The Victoria's Secret Catalog Never Stops Coming: And Other Lessons I Learned from Breast Cancer

Book by Nash Jennie

Lesson #1:

Survival Is a Matter of Instinct

You know your body better than anyone else. If you think you have cancer or you dream you have cancer or you have a nagging, persistent belief that the cancer you conquered has recurred, then keep pushing for answers until you're sure, one way or the other. Even if you have a long history of being a hysterical hypochondriac, trust your instincts. Finding cancer early saves lives, and it's just about the only really sure thing that does.

I imagined I had cancer before I knew I had it. The idea of it crept into my consciousness like a song that I couldn't stop singing -- a melody I couldn't remember ever learning, but whose particular sound was stuck in my head all the same, insisting on being heard.

The first faint notes came from a local news report in my hometown of Santa Barbara, California, and though I now live a hundred miles to the south, the flurry of phone calls that followed -- "Did you hear?" "Have you talked to her?" -- obliterated the barriers of distance: Lisa, a dear friend from high school, had been diagnosed with advanced metastatic lung cancer. This was news in that town because Lisa was the daughter of the city's congresswoman who had won her husband's seat after his sudden, midterm death from a heart attack two years before. It was both awful and amazing, like learning that lightning had struck in the same place twice. I immediately picked up the phone and called Lisa, hoping that the reports were wrong, hoping that it was a terrible rumor, hoping -- uncharitably -- that maybe they'd gotten the name wrong and it was Lisa's little sister or brother who was ill.

Nathan, Lisa's husband, answered the phone -- and I pictured him stationed there in the living room of their Berkeley home, stoic and generous, rising to the occasion of a phone ringing off the hook. I didn't know Nathan well, but I recalled how he had pursued Lisa in college, convinced that she was the woman he was destined to marry, and how Lisa had hemmed and hawed, concerned with the philosophical questions of how you could decide on one person to share your life, and how you could know when you'd found him. It seemed a laughable debate, when Lisa finally brought Nathan home: she was a very tall, very blond, very blue-eyed woman with a happy, open face, and Nathan looked like a carbon copy who had been designed for the express purpose of being her life's mate.

He told me the same thing he told all the other stunned callers who dialed their house in Berkeley that night: "It's true. We just found out. She'll call when we know more."

At Santa Barbara High School in the mid-1980s, Lisa was a homecoming princess, a nationally competitive long-distance swimmer, valedictorian of our class, my neighbor, and the first person I had ever met who recognized, understood, applauded, and shared my ambitious nature. She was a smart girl who prided herself on her smartness and for that alone I would have loved her because it gave me the confidence to feel proud, too. We took the exact same schedule of advanced placement courses and pushed and prodded each other to achieve the grand ambitions we both nurtured like pearls. At the time, we weren't sure exactly what those ambitions were or where they might take us; we only felt the fierceness of the desire to do something or be someone, and that desire brought us together -- sometimes in unexpected ways and places.

The summer after our junior year, I went to England for an immersion course in Shakespeare's plays. I was thrilled about the adventure but homesick from the moment I stepped on the plane in Los Angeles. I was the youngest student on the trip by five years -- the only high school student -- and I not only felt scared of the intellectual challenge, I felt scared of the reality of being in a foreign country with a group of strangers. We had two days in London before going out to Stratford, where we would be studying. On one of those days, we went to visit St. Paul's Cathedral. I was sitting in one of the pews, staring up at the dome and listening to the hushed sounds of a throng of people trying to be silent, when I heard someone say my name -- too loudly. I snapped around to see Lisa, standing there in the aisle, towering above the crowd.

I sprang up to hug her. "What are you doing here?" I demanded, thinking she had somehow come to give me a message or bring me something I'd forgotten to pack.

"My dad just decided to come," she explained. I looked over her shoulder at her dad, as if his presence would confirm the fact of her being there.

"But how did you know I would be here?" I pressed, thinking that somehow my mother -- a travel agent -- had passed along some inside information.

"I had no idea you'd be here," Lisa explained, laughing. "I pictured you watching A Winter's Tale in some dark old theater in Stratford."

"That's Wednesday," I said, feeling excited again about doing what I'd come to England to do.

