October–December 2005
I was in a hurry to be put back together again. The expansion process had to be completed before the next operation—the exchange surgery—could be scheduled. In that next phase, Dr. Choi would remove the expanders and replace them with silicone implants. I would then have reconstructed, natural-feeling breasts with no nipples. Three months after that, when the incisions healed, Dr. Choi would perform the third and final surgery—nipple reconstruction. The whole process would take five months from first surgery to last.
The faster I finished expanding my chest muscles, the sooner I could have the second operation. I saw Dr. Choi in her office every Tuesday for weekly fills. She’d inject a needle into each expander and add saline, gradually expanding the chest muscles to make room for the implants. Luckily, I’d chosen to create small new breasts, which meant I would not need to expand the muscles far, so the process would move quickly.
Each week I had the curious experience of walking around with a different breast size. After a lifetime spent at 32D, wearing a little black dress as a 32A was a novelty. I felt like Audrey Hepburn. But an A-cup seemed too small to keep. The next week I was a small B. I tried on an array of clothes to see how that felt. I was Goldilocks and the boobs were the porridge: “These are too small, these are too big, these are just right.” But it didn’t go in that order. After my Tuesday fills I would spend the remainder of the week trying out the new size. I was happy at 240 cc (a full B-cup) but I wasn’t positive—maybe one size up would feel good, too. It didn’t. After the next fill I felt large and busty in T-shirts again—that old feeling of self-consciousness returned. 240 cc was just right.
I did not experience pain during the fills, just a mild sensation of pressure, because I’d chosen implants that were 240 cc of silicone. Implants can be up to 700 or 800 cc. I read threads on FORCE in which women wrote that their muscle pain kicked in during the final fills—when the muscles were stretched to capacity. Because my new breasts were so small, I avoided this sensation.
Just over a week after surgery (once the drains were removed) I went out with Cara and Gillian to a cocktail party. I wore my Audrey Hepburn little black dress, heels, and red lipstick. No one would have guessed I’d just undergone a mastectomy or that my body was under construction. I was woozy from Vicodin, but to all appearances I could have been tipsy from Stoli or champagne. One or two acquaintances commented that I’d lost weight (my smaller breasts created this illusion). I felt self-conscious only when I hugged someone hello. My breasts were hard, like armor—surely anyone who hugged me would notice? No one seemed to. In the course of conversation I told a woman that I was a little out of it because I was on Vicodin as a result of surgery I’d had the previous week. “What type of surgery?” she asked.
“I have the breast cancer gene,” I said. “I had my breasts removed.” She was dumbstruck.
Whenever I would tell anyone in the weeks to come that I’d just had a preventative mastectomy, the response was always the same—disbelief. I don’t know if it’s because I looked young or because I didn’t have cancer. It was probably a combination of both.
On November 7, 2005, about seven weeks after the mastectomy, Danielle escorted me to the hospital for the exchange surgery. The morning of my first operation I’d felt strong, fresh from ten days of swimming and yoga. This time, I felt weak and run-down before we started. My father was in Florida, so it was just me and Dani. We rolled out of bed at dawn and grabbed a cab to the hospital. I certainly hadn’t bothered with makeup. We were sitting in a changing cubicle waiting for Dr. Choi when Dr. Kutchin, the handsome chief resident, showed up. I pulled the blue mesh hospital hat off my head.
“Hey, I’m doing surgery with Dr. Roses this morning and Dr. Choi told me you were here. I thought I’d stop by and say hello.”
“That’s so nice of you,” I stuttered.
“So, how are you doing?”
“Good. You know … happy to put this second operation behind me.”
“Well, good luck. I’ll try to check in on you in recovery.”
Dr. Kutchin left, and Dani and I turned into giggling, frazzled eighth graders.
“Did you bring my makeup? I need some blush!” I cried.
“Yes—it’s in the bag. He likes you!”
“I look like hell—he said he was going to visit in recovery!”
“Don’t worry.” Dani took out a makeup brush and dusted my cheeks until they were rosy. “All better.”
Dr. Choi arrived.
“How are you doing this morning?”
Dani flew into yenta mode.
“Dr. Kutchin just came by to see Jessica …. We were wondering if he’s single ….”
“I think he is,” Dr. Choi said conspiratorially, like she was one of our girlfriends. “I’ll find out.”
“The guy assisted in removing my breasts!” I said. “This is too bizarre.”
“It’s a postmodern world,” Danielle replied.
I woke up in recovery feeling horrible. I was nauseous and my mouth felt like sandpaper. Through my haze I saw Danielle. Next to her was not Dr. Kutchin, but a nice, suburban Jewish mother.
“I’m Donna’s mom,” she said. “I ran all around the hospital trying to find you. Donna wanted to come, but she’s in the admitting room. She sends her love.”
“Send her mine,” I said with slurred cotton-mouth.
As it happened, Donna’s mastectomy was scheduled on the very same day as my exchange surgery.
“I’ll call the hospital tomorrow to check on her,” I said.
Danielle and I did not wait around to see if Dr. Kutchin showed up. We both felt ill and wanted to get out of the hospital and home to bed as swiftly as possible. As soon as we got to the apartment, I threw up. Once I vacated the bathroom, Danielle went in and threw up. I was sick from anesthesia; Danielle was newly pregnant. We were sick as dogs, in an apartment with one bathroom. Though we did find the humor in it, it was not a pretty scene.
