From Bad News to Breath Cancer

Within minutes of recovering from the emotional tsunami caused by learning that her mother had just been diagnosed with breast cancer, our always inquisitive nine year-old, Emma, began to ask probing questions. Among the first questions were, "So, do they put on a long glove and reach down your throat to pull out the breath cancer."

We reassured her that mommy's cancer had nothing to do with her breath, but rather her breast (if we were more opportunistic parents we would have told her that she might get breath cancer too if she didn't continue to brush and floss everyday, but such manipulations didn't seem appropriate at that moment).  Emma's sincere question comment did prove to provide some comic relief in an otherwise sober and serious moment.

Dr. Myers, our primary care physician, had called Lisa mid-afternoon on Monday to her inform her that the results of her mammogram and biopsy suggested that the large lump in her breast was indeed cancerous--something that Lisa had known for several weeks.  Lisa was so sure that it was cancerous that she was ready to demand a "recount" if you will, had the results suggested anything but cancer.

I, on the hand, didn't expect the results to come back that way.  My head was too firmly planted in the sand to know otherwise; in fact, it was so far in the sand that on the previous Friday night when Lisa said to me as we lay in bed that "Monday was such a long time to wait," I replied, "A long time for what?"

That did not go over well.  Such a slip of the mind was infinitely worse than forgetting an anniversary or a birthday (something I have never done, primarily because Lisa and I share the same birthday which happens to also be our anniversary).  While the pending results of the biopsy that had been performed the prior Tuesday were certainly on the forefront of Lisa's mind, my mind was on, well, most everything else.    Pathetic but nevertheless true.

Best sale I ever made:  Somehow she loves me despite me.

The wait between the biopsy and its results was particularly long because the extended Thanksgiving Day weekend was sandwiched in between.  In addition, the wait from Lisa's early premonitions about having breast cancer to the moment we learned of the biopsy results was even longer, as we couldn't obtain an appointment for mammogram for several weeks.  It must be a busy time of year.

Speaking of busy, one reason that Lisa was on heightened alert for breast cancer was that our good friend and neighbor, Edy Buss, is currently being treated for breast cancer.  Edy is just a few years older than Lisa, and she was diagnosed in late August. After a successful surgery, Edy is currently undergoing chemotherapy, and she--both in body and spirit--is responding like a super-hero.  It has struck me as odd that two good friends in the same neighborhood would battle the same disease at the same time.  One can't help but wonder if there is something in the water . . .

The Phone Call
I learned from the previous Friday night, and by that next Monday I was more conscious and connected to what was coming.  Still, I didn't feel a sense of pending doom, and therefore, I wasn't expecting a diagnosis other than one that could conclude that the lump in Lisa's breast was benign.  As I left for the office Monday morning, I kissed Lisa goodbye and told her to call me if she got a call from Dr. Myers.

That call came about 3:00 p.m.  Lisa, in a very matter of fact, seemingly unemotional way, rehearsed for me her conversation with Dr. Myers, who had just delivered the bad news.  Though I didn't expect that diagnosis, when I heard Lisa talk about it, I wasn't surprised.  Her intuition had said breast cancer, and as she spoke, I wondered why I had doubted her intuition this time.  I don't recall it ever being wrong.

It wasn't wrong just over seven years ago when she told me privately, "I feel like someone is going to die soon, and I think it might be me."  A few nights later I happened to watch the movie Charlie--a movie about, among other things, a young mother who dies of cancer.  Not a good movie to watch days after your wife announces that she thinks she or someone close to us might die.

Lisa did not die a few months later, but her otherwise healthy, fit 44 year-old brother, Mark, did.  He collapsed with a heart attack while jogging one afternoon.  He spent too many minutes without oxygen, lapsed into a coma, and died 5 days later. Her intuition was right then.  It has been right countless times.

About 30 seconds into her rehearsal of her conversation with Dr. Myers, I put on my coat, and quietly left the office.  The primary message I got from Lisa as I walked from my office to my car was one of confusion:  Dr. Myers had called, said I had cancer, expressed empathy in a tender, compassionate way, told me I could call him at home anytime,  but then immediately asked me if I had a preference of surgeon, and advised me to go see one very soon.  And that was it.  Isn't he supposed to guide me.  Why do I need to call a surgeon first? Is that the first person I need to see?  I'm lost.

