Bruise: On Living with the Fear of Dying -The Toast

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We were born from this bruise, their marriage.

Soon my father died, and I was awake and lying on the pullout couch watching Saturday Night Live for the first time. I was ten years old. O.J. Simpson was the host. The musical guest was Ricki Lee Jones. Chuck E.’s in Love. Her beret. Long hair and teeth.

The next morning I would fly in an airplane for the first time. I drank ginger ale and chewed gum to make my ears pop.

Over the years, the memory of my father faded, the edges first and then the center until he was not even a ghost anymore, but a little boy in a photograph wearing a cowboy hat.

My right arm hurt, and when I lifted up my shirtsleeve I saw that there was an enormous bruise with a lump in the middle of it. I couldn’t figure out where it had come from until I remembered that I’d been to the doctor the week before and had blood drawn on my right arm, which I never do because I am right-handed. I suspected this bruise had something to do with the blood draw.

Privately, I was defensive about it. I didn’t want anyone to see it and think that my husband had done it to me. That he had grabbed me hard around my arm, his thumb pushing into the skin. I didn’t want that. I remember when I shut my thumb in the door to my old apartment once long ago, and when my then-boyfriend brought me to the emergency room the doctor ushered him out of the room and asked if he had done it to me. I was shocked. That was not me. That was my mother.

Lovers did not bruise me.

So I showed the bruise to people and made a point of saying I had no idea where it had come from. I talked about it with friends. I fondled it at night. I tried to wish it away because I believed it meant something more. Something deadly.

Finally, when a doctor friend was over, I gauchely asked him to look at my bruise. He licked his finger and ran it over the bruise, winced, and said I should have it looked at.

I made an appointment. My mother had always had weird blood clotting issues. She had varicose veins and was often hospitalized for clots. My doctor asked me questions and set me up for a bunch of blood tests to test for clotting disorders. But really, she was not worried.

Then she asked me if I had maybe drank too much before the bruise, because sometimes binge-drinking much can cause the liver to malfunction thus your clotting capabilities are out of whack.

My liver. I had liver cancer. This was it.

“You’re freaking me out,” I said, tearing up. “Do you think it’s my liver?”

She took a breath. “Here’s the thing,” she said. “It’s not a scientific study or anything, just something I’ve noticed from patients over the years.” She handed me a box of Kleenex. “Women like you,” she said, “women whose mothers had breast cancer when they were young often immediately leap to the conclusion that whatever is wrong with them is cancer.”

I told her that the fear did not rule my life, but it was there. We talked some more. I told her about my father dying unexpectedly when I was young. I told her how I wanted, needed, to be healthy for my son.

I blew my nose.

After I had my blood drawn, I walked out of the office and got into my car. People all around me were walking around with their coffee cups, acting like nothing unusual was happening.

This was it. I was dying.

I spend a great deal of my time thinking about dying. Worrying over it. Counting how many possible years I might have left. Bargaining.

From the minute my son was born, my life became about making sure he would have the longest, healthiest, happiest life ever. I know I should say that I felt this from the minute I was pregnant, but I didn’t feel much then but awe and fear, which led me down a path of terror, anger, sorrow, and love.

I found out I was pregnant a few days before my thirty-ninth birthday, placing me firmly in the Advanced Maternal Age category of pregnancy. I was an exhausted and miserable pregnant person. I was weepy. I was hungry. I had a lot of pain. I also felt lonely. My mother had been dead for several years. Most of my friends lived far away from me. My husband and I had been so long childless that we knew we would have to redefine ourselves entirely. We were scared.

I’ve always been depressed by The Little Prince. How he lived on his lonely planet. It felt like death to me, when I looked at him. Alone. No one to love. No comfort.

And yet, I have always perceived myself as an optimist. A cynical optimist, maybe. Is that a category?

The bruise faded. My tests came back and all was well. The fear lingered, gnawed. I couldn’t let go of the feeling that something bad was going to happen.

