Please, women who love and are loved...

By Elizabeth Kaplan Woy ’57

I am fervent regarding early detection — perhaps somewhat perversely, because I have benefited from another woman’s lapse in attentiveness.

My husband’s first wife died of breast cancer. From all reports, she was a terrific person, and I feel honored and gratified when I hear people say good things about her. As I understand it, she had fibrous breasts. After several experiences of having cysts aspirated and biopsied, with no worrisome findings, she assumed that the next one or ones were also benign. She was wrong. They weren’t.

I constantly remind my daughter, step-daughters and daughter-in-law, whose mother also died of breast cancer, to do what is necessary and wise about diagnostic tests. As for myself, I sort of do what is recommended: a yearly mammogram. (I’m not perfect; for reasons that aren’t even clear to me, I am sometimes negligent regarding self-examination.)

Granted, a mammogram can be somewhat discomforting. But far more unnerving is the 15-minute wait to be called in for a report of the physician’s reading, when I’m sharing the room with other women who might have truly troubling concerns because of a previous lump or significant family history.

Regardless of statistics on occurrences and deaths from malignancies at other sites, breast cancer is the disease that women most fear. We have reason to be apprehensive. Please — women who love and are loved — have mammograms, self-examine, and spread the word.

Please, women who love and are loved...
By Elizabeth Kaplan Woy '57
Through fear, the Sticking Place and beyond
By Terry Steiner Graybill '71
A birthday present: doing one's homework
Genevieve Atwood '68, by Lynn Litterine '96
'You learn there's no time like the present.'
Catherine Sease '69, by Lynn Litterine '96
'I choose the language of peace.'
By Melodee Kornacker '60
'Tom'
By Susan Johnson '62

Through fear, the Sticking Place, and beyond

By Terry Sisk Graybill ’71

During my annual checkup, my doctor told me she’d found a rather large lump in my breast. She helped me find it and encouraged me to check myself. It was time, she noted, for a mammogram. Since I tend to have cystic breasts, we agreed it was probably nothing to worry about but wise to have it checked.

Two days later I attended a Bryn Mawr Alumnae Bulletin Editorial Board meeting. We discussed doing some articles on breast cancer. By including stories of personal experience as well as presenting physician perspectives, we hoped to encourage readers to consult with their personal physicians and deal with any potential problems as soon as possible. I felt as if this message spoke directly to me.

And so despite some reluctance, (yes it hurts, no matter what they say), I dragged myself to the hospital and had the mammogram. Sitting afterwards in the changing area with other women of different ages, I listened to the stories: one had had cancer and was hoping to still be cancer free; another was half-convinced she had cancer. We were all waiting to be told the films had turned out so we could go. Or not.

When mine did turn out, it was time for an ultrasound, given this questionable lump. The staff was kind — one even turned the monitor so I could see what he was seeing. But while this tech told me that he wanted patients to feel as comfortable as they could, he couldn’t banish my fear. What if this time it was ...? The news, however, was good — the lump was cystic. I could breathe deeply and go home.

The next day my doctor recommended that I see the surgeon and probably have the lump aspirated as a precautionary measure, despite the mammogram and ultrasound results. Immediately my fear returned. I’d had a bad experience some years before with another surgeon. Again I’d been referred because of a breast lump, but when I thought he was going to discuss options with me, suddenly he was coming at me with a needle, ignoring my protestations. I suppose he thought it best to get it over with quickly. I, however, wasn’t prepared and the procedure was quite painful. Now at the thought of going through this again, I found myself reluctant, fearful and embarrassed by my reaction. My doctor reassured me that this surgeon she was recommending was wonderful, in fact had even done an aspiration on a lump in my doctor’s breast a few years earlier. So I agreed and took my referral and went on my way.

But I didn’t go to the surgeon. Cystic lumps often disappear as rapidly as they appear, and I kept hoping this one would as well. A few months passed and it was time for the next Editorial Board meeting. Again we discussed the articles on breast cancer and I sat feeling guilty, remembering the referral form. But still I didn’t go.

The flu took me back to the doctor some months later. She asked if I’d gone to the surgeon. When I admitted I hadn’t gone and she found the lump was still there, she gave me another referral and encouraged me to go this time. Again I agreed and again I didn’t go.

Finally, after many months, I took Lady MacBeth’s advice to “Screw your courage to the Sticking Place” and went to the surgeon (with my third referral), a paltry three days before the next Editorial Board meeting! Though I had told no one on the committee about my fears, I felt that I needed to deal with my internal demon before that meeting.

