A Brave Young Mother's Thoughts Before Surgery

I had completely forgotten that on Feb. 8, five years ago today, our daughter Eleni went into surgery in Florida to remove one of her ovaries that had been swallowed up by a possibly malignant cyst.  While I stayed in her apartment with six-month-old Amalia, the rest of the family were at the hospital waiting to hear the report, and the suspense was unbearable.  When I finally got the phone call, I posted on Facebook: "Who was it that said the most beautiful word in the English language is 'benign'?"  The happy ending to this story is that three years later, Eleni and Emilio were able to add Amalia's little brother Nicolas to their family.   But today, I re-read the essay Eleni managed to write and post on her blog "The Liminal Stage" before going off to the hospital.  I'm re-posting it here, because I think it's so eloquent and brave, and to remind us how blessed we are.

Same Same, But Different

February 8, 2012 by Eleni 11 Comments

Almost exactly 10 years ago I had a cyst removed from my right ovary. It was discovered during my annual gynecologic exam, which I had scheduled early because I was about to move to Greece to oversee the rebuilding of my grandparents’ house, which had fallen into ruin after the Greek Civil War, an experience would form the basis of my travel memoir, North of Ithaka. 

My doctor assured me that the cyst was probably nothing to worry about, that it was most likely water-filled, or a benign growth like afibroid or a dermoid. But a post-surgical biopsy showed it to be a low-malignant potential tumor, which isn’t cancerous, but isn’t benign either, and a CT-scan revealed that I still had two small cysts on the back of that ovary.

Some people counseled me to have that ovary removed, pointing out that your chances of getting pregnant are the same with one ovary as with two (because the remaining ovary steps up its hormone production and releases an egg every month instead of every other). But I was young (27) and very single, and didn’t know what the future held, so I wanted to keep both ovaries just to be safe. So I opted to have routine ultrasounds to make sure that the cysts hadn’t grown in size.

They stayed the same for the next ten years, even throughout my pregnancy. Then last week, in my six-month post-delivery checkup, we did the usual ultrasound and it revealed an 8-cm cyst on my right ovary (actually, the cyst is so large it has sort of swallowed the ovary). Everyone agreed that it (and, this time, the dwarfed ovary) had to come out. It was déja vu all over again.

Only this time everything felt totally different. On the one hand, I was much better off than I had been during my first surgery, when I was young and single and had no idea if I’d ever have children. I now have the incredible husband I wasn’t sure existed, and we already have one very funny, highly adorable baby. A baby who came partly from an egg that the problematic right ovary had dropped (I know because during my pregnancy ultrasounds we saw the corpus luteum cyst, which remains when the egg is released, on the right).

But that’s where things get complicated. That what’s changed the most since my last surgery–this little baby. She depends on me for everything, down to the food she eats. The truth is, she’d get by just fine if I weren’t around–she has her papi and three grandmothers and loving aunts and grandpas and all the rest–but she’s also such a delight to be around that I don’t want to miss watching her discover the world, not even for the day I’ll be surgery. She gets so excited feeling the wind or watching the rain or when a stranger waves at her, and I want to see every one of those smiles and hear her guttural little laugh.

The oophorectamy I’m having today is an outpatient procedure. If all goes well, I should be in and out the same day, and after three days of pumping and dumping (and Amalía’s grandma giving her milk I’ve stored) the anesthesia will be out of my system and I can feed her again.

So I’ve been trying not to get all Terms of Endearment about what I hope what will be a minor procedure. The doctor told me that there’s a 20% chance the mass is cancerous, given my history and the tumor’s size, but I’ve been trying to focus on the 80%. And eighty percent is pretty good odds, even though it’s a B-, and nobody likes a B-, not even in gym class. That’s probably my problem–my life is the equivalent of grade inflation; I have the family I always wanted (although I would like to keep adding to it), and my novel is coming out in a week; maybe I’ve been too lucky and now I want everything to be A+ all the time without the interference of clear-liquid diets, surgery, and whisperings of mortality.

But I’ve been talking to some of my girlfriends, and I think it’s not just me and my unrealistic expectations. One friend was about to go in for dental surgery when I called her, and, knowing she was about to be put under general anesthesia, she said she couldn’t stop thinking about who would raise her child if something were to happen to her, where her husband would move, and what influences would dominate her baby’s life. It may be maudlin, but it’s also natural and unavoidable. Everyone tells you that everything changes when you have a baby; this is just one of the unexpected ways in which that is true.

I think that’s one of the most significant things that changes when you have a child; you become aware that if something were to happen to you, you would miss out not only on experiencing your life, but also on witnessing his or hers. The joy of life doubles, but then, so does the risk, the potential loss.

I realize this blog’s a bit of a downer. And that’s how life has been lately, but only in moments. Because every day there are incidents that are so amazing, watching Amalía laugh at her grandparents who are visiting, as she tries to bite their knuckles to soothe her teething, or they pinch her nose. And those moments are so purely fun that they’re not even outweighed by the fear of missing out on them.

So I’m trying not to worry too much, to stay calm until the surgery happens and to hope everything goes well. I do what I can to feel in control, employing the rituals that give me comfort. I pray. I went to church and took communion. I bought my mother a necklace with an image of Ganesh, remover of obstacles, on it. And I had my toenails painted, because every time I look at them while I’m having a medical test they cheer me up.