Then a few months later, I received terrible news about a close family member. She had breast cancer. It was treatable, but still terrifying for those of us who love her, for those of us who feel that we cannot live without her.

The island that I live on—have lived on since a young age—shrank. The black water crept closer, the sky darkened. I was the Little Prince.

For me, this loved one’s news meant that it was time to take the BRCA1 and BRCA2 genetic test that I had been avoiding since I heard about them. These tests check to see whether you have the known genetic mutation for breast and other cancers. I was taking the test not so much for myself at this point, but for my then-six-year-old child. If I tested positive (or tested the dreaded “unknown variant,” which leaves you in a limbo), then I would have some choices to make.

What I decided was that, given my age and given the fact that we would not be having any more children, I would have a double mastectomy and oophorectomy if I tested positive. I would do this so that I could reduce my risk and potentially live longer.

My mother had breast cancer when she was younger than I am now. I remember the day she showed me her mastectomy scar. All of her breast tissue and her lymph nodes had been removed on one side. This meant she required no further treatment. The cancer was gone. I must have been five or six and not really sure what I was seeing and why she was showing it to me.

When she first discovered whatever it was she discovered in that left breast, she told us that that night before she was going to be diagnosed, Bobby Vinton came to her and sat on the side of her bed and told her it was going to be okay. He had been on television a lot lately promoting his upcoming show, on it he would surely sing, “Blue Velvet.” So he came to her in the night and told her she would live.

In her hospital room, she and the woman she shared it with drank sherry and smoked cigarettes. When she came home, my father gave her a blue Pinto hatchback. She lived. She took up doing guided mediation in the living room. She had a cassette tape that she would play in the tape recorder and we would all listen.

Cancer did kill her eventually, but by then she was older and it was a cancer caused by her life choices and not cancer thrust upon her simply because she was a woman.

When I first went to see the genetic counselor in order to discuss my tests, she reinforced for me the sad fact that all women are at risk for breast cancer. The other side of this coin is that even if one of your relatives currently has or once had breast cancer, that does not mean that you will have it.

I went for my results four weeks after my blood was drawn. During those four weeks, my beloved family member was recuperating from her surgery and then heading back to work. From the time of her diagnosis to the time of her returning to work after her surgery, less than two months had passed. Her diagnosis, which had prompted me to go forward with these tests, was bumping me into an even higher-risk category, but also affording me the right to have this expensive test taken and paid for by my insurance. Her diagnosis was also allowing me to not only receive a mammogram once a year, but then to also receive a breast MRI six months after that mammogram. For the rest of my life.

Her diagnosis, then, will potentially save my life. Just as my mother’s diagnosis and all of my other relatives’ who have been diagnosed with breast cancer (five in all so far), have led me down the path where I have had a mammogram every year since I was thirty.

My loved one’s BRCA1 and BRCA2 tests came back negative, but this meant nothing regarding mine. The only people whose BRCA tests relate to you are your parents. If both of your parents test negative for the gene mutation, then you most likely will be negative as well. If even one of your parents is positive, then you may be also be, but you can’t know for sure without a test. Both of my parents are dead.

We are these puzzle pieces of each other, laced together, intertwined genes and nurture and nature. The test results would not just be for me, they would be for my son and his children, should he choose to have them. If I tested positive, he would need to know at some point when he was older. If I tested negative, he would still need to have the results from his father to know whether he was negative for the gene mutation. But at least he would know this one piece of information from me.

The reality is that the BRCA gene mutation is rare. Still, if you are at high risk, it is important to test for it because it is one of the best indicators for breast cancer (and ovarian and other cancers) that we have. I felt certain that I would be negative, but there was a small part of me that feared the outcome.

I woke up at 3:00 AM on the day I was to get the results. I stood on my island and plotted two paths. One leading to decisions and surgeries and information to be passed on. The other leading to…what? Leading to that much less fear. Leading to the water receding just a bit.

