The Mammogram Rite

On my 40th birthday, (some years ago now), I received an unexpected greeting card from my doctor.  How lovely, right? Happy Birthday, it read: Time to schedule a mammogram!  In one fell sentence, I plummeted maiden to mother to crone. My breasts shriveled from sexy tools used to attract a mate, skipped over their potential as a beneficent means of nurturing a child, and became an instrument of terror. My doctor’s message had inducted me into a modern female rite: the mammogram.

I experienced my first much-too-soon-after-a-routine-mammogram phone call last spring. Every hour between the hospital’s name appearing on the caller ID and my scheduled appointment the next morning was fitful and labored: troubled breathing, troubled working, troubled sleeping, troubled appetite. My imagination took hold and having already survived leukemia, had sufficient fuel. Guiltily I remembered the palpable lump in my right breast discovered ten years ago. The one I had core-sampled and that was found benign. The one I allowed to remain, filed as the result of a freak paint-roller-refill mishap. I began to vibrate to the latent anxiety I think all women possess, attuned as we are to the omnipresent pink-ribboned products and messages surrounding us. The subtext hums, hey girl, those tits of yours could rise up and kill you someday.

My beloved delivered me bodily to the clinic the next morning. It (my body) filled out the paperwork and settled in to wait among the magazines, other women bodies, and their attending husbands.

I heard my name and followed the beckoning nurse through the door separating the all-purpose waiting room from the one specialized for breast-cancer-related procedures. It was a portal leading to a domain clinically feminine, patronizingly feminine. The nurse instructed me to disrobe from the waist up, put on a dehumanizing gown with the opening at the front, lock up my belongings, then wait alongside a throw pillow embroidered with an encouraging quote placed to soften a straight-backed chair upholstered in chosen-by-experts-to-calm-and-make-you-as-a-woman-feel-valued-and-heard pinks, blue and mauves, muted of course. I tried to recall if the waiting room for leukemia patients had been similarly contrived in orange. It hadn’t.

For all its efforts to calm this carefully crafted backdrop was bewilderingly paired with relentless pop music hammering its tattoo at 130 bpm. My shoulders flinched toward my ears with each artificial snare sample. I looked around the room for commiseration and found just one other, a woman, eyes fixed straight ahead, making herself still and inconspicuous in the corner opposite me, as though inconspicuousness would negate her presence. She reminded me of a rabbit wary of a predator, so still, heart racing.

Is this your first call back?” It was.
Is it just me or is this music awful?” It wasn’t just me.
I haven’t slept or eaten since the call, have you?” She hadn’t.

We shared the nervous small talk of strangers made comrades while sitting alone together with death in the room. It was her first time I guessed. Not mine. Though Death and I hadn’t seen each other some four years and I’d grown unaccustomed and unwelcoming to it in the interim.

Death attends my mammogram
Death attends my mammogram

I heard my name and followed the technician into her workspace. She was either remarkably intuitive or routinely practiced in recognizing and neutralizing the terror I carried with me. She soothed, “A call back on a mammogram is routine. It occurs any time there is a change, even a tiny change, from your last mammogram. Here is what we found that caused us concern.” 

My eyes immediately scanned the bottom of the image where I knew the paint-roller-refill related lump loomed. The technician pointed instead to a cluster of minuscule dots in an entirely different portion of my breast. She continued, “This tiny cluster of calcifications wasn’t on your last exam. Most calcifications are normal, but if these are abnormal don’t worry. They are small; we will have caught it very early.

And then she commenced with the crushing.

A mammogram callback allows no go-home-and-wait for the results. The doctor considers the evidence in a nearby room while you sit nervously in a holding cell for his verdict. That day’s doctor declared the cluster most likely benign, chastised me for going too long between mammograms (2 and a half years) then with the nurse standing witness insisted I sign a memo vowing to make a follow-up appointment in six months. Just in case. He then asked if I had any questions. I did, one: “Do you have control over that awful music in the waiting room? It is relentlessly upbeat and frenetic for patients who are already stressed and tense. I mean really, think about it.” The doctor stared at me. The nurse laughed out loud. I realized then women like me were probably responsible for the decor I complained about earlier.

Liberated from my holding cell, degowned and rehumanized I skirted the breast-cancer-related waiting room en route to the all-purpose one and my beloved. More than twenty women now occupied that space, sitting silently, uncomfortably, eyes fixed straight ahead, making themselves still and inconspicuous. Pensively tolerating the music. All these women, topless under dehumanizing gowns with the opening at the front. Sitting alone together with death in the room. Hearts racing like rabbits. Each waiting for the sound of her name, hoping to be a lucky one, lucky like me that day. I wondered what Margaret Atwood would say.

I bought myself a couple of new bras this week even though or maybe because it was the week scheduled for my 6-month follow-up. You know, testing fate. As I tried them on, adjusting the straps, shifting my breasts around, my beloved asked if it was fun to have boobs.  “Not really,” I answered. “They look nice I guess, but they can get in the way. Sometimes they ache and feel heavy. Even small ones like mine. And they don’t come without risk. They could kill you.” Turns out, according to the follow-up mammogram, my boobs aren’t going to kill me. At least not today.

While standing at the machine with my tiny breast inconceivably stretched onto the acrylic shelf, crushed between it and an upper panel, first mechanically then (yes one more turn of the dial please) manually, hands gripping the sides, holding my breath on command until given permission to breathe again, I couldn’t help but observe: A mammogram is an absurd, unnatural, painful, contorting experience with a dollop of radiation on top. Women, wild women, my ancestral women never did this. Could never have imagined willingly participating in this. Sure, they died, but we all die. I couldn’t help but ask: “Why am I compelled to bring my body to this altar for this ritual once a year for the remainder of my days? What is it I am trying to prevent?” 

My doctor said a routine mammogram is something a gal my age should have every two years after 40. The doctor who analyzed my images insisted the American Cancer Society recommends a mammogram annually. The internet supports versions of both positions. All three were quite serious about my regular, unquestioning participation to prevent an untimely death. Ah, I see. The Mammogram Rite, such a small sacrifice to avoid death and prolong life (as if longevity were equivalent to living) if we but catch it early.

Caught It in time
Death—that naughty child
Its intentions
For later

Am I alone in finding it strange that every woman over 40, regardless of her history or risk factors is encouraged (coerced, intimidated, pressured) to perform this singular test on one part of the whole body, every year for the remainder of their lives to prevent an untimely death? At what age is death no longer considered untimely? If society is concerned about untimely death, let’s acknowledge that breast cancer isn’t the only thing that can kill a girl. Heart disease, colon cancer (just as likely), buses, leukemia (rare sure but it happened to me)—the annual mammogram will not catch any of these thingsIf you should encounter one of these in your lifetime (or something worse) and it doesn’t kill you after all well, you will soon discover trying to avoid an untimely death by avoiding illness has been a waste of living. Death is with you no matter how inconspicuous you become and no one gets to pick their time. Acceptance of illness and death is not resignation. It demonstrates a deep understanding of what it means to be alive.

Cuppa with Death
Getting Reacquainted with Death

I was once well acquainted with Death. I called it “friend.” I even begged it to take me, but it wasn’t my time. I knew once there is no such thing as an untimely death. I trusted but forgot, until the mammogram callback, and the six-month follow-up reminded me. The mammogram is not the ritual I want to use to strengthen my relationship with Death. Going forward this heart-racing rabbit will be inviting Death round for tea and conversation daily. I’m over 40 after all.