The surgeon was as wonderful as my doctor had predicted. She was kind, friendly, talked with me and put me at ease. I talked with her about my fears. She too found the lump, now nearly 12 months after it was first observed. She reviewed the mammogram results and the ultrasound and commented that the lump, which also felt cystic, was now smaller than was noted in the report. Then she gave me the news. She didn’t need to aspirate the lump. While aspiration had been the standard procedure for years, ultrasonography was now considered a strong enough diagnostic tool that they no longer routinely aspirated lumps unless the ultrasound was inconclusive. I asked whether she would recommend aspirating the lump if I hadn’t revealed that I was so phobic. She said no, the reports clearly indicated that the lump was cystic.

Facing my fears had been harder than any actual news I received. And despite our fears, the news isn’t always bad. I thought I knew what the standard response or treatment would be. But science marches on and things improve. We just have to keep facing our fears and go on.

And then she said it. Right during my moment of weak knees, extreme relief and joy. “But Terry, now it’s time for your next mammogram!”

Please, women who love and are loved...
By Elizabeth Kaplan Woy '57
Through fear, the Sticking Place and beyond
By Terry Steiner Graybill '71
A birthday present: doing one's homework
Genevieve Atwood '68, by Lynn Litterine '96
'You learn there's no time like the present.'
Catherine Sease '69, by Lynn Litterine '96
'I choose the language of peace.'
By Melodee Kornacker '60
'Tom'
By Susan Johnson '62

A birthday gift -- doing my homework

By Lynn Litterine ’96

Genevieve Atwood ’68 thought of her college days at Bryn Mawr when she began going for routine mammograms at age 40.

“I gave them to myself as a birthday present every year; it was an easy way to remember to do it,” she says. “I saw it as doing my homework, just as I did my homework at Bryn Mawr.”

Attending to that homework paid off in June 1996 with the early detection of an unpalpable cancer the size of her littlest fingernail. The lump, which Genevieve says was evident in the follow-up X-rays —“It did not take a rocket scientist to see it in the detailed ones” — had not been caught in her 1995 mammogram.

photo of Genevieve Atwood“But after identifying it in 1996, you could see it in the ’95 pictures. It looked just like Cancer the Crab, with legs on both sides; I recognized the shape,” she says. “If I’d been going every two years, instead of annually, it would not have been caught in ’96.”

This interested Genevieve especially because during three terms as a Utah state legislator in the 1970s, she had participated in the debate over allocating state funds for breast cancer screening. The experience had educated her in breast cancer statistics and in the ‘it-won’t-happen-to-me’ phenomenon.

“I was struck by the concept of prevention. It made me feel I had to get my mammograms,” she says.

It’s part of being in the “generation that’s doing things right” about breast cancer, she adds, but even when women do their homework ahead, a breast-cancer diagnosis throws life into fast-forward mode.

“You can find yourself directed by the medical technology because you’re caught up in the excitement of the moment,” Genevieve says. “I was reading like crazy, but I still didn’t get a second opinion initially.”

Because she was working for the University of Utah at the time, she eventually wound up at its student health center.

“They were the ones who tried to slow [the process] down,” Genevieve explains. “They got me to take second opinions when I had been afraid of hurting the feelings of [my doctors].”

She explains that because her first doctor was so invested in the autonomy of the patient’s choice between lumpectomy and mastectomy, the two of them wound up trying to read each other’s preferences, and she felt somewhat lost.

“Once he felt I was on the mastectomy track, he wanted to make me feel good about my decision.”

She began taking her husband or a friend to interviews with doctors.

“My reaction had been to do it on my own,”Genevieve says. “But I learned that I needed an extra set of ears along. Going in the direction you decided on isn’t hard; deciding which direction to take is the hard part.”

She was surprised to find that she appreciated a more directive approach to her surgery.

“It was really counterintuitive,” Genevieve says. “I would have thought that the ‘part of a team’ approach was better for me, but it was a lot less comforting than the more direct approach of my second surgeon. When you’re not a co-equal [in experience], you are going for their expertise.”

On July 1, 1996, she had a lumpectomy, which involves two surgical sites because it includes the removal of some lymph nodes, but it was understood that the surgeon would have performed a mastectomy if what was found inside the breast had warranted it. Genevieve describes the out-patient procedure as “pretty straightforward.” It was followed up with six weeks of daily radiation treatments.

“I got to respect my body more,” she says. “At Bryn Mawr, I always wanted it to be thinner than it was, or stronger than it was. I wanted to control it, to exercise it in a way that pushed it to the limit. Now I appreciate its basic propensity to get better; I became confident that my body and I were on the same team.”

And she certainly didn’t feel alone as she healed. Genevieve is a geologist, and because she teaches teachers, summer is her busy season. She recuperated in time to teach seven sessions in 1996. In every single group, there was another woman who also had had breast cancer.