I lay on my bed and thought of my mother lying on hers. Bobby Vinton coming to her and sitting beside her. I think she said he held her hand. I think she said she knew he wasn’t real but she also knew he was real. She said she knew she would not, could not die. She had four daughters to raise. She would live for them.

The first thing the counselor told me when I saw her that morning was that my results were negative. I was relieved. Of course I was but it was a strange relief because it was one that said you are still highly likely to get breast cancer because of your familial links but your risk is not from this particular gene mutation and you won’t, necessarily, pass this on to your child and child’s children.

But you are safe. For now, you are safe.

She took me through a risk assessment program to figure out where my risk is right now including the negative results. She got to the point where she asked me how old I was when I had my son. “Thirty-nine,” I said.

“Oh,” she said and turned to me. “I’m just about to be thirty-nine and I’m pregnant. Am I going to be okay? I am, right?”

“Yes,” I reassured her. “You’ll be fine.”

She has two other children, born when she was younger, but now finds herself terrified to be placed in this Advanced Maternal Age category. I told her about all of the positive aspects of being an older mother, about how you have all of this great knowledge about life to share, and how you don’t worry so much about all of the life things you need to get done because you’ve already done so much.

We talked through her fear. She kept her hand on her belly, just barely noticeable now that she had pointed it out.

On the day I found out I was pregnant, I couldn’t get in touch with my husband because he was at work in a meeting. I called him. Emailed. Nothing. I felt like I needed to do something with the information. Yell it to the world.

The counselor plugged the final numbers into the program. “Your risk is 28%,” she said, which is roughly three times that of the average woman my age.

“You’re going to be fine,” I said to this woman of advanced maternal age who spends her days counseling women who are at high risk for breast cancer. “You’ll be great,” I said to her.

On that first day that I knew I was pregnant, I walked outside and stood in amongst the trees. I looked up at the cloud-white sky and thought of my mother and father, both dead, but living now again in me, pushing forward with this child growing inside me. Their bad and good genes all mixing with those of my husband’s family and creating this new being. This new being will be perfect and he will be flawed. We had all made him together and he would be one of us.

It is shorts weather and my son’s legs are covered in bruises as always. He runs and bangs into things. He collects these bruises like stickers. My own bruise has long faded. Still, I run my hand over the spot, feeling for the lump. There is nothing but my skin, freckled and spotted by age.

Now, I am a few years younger than my father was when he died. My son is seven going on eight. I don’t remember much about my father. What I know is what people tell me. But I remember is the fear of their voices, waking us in the night. Their fighting. Their mutual anger and distrust.

I remember that when it was Hockey Night in Canada we were not allowed near the television because my dad needed to watch. I remember that he told me once if I didn’t get out of the way he would put my head through the television. I remember that he called me “the babe” because I was the baby. I remember he used to play island with my sisters and me. We would all be on the bed with sharks circling us. I remember that he taught us how to fish and how to paddle a canoe. That he took us skiing and hiking. I remember the intonations of his voice.

What I don’t remember are any of our conversations. I don’t remember what it felt like to be with him. I don’t remember how his presence filled the space around me.

I am filled with panic that if I died now or even if I died when my son is ten, he would not remember me. He would not remember my smell or the stories I told him. He might even forget my face.

The idea of survival fills my every thought.

My son finds me watching Ultimate Survival Alaska and asks me why I’m so interested in all of this survival stuff because I’m also reading several books about bush craft. I tell him that the idea of survival and survival techniques inspire me in my art. This is partly true.

But the whole truth is this: I think about my own death too often. I think about death and about how I don’t want to die and leave you. I can’t leave you.

But then I realize that I will never leave you.

No matter what, you will be carrying me forward within your genes. I will be a part of the twists and curls that make you into yourself. Your bruises are my bruises, too, fading away but always there as a reminder of our hurt and our love.

You were born from this bruise, my life.

Myfanwy Collins has published a novel, Echolocation, a collection of short fiction, I Am Holding Your Hand, and a young adult novel, The Book of Laney. She teaches creative writing to adult and continuing education students.

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