September 2005
Danielle slept over the night before the surgery. We shared the queen-size bed, just as I had shared a bed with my mother all those months. I lay awake all night, staring at the ceiling and at the clock. Jolie slept on the sofa in the living room. Danielle and Jolie planned to live with me and take care of me for two weeks post-op.
Though sleepless, I felt remarkably calm. I was ready for battle. Strong in my resolve. I thought of what I was about to endure as a rite of passage into adulthood. Though I was thirty-five, I saw myself as much younger. If I hadn’t felt like a grown-up before, I certainly did now. I’d taken my health and my future into my own hands. I, alone, had made this decision. No doctor had told me I had to do it. No one but I was responsible for this.
At five a.m., it was time to leave for the hospital. I turned to Danielle. “Okay, now I’m starting to get scared.”
I sat in the admitting room with Danielle and my dad. I was wearing a hospital gown and holding a gauzy blue hospital cap. Dani and I had looked through the gowns and chosen one with the small (“more feminine”) pattern that our mom had preferred.
There was no escaping the familiarity of this scene. The three of us had been in this hospital, in an admitting room, presurgery, too many times before. I put on the little hospital booties. Once again, I was in my mother’s shoes. With one enormous distinction: I wasn’t sick. Thank God I wasn’t sick.
I had put on a little blush and lipstick that morning while dressing for the hospital. I was, after all, my mother’s daughter. I thought of her packed in the Hummer with me, Dad, Dani, the driver, and two dogs, en route to surgery, showing me her pink and lavender silk nighties: “I like to be pretty till the last minute!”
Danielle and I went into a presurgery changing cubicle to wait for Dr. Choi. She was going to come in and draw markings on my breasts, sketch out where the incisions would be made. Dr. Roses came by first. He gave us a warm greeting and introduced us to his chief resident, Dr. Kutchin, who would be assisting him. Dr. Kutchin was young and handsome. Dani gave me a look—maybe I would end up marrying my surgeon after all! Dr. Roses spoke about how our mother had been his patient and what a wonderful woman she was while Dr. Kutchin listened thoughtfully. Dr. Roses said he’d see me in the operating room and walked off. Before trailing him, Dr. Kutchin smiled at me and flashed two surgical hats—one red, one blue.
“You decide which color I should wear, Jessica. For luck.”
I caught his eye. “Definitely the blue.”
He tied the blue one on his head. “See you soon.”
“He’s flirting with you!” Dani said with excitement.
“You think …? Thank goodness I put on blush this morning!”
Dr. Choi came in. I opened my hospital gown and she drew lines on my breasts. Danielle sat beside me. The moment was surreal. My breasts were here, my body was whole. When I woke up, they would be gone.
A nurse led me into the OR and I climbed up onto the operating table. The room was too bright. I felt like I was in a play. The anesthesiologist asked me questions about writing for television while putting the IV in my arm. Everyone perked up when I said my friend David Zabel was the head writer on ER. I asked if they watched the show, but before I heard the answer, I blacked out.
I have no memory of the first several hours after surgery. Danielle tells me I woke up in the recovery room happy and smiling and pretty, too. “You’re the only person who could come out of five hours of surgery with her blush and lipstick looking fresh and rosy!” Dr. Choi had placed tissue expanders under my pectoral muscles and filled them with saline. Though I was bandaged and had drains attached to me, you could see subtle breast mounds—I was the tiniest size A. I had a morphine drip, was drugged and loopy. Danielle said I was sitting up tall and showing off my new “ballerina body.”
The first post-op memory I have was from early that same evening. My dad had gone home, Danielle was out getting food, and I was alone in a private room with a nurse named Verona. It was like I had suddenly come to. I was aware of my surroundings and I felt my body. My chest felt like I’d been run over by a truck. I gasped from the pain, and Verona told me to press the button for morphine. My bladder was painfully full. She helped me get out of the bed and walk with my IV pole to the bathroom. I sat there for fifteen minutes, ran water in the sink, but could not pee. My stomach muscles were clenched and I could not relax them. I started to panic. Verona went to get a nurse on the floor to put in a catheter. Back in the bed, a nurse tried to insert a catheter but was having trouble.
