Wednesday, 31 March 2010

Geek like me.

‘I have NEVER seen you like that,’ huffed P as we pulled away from the hospital following our last appointment with Smiley Surgeon.
‘You haaaave,’ I chirped confidently. (A rather misplaced confidence, given the masterclass in goondom I’d just performed in my surgeon’s office.)
‘Why do you go all high-pitched?’ he quizzed, now mimicking my tone. ‘You’re all “Hi! I’m Lisa Lynch! I’m friendly and cheerful! Please love me!” And all in that weird voice you do.’
‘Fuck off,’ I spat, in an altogether lower octave.
‘Seriously though, babe, you’re a proper goof.’
‘I can’t help it!’ I squealed. ‘Honestly! I sit in that waiting room giving myself little pep-talks before every appointment. “Don’t do it this time, Lis. Play it cool, Lis. Act normal, Lis.” But when I get in there it all turns to shit. I literally have no control over it. It’s chemical.’
P continued to skit me. ‘And all that stuff about The Curly Professor. “Ooh, and he told me to pass on his regards, and to tell you that you’ve done a really excellent job!” I mean, come on, woman.’
‘But he did say that!’ I protested.
‘I know he did. But it’s the way you say it. You’re such a massive fucking suck-up.’
‘Oh, just… sod off,’ I sulked, as P near pissed himself laughing.

At the risk of making excuses for myself when I ought to be waving a giant white flag, I do think that there was a bloody good reason for my added goondom this time. A couple of bloody good reasons, in fact.

For one, Smiley Surgeon didn’t just agree with The Curly Professor’s prophylactic-mastectomy-and-oophorectomy advice, but went one – nay, two – better by suggesting that they could both be done this autumn (this autumn!) and – crucially – at the same time (the same time!). And after hearing that, of course, I damn near crawled across his desk and hugged the glasses clean off his face.

My second goon-excuse, though, is that this was the appointment during which I was to give Smiley Surgeon – as I’d promised the last time I saw him – an early copy of my book. (Which, by the way, is out in two weeks and available to pre-order from all good online retailers. *double thumbs up*) And so, despite the gravity of the stuff we were talking about in our consultation, the high-pitched voice in my head persisted in reminding me about the gift I had to give him all the way through our session.

‘You mustn’t forget the book!’ the voice chided as Smiley Surgeon examined my bothersome boobs.
‘But don’t make a massive deal of it!’ it pestered as he declared that he’d be able to preserve my right nipple. (Preserve my nipple! Actually, make that goon-excuse #3.)
‘And don’t mention that he’s in it!’ it nagged as he made me aware of the small yet positive impact that preventative surgery could have on my life expectancy.
‘Just slide it across the desk and be outta here!’ it teased as he promised to refer me to a gynaecological surgeon to discuss the details of my oophorectomy.

And then it was my turn.
‘So does that answer all your questions?’ Smiley Surgeon asked after talking me through everything I needed to know.
‘I think so, yep,’ I said, doing what I could to talk above my inner voice. ‘So I guess I’ll have my MRI done and then come back to you for the mammogram in June, and then if all the scans are clear I s’pose we can crack on.’ (I actually said ‘crack on’. Like we were talking about a haircut, and not the removal of my ladybits.)
‘Indeed,’ he said.
‘Cool,’ I said.
‘So if that’s it, then…’ Smiley Surgeon concluded, pushing himself up from the arms of his chair.
‘Actually, um... there is one more thing,’ I stuttered, getting squeakier with every syllable. ‘Remember how I told you about my book?’
‘Oh yes! Have you got it?’ he asked, enthusiastically.
‘Well, this is your copy,’ I said, sliding it across the desk as the voice had advised.
‘Brilliant!’ he exclaimed, turning it over to look at the back cover. ‘Brilliant! And a quote from The Telegraph! That’s very prestigious!’
‘Oh heck, don’t get your hopes up,’ I goofed, as he continued to read the blurb.

