telling me a few days will make that much difference?” She was horrified. What was he saying to her? That she was dying? The thought and the terror of it made her tremble.
“A few days won't necessarily make that much difference,” he admitted cautiously, “but you can't afford to drag your heels on this. You need to choose a surgeon and get the biopsy done as soon as possible, and then you'll have to see what he recommends, based on the pathologist's findings.” Oh God. It was all so complicated and frightening, and so ugly.
“Can't you do the biopsy?” She sounded suddenly desperate and very frightened. She felt as vulnerable as she had feared she would when she went to the mammography lab and began to panic. And now, the worst had happened, or almost. It was happening. It was rolling out in front of her like a terrifying movie.
“I don't do biopsies. You need a surgeon.” He picked up a piece of paper from his desk then, and she noticed that she had already been there for half an hour, but suddenly her whole life had changed, and she wasn't ready to leave yet. “I wrote down the names of a few very good people, a woman and two men. You should talk to them, and see who you like best. They're all excellent surgeons.” Surgeons!
“I don't have time for this.” She started to cry in spite of herself, it was all so horrifying, and she felt uncharacteristically overwhelmed and astonishingly helpless. She was torn between anger and terror. “I don't have time to go shopping for a doctor. I have a trial, I can't suddenly back out of it. I have responsibilities.” She sounded hysterical even to her own ears, but she couldn't help it. And then she looked up at him in genuine terror. “Do you think it's malignant?”
“Possibly.” He wanted to be honest with her. On the film, it didn't look good. “It could very well be. Or it could be fooling us into thinking it is. We won't know till you get the biopsy, but it's important that you do that quickly, so you can decide on a plan of action.”
“What does that mean?”
“It means that if the biopsy is positive, you'll have to make some decisions about the course of treatment. Your surgeon will advise you, of course, but some of the decisions will have to be yours.”
“You mean like whether or not to take my breast off?” She looked appalled and her voice was shrill as she asked him.
“Let's not get ahead of ourselves here. We don't know anything yet, do we?” He was trying to be gentle with her, but it was making it worse. She wanted to face it now, she wanted him to swear to her it wouldn't be malignant. But he couldn't do that.
“We know I have a mass deep in my breast, and you're worried about it. That could mean I'll lose a breast, couldn't it?” She had him on the witness stand and she was relentless.
“Yes, it could,” he said quietly. He was deeply sorry for her. He had always liked her, and this was a terrible blow for any woman.
“And then what? That's it? The breast is off, no more problems?”
“Possibly, but not necessarily. It's not as simple as all that. I wish it were, but it isn't. It will depend on the type of tumor you have, the extent of its malignancy, if there is any, and the nature of the involvement. It will depend on whether or not your lymph nodes are involved, how many, and whether or not it has spread to other parts of your body. Alex, there are no simple answers. You may need extensive surgery, you may need a lumpectomy, you could need a course of chemotherapy, or radiation. I just don't know. I can't tell you anything until you have a biopsy. And I don't care how busy you are, make time to talk to these surgeons. You have to.”
“How soon?”
“Do your trial if you have to, if it's really only a week or two, but plan to have the biopsy in two weeks, no matter what. And we'll take it from there after you do that.”
“Who do you like best on this list?” She handed it back to him, and he glanced at it, and then handed it back to her quietly.
“They're all excellent, but I like Peter Herman. He's a very good man, and a nice one.