I had not had plastic surgery, was not familiar, stopped breathing because I was so stunned by this remark. On what basis had she concluded this? Something in my chart?
“I don’t have implants, I—” I said, shaking in my sweater. It sounded like I was lying.
“Well,” she said, glancing and clucking at me, “You have very large breasts, then, for your frame.”
Absolutely incredulous, I responded, “Yeah? Well, all this can be yours.”
And Charles had the audacity to shoot me a look.
IT STILL AMAZES me, which I guess doesn’t mean that much, since it happened only three weeks ago. But is it possible for a breast surgeon to say to someone who has a genetic certainty of getting cancer, and is about to learn there’s a spot of calcification on her especially-dense-very-large breast scans, “Well, since you have implants,” without knowing whether that’s true? It seems impossible to me, even now, after it happened. That night, Charles gently implied that if I were less abrasive and crazy, my conversations would go awry less often, less reliably. I railed back at him that it was her fault, said I hadn’t done anything to prompt her idiotic comment about the surgery she’d assumed I’d had. I said, how dare she? I didn’t want her as a surgeon; how could anyone who said such insane and inappropriate things to her patients be a reasonable doctor?
Charles calmly recycled the word “reasonable;” she was the best breast surgeon in the state, I should “be reasonable,” it wasn’t important to like her, we just needed her to save my life was all. As long as we could count on her to do her job, it hardly mattered whether she was “likable.” I shut his voice out. I teach poetry, like I said, and I don’t let my students use the word “likable” when describing the work they read or write. I don’t care whether characters—or even people, really—are “likable.” Can they just not be unbearably tedious?
But here, I clung to the word, because it seemed to me that if a surgeon was that insensitive, she lacked the capacity to care about my life enough to save it. I considered giving her a copy of my first collection of poems, many of them about bodies, but I haven’t yet. She doesn’t strike me as a reader of poetry. And if she is cleverer than I think, and understands the embedded criticism or even the title, Temporary Conditions (which now seems like a joke), will her understanding make her more likely to leave something dangerous inside me? To scrape less close to my chest wall? Save me less?
“Let’s schedule a nipple-sparing mastectomy for as soon as we can.”
“Oh, okay, yes.” Nipple-sparing! I saw a double “r” instead of just one, sparring, not sparing, nipples in fencing costumes, jabbing at each other. From there I got sparking, nipples with flashing metal tassels, chips of flame flying. Dr. A was staring at me. She could tell something, but I didn’t know what.
“Do you have any questions?” She sighed, maybe bracing herself for whatever unpredictable social fireball I might lob at her next. She struck me as the sort of doctor who resented being asked anything at all. She was already halfway out the exam room door, and who could blame her? She got to escape each of us and our miserable fear and questions over and over in that lime-green hallway, and then at the end of each day.
Look how normal I was, though! I wanted to prove her wrong, to make this conversation okay. After all, there was still one day left before I gave up pleasing anyone ever. I asked, “How long is the recovery? I mean, before I’m okay?”
She dared to look bored by this. What had she been expecting? Hoping for?
Then she asked, “Do you mean how you look? Or how you feel?”
Ah, so Dr. A thought I cared too much about what I looked like. I had felt the vicious undercurrent of this judgment every time she spoke, from the aggressively frumpy pedestal of her own cancer-free body.
“How I feel, obviously,” I defended myself. “When I can be up and about, when I can teach.” See, I’m smart!
“Well.” She surveyed me, made some vague and slurring sounds about two weeks, three weeks, depends, blah blah, drains, oh, and fluid. Fluid? She clapped a black folder shut fast—what doctor carries a black folder?—and left. She was a Disney villain. About to save my life. Or not.
“Thank you!” I cried out, hoping to inspire love in her, make her want to rescue me.
She glanced back over her shoulder, a lemon look on her face. “I’m going to send you over to Dr. B, our plastic surgeon now. He can discuss reconstruction options with you.”
The door clicked. I was alone, free of her. I stripped off the paper towel, folded it, and put it in my purse because I didn’t want to open the dead-gown bin. Then I slowly and carefully returned my body to its own clothing—inappropriately tight jeans, a silver T-shirt, a scarf, and bronze ankle boots. It was, I guessed, my hideous, visible vanity that made Dr. A so scornful of me.
I walked from Dr. A’s office to Dr. B’s office across the hall, zig-zagging to avoid the quickest route between any A and B and looking dizzily at the other women sitting in the waiting room. One in three of them would, at some point, find herself where I was. I felt such gutting sorrow at that fact that I swayed and sat, nauseated with our collective misery, as fearful for a moment for those strangers as I was for myself. Back in another orange chair, I realized the news was still on, a different anchorman now, his voice eerily similar to the first one’s.
“According to the autopsy reports, whoever killed the seventeen-year-old high school senior peeled off her skin. Meticulously,” he reported.
Meticulously? How did they know? And did they discover the peeling after she had already decayed? How was that possible? Forensics? What did they do, test the dirt and bone and skin cells? What skin cells? And how, from such testing, could they get peeling, let alone meticulously? Something involuntary and metrical inside me was leading me from subjects of the flesh to other subjects of the flesh, as if my mind and I were bouncing down enjambed lines. I landed on my own skin, being peeled away, tissue taken from underneath, replaced with what? Something plastic, something lasting.
Once I was in Dr. B’s office, he drew pictures of breasts, too, teardrops versus perfectly round planets. They were lovely; he was a much better artist than Dr. A, which I guessed made sense. He was wearing a lavender bow tie and looked meticulous. Oh, his waxy, prettily ageless face! Had he done his own work? Put himself half to sleep and reconstructed his neck, backspaced wrinkles off the page of his face? And when he peeled people’s skin back (mine, for example), when he worked on our faces or breasts or whatever construction site needed injecting, stretching, or implanting, did he move “meticulously?” His hands looked precise and graceful, instruments of poetic care. I imagined them coming into contact with my skin, tracing lines down my body, tickling my back, playing “X marks the spot” and then burrowing under my skin, into the blood and tissue—or absence of tissue—beneath.
When I stopped thinking about his clothes and fingers and the cartoon breasts he’d drawn, I realized we had moved on and the words coming out of his mouth were “fat grafting” and “grades of silicone.” He had asked me something, something about where he’d farm fat from elsewhere on my body and which of the various gummy shapes he was pointing to on his desk I’d like him to implant under the muscle wall of my chest.
He looked at me expectantly, as if I might have a response to any of this.
CHAPTER TWO
IT WAS JUST TWO DAYS LATER—yesterday, November 3rd—that I found myself in a bathtub five floors above University Street, soaping up one of my graduate students.
I don’t mean this as an excuse, since bathing my student was a low I never thought I’d sink to, but I’m certain that I wouldn’t have been there if I hadn’t just discovered that I was literally coming apart. I don’t mean “found myself” in a spiritual sense or to suggest it wasn’t by my own agency that I took—or, well, Leah