During the winter months of our last year in high school, Lisa and I would race off campus at lunchtime in her red convertible VW Bug to search our mailboxes for college acceptance letters. Lisa got more than I did, but we both eventually settled on colleges we were sure would help us shape and launch our dreams. She ended up at Stanford and I went east to Wellesley, three thousand miles away.

After college, we each married and we each had two children -- boys for Lisa, girls for me. We lived near each other for short periods of time in New York and then in Los Angeles, but our friendship didn't become a relationship about our kids and husbands. It remained a private encouragement society. Lisa encouraged me to keep writing what I wanted to write rather than what other people wanted me to write, and I encouraged her to stay true to herself and her own ideas as she made her way through the maze of academia. She was working toward a degree in narrative psychology and quietly doing innovative and award-winning work that brought together elements of linguistics and psychology. She was interested in the way that people with various mental disorders tell stories about themselves, why they tell them, and what they mean.

During her third winter as an assistant professor of psychology at Berkeley, Lisa caught a cough that wouldn't go away. Instead of being told she had strep throat or bronchitis or pneumonia like so many other people going into the cold season, she was told she had lung cancer and that it had already invaded the bones in her spine. No one ever talked about how long she had to live, or even whether she would live, but no one had to. Metastatic lung cancer, even in an otherwise healthy thirty-five-year-old woman, is a staggeringly virulent disease.

I wanted to fly to Berkeley immediately to do something to help -- but everyone wanted to fly to Berkeley to do something to help and there wasn't room for us all, either at the house or in Lisa's illness. Lisa's mom would be there as Lisa started her chemo, her sister would follow, and Lisa and Nathan had a network of devoted and generous friends who knew their two boys, knew the routines of their days, and knew what was needed to help. "Don't come," Lisa said. "It's too overwhelming right now." I was just an out-of-town high school friend who wasn't needed at the center of the crisis. I felt helpless and stung, and I did the only things I felt I could: I worried; I talked constantly with everyone I knew who knew her; I mailed her cards and letters, quotes, and stories; and I bought her a hat.

Lisa expected to lose her hair immediately from the chemo and she'd decided not to wear a wig. She'd gone out with her mother to look at them but couldn't bring herself to buy one or wear one. I imagined I would have done the same. I scoured the stores for hats that looked soft and wearable, and found a cotton hat in a watery blue batik print that looked exactly like the kind of thing Lisa would wear. Blue, to match her eyes. Bright, to match her spirit. Not too fussy or prissy. I felt pleased with myself as I wrapped the hat in tissue paper and sealed it in a padded envelope, but as soon as I mailed the package, I realized how small my efforts were. They didn't do anything meaningful to help Lisa heal, and they didn't do anything to alleviate my fear for my friend.

I bolted awake in the middle of the night with my brain spinning, imagining what it must be like to have lung cancer. I pictured Lisa's breath moving slowly in and out of her lungs as she lay awake at night picturing the mutant cells that wouldn't accept the message to stop reproducing. I could hear David, her five-year-old son, coming up to her and saying something innocent -- "I can get you a Band-Aid for your cancer, Mom" -- and the tears that would spring to her eyes as she had to either lie and thank him or tell the truth and shatter him. I pictured her husband looking at her with an expression that couldn't possibly hide how scared he was that she would die and leave him alone with a house, two boys, and a life that was meant to be shared.

I got so good at imagining the dread of the disease that after only a few nights I decided that it must not be my imagination at all. I decided that I, too, must have cancer. I'd had a small tightness in a vague place on the left side of my chest, and for months I'd thought of it as a pulled muscle or mild recurrent heartburn. I was now convinced that it was a mass of insatiable cancer cells marching through my breast.

Cancer works well as an imagined illness because it generally has no discernible cause. Unless you work in an asbestos plant or smoke two packs of cigarettes a day, you can't ever really say why cancer turns up in your body. It could be the hormones in the milk, the pesticides on the fruit, the smog in the air, the stress in our lives, or that nitrate-filled bologna sandwich you had for lunch every single day from kindergarten through sixth grade. It might have to do with how early you got your period, how late you had your children, how little you nursed them, how much you depended on birth control pills -- or all of the above. Anyone could get cancer, for any of those reasons or for none of them, so why not me? What if me?