It was at this point that I suddenly remembered the horribly soppy message I’d written inside the cover. Fuck – the message! ‘An acknowledgement in a book doesn’t quite cut it…’ Oh fuckshitbollocks. ‘Thank you for giving me a breast I’ve come to love every bit as much as the one I lost…’ And, oh no – double fuckshitbollocks – the massive kiss! And the heart! In pink pen! What the fuck had I done? I'll tell you what I'd done. I’d just handed the man responsible for my cancer-prevention a book in which I swear like a trooper, talk at length about my bowel movements, and reveal that I’m a little bit in love with the doctors who’ve treated me. A book in which he doesn’t even know he’s a major character. A major character with a pet name, ferfuckssake.

‘Abort mission! Abort mission!’ screamed the voice in my head. ‘Pick up your bag! Leave the building! Get the fuck out! NOW!’ Panicked adrenaline forced me out of my seat and into my jacket in a single flinch.

Smiley Surgeon continued to hold up my book’s cover at his eye level, and proudly turned it around to show the trainee surgeon who’d been observing our appointment. I’d barely even noticed she was there.
‘This is amazing, Lisa,’ he said, taking his smiley moniker to new levels.
I shrugged and blushed simultaneously, as P made a gesture that suggested we ought to be leaving.
‘It’s great that you’ve turned all of this into something so positive,’ Smiley Surgeon went on. Which, of course, made me blush even more.
‘Pahh,’ I burbled, maniacally waving a hand in front of my face in the hope of passing off my reddening cheeks as a hot flush.
‘My, you are determined,’ he said, bringing our meeting to a close as I sheepishly skulked out of the room.
‘Yup,’ said the voice in my head. ‘You’re determined, all right. Determined to make yourself look like the right tit he’s going to remove.’

Tuesday, 23 March 2010

My way.

The no-kids clause isn’t something I wanted to write about again, given that me and P are so over it that it’s almost a non-issue. But something that happened at the hospital last week has had the pair of us thinking about it again – not in terms of the way we’ve chosen to handle it, but the way in which others do.

First, then, I’d better clear up the stuff in the background, point one of which is last week’s appointment with (old-time blog favourite) The Curly Professor – who, until Friday, I hadn’t seen since my diagnosis. (And whether it’s relevant to you or not, I feel compelled to reveal that, in the waiting room prior to our appointment, P and I were flicking through the hospital magazine, only to discover that The Curly Professor has won an international award for pioneering breast-cancer research. Just sayin’.)

‘Lovely to see you again!’ he said, extending his hand for us to shake. ‘And good that it’s under rather different circumstances this time, eh?’
‘Hell yeah,’ I concurred.
He took a seat on the treatment bed, legs crossed casually and back leaning against the wall, as he introduced us to the visiting junior assistant (and for those of you who’ve been here a while – yes, another glamorous one) who, if it was okay with us, would be observing our appointment. The Curly Professor, I’ve come to realise, always has a glamorous assistant. Much like a magician. (And for my next trick, I will make this tumour disappear!) And so The Lovely Debbie McGee sat on a chair beside him, smiled and, well, observed.

‘So, let me have a look at you, then,’ he said, washing his hands as I whipped off my dress. (I’ve never asked him, but I imagine this part never gets any less surreal for P.) I lay back on the bed, wishing I’d worn different leggings than the ones with a hole in the waistband.
‘Right then,’ said TCP, clapping his hands together as he approached me from the other side of the room. ‘And which one is it?’
HA! WHICH ONE IS IT! He couldn’t tell! ‘Smiley Surgeon’s going to LOVE this,’ I thought. The Curly Professor clearly read my mind.
‘Remind me who did your surgery?’ he asked, leaning closer as he examined me.
Thankfully my professor’s real name – and not the blog name I’ve given him – left my mouth.
‘And when are you seeing him next?’
‘Tuesday.’
‘Well do send him my regards,’ he said, moving from my fake to my real tit. ‘And you tell him from me that this is really excellent work.’
‘Mm,’ I hummed, filled with pride on his behalf. ‘It is quite amazing, isn’t it?’ I don’t think I’d realised until that point just how much I’ve come to love my new tit. In fact, I love it so much that I think I’m going to write just that inside the cover of the book I’ll be giving Smiley Surgeon this afternoon. (Perhaps I’ll also wrap it up in police-caution tape: WARNING: SUCK-UP ALERT!)

