The crescent beside my eye (running in the living room, six years-old), the pale, asymmetrical patch above my lip (Chicken pox at eight), the toothy line across my right knee (couch jumping at twelve), the long, deep crevice on my left thigh (botched surgery at fifteen)—I’ve always liked my scars, those stories on skin.
And yet, there are two I’ve failed to disclose: the puffy red line just beneath my clavicle where a port was installed to deliver chemotherapy, and the jagged dent across my left breast where my nipple used to be—cancer at thirty-four.
The earlier scars are testament to incidents I have passed through. I’ll never have chicken pox again. I’ll never jump off the couch or (god-willing) run face-first into a 1982 Zenith television set mounted on particle board, but I might have cancer again. That experience, I can never fully move beyond. The scar on my breast doesn’t quite end; it’s part of an ongoing story.
“Take them both,” were my first words to the surgeon, not because I felt indifferent toward my breasts, but because in the days following my diagnosis, they seemed little more than cancer aliens hanging parasitically from my chest.
Between us, my surgeon placed a cross section of a breast, beads of lymph nodes branching out where an armpit would be. With a blue ballpoint pen, she scribbled in my tumor, pea-sized, just south of the nipple, colored in two of the lymph nodes (where we knew the cancer had crept), and explained she would rather remove all the nodes, the tumor, and spare the breast.
“If you were in my position . . .?”
She tapped the diagram. “I’d try this first.”
The day before the surgery, she told me that after consulting with her colleagues she thought it “best to remove the nipple as well.”
I received this information stoically, but inside all I could think of was the scene in The Wall where Bob Geldof razors off his nipple; I could never un-see that scene, and as a teenager, I could never get past that part without covering my eyes.
The night before surgery, I drank a glass of wine and looked down my shirt. That nipple is in my baby pictures; that nipple wore my first bra; that nipple was with my lovers; that nipple has been abroad for Christ’s sake.
I wondered what my surgeon would do with it. I imagined her popping it off like a bottle cap, flicking it into the trash.
And though I laughed at my sentimentality about my nipple, I couldn’t help but shudder at the notion, couldn’t help but think a breast without a nipple was like an eye without a pupil – disturbing, unnatural, something else entirely.
During the first two weeks of February 2011, my once perfectly beautiful breast, with its puckered pink nipple, had been subject to biopsies, ultrasounds, mammograms, strangers’ hands and finally, an operation. After the latter, what remained looked as though it had been in a fight.
“I’d like to see the other guy,” I groggily joked as the nurse changed my bandages revealing a breast that was swollen, bruised shades of purple, yellow and red, a short dash of black stitches where the nipple once was.
Sometimes when I saw my breast, I cried.
Not that it looked that bad. In fact, as these things go, my surgeon had done a beautiful job. Even now when I go for mammograms and other disrobing exams, nurses and doctors marvel at her handiwork. Who did your surgery? Some will ask, the way one might ask about a haircut.
Still, it was what the breast represented, what the missing nipple meant. The nipple was the first casualty in a year of losses that included (some) friends, energy, sex-drive, certainty and hair. I no longer felt young. I no longer fantasized about the future without the specter of cancer haunting my projections. I would never again be able to casually hook-up with a woman without having to explain the dramatic absence on my breast. (To the latter end, I have concluded that should the opportunity arise, I will say my nipple was clawed off by a tiger while on location for National Geographic.)
Five months of chemo was a lot more physically challenging than losing the nipple, but while the effects of that drug have mostly dissipated, the surgery to my breast has rendered it tight, more like a muscle than a gland. And my nipple is still gone.
“Think of it,” a close friend once suggested. “As a mark of your survival.”
But I don’t regard myself a survivor. All of us, cancer or no, are only survivors until we’re not.
I have grown accustomed to the sight of my breast, the turgid, leathery feel of the scar, but I do not love it. Instead, it is but one of many shitty reminders of cancer – from the anti-estrogen pill I swallow down each morning with breakfast, to the permanent numbness in my left arm.
But while the nipple may be gone, humor is with me. In the early days after my surgery, I sang country songs in the shower to lessen the pain of seeing what had become of my breast, “Nipple done left ain’t never comin’ back.” Meditation is with me—a band of mala beads and a mantra, “What’s this? Don’t know.” Poetry is with me: a line by the late Robert Dana, “Every day I live I live forever.” Good psychotherapy is with me, teaching me how to embrace fear and ask for what I need. Long walks are with me: the movement of my flawed body, air in my lungs, my heart knocking steady in my chest. Friends are with me. Family is with me. And while I may never love the aftermath of my “nipple-ectomy”, time has enabled me to no longer view the absence on my breast as a reminder of something taken from me, or given up, but rather the remains of a fair trade, of something relinquished, in exchange for more life.