I'm not a hypochondriac in the usual sense of the word. I don't imagine myself actually plagued with horrible disease, complete with real or even imaginary symptoms. I come, in fact, from unusually healthy stock: in my family, no one gets sick and they live so long, they don't so much die as wither and decay. My feared diseases are always hypothetical, things that might happen sometime out there in the void of the future. They're the mental exercises of someone who's read hundreds of books about things that fall apart, of someone who was a child of divorce and learned early that nothing stays whole forever. Other than visits related to pregnancy and childbirth, I'd been to the doctor exactly three times in the last ten years.

Still, as I stepped into my family practitioner's office, I was aware that my story sounded paranoid: I had a sore spot on my breast that got more pronounced when my friend found out she had lung cancer and I realized there was nothing I could do to help. I put on the paper gown, sat on the table, and entertained thoughts of slipping back into my clothes and sneaking out the door. The only thing that kept me in place was a poster on the wall next to the examining table. It was an illustration of the lungs, showing one red healthy lung and one gray cancerous lung. It was a detailed, four-color blowup of Lisa's exact disease.

When the doctor showed up with my chart in her hand and asked what the trouble was, I explained about the sore spot and quickly added that there was also this thing about my friend who was just my age, with two kids just like mine, who'd gone in with a cough and come out with cancer. My doctor listened, nodded, and did a breast exam. "There's nothing here," she said, creasing her forehead and shaking her head. "I think it's just a sore rib, but to make yourself feel better, why don't you go get a mammogram?"

I could have gone home and forgotten about it, convinced that I'd followed my paranoia to its furthest practical end. Most women don't get their first mammogram until they're forty. Many HMOs would prefer that we not get into the habit until we're fifty, when our breasts aren't as dense and our odds of getting a clean bill of health aren't as good. But Lisa had already proven to me that cancer knows no age limits, and I was eager to clean the slate of my imagination. A week later I stood half naked in a cold room and had a technician with cold hands squeeze my breasts between the cold plates of a cold machine and tell me not to breathe. She stepped behind a shield, produced a sound similar to the one made by Darth Vader's light saber, then told me to tie up my gown and wait while she showed my films to the radiologist.

I waited in the examining room, thinking of Lisa. She had sat in a room just like this, waiting to hear the results of a test just like mine, and someone had walked in and said the word cancer. What would it be like to hear news like that? How had she felt? How would I feel? I decided that it would be easy to be shocked but hard to be surprised; after all, I was sitting in a medical facility whose entire purpose for being was to find cancer in women's breasts. It wasn't as if they were going to come back and tell me there was something wrong with my big toe. They were either going to find cancer or they weren't. I was either going to continue to be a witness to my friend's struggle to live -- a worried outsider with my nose pressed against the glass -- or I was going to join her struggle in the most personal and perilous way possible. I thought these thoughts, but I didn't for one second believe that anyone was actually going to walk back into the room and announce that there was something wrong.

When the radiologist came back, she confirmed what my doctor had determined: that there was nothing but healthy breast tissue in the place I was complaining about. I nodded, easily convinced. She went on to point out, however, that there were tiny calcifications in my other breast that she wanted to keep an eye on. "Lots of women have them," she explained, as if we were talking about oily skin or cellulite, "and ninety percent of the time they don't mean a thing, especially in someone your age. Come back in six months and we'll check them again."

Sure, no problem, we'll check them again, I thought. As far as I was concerned, what I had feared had not occurred. I hadn't imagined anything wrong anywhere else in my body besides my left breast, and since there was nothing there, I relaxed the grip of my imagination. No more dreams of disease woke me in the middle of the night.

For the next six months, Lisa continued to battle cancer. She didn't like to talk about her treatments or their side effects or her future; whenever we talked, she always wanted to know how my kids were doing or how my work was going, so I told self-conscious anecdotes about Emily's swimming lessons, Carlyn's spelling tests, and the mysterious error messages I was getting from my hard drive. I pieced together the story of her illness from conversations with friends in New York, San Francisco, Washington, and Santa Barbara. We pooled our knowledge -- she told me this, she told me that, so-and-so's mother ran into Lisa's mother who said such-and-such about her prognosis. Lisa's cancer was inoperable. She had two courses of high-dose chemotherapy to try to halt the tumor in her lungs and spine. She used yoga, meditation, visualization, and acupuncture to try to turn the considerable power of her brain again...