The rest of the appointment was filled with statistics and home-truths and new terminology and recommendations, so I’ll save you a further 40 minutes’ worth of dialogue and just give you the headlines instead.

BONG!
It turns out that, thanks to my hibernating ovaries, I have the beginnings of osteoporosis. So I need to go on a new weekly drug to ensure dem bones don’t get any worse.
BONG!
Now that we know about The Bullshit Gene, I’m back under the hospital microscope, and will be checked roughly every six weeks. I can’t tell you what an enormous reassurance that is.
BONG!
The solution to The Gene Problem isn’t going to be a quick-fix, but more of a long-term project that sees us through the next two to three years.
BONG!
As I’d expected, The Curly Professor recommended another mastectomy. Having it done would significantly reduce my now-heightened risk of having to put up my fists for another round with The Bullshit. So long, right tit.
BONG!
Before that can be done, however, we’ve got to carefully investigate what’s going on beneath my pesky puppies at the moment as – now we know that I’m carrying the BRCA-2 gene – the most immediate risk right now is a recurrence of cancer in the little tissue that’s left in my left breast. So, next step: breast MRI, then another mammogram.
BONG!
Of course, we’ve got to prepare for there being a residual problem, but for now let’s assume there’s nothing to worry about. In which case, we’ll plan to have the mastectomy done within eight months to a year.
BONG!
After much discussion about mine and P’s insistence that we’d NEVER (yes, in capital letters) be prepared to take the risk of trying to get pregnant (given that pregnancy = oestrogen and oestrogen = potential kryptonite), The Curly Professor also suggested an oophorectomy – but not yet. That’s something that will come much later – probably not even for another 18 months – but that would undoubtedly help matters, what with BRCA-2 being responsible for oestrogen-receptive cancers in both the breasts and the ovaries.

Which brings me back – albeit in the least cohesive way possible – to my original point, and how other people respond to mine and P’s handling of the no-kids issue.
‘Obviously an oophorectomy is non-reversible…’ said The Curly Professor.
‘We know that,’ I nodded, in tandem with my husband.
‘And you are absolutely certain that you’d never want to attempt to get pregnant?’
‘Absolutely. We’re definitely not doing it. Definitely not,’ I insisted. P kept nodding.
‘Right,’ he said, in that gloriously non-judgmental way that I adore about top medical professionals.
‘Besides, I’m almost certainly menopausal so it’s doubtless off the cards anyway,’ I added.
‘Ah, of course, yes.’
‘I must say, it’s unusual that you’re so adamant,’ he said. ‘Most women aren’t so sure.’
‘I’m not most women,’ I asserted.
‘I can see that,’ he said with a smile. ‘You know, you really are dealing with all of this incredibly well. And after everything that’s been thrown at you...’
‘Well, you just get on with it, don’t you?’ (That’s my stock answer whenever anyone tells me how well I’m handling things.)
‘I suppose you do,’ he said. ‘And so, then, I’d have a think about having the oophorectomy. But there’s no rush to decide, obviously. Don’t you agree?’ he asked of The Lovely Debbie McGee.
‘Well, no, actually,’ she said, to which the three of us blinked in surprise. ‘I wouldn’t recommend that in someone so young.’
‘Oh, why?’ asked TCP.
‘The thing is,’ she said, fixing her gaze on him in the way that your mum would whenever she wanted your dad’s backup on a telling-off, ‘Things change.’ She continued to give him that look, tilting her head down slightly and looking upwards at him with raised eyebrows.
‘Erm, I am here, you know,’ I thought, before piping up. ‘I do know what you mean by that,’ I snapped, ‘but I’m telling you THAT WILL NOT CHANGE.’
‘Absolutely not,’ concurred P. ‘No way.’
‘Well, I’m just saying,’ she said.
‘And so am I,’ I said, reddening as I spoke. ‘THAT WILL NOT CHANGE.’