 I also see signs everywhere, or I hear them rather; “the Rose” was playing on the muzak system during my MRI, and I remembered singing it with my sister in the backseat of the car on a drive across Greece with my parents. “Dynamite”, which was sort of a theme song of our wedding reception, played on the radio the way to one doctor’s appointment, and I had to laugh out loud that I considered a cheesy disco tune to be a message from on high. I saw a big rainbow en route to my pre-op blood typing. And every time Amalía chuckles her vaguely evil little chuckle I think it’s a promise that I’ve got a lot more of those coming to me.

Because after the initial appointment when I learned I need surgery, I rushed home to relieve the babysitter, who was already late for her next appointment, since what was supposed to be a routine doctor’s visit took so long. Then I wheeled Amalía’s stroller down to the beach to show her the ocean and to promise that there’ so much more we’re going to discover together in the future, and she laughed to show she understood what I was trying to tell her.

Writing Your Own Obituary?

You probably saw, as I did, the obituary of Seattle author Jane Catharine Lotter, who died of cancer on July 18 at the age of 60.  When her obituary was published on July 28 in the Seattle Times, it quickly went viral, presumably because it was so eloquent, witty, wise and moving, and because she wrote it herself.

 Jane had written a weekly humor column called “Jane Explains” as well as a comic novel “The Bette Davis Club”.  A number of journalists and bloggers discussed Jane’s unusual obituary, most of them quoting the first sentence: “One of the few advantages of dying from Grade 3, Stage IIIC endometrial cancer…is that you have time to write your own obituary.”

I printed out and saved it, because I’ve always intended to write my own obituary, (my kids asked me to—I guess so THEY wouldn’t have to do it) and since I’m now 72, that’s on my “To Do Sometime” list.  But I never, until now, considered writing it in the first person, like a letter.

Here is my favorite part of Jane’s obit, near the end: 

“Bobby M., I love you up to the sky.  Thank you for all the laughter and the love and for standing by me at the end.  Tessa and Riley, I love you so much, and I’m so proud of you.  I wish you such good things.  May you, every day, connect with the brilliance of your own spirit.  And may you always remember that obstacles in the path are not obstacles, they ARE the path.

“I believe we are each of us connected to every person and everything on this Earth, that we are in fact one divine organism having an infinite spiritual existence.  Of course, we may not always comprehend that.  And really, that’s a discussion for another time.  So let’s cut to the chase.

“I was given the gift of life, and now I have to give it back.  This is hard. But I was a lucky woman, who led a lucky existence, and for this I am grateful.  I first got sick in January 2010.  When the cancer recurred last year and was terminal, I decided to be joyful about having had a full life, rather than sad about having to die.  Amazingly, this outlook worked for me.  (Well, you know, most of the time.) Meditation and the study of Buddhist philosophy also helped me accept what I could not change. At any rate, I am at peace.  And on that upbeat note, I take my mortal leave of this rollicking, revolving world—this sun, that moon, that walk around Green Lake, that stroll through the Pike Place Market, the memory of a child’s hand in mine.”

No wonder that obituary went viral, I thought, Jane Catherine Lotter was a brilliant writer. 

Then, yesterday, I was reading old newspapers because I had been out of the country during July, and in the weekly “Grafton News”, published in my tiny New England village, I found another obituary written in the first person—this one by a  nurse named Laura Jean Bassett Toomey Whiting, who also died of cancer at age 60 and wrote an obituary that was as eloquent and moving as Jane Lotter’s.  (The obit was also printed in the Worcester Telegram & Gazette.)  To my amazement, Laura died on July 19-- one day after Jane Lotter-- so her obit couldn’t have been inspired by Jane’s, as I first assumed. Both the obituaries were published in late July.

Unlike Jane, Laura Whiting did not say she was at peace with dying: 

“It is with great sadness that I leave you…Although my cancer is incompatible with life, I am not prepared or ready to go. There is still so much I want to do.  I want to grow old with my best friend and husband, Larry…I want to watch my children and grandchildren grow up…But I am so happy to have lived to help plan my daughter’s wedding on July 20, 2013 [the day after Laura died—and they did go through with it.] I am amazed that my desire to participate in this wonderful celebration somehow gave me the strength to do so.”

Laura writes that, in 1970, when she was in nursing school, she contracted  Hodgkin’s Disease but was cured.

“Being cured of cancer also allowed me my greatest achievement:  to have five beautiful, wonderful and healthy children.”

At the end, having  recounted her life, Laura says: “I am a 43-year survivor of cancer, not a victim.  Despite the fact that I again have cancer, my long survival is miraculous.  Cancer certainly challenges a person, their family and their friends…but it also gives us a chance to think about what is important…It allows you to say ‘I love you’ to a wider circle of friends, and to say ‘I love you’ more often to family.  Many friends and family have gone to great effort to gather to celebrate life with me…What a gift!...Life is not measured by the number of breaths we take, but by the moments that take our breath away.  Thank you for those moments, those gifts.  I love you.

“I have chosen to donate my body to the University of Massachusetts Medical School in recognition of the importance of studying the human body in the education of medical students, with the expectation that they will use what they learn from me to help relieve human suffering.”

Reading Laura’s obituary inspired many Massachusetts readers who did not know her to sign into her on-line guest book, saying what a remarkable woman she must have been.  And here is a comment from Joyce Leoleis, who did know her:

“I am lucky to be one of the Memorial Hospital screeners who got to see and enjoy Laura almost every day... Her incredible approach to life, both before and during her illness, will always be an inspiration to us all. A wise woman once told me that a mother’s job when her children are young is to teach them how to live. When they are older, a mother’s job is to teach her children how to die. Laura did both with a quiet dignity and grace that will never be forgotten.”

I’ve added Laura’s obituary to my file of inspiration for the day when I sit down to write my own obituary—a task I have to stop putting off.