Please, women who love and are loved...
By Elizabeth Kaplan Woy '57
Through fear, the Sticking Place and beyond
By Terry Steiner Graybill '71
A birthday present: doing one's homework
Genevieve Atwood '68, by Lynn Litterine '96
'You learn there's no time like the present.'
Catherine Sease '69, by Lynn Litterine '96
'I choose the language of peace.'
By Melodee Kornacker '60
'Tom'
By Susan Johnson '62

‘I choose the language of peace’

By Melodee Siegel Kornacker ’60

My mother’s terror of death, especially from cancer, shadowed my childhood.

She is now 83, reasonably healthy and a Kervorkian fan.

Thirty years ago, I joined a health club. One day a middle-aged woman emerged from the shower with a towel around her torso and headed for a nearby locker. When she shed the towel, I could see that she had only one breast and was distinctly scarred where the other had once been. In rapid succession, I felt shock and overwhelming relief. The secrecy, the dread, fell away from me as she unselfconsciously dried off and got dressed. Although no word ever passed between us, she is one of my most valued teachers.

During a very lonely time of my life, I waited several months (much longer than I would today) while my doctor decided whether to biopsy an armpit lymph node. I felt sad and anxious, but not terrified. It was negative. Later on, I had laparascopic surgery for what might have been ovarian cancer but wasn’t.

photo of Melodee KornackerWhen I was diagnosed with neck cancer in 1994, all the organized local support groups were concerned exclusively with breast cancer. Other cancers can have equally profound effects on women’s bodies, relationships and inner lives. While we want all good things for our sisters who live with breast cancer, I and my women friends with brain, intestinal, ovarian and other cancers (and other life-threatening or disabling conditions) wish it were possible to draw on some of this structured support for our own needs. It takes more time and energy than we are willing to spend to establish regular groups; we do our best to encourage each other informally.

My own cancer is more existential than most: It appeared in a neck lymph node to which it traveled from points unknown. Surgery to remove more tissue in the area of the node showed no additional malignancy. The docs agreed about chemotherapy (no) and disagreed about radiation (I decided against it).

That may or may not be the end of the story. I present myself at Sloan-Kettering periodically for ritual inspection. Five years will not be a magic number. I am blessed with loving family and friends. I savor each day.

Over the years, I have conducted support groups for people touched by HIV and for the widowed elderly. I am a hospice volunteer. Thoughts of wellness and illness are always with me. Out of deep conviction I say “person living with,” never “victim” and seldom “patient.” I reject violent or military language — “battle,” “fight,” “war” — in relation to my own body. I choose the language of peace. Peace, not surrender. I believe each of us must be active in our own health care, choosing when and what doctors will do for us and never allowing anything to be done to us.

Please, women who love and are loved...
By Elizabeth Kaplan Woy '57
Through fear, the Sticking Place and beyond
By Terry Steiner Graybill '71
A birthday present: doing one's homework
Genevieve Atwood '68, by Lynn Litterine '96
'You learn there's no time like the present.'
Catherine Sease '69, by Lynn Litterine '96
'I choose the language of peace.'
By Melodee Kornacker '60
'Tom'
By Susan Johnson '62

‘You learn that there’s no time like the present’

By Lynn Litterine ’96

Catherine Sease ’69 tries to make it very clear why two instances of breast cancer since 1991 have brought more positive than negative into her life. She knows she can afford to emphasize the gains. She has passed the fifth anniversary of her first lumpectomy, in 1991, with no recurrence of the cancer that was diagnosed in her left breast. In addition, the cancer found in her right breast in 1993 was a small site of a different type of cancer, one that grows very slowly; it had not metastasized from the earlier one. This cancer was removed during biopsy. Still, there’s a hesitancy in her voice as she describes the three years around those diagnoses; they were “pretty hard,” she says.

“It’s a bad experience, and I wouldn’t wish it for anybody, but the way it’s turned out, it’s been an extraordinarily positive experience for me,” she says. “Overall, it’s been for the better. Yes, I have some scars, and my breasts are not symmetrical, but I’ve grown.”

One important change for Catherine has been in her concept of time.

“I realize time is short; I realize that my life is finite. It’s changed my priorities. I’m more likely to do something now because I want to do it. Before, I’d think that it was too expensive, or that it took too much time from work.”

Catherine is an archeological conservator and head of conservation and collections management for anthropology at the Field Museum in Chicago. Her husband, David Reese, is an archeologist. They have always traveled, but they are more likely now to treat themselves when they do.