‘That pissed me off,’ said P later, as we hung around waiting for test results. ‘She wasn’t looking at that from the perspective of a doctor; she was looking at it from the perspective of a woman.’
‘Precisely,’ I said.
‘It’s almost irresponsible,’ he said.
‘Not really, love,’ I conceded. ‘She can’t help seeing it that way. But it does make you realise just how amazing The Curly Professor is. He responds to us as us; not just as faceless patients. And he doesn’t just take into account what’s written in my file, but how we each react to all of this. It’s one hell of a skill.’

After I’d silenced The Lovely Debbie McGee, me, P and The Curly Professor talked a bit about that. TCP called it ‘personalised medicine.’ I call it damn good practice. Now, I don’t know how it works at medical school, but surely learning to respond to your patients in the way they will most appreciate is something that can’t be taught. Nor is it a thing they can ask you outright. (‘Okay, Mrs Lynch, so would you rather I took the no-shit approach today, or the tilted-head approach. Entirely your call.’)

And so when P and I thumped down our feet on the pregnancy issue, TCP didn’t raise an eyebrow at our decision. He just responded to it in the manner we’ve come to value so greatly: by giving us the facts. And – if you’ll allow me to state my case once and for all – for me and P, the facts are thus. Wholly aside from the fact that my almost-certain early-menopause has put paid to the idea of having children naturally anyway, even if it hadn’t we would still under no circumstances be prepared to run the risk of more oestrogen than is necessary entering my system by doing whatever it took to get pregnant. And yes, I know that no medical professional would ever say that the oestrogen from pregnancy might automatically spawn cancer cells, or even that the two failed pregnancies that P and I had prior to The Bullshit were responsible for the size and spread of my tumour. But – and here’s the clincher – we can’t ever say with 100% certainty that it didn’t exacerbate the problem. I also know that, for a lot of women, that wouldn’t be enough to put them off the idea of conceiving. (‘You can’t have kids’ and ‘having kids could be dangerous to you’ are, of course, entirely different issues.) But, like I said to The Curly Professor, I’m not most women. And so for this woman – and, it’s important to add, for her husband too – even if the risk of reawakening The Bullshit by getting pregnant is as tiny as 0.5% (0.5% with a question mark after it, even) it remains very much a no-go. It’s like my Mum said recently: ‘We don’t want anyone new – we just want you.’

It’s one helluva grey-area issue, granted. But, much like everyone has their own way of dealing with The Bullshit itself, this is our way of dealing with a Bullshit side-effect. And we’re unapologetic about that. We don’t need anyone to give us their opinion, nor do we need anyone to pass judgment or tell us how they’d do things differently. We just need people to accept the facts as we see them, and move on. Which is why we left our appointment with The Curly Professor feeling at ease, reassured and prepared for the Bullshit-Gene-battling road ahead, safe in the knowledge that we’ve got the Harry Houdini of oncology on our side.

Thursday, 18 March 2010

No apologies necessary.

I find it difficult to understand when people tell me that they ‘feel sorry’ for me. I can appreciate why they say it, of course – shit, I’d probably say the same if I met me (well, that and perhaps it’s time to curb the swearing) – but that doesn’t mean that it sits comfortably with me.

It’s a remark I heard a lot in the immediate time after my diagnosis. But back then, I tended to agree with whoever said it. Hell, I kinda felt sorry for myself, too. Now, though, in the wake of The Gene News, it’s been a sentence I’ve started to hear more frequently again. But this time around, hearing it said just feels plain weird. Because the thing is, I don’t feel sorry for myself at all. Quietly pissed off, maybe, and perhaps a little frightened, but definitely not sorry for myself. Because, meh, it is what it is. And the best thing I can do is just get on with it.

