IT'S PROBABLY NOTHING

But that doesn't mean that there's nothing there

Last Friday I went to UCSF to check out a 2.5cm firm mobile lump 7cm from my nipple at 11 o'clock. It’s fine, it’s nothing, I knew it was nothing. But I got really sick in April and the beginning of May and then I got some weird bruises on my eyelids and then I felt a blob below my armpit on the right hand side so I went to One Medical to see a nurse practitioner who asked why I had made the appointment. She was not worried about the dark spots on my eyelids, which she said were not bruises, but when she felt my right breast she said right away:

“I feel that.” 

Her recommendation was that I go to UCSF for a diagnostic mammogram and the whole story just fell out of my mouth.

I went through this in 2021, I told her, and I left without clarity and bill for $700 which was my portion (10%) of three diagnostic tests including a thin needle biopsy which I felt was intrusive and unnecessary. It’s hard to write about the details but let’s just say there was moment where I went into the bathroom and cried after the needle had gone under my skin and dug around in the flesh.

**

“I think we can just keep an eye on that,” the admitting student had said after she felt what I had felt on the day of the biopsy. “But if you’re comfortable I’ll ask the doctor to come in and take a look.” I had been relieved to hear her say it and I agreed, but somehow I also took on her deference.

“Sure,” I said, consenting in both writing and speech.

When he arrived he took over, feeling the lump with his hands and going right for the needle. 

“How will you be sure you can get a good sample?” I had asked, “because the firm lump is so small.”

“Experience,” he had said, I shit you not.

“Well, we got two out of the three kinds of tissue we need for the sample,” he had said, after he took the sample, his face still in the microscope.

“That’s exactly what I was asking you about,” I said.

“Well, do you want me to go in again?” he asked, as if it had been my fault he had not been able to do his job with accuracy. 

“No, I do not,” I said. That’s when I went into the bathroom and cried.

“I’m going to note this as fatty tissue,” the doctor said when I returned. 

I contested the bill in writing. I got billed anyway. I never really knew if the biopsy had been as conclusive as the doctor had reported. And that was the end of that. 

**

I felt my own self-judgment as I told the nurse practitioner the whole story, which, after all, landed with the best possible news one could ask for after a thin needle biopsy. And yet I was very sure that I did not want a repeat performance.

We talked it all through and decided that there wasn’t any way to predict whether a thin needle biopsy would be suggested again this time and that because UCSF was a teaching facility it really was the best place to go. She made a referral for the diagnostic mammogram and off I went to schedule it, pausing only to text a friend who had just gone through something similar. In the chat I said I wanted a second opinion but that I didn’t even know who to ask.

I thought for a moment. When I had been sick in April I had gone to One Medical a number of times, taken all the medicines and gotten more and more sick. During that time I went to an acupuncturist and took a vial of Chinese herbs twice a day for three-five days, twice over, and this is how I got what I needed to heal. I don’t really know what else to say about this except for that that is what happened. I don’t think I should be relying only on eastern medicine when I have questions about my health. I do know that every single general nurse practitioner and MD were not at all phased when I couldn’t stop coughing every night between 6pm-9pm for six weeks straight and no one asked how dark things had gotten when 5pm rolled around. 

So I wrote the acupuncturist for a second option and she said that of course she would not recommend acupuncture for a lump, as she expected that I knew, but that I might press for a breast MRI if I knew I had dense breast tissue and so I sent word to the nurse practitioner asking what she thought of that option.

DING DING DING!!! THIS QUESTION HIT THE JACKPOT. Not that I ended up with a breast MRI but this inquiry scaled down my appointment at UCSF from a diagnostic mammogram to a consultation, which I hadn’t even realized was an option. Basically, I just had to enter the building again in order to pay a $30 co-pay to talk to the leading experts in the field of breast cancer in order to make my own decision from there.

It was harder than I expected to enter the building. I had resentments, which I knew were unfair given my own passivity but also my own shame about feeling alienated from my body. I was embarrassed to say I didn’t know how to give myself a breast exam or what was I looking for? And also I was embarrassed that I felt confused. Most people are fine with getting their annual mammogram and letting that be that but I wanted more for myself. I wanted to have a relationship with my body that made sense and was not only mediated by technology and then translated by an expert in that technology. It’s not that I didn’t want conventional medical help, it’s just that I wanted a different kind of help first.

to be continued