Once again, I was bandaged and could not shower for a week, but at least this time there were no drains. And once again I was on Vicodin. My new silicone breasts felt soft and real to the touch, though they were completely numb. It was as if the doctors had shot Novocaine into both breast mounds. I was told that some patients regained feeling in time while some did not. The wounds were taped and I tried not to look at them. When I peeked, I saw a long, horizontal knife line across each breast. The incisions were stitched and scary-looking. There were no nipples.
Though the second operation was minor compared to the first, for me it was a more difficult recovery. The first operation was a symbolic triumph—I’d taken a brave step and all my friends and family had gathered around in support. This time, the procedure was sheer drudgery. I’d had a bad reaction to the anesthesia. It was just me and Dani vying for the toilet. When the nausea subsided, I got a bad cold. Everything felt darkened by a gray cloud.
About three weeks later, my wounds had begun to heal. I was off the Vicodin and allowed to drink. It was the night before Thanksgiving. I got dressed up and went to a party with Cara thrown by a woman named Nadia. We’d all been in a theater company together in the early nineties, and Nadia had been throwing this annual bash ever since. It was a homecoming of sorts for us to see all our old cronies. It was also an occasion on which everyone famously regressed, got drunk, hooked up, and pretended we were still twenty.
In the spirit of the night, I downed a few vodka tonics. I’m a lightweight drinker, so I was gone at drink number two. A handsome movie studio executive I used to date was there. My memory of the evening is blurry, but somehow I wound up in his arms with him telling me I was beautiful. He kissed me and asked if I wanted to leave with him. In that moment, I truly experienced a postmodern quandary. I’d just elected to remove my breasts in an attempt to preempt cancer and was only half reconstructed, yet I was in the arms of an attractive ex-flame. What to do? I left with him and insisted we go to the Waverly Diner, where I informed him of my travails over a milk shake and fries. He listened patiently, said all the right things—the mastectomy didn’t matter, I was still appealing, et cetera. He was in town from Hollywood for a few days and said he wanted to see me over the weekend. He dropped me off in a taxi, kissed me good night, said we’d speak tomorrow. Not surprisingly, I did not hear from him again.
MY FAMILY was in Florida for Christmas. My dad was now spending winters in Del Ray, and Danielle and Bruce were planning their January wedding in Palm Beach. I usually love the Christmas season in New York. This year I could not get out of bed. The farthest I traveled was to my desk to halfheartedly type away at a book proposal about my BRCA experiences. In truth, I was in the thick of it and had no clarity, no perspective, and no clue about how to tell the story. I was still living it. I didn’t know how it would all turn out, and that month, things were not looking up.
I spent a lot of time thinking about my mother, trying to wrap my head around the fact that she was gone. It had been over two years since her death, but the permanence of her absence still hit me in waves. She was such a vibrant human being. Where did she go? What happens to all that energy, striving, passion, yearning? It just evaporates? I also spent time thinking about Adrian. Previously, every time he had come into my mind, I’d pushed him away. I’d been grieving over so many other things, thinking of Adrian had just been too much. Now I remembered him, how alive I had felt in his presence. I Googled him and found a video of him performing stand-up in the eighties. I listened to his voice and watched his younger self with morbid fascination. I was dwelling on death and obsessing about my dead, married ex-boyfriend. I was not in a good way.
Once again, Jonathan and Alexandra came to my rescue, dragging me out of the house. I joined them at a Christmas party at a friend’s apartment in the East Village. It was cozy and warm with Christmas lights twinkling on the small tree. I ran into Ali Marsh.
“How’s Anna?” I asked. “I e-mailed her twice recently, but she didn’t write back.”
Ali looked tense.
“I didn’t want to tell you this, because I didn’t want to upset you, but she’s not doing well. The cancer is back.”
I gasped. It had only been four months since we’d met for coffee and she’d been in full remission.
“They found a lump in her remaining breast tissue?” I asked in horror.
“It’s spread. The cancer is in her bones—her neck, ribs, and spine.”
I burst into tears and so did Ali. We hugged and wept on the corner of a sofa while everyone else drank eggnog.
It was only much later that I would learn the details of Anna’s illness. In mid-November she had been experiencing back pain and went for another PET scan. This time spots lit up in her mediastinum, cervical spine, left seventh rib, and right upper back. A bone biopsy of her rib confirmed that it was cancer.
Cancer in bones grows from the inside. It grows outward and ultimately breaks the bone.
One morning in late November, a mere ten days after she’d learned her cancer had metastasized, Anna sat up in bed, heard a snap, and felt piercing, indescribable pain. Chiq called an ambulance. Her neck had cracked. The CAT scan would show she had “a fractured cervical spine, but stable.” She would wear a permanent neck brace.
Anna’s mother was undergoing a hysterectomy that day at a hospital across town, and Anna’s sister was with her, so Chiq called Ali to meet them at the hospital. Typically, Anna was the heartiest woman you would ever meet. She went through brutal chemotherapy treatment without uttering a complaint. Cancer had never fazed her. This day, in the hospital waiting room, in gut-wrenching pain, was the one and only time Ali ever saw Anna break down. Anna wept and cried, “I know the cancer’s in my neck and it’s so close to my brain—it’s going to go to my brain! It’s eating me alive.”