Tomorrow afternoon sees the first of what I’m assuming will be many gene-related appointments, now that I’ve been launched back into the system – albeit this time for cancer prevention (I hope) rather than treatment. And, na├»ve as it might sound right now, I reckon I’ve got my head around it all as much as I can. See, to my mind, if there’s anything – anything at all – that can be done to reduce my chances of another round with The Bullshit – by however small a percentage – then I’m damn well going to use my powers of kick-ass to ensure that it gets done.

Prior to any preventative surgery, however, will be a series of testing to determine whether or not there is currently any residual cancer twatting about inside of me that we don’t know about. And that, right now, is a far scarier prospect than anything a scalpel can administer. My way of dealing with it thus far has been to assume that there are cancer cells, bobbing about in my body like a lost team of canoeists. Some might call that cynical or defeatist. I call it going equipped.

It’s not everyone’s way, granted, but I like to picture the worst-case scenario. And while I know that a part of me does that because it assumes I will therefore be immune to any further shocks (which of course I won’t), I also think it’s something I tend to do in order to give myself more chance of a happier outcome. Because if I’m prepared to receive news of an impossible-to-treat cancer, then hearing something even a little less terrifying will be a pleasant surprise, no? I know, I know. Blonde Logic.


I explained it to Tills earlier this week. 
(That's Tills there, by the way. She'd like me to point out that she's prettier when she's not tired. But frankly I think she knocks Penelope Cruz into a cocked hat even when there's baby-sick on her shoulder.)
‘You did that last time around, didn’t you, expecting the worst?’ she queried.
‘What, before I got my CT scan results? Yeah, I s’pose I did,’ I agreed.
‘Mm, you’re good at it,’ she said, in a statement that anyone other than a best mate would have taken offence to.
‘S’pose,’ I nodded. ‘I just like to be prepared, is all.’
‘There’s a theory about that in therapy,’ said Tills. ‘How uncertainty fucks up people and makes them fantasise terrible things to fill the gap. But you’re priming yourself, really.’ (This is why I love Tills so much. Nobody else could spin my Blonde Logic into deliberate intelligence.)
‘I guess that makes sense,’ I said. ‘I just want to get on with things, y’know? It’s like imagining the most awful thing somehow allows me to get past it so I can, I dunno, just carry on with everything else; carry on with nicer things. Like today,’ I added, in reference to the meeting I’d just left to discuss a possible screen adaptation of The C-Word. (Yes, you heard that right.)
‘You are good at it though,’ she assured me. ‘You have a great way of planning lovely things to think about in difficult times.’

But smart as Tills undeniably is, I think that last comment was spoken from behind friend-tinted glasses. (Y’know, the same way that true mates never tell you when you’ve made a tit of yourself after too many beers, and always disagree when you whine about your enormous bottom.) Because of all the lovely things I’ve had to think about during my difficult times – and, boy, have there been some lovely things – I don’t think I can really take credit for ‘planning’ any of them. And while my mantra has always been ‘when the chips are down, book a holiday’, what Tills mentioned is different. None of the better things to come out of The Bullshit were premeditated; just the universe’s weird way of paying me back. The blog happened because I just felt like writing. The book happened because a literary agent saw Stephen Fry’s tweet. Those things were happy accidents, coming along at a time when I needed them most, and making me feel even jammier than I already did – despite The Bullshit; despite the Bullshit Gene.

So, you see, there’s no need to feel bad for me. It’s all good. I don’t feel sorry – I feel lucky.

Actually, that’s a bit of a fib. I do feel sorry – sorry for anyone whose life isn’t as wonderful as this.

Monday, 8 March 2010

Stronger than me.

‘I’m glad the f-word is back,’ said a family friend in an email she sent me this week. ‘That means to me that you are in a fighting mood and ready to do battle.’ And she’s right. Because in the post-shit-news routine of shock/terror/upset/anger/practicality that I talked about in my previous blog post, I clean forgot the thing that comes next: pure, unreserved, belligerent kick-ass.

