us, her voice cracking. And it had been bottled up inside her for so long that it all came out in a gush. “A breast,” she said. “Just a breast. You wouldn't think it would be so . . .”