I hung up with Lisa as I got into my car.  Tears started when I left the parking lot. On the way home I called Dr. Myers's office:  "Hi, this is Jeff Reeves. Dr. Myers just called my wife, Lisa, regarding a rather weighty diagnoses.  I have some follow-up questions.  Can you have him me asap?"

One Hot Mamma 

When I arrived home, Samantha, our 16-year old daughter, was in the kitchen with Lisa. It was obvious that Lisa had been crying, but it was also obvious that she hadn't told Samantha anything.  I knew Samantha was aware that something out of the ordinary was wrong, but she didn't probe.  Mom had been crying and Dad was home at 3:30 p.m. Something was not right. Sam left the house as Emma walked in the front door, home from school.  I still had not been able to give Lisa the long-embrace I desperately wished for.  Such an embrace would tip Emma off, and at that point we knew so little about the news we had just received that neither of us were ready show any concern in front of our children.

I made up an excuse to take Lisa out of the kitchen and into our bedroom, where we embraced. Moments later, Dr. Myers returned my phone call.  I placed him on speaker phone, and Lisa listened as I asked clarifying and probing questions. At the end of this phone call, Lisa and I had clarity.  The results from the previous week's test suggested Ductal Carcinoma in Situ (DCIS), High Grade.


Dr. Myers frankly said that the diagnosis was both good and bad.  Good--in that the term in Situ means "in its original place," which means that the cancer shows no signs of having branched out, and is likely not invasive yet.  Bad--in that it was "high grade," which means that cancerous cells were active, aggressive and are likely to become invasive if not treated quickly.

When I asked why we needed to see a surgeon first, he explain it succinctly and satisfyingly:  the tests they were able to perform on Lisa to date are limited, and while they represent a fair degree of accuracy, until a surgeon is able to open you up, it is difficult for them to predict with certainty where the cancer might have spread.

The confusion that Lisa felt after her first conversation with Dr. Myers was now gone.  We left this conversation with a clear sense of the necessary steps to take.  Our first objective was to get an appointment with a surgeon.  Thus, my first call was to our friend, Edy, who provided a wealth of information, encouragement, and empathy.   Edy not only gave the name of number of her surgeon, but she walked me through what would be our first week of the post-diagnosis period:  what we would feel, what would happen, why it would happen, and a few tips on how to deal with it all.  Minutes later I secured an appointment for that Thursday with her surgeon, Dr. Jennifer Tittensor, whose focus is breast cancer.

With Whom and When Do We Share?
In my first conversation with Edy, she had mentioned that she and her husband, Robbie, had waited two weeks before telling anyone about her cancer.  They wanted to gather all the information they could and decide what their game plan was before they worried anyone with such news.  Such an approach made perfect sense--particularly for Edy and Robbie, who are organized, deliberate, methodical, and effective people.  Intellectually, that approach made sense to me as well.  Why worry loved ones before we know how extensive it is, and how we're going to attack it?  Interestingly, Lisa, who is by nature much more private than I am, had different feelings.  As I explained that I was for adopting Edy's approach, she responded, softly, "You know, I wouldn't mind a few extra prayers in the meantime."  Nothing more needed to be said.  I was on board immediately--I wasn't going to fight that intuition again.

We first told Lisa's parents.  I stalled on telling my parents, initially deciding that I didn't want to ruin their vacation (they're in Hawaii right now).  Our kids came next--which brings us full circle to my opening comments about breath cancer.  Lisa's intuition was right again.  We shared a beautiful moment with our children.   In our specific case, it was the right thing to tell them early in the process. For one, Samantha already suspected something was terribly wrong. To leave her hanging for two weeks would have been cruel.