“Relax!” she hollered. “You’re too tense!” This launched a full-blown anxiety attack.
“Are you kidding? If I could relax I wouldn’t need a goddamn catheter!” I yelled back. The nurse gave up on the catheter and gave me an Ativan instead. After an hour of sitting in the bathroom, listening to running water in the sink and shower, and putting hot, soaking towels on my forehead, I finally felt my muscles unclench enough to allow me to pee. Afterward, Verona took me for a walk around the floor. She put her arm around my waist. This maternal gesture made me realize I was yearning for my mother. In that instant, I remembered that my mother was gone, and my breasts were gone. We walked. I shook and wept.
I remained in the hospital for four days. They were a blur. My friends sent endless bouquets of flowers. I was too woozy to take phone calls, but Danielle told me who sent each arrangement. I allowed very few visitors.
Once home from the hospital, I had two large drainage tubes attached to me, one on each side. Clear tubing collected blood-tinged fluid from each of my breast wounds and connected to plastic containers that I wore pinned to my cotton nighties. The drains needed to be emptied and the fluid measured twice a day. I was high on Vicodin and felt no pain, so rather than recuperating quietly and prone, I hostessed an around-the-clock party for a week in my glamorous attire of nightie-and-drains. I hate to say it was like sitting shivah—thankfully this occasion was about life, not death—but shivah is the closest comparison I can make. Friends stopped by every day to visit, eat, and keep me company. Danielle was sleeping in the bed with me and Jolie was sleeping on the sofa; my dad was always there. Jonathan, Alexandra, and Gordon came over every day. Kay, Gillian, and my friend Cara were constant presences. Cara had gone through a terrible breakup that week. She was traumatized, so she moved in with us and slept on the air mattress in my bedroom. My dad’s old black Lab, Sam, had just been released from the animal hospital—his belly was shaved from surgery, he had a red cast on his leg, and he could barely walk. So Sam moved into the living room and slept on his dog bed. One afternoon, my friend Michael Panes came over and played the piano and we gathered around and sang show tunes. It was a circus.
The breast expanders were hard—like breastplates of armor. The drugs masked the acute pain, but my chest still ached. The expanders beneath the muscles applied a constant pressure. Many women on FORCE liken the feeling to an elephant sitting on your chest. I wasn’t allowed to shower for over a week. Sleep—and shower—deprived, I was nevertheless a happy hostess. Like the week prior to my surgery, the first postoperation days were unexpectedly joyful.
Not surprisingly, Doctor Choi was less than pleased when she examined me in her office the following week. I’d been instructed not to raise my arms, engage in much upper-body movement, or lift anything. Instead I’d been running around the house, serving guests, making beds, and singing show tunes. I’d overdone it. Fluid had accumulated and was leaking out of my breast wounds. Infection after mastectomy and reconstruction can present complications. A generalized infection would have to be treated with either oral or IV antibiotics. If bacteria got around the implant and the infection didn’t respond to antibiotics, it could become a serious problem. I did not yet have an infection, but I’d come close. Dr. Choi took out my drains and shut down the party.
Two weeks after surgery, Dr. Choi told me it was time to stop taking the Vicodin. A half day without drugs was a rude awakening. I’d had no idea my body was in such pain. Suddenly, Vicodin became the most precious thing in the world. I told Dr. Choi I was not ready to stop taking it. She wrote another prescription and I weaned myself off of it, slowly.
Two weeks after surgery, I went in to see Dr. Roses for an exam. He held the pathology report in his hand.
“You had precancerous changes in your right breast tissue, Jessica. Atypical ductal hyperplasia.”
I was shocked.
“If you had any doubt about the course of action you chose, this should dispel it. You did the right thing.”