I have, since my diagnosis, believed that I am now officially unshockable. I assumed that hearing the words ‘signs consistent with breast cancer’ – those same words that came so out of the blue that they ought to have been delivered by a Smurf – meant that I had maxed out on my life’s limit of surprise. I thought that, in my repertoire of reactions, astonishment was an emotion I’d never again need to convey. And I figured that I was still so taken aback by that initial shock that I would forevermore be able to anticipate any nasty surprises coming my way, and prep myself for them like a particularly terrifying job interview.
I was wrong.
Because just as I was getting used to the novelty of not thinking about cancer all the damn time; just as I was happily filing my nails while leaning against my goalpost, The Bullshit pulled one back. And as I blithely stared at my cuticles, only casually aware of the game being played before me, The Bullshit produced the goal of the season: a screamer from way back inside its own half that thundered past me like a bullet from a gun before I'd even had a chance to reach out my hand to stop it.
Last Friday afternoon, I left work early to head to a hospital appointment. An appointment so non-event-ish, I assumed, that I even told P not to bother coming with me. It was for one of the many studies and clinical trials I’ve put my name to, this time about genetics in occurrences of breast cancer in younger women. It’s enabled the folk in that department to have access to my medical file, to run tests on my blood samples, and to map out my family tree and ancestral cancer history, minuscule though it is. And it’s been pretty interesting, as these studies often are.
To say I had the Friday Feeling would be playing it down somewhat. Not only was it payday, but payday at the end of my least favourite month of the year, and as I turned the corner to the hospital, I chirpily swung the French Connection bag that housed my lunchime payday-purchase: a cheery floral skirt that marked the official opening of my spring wardrobe.
‘Ooh, have you been shopping? Let’s see,’ said my consultant geneticist (let’s call her the Gene Genie, given that she’ll doubtless be making a more regular appearance on this blog).
This, I now realise, was as big a hint as any that the appointment wasn’t going to be quite the non-event I’d anticipated. Because, when medical staff start commenting on your clothes – like the nurse who gushed about my scuffed red shoes minutes prior to my diagnosis – you know that something’s up.
‘So I saw you with your husband last time, yes?’ she asked.
‘Yeah, but he’s at work this afternoon,’ I said. ‘He works in sales and it’s the last day of the sales month so it’s important that he’s around in the office to make sure all the targets are getting hit.’ (I always give people way more information than they need to hear.)
‘Oh-kayy,’ she said, ominously. ‘So, has anything changed since the last time I saw you?’
‘It has, actually. My auntie; that one there,’ I replied, pointing to a circle beside the square that represented my Dad on our family tree. ‘She’s been diagnosed with breast cancer. Just a couple of weeks ago. She’s had a mastectomy and she’ll be going back for further histology results next week.’
The Gene Genie coloured in half of my auntie’s circle with her biro. ‘Ahaa. That’s very interesting,’ she said.
‘It is isn’t it?’ I interrupted. ‘And weird, right? No occurrence of breast cancer in this whole family tree until me and now my auntie too? It’s one hell of a coincidence.’ There I went again, talking too much.
‘Well actually,’ she added, producing a piece of paper that looked like a form you’d read your A-level results from. ‘It’s interesting in light of what we’ve discovered from your blood tests.’
‘Now this will undoubtedly come as a shock – it certainly did for us – but we’ve discovered that you are, in fact, carrying the breast cancer gene.’
I looked from the results slip to the treatment bed opposite. The head of the bed was at a 45-degree angle. I had an urge to straighten it.
‘But last time we concluded that I definitely wouldn’t have the gene,’ I protested, convinced she’d got it wrong.
‘Well, given the lack of family history, none of us could have expected this. We even tested it three times. And this, I must say, is an incredibly unusual way round for the gene to present itself.’
‘You’re not kidding,’ I huffed.
‘I know it must be a huge shock,’ she said again. ‘And, like most people, I expect your first instinct will be to think about survival.’
I didn’t tell her that my first instinct had been to obsessive-compulsively straighten her treatment bed.
And that’s where the dialogue ends. Because, as one tends to do in these situations, I didn’t take it all in. I know she told me that the gene I have is called BRCA-2, and that it relates to oestrogen-receptive cancers. I know she talked about my greatly increased chance of a breast-cancer recurrence (as much as 80%, according to this website). I know she suggested making swift appointments with the necessary experts to talk about my preventative-surgery options. And I know she talked me through every member of my family, how they could get tested and what it meant for them, given the assumption that the faulty gene has come from Dad’s side. But more than that, I can’t remember exactly what was said in our 90-minute appointment, because all I could think was: ‘So that’s it, then. That’s why I got cancer.’
To shamelessly plagiarise my old man’s analogy, it felt like someone had shoved a firecracker between my ears. All the thoughts about what this meant – for me, for my family, for P, for the narrative of my book, for my remaining natural tit, for my ovaries, for my uterus, for my sex life, for my body image, for my life expectancy – fizzed inside my head in a mess I couldn’t control. I tried to grab each one and pocket it into a corner like a game of Hungry Hippos, but I couldn’t decide which problem to deal with first. Because the one thought that continually ushered them all out of the way was: ‘So that’s why I got cancer.’
You might imagine that there was some relief to be had in hearing that – and for my family, I think, there has been – but I now realise that there was a huge part of me that appreciated the randomness of my diagnosis. There was a weird safety in its freak nature, like being hit by a bus or struck by lightning. Because, really, how often does that happen to a person twice?
But now, there was a reason. And not just a reason, but a large, looming threat to spend the rest of my life living beneath, with the potential to define me in a way that I constantly try so fucking hard to avoid. I don’t want to spend my life battling cancer. I want to be shut of the motherfucker. (Eh up, the fucks are back.) I want it to piss right off and just be a quirky little story I can tell people in the future, the way that Winona Ryder might talk about her shoplifting or Stephen Fry might talk about his prison sentence. I want to be defined as happy Lisa; as lucky Lisa; as Lisa the wife; as Lisa the friend; as Lisa the writer – oh, how I want to be defined as Lisa the writer – and not as Lisa the cancer patient, or Lisa the one who everybody has to worry about. I’ve had my fill of being on the receiving end of people’s worry. And if they really must worry, then let them worry about me eating too many Curly Wurlys or not selling enough books or not knowing when to stop with cava – not about when The Bullshit may strike again.
I know that discovering that you’re carrying the BRCA gene isn’t a cancer diagnosis. (I suppose it’s more like a cancer consultation-period.) And I know that there are good things to come from knowing what I now do, like the favour it’s done my family and the opportunity for me to lower those heightened recurrence chances. But there are undoubtedly similarities between the two, as well. The process of feelings you go through – shock, terror, upset, anger, practicality – remind you of when you were diagnosed. Your family and friends’ reactions remind you of when you were diagnosed. And the seriousness with which people speak to you reminds you of when you were diagnosed.
So there we go. That’s the reason I got breast cancer. And, thanks to that reason, there’s a hell of a lot of information that I’ve got to spend the next few months getting my head around. There are experts to speak to; tests to have; decisions to make. But first, I think, I just need to get over the shock of being shocked. And once that shock has subsided, I’ve got to learn to live with a lot of uncertainties. But there’s one thing I know for sure: The Bullshit ain’t over.