Black holes: Illusion of health melts

Lying on my right side on the examining table, I gaze at the monitor next to me. As the technician guides a palm-sized plastic probe over my breast, the ultrasound records an image of the tissue rolling across the screen: gray with streaks and specks of white and swirling black holes, like the ones in outer space.

I'm here because an earlier mammogram showed a "density" in my left breast. I learned about it after returning from a holiday spent with a dozen women friends I've known for decades. I had marveled that we all remain in good health.

Is this an illusion soon to end?

This morning, I entered the spanking new outpatient clinic early for my appointment. In the women's clinic, a receptionist sends me to join a half dozen other women in the waiting room, a cheerful space gleaming with peach walls.

Fearing my task, I see only gray.

A tailored young woman efficiently ushers me into her office to inquire if there are any changes in my insurance and address. I confirm that nothing had changed in the 10 days since I got my mammogram.

Or has it?

One in every eight women will get breast cancer. While many can trace the disease to family genetics, some– like me– have no family history at all. Still, I'm well over 40 (another risk factor). I could be the one in eight.

I wait another 20 minutes.

In a small dressing room, I'm directed to exchange my blouse and bra for a waist-length pink smock. I then sit for another quarter hour until the technician arrives.

A pleasant, petite woman in her 40s, she positions me facing the machine, which she adjusts until a flat rectangular plate is opposite my left breast. Spreading the tissue with her hands, she places the breast on the plate, and then lowers an upper plate to compress the breast as flat as possible. The actual mammogram usually takes only a minute. It is uncomfortable, but usually routine.

Only this time it's not routine.

The additional images will give the doctor more detailed pictures to examine for signs of tumors. I feel vulnerable. Something unknown is in my breast.

After several pictures, the technician repositions me and my breast for almost-vertical images of the compressed tissue. After intently reviewing the pictures, she again moves me, this time to further compress a portion of the breast.

Squeezing the breast for a mammogram hurts. Today, however, the procedure doesn't bother me physically, but psychically I feel wrung out.

I remember what my friend Susie said the other night when I literally cried on her shoulder about my call-back: "Women do survive breast cancer, if it is breast cancer."

I think of Carol who has survived almost 35 years, of Virginia who has survived 15, Elizabeth who has survived five, and Judy, who recently had her one-year anniversary.

And I remember my mother-in-law, Alma, and classmate Susan, who died from breast cancer.

The technician finishes. I return to the dressing room and pass the time by reading, trying unsuccessfully to divert my attention from why I am here. What will I do if I have cancer?

The minutes tick by– five, 10, 15.

I write questions for the doctor: What are the next steps? What are my alternatives? How quickly must I make decisions? I think about my family and my work. If I have cancer, I will take the time for treatment and to heal, even if it means leaving work.

Recently, I experienced a very stressful period in my work life. I have tried to counteract it by exercise, prayer, and meditation. Yet I wonder about the stress. Do the pressures of everyday living make me and other women more vulnerable to cancer?

I look at my watch: 25 minutes have gone by since the technician left. I wait 10 more minutes, and then she knocks. She needs more images, so I return to the machine for more pictures. And wait again.

Twenty minutes later, a new technician arrives. The doctor needs a sonogram, she says, so I enter a new room with an examining table and equipment. As I lie on the table, the technician guides a handheld probe over my left breast while looking at the monitor next to me.

In response to my question, she explains that ultrasound sends high frequency waves through the breast and converts them to images. The resulting sonogram is more sensitive to the tissue than the mammogram. After finishing and printing out her work, she says "Wait here, and the doctor will come talk with you. Or sometimes, when there's nothing wrong, he sends me." I realize that I have left my written questions in my briefcase in the dressing room.

I sit up on the table, still naked to the waist. The image of my breast remains on the screen. The picture reminds me of space when I look up at the stars at night– shining objects and swirling filmy portions of the Milky Way and darkness. I think of images I've seen of black holes that suck everything into them. Are the swirls I see in the tissue like that-­ black holes sucking my life into them?

As the door opens, I inhale deeply, and before I can register that it's the technician, not the doctor, she says:

"You're okay. The sonogram shows there's nothing wrong."

I'm grateful. The blackness is not a black hole after all. As I dress, I think, this time at least, I am lucky; I'm not the one in eight. I walk out of the clinic with a distinct bounce to my step. I don't want to forget this feeling of how precious and precarious life is. I don't have a moment to waste.

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