It was a good idea. This had to be purely professional.
‘Anna doesn’t let me close. She and I went our different ways early, and she’s never let me help her, even though bringing up her kids on her own must be a nightmare. But now… I came down to see her a couple of weeks ago, and something’s scaring her. She won’t tell me what. But I know her well enough to realise it’s something bad. I’ve been badgering her by phone from Sydney ever since. Finally I’ve made her to agree to come and see you.’
‘Anna?’ Em turned her full attention onto the woman before her.
Like her brother, Anna was a vivid redhead, but there the resemblance ended. Younger than her brother, she actually looked much older than him. Her short red curls were a bit uneven, as if they’d been cut at home, her green eyes were shadowed and she seemed…defeated.
In fact, she looked as if the world had dealt her some really hard knocks, and with this one she was about to topple over.
‘Y-yes?’ Her voice was barely a whisper, but Em could hear the fear.
‘Would you like your brother to leave so you can tell me what’s wrong in private?’ Em cast a warning glance at Jonas. Having brought her this far, he must understand he had to be prepared to back off.
But he knew. ‘I’ll go if you like,’ he offered, and half rose, but Anna’s hand came out and caught him. ‘No.’
Jonas sank again. ‘Then tell us what’s wrong, Anna,’ he said softly. ‘We’re with you all the way. Both of us are. But you have to tell us what’s happening.’
Anna took a deep breath. She raised her face to Em’s and her eyes were like those of a rabbit caught in headlights-terrified beyond belief.
‘Tell us, Anna,’ Em said gently, and the girl shuddered.
‘I don’t…I don’t know if I can face it. My kids…’
‘Just tell us.’
‘There’s a lump in my breast. I think I have breast cancer.’
There was, indeed, a lump in Anna’s breast. It was as big as a pea and close to the nipple, and it moved a little as Em gently palpated it.
‘How long have you been able to feel it?’ Em asked, carefully examining the rest of the breast. There was nothing else-just the one tiny, single lump.
‘F-four weeks.’
‘Is that all? That’s great,’ Em said warmly. She had Anna on the examination couch behind the screen. Jonas stayed out of the way, but he was still within earshot. ‘It’s very small and you’ve come early.’
‘Early?’
‘Some women worry about a lump like this for a year or more without having it checked,’ Em told her. ‘You have no idea the kind of trouble that can cause. But you’ve come quickly. And this is small. It’s less than a centimetre across, I’d think,’ she added for the benefit of the listening Jonas.
But Anna was trembling under her hands, afraid to meet her eyes. ‘So it is cancer?’
‘It might well be a small breast cancer,’ Em admitted. There was no use giving false reassurance when the most important thing was to get Anna to agree to have the necessary tests. ‘But there’s also a very good chance it’s just a harmless cyst. Cysts in breasts are common-much more common than cancer-and they feel very similar. It needs a biopsy to tell the difference.’
‘So…’ The girl’s eyes flew to hers, hope flaring. ‘This may well be just a waste of time. If it’s just a cyst, I can go home and forget it.’
‘Yes, but you can’t go home and forget it yet,’ Em told her. ‘Because you may be right in your first guess. Your age means that you’re in a low-risk group for breast cancer, but we have to exclude that possibility.’
‘But I don’t want to know.’ Anna put her hand to her mouth as if to stifle a sob. ‘If it is…cancer…then I want to be as normal as I can for as long as I can. I have three kids. I want to be there for them. Jonas made me come, but if it’s cancer then it’s better not to know.’
‘Well, that’s exactly where you’re wrong.’ Em handed Anna back her blouse-and a tissue-and waited until she was decent. Then she pushed back the screen so Jonas could join in the conversation. ‘It’s far, far better to know.’
‘Why? So you can cut off my breast?’
‘That hardly ever happens any more,’ Jonas growled. Unable to restrain himself, he rose and moved to give his sister a hug. ‘For heaven’s sake…Stoopid. Why didn’t you tell me? I could have eased your fears.’
‘By agreeing I may have cancer?’ She was looking wildly from one to another. She was very close to the edge, Em thought, and knew this visit was the culmination of weeks without sleeping. ‘No one’s easing my fears now.’
‘I can do that,’ Em said gently, but there was a note of iron in her voice. What Anna didn’t need was false sympathy or reassurance. She needed facts. ‘Sit down, Anna.’
And Anna sat, still looking like a hunted animal. She was like a tigress defending her cubs, Em thought, and suddenly realised that the comparison was appropriate. Anna wasn’t scared for herself as much as for the three small children who depended on her.
‘Anna, your brother’s a surgeon,’ she told her, casting a quick glance at Jonas. He could intervene any time he liked, but she sensed he wanted this to come from her. ‘He’ll back up everything I say, but I want you to listen.’
She held up her hand.
‘One, you’ve come very early, and the lump I’m feeling seems very well defined. That means it’s either a nice little cyst, which we can confirm with a biopsy, or, at worst, it’ll be a small cancer that we can remove. Now, I can’t make promises until the tests have been done, but if, as I suspect, it’s confined to the one small area, then there’ll be no question of you losing your breast, even if it is cancer.’
‘But I’d want…’ Anna gasped, then continued. ‘If it’s cancer I’d want it off. All off. The whole breast.’
‘Surgeons don’t remove breasts without very good reason,’ Em told her. ‘Even if it is cancer, with modern surgical techniques there’s usually no need. They’d simply take away the affected part. That means you’d be left with a scar and one breast a little smaller than the other.’
‘And that’s it?’ Anna looked as if she just plain didn’t believe Em. ‘What about chemotherapy?’
‘If it’s as early as I suspect it must be, then you’d undergo a six-week course of radiotherapy just to mop up any stray cells. Then you and the oncologist would decide whether you wanted chemo.’
‘But…’
‘The survival rate for early breast cancer is great,’ Em said firmly. ‘After surgery and radiotherapy it’s well over ninety percent. And it’s not the fearful experience it once was. Honestly, Anna, about the worst side effect of current chemotherapy is fatigue as your body copes with medication, and hair loss. And hair loss is no big deal.’
She grinned. She may as well be honest here. ‘You and your brother are so good-looking that having shiny scalps would only make the pair of you even more attractive. It’d just bring you back to be on a level with the rest of us ordinary mortals.’
‘And I’d shave with you,’ Jonas said promptly, and he finally succeeded in drawing a smile from his sister.
‘You wouldn’t.’
‘Watch me!’
Em blinked. The thought of a bald Jonas…
Good grief. Once more, there was a wave of pure fantasy. Jonas bald…
She was right. They’d both be stunningly attractive, no matter what they did to their hair, or…or anything.
But Anna was back on consequences. ‘I don’t want to be bald.’
‘So you never need to be,’ Em told her. ‘The health system in this country makes sure you’ll get a wig if you want one, no matter what your income is, and wigs are great.’ She smiled at the pair of them. The tension was decreasing by the minute. ‘You know June Mathews?’
‘I…yes.’ Everyone knew June. She ran the local minimart. June was a stunning strawberry blonde. Or, to put it more truthfully, she was an interim strawberry blonde. Until she tired of it.
‘June doesn’t dye her hair.’ Em’s smile widened. ‘Whenever June tires of her hairstyle, she just buys a new one.’
‘You’re kidding!’
‘I’m not kidding.’ Once more, Em’s voice gentled. ‘She doesn’t mind me telling people who need to know, as