“We saw a trip to Turkey advertised, a chance to explore sites along the coast by boat with a famous archaeologist on board. My old response would have been, ‘Wouldn’t this be fun?’ My new response was, ‘Let’s do it.’ We stayed in fancy hotels and had a wonderful time,” she says. “I’m more inclined now to fly to the East Coast to visit my family for a weekend, too.”

She has also decided to go back to school for a Ph.D.

“I decided that I want a doctorate,” Catherine says. “I don’t need it for work; I want to do it for myself.”

While her research material is available at the Field Museum, she will have to do a six-month residence at the university in London where she was accepted. She expects to move there temporarily early in 1998, and although it’s not convenient, she’s determined to pursue her goal.

“That’s the kind of thing that cancer changes,” she says. “You learn that there’s no time like the present, because there may not be a tomorrow.”

While the present has become more meaningful, it also has become less pressured for Catherine.

“My priorities are different. I can sort out what’s insignificant or inconsequential now,” she says. “If the registrar comes with complaints about what color form someone filled in, I can say, ‘Who cares?’ It’s been beneficial in terms of my productivity at work, and my stress levels have plummeted.”

Catherine has always been very healthy, and initially, she says, this made the diagnosis of cancer even more disorienting, but going through treatment has produced a stronger faith in her body.

“I was caught unawares,” she says. “The minute you get the diagnosis, your whole world is upside down. Having my tonsils out at age 3 was the only other time I’d even been in the hospital. But a human being is amazingly robust. I surprised myself by what I could tolerate if I really had to.”

Please, women who love and are loved...
By Elizabeth Kaplan Woy '57
Through fear, the Sticking Place and beyond
By Terry Steiner Graybill '71
A birthday present: doing one's homework
Genevieve Atwood '68, by Lynn Litterine '96
'You learn there's no time like the present.'
Catherine Sease '69, by Lynn Litterine '96
'I choose the language of peace.'
By Melodee Kornacker '60
'Tom'
By Susan Johnson '62

‘TOM’

By Susan Johnson ’62

Tom is someone I scarcely know at all. I don’t know his last name, or his story, or his likes and dislikes, or where he lives. I met him three years ago, for only 15 minutes or perhaps half an hour, and I do not remember what he looks like. I know his first name only because of his white and green plastic name tag. “Tom, Tom,” I remember reading as I clutched his hand, my mind trying to anchor itself on the short simplicity of the name.

photo of Susan JohnsonTom entered my life at a difficult moment. I was in a hospital, lying on the operating table, in the operating room, my body naked, swathed in a white gown and surgical drapes, catheters in my veins, unknown men and women in green and white, their faces covered, bustling about, cleaning things up, putting things away, saving things in carefully labeled containers. The room itself was all shiny metal and hard edges and bright lights, but quiet, very quiet.

I had just been told by my breast surgeon that, yes indeed, the lump they had removed from my right breast was cancer, “invasive ductal carcinoma,” to give it its fully clinical and terrifying name. I began to cry and slowly, with great effort, to shake my head back and forth, “No, No,” trying simultaneously to escape the table and to deny the reality of what I had just heard. The shaking escalated into a trembling that overtook my whole body.

Suddenly, emerging from the fog of anesthetic and fright, there was the large firm hand of an attending nurse, grasping mine. “Susan, I’m sorry. Susan, I’m sorry,” he kept saying, as if he had been charged to convey the condolences of the universe.

They lifted me from the operating table onto a gurney and put up the sides so I wouldn’t fall off or — had I been able to — jump off. The nurse continued to hold my hand as he wheeled me into the recovery room. He had to let go for a moment while he pushed and pulled the gurney into its parking space between other recovering patients, and then he returned to the side of the bed. He took up my hand again, I think to say goodbye. His duties with me were over, and his schedule called for him to be elsewhere. There was the slightest hesitation in his grip — and then he made his decision. He adjusted his hand to get a firmer hold of mine, his body relaxed, and he settled in to stay where he was, beside me.

“Tom,” I noticed his name tag for the first time. “Tom,” I read. “Tom, ” I repeated to myself, a mantra of consolation. “Tom,” I thought, as the trembling gradually eased.

Tom is someone I scarcely know at all, but I know the most important thing about him.
“Tom” is the beginning of a longer essay that will be published elsewhere.

Please, women who love and are loved...
By Elizabeth Kaplan Woy '57
Through fear, the Sticking Place and beyond
By Terry Steiner Graybill '71
A birthday present: doing one's homework
Genevieve Atwood '68, by Lynn Litterine '96
'You learn there's no time like the present.'
Catherine Sease '69, by Lynn Litterine '96
'I choose the language of peace.'
By Melodee Kornacker '60
'Tom'
By Susan Johnson '62

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