I can’t honestly say that I’m like that normally. If someone bumps into me on the tube, stops suddenly in front of me in the middle of the pavement or trolley-barges me in the supermarket, I’m not exactly likely to put up my fists. (That said, I turn into The Hulk when people forget to indicate/won't stick to their own lane/fail to wave thank-you when you’ve given way. With the security of 4,000 pounds of encased aluminium, I’m a foul-mouthed, badass bitch.)

But while I’m far from a timid wallflower, that degree of kick-ass isn’t something I normally possess. Much like Peter Petrelli’s abilities, it’s a power that only presents itself when absolutely necessary. It came in handy when I had to force myself out of the door for chemo on a Friday morning. It helped when P and I had to suck it up and get on with baby-making after our second miscarriage. And it showed up in spectacular style when I caught an especially rubbish boyfriend in bed with his ex.

I’ve been thinking a lot about ex-boyfriends lately, as it goes. Not like that – more in the sense of wondering, if I’d still been with any of my few ex-boyfriends today, how they’d have handled The Bullshit. And, in the nicest possible way (well, not in the case of Cheating Ex), I’m afraid there’s only one answer: dreadfully.

I am, of course, inconceivably lucky to be able to call myself P’s wife for more reasons than just his dependability, support and calmness in the face of The Bullshit. (He also happens to be compassionate, sexy, hilarious, sweet-smelling and generally down-right wonderful.) But how fortunate that, in light of the stuff that he and I have had to deal with, he is indeed all of those things.

I’ll say it again: the news we’ve had recently is NOT a cancer diagnosis. But, like I also said last week, there are undoubtedly parallels between learning that you have cancer and discovering that you have up to an 80% chance of getting it again. And so, much like I was in June 2008, now that I’ve brushed aside my fears and am existing purely on kick-ass, I’m back to worrying about how everybody else is handling this. Particularly P.

Much like mine, his initial reaction to The Gene News was very emotional. (He won’t thank me for saying that.) But also in resemblance with each other’s early responses to my dodgy genes are our feelings about the way we’re going to handle them. First off, there’s no option for us but to deal with this together. (Last week, P even talked about ‘when we got cancer’, and I loved him that little bit more for it.) And, though it’s wholly pre-emptive thinking – given that our appointment with the oncologist isn’t for two weeks – we’re each of the opinion that whatever it takes to reduce my chances of a cancer recurrence, we’ll do it. Hell, even if it meant chopping off an arm or locking myself in a light-starved room with only What Katie Did Next for comfort, I dare say I’d go for it. It might not come to more surgery, of course. (Mind you, that’s probably like the ‘might’ in ‘you might not get breast cancer again’.) But if it does, we’re ready. Or, at least, I am. And that’s what I mean by worrying about P.

See, before I had my left tit removed, I was concerned about what it would be like for P to have somehow found himself lumped with a one-breasted reproductive-vacuum of a wife. But now, The Gene News has pushed things one step further. Because what we’re looking at today is the prospect of not just losing my right tit, too, but potentially also my ovaries and/or womb. And that, I’m sure you’ll agree, does not a hot wife make.

Personally, I like to think that my ladybits aren’t the things that make me a woman. (Don’t hold me to that just yet, mind. That’s a concept I intend to dedicate a lot of thought to. Prepare yourself for the return of Mr Marbles.) But does the same apply for P? Might he wish that I looked different? What effect might the loss of my girly essentials have on our sex life? Might it be like new year’s eve without the fireworks? Hell, might ‘new year’s eve’ even be possible at all? Thus you see what I mean about being grateful that it’ll be P – dependable, supportive, calm P – who’ll have to deal with those things. But of course at the same time I’m not grateful at all. I’m cross. Because nobody deserves to have to deal with that shit less than him.

So can I see Cheating Ex being able to handle all that? Can I bollocks. Can I see P being able to handle it? Course I can. Because the thing is, P's kick-ass powers rival even his wife’s.

Monday, 1 March 2010

The reason.

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.’
‘Oh?’
‘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.