the biopsy results had turned out negative, anguishing Bill prematurely would have been an unnecessary cruelty.
Now…
She couldn’t keep it from him any longer, of course. Or from Emily. Unfair to both of them if she tried even for a little while longer; unfair to herself. She would need their support to get through what lay ahead. She’d always believed that any sort of physical illness was affected, positively or negatively, by the person’s mental attitude-and her optimism wasn’t unshakable. It would require plenty of shoring up over the next few months…
The door to the inner offices opened and the heavyset young nurse put her head out. “Ms. Wade? Will you come in, please?”
The tight-lipped woman shifted position on her chair and aimed a frown in Kerry’s direction. Waiting longer, so she believed it should be her turn. Kerry smiled at her, thinking: You don’t know how lucky you are, lady. I wish all I was facing here was a little inconvenience and a sore butt. It wasn’t much of a private joke, but it allowed her to hold the smile in place as she followed the nurse inside.
None of the usual routine today of being weighed and having her pulse rate and blood pressure taken; nor was she deposited in one of the examining rooms as per usual. Ushered straight into Dr. Pappas’s private office, where the doctor stood waiting behind her desk. The nurse closed the door behind Kerry as soon as she stepped through.
Audra Pappas had been her gynecologist for more than fifteen years. Their relationship was strictly doctor- patient, pleasant enough but without any personal connection. That was fine with Kerry, now especially. No- nonsense, straightforward professionalism was what she wanted and needed in the present circumstances. So was the air of authoritative competence she projected. Competence and efficiency were the two words that best described Dr. Pappas. Midforties, tall, sandy-haired, brusque, with very little if any sense of humor-as if life and the practice of medicine were too important to her to be tempered with either levity or social niceties.
She seldom smiled, but she smiled now, a brief stretching of her closed lips, as she took Kerry’s hand-a firm handshaker, Dr. Pappas-and invited her to sit down. Professional, that smile, meant to be reassuring. If Kerry hadn’t known what was coming, the uncharacteristic smile would have told her.
Pappas sat behind her desk, folded her hands on top of a thick file folder. The Kerry Wade file, no doubt. Wherein the damning evidence lay. At length she said, “I imagine you know why I asked you to come in this afternoon.”
“The biopsy results. Bad news.”
“Well, the results are not what we hoped for. To begin with, the biopsy surgeon wasn’t able to remove the entire mass.”
“Large tumor, then.”
“Substantial, yes.”
“And not benign.”
“No. Malignant, I’m afraid.”
Despite the fact that she’d prepared herself for it, the confirmation still jolted her a little. Malignant. What a nasty little word that was, one of those words that exactly fits and conveys its meaning. A malignant word.
She cleared her throat before she trusted herself to speak in a normal voice. “Do you think we caught it early enough?”
“I hope we have.”
“Meaning it’s too soon to tell?”
“Yes.”
“So. What’s the next step?”
“You’ll need to consult with a cancer surgeon. As soon as possible.”
“Is there one you recommend?”
“Dr. Emil Janek at UC Med Center is one of the best. I’ll make an appointment for you.”
“All right. And then what? Further tests, surgery?”
“Both.”
“What kind of surgery? Lumpectomy?”
“Dr. Janek will help you make that decision. It depends, first of all, on the grade and stage of the tumor and whether its borders seem fairly distinct or not. The more diffuse the cells, the more invasive the cancer and the more radical the necessary surgery.”
“Full or partial mastectomy.”
“Yes. Some women opt for that in any case.”
“Better chance of survival?”
“Actually,” Pappas said, “clinical studies have shown there’s a small difference in the survival rate between a lumpectory and either type of mastectomy. The reason some women make that choice is the need for a period of radiation therapy following a lumpectomy.”
“How long a period?”
“A minimum of six weeks, five days a week. Longer, if necessary, to make certain all the cancerous cells in the breast have been destroyed.”
She dreaded the thought of losing a breast, of the need for reconstructive surgery or worse, a prosthesis. It wouldn’t matter to Bill, would have no effect on their relationship, but it would matter to her; it was her breast, a part of Kerry Wade that would be lost forever. But the prospect of six weeks of radiation was no more appealing. Fatigue, all the other side effects… God.
“There are a number of other factors involved in the decision as to what’s best for you,” Pappas was saying. “Your age. The general state of your health, which is very good. The fact that you’re postmenopausal. Your family medical history.”
“There’s been no incidence of breast cancer in my family,” Kerry said.
“Any other type of cancer?”
“I’m not sure.”
“You’ll need to find out.”
“I know. How long before we know how invasive the cancer is and what type of surgery I should have?”
“I can’t give you an exact time line. You’ll have to discuss that with Dr. Janek.”
“Can my decision wait as long as two weeks?”
“Possibly. Why do you need that much time?”
Simple enough to explain. I might need that much time, doctor, because it may take that long to get the results of the DNA test. I don’t know who my biological father is, you see-I don’t know if I’m the daughter of the man who raised me or the child of a drunken rapist. And if I am the child of a rapist, then that makes the situation all the worse because he’s dead and I don’t know anything about his background or any way to find out if there was a history of cancer in his family.
But she couldn’t say any of that to Dr. Pappas. And probably not to Dr. Janek until she found out one way or another. Her secret until then, hers and Cybil’s and Bill’s.
She cleared her throat again. “It’s a personal matter.”
“Having to do with your husband?” Pappas asked bluntly.
“No. Lord, no. He’ll be supportive no matter what.”
“Have you told him yet?”
“Not yet. I wanted to know the biopsy results first.”
“Don’t delay. This isn’t something that should be faced alone.”
“I know,” Kerry said, “and I won’t put it off. I’ll tell him tonight.”
“Good. And Kerry”-one of the few times Pappas had used her given name-“remember that breast cancer is not the devastating disease it once was. It can be treated, it can be cured in most instances of early discovery. Be optimistic.”
“I am, doctor. I am.”
So why did she feel, all of a sudden, as if she was going to burst into tears?