The initial moments were shocking to say the least.  Emma wept uncontrollably for about five minutes. Daphne, our 11 year old, immediately burst into tears simultaneous with Emma but that cooled to a sniffle more quickly than it did for Emma.  Samantha tried to hold back tears, and partially succeeded.  Jeffrey, 14-year old and lone boy, sat stoically still during our discussion.  Men tend to go into their man cave to grieve, and I believe Jeffrey was going into his figurative cave as well.

Lisa was strong and only shed tears when her girls lost it, at which point she began to question her decision to tell everyone.  By that time, however, I knew she had made the right decision to discuss this now. She made the perfect comment to Emma, as she tried to console her:  "Emma, I will tell you when you need to worry.  Right now you do not need to.  But I will tell you when or if you need to."  I led much of the discussion, and until I offered the family prayer at the end of our meeting, I was able to do so without too many tears.

I chose to remind our children of a similar meeting we held just over two years ago, as we sat as a family in a hotel room near Primary Children's Medical Center.  Our baby, Abigail, who had been born the day before, was in the NICU at Primary Children's, and had been diagnosed with life-threatening congenital heart defects.  I reminded them what I told them then:  that Mom and I felt peace in the face of the natural anxiety that comes with the unknown; that even though we did not know if Abigail was going to make it, we had the peace that whatever was best for our family would happen; and finally, that this was a unique opportunity for our family to grow closer to each other and to the Savior. Let's not waste it.

When I told them those words two years ago, I said it with a complete sincerity and with a confidence that only comes from feeling peace in the face of uncertainty.  I had that same confidence this time.

Abby at 9 days

Abby last spring. Her "zipper" scar remains, though faint.

Comparing the Two Medical Trials
Within moments of learning about Lisa's cancer, I began to reflect on how this latest medical crisis compared  to the last.  They are different in so many ways.  Abby's ordeal--at least the first 9 days of it--makes for a good Hollywood story:  a diagnosis that went from a mild concern that she had swallowed some meconium to a congenital heart defect within hours, multiple Life Flights, a blessing from a prophet, being whisked off to Stanford literally moments after her siblings got to touch and see for what might have been the first and last time,  mom and a dad leaving town for who knows how many weeks with only one pair of underwear and one change of clothes, her a surgery by a world-renowned pediatric heart surgeon, and her complete, total recovery and unblemished history since.  Great stuff.

Lisa's is different. For one, it unfolded much more slowly, and we didn't find ourselves dazed, and in a whirlwind when we first learned the diagnosis.  She suspects breast cancer, and goes to her primary care physician, who is concerned and tells her to check it out.  Three weeks later--after multiple attempts by her, her doctor, and her insurance company to get her an earlier appointment--she finally got in.  The mammographer was concerned and had her do a biopsy of the breast tissue on the spot.  Thanksgiving gets in the way, and so the results aren't available for another six days. In the meantime, I'm pretty much consumed with work and don't spend too much thinking about the pending test results.

The other way in which this is different is that all of this is happening with the context of our regular, daily pattern.  Dad still makes breakfast for everyone (the one thing I can cook beside frozen pizza), Mom still packs lunches, Dad still goes to work, Mom still calls contractors about the basement we're trying to finish, Dad still gets frustrated by and is still invigorated by his work, Mom gets frustrated that everyone's homework isn't done, etc.

Yet despite those differences, there is one very similar element--one very familiar element that I prize more than anything.  Marx called it "opium for the masses"; I call it the Holy Ghost.  It is something that I cannot deny, a real power that is so different from the counterfeit emotion that wishful thinking usually brings. I believe that such wishful thinking is what Marx had in mind with his opium comment.  But like any narcotic, when you hope for or put trust in things that just aren't true, you are, in the long run, left with nothing.

I have wished for things that were contrary to the laws of nature; I have wished for good things that deep down I knew would not come true; and I have felt the hallowness that accompanies such efforts.  The peace that Lisa and I feel right now is nothing like that. This is substantive.  This is satisfying. This is rejuvenating.  This is clarifying.  There is a serenity and spirit of peace in our house right now for which we are deeply grateful.

And while we sincerely apologize to my insurance company (again), we are grateful for another opportunity to grow closer to each other and to the Savior.