CHAPTER FIVE
OLIVIA
ROUTINE APPOINTMENT. THAT’S ALL. NOTHING IS wrong.
I adjust the flimsy gown over my thighs as I sit in Dr. Nolan’s office waiting for her to arrive. I don’t even feel any irritation in my breast anymore, so maybe the lump just went away. I press my fingers tentatively to the side of my breast, startling slightly at the sound of a knock on the door.
Dr. Nolan, gray-haired and no-nonsense, enters and greets me with her usual brisk attitude before she sits in front of the computer to open my file.
“So you found a lump in your breast, Liv?” she asks.
Dean did. I suddenly wonder if I’d even have noticed it myself, if he hadn’t found it.
“Yes.” I gesture to my left breast. “On the side. It’s about the size of a small marble, and it feels hard.”
“Hmm.” She studies my chart for a minute. “Any family history of breast cancer?”
She asks the question casually, but it stabs into me like a thin, sharp blade. I haven’t even thought that word, let alone said it aloud.
“Not that I know of,” I say. “But I don’t know much about the women in my family. Only my father’s sister and my mother. My maternal grandmother passed away a few years ago, but…”
My voice trails off. I don’t know what she died from. For all I know, it was breast cancer.
Or not. At all.
“I don’t know,” I add.
Dr. Nolan nods. “Okay, let’s take a look.”
Dr. Nolan has been our family doctor ever since Dean and I moved to Mirror Lake. She’s seen me through three pregnancies, a miscarriage and, because of her obstetrics specialization, she delivered both Nicholas and Bella. She’s seen our children for every well-child visit, every earache or nasty cold, and she met us at the hospital the time Nicholas ended up in the ICU after spiking a high fever. She’s always been calm, practical, honest, and reassuring. And I’ve always been comfortable with her… except for now.
When she instructs me to lie back and unfastens the ties of my gown, my stomach knots with anxiety. I look at the ceiling, trying not to feel the prodding of her hands and fingers on my breasts, like she’s kneading dough.
I have a strange hope she won’t find anything unusual. Maybe it was a mistake, and Dean didn’t feel it after all, maybe he was just—
Except that I felt it too. We can’t both have been mistaken.
“Yes,” Dr. Nolan says, poking at my left breast. “There it is.”
My teeth clench involuntarily. I count the ceiling tiles above me. Dr. Nolan feels the lump for what seems like an inordinately long time. She presses her fingers against it and moves it around as if she’s assessing every detail.
“So what do you think?” I ask when I can’t stand it any longer.
She doesn’t respond.
That’s not good.
“You’ve never had any problems with cysts or lumps before your period, have you?” she asks.
“No.”
“Any recent injuries or accidents? Or any pain?”
“No injuries. I noticed a little bit of discomfort a couple of times, but no real pain.”
“Any discharge from your nipples?”
“No.”
Dr. Nolan spends even more time feeling every inch of both breasts, until I begin to think I’m going to be bruised by the time this is over. I watch her face, hoping against hope that her grave expression will ease into relief and she’ll tell me it feels exactly like a cyst or some other ordinary, unscary thing.
Finally she moves away and folds my gown back into place. I sit up, my heart thumping against my chest.
“So what’s the diagnosis?” I ask, making an effort to keep my voice light.
Dr. Nolan peels off her gloves and turns to face me again. She’s always been a sympathetic but stoic doctor, not given to expressing her own emotions. So when she looks at me with faint worry, I have to smother a surge of apprehension.
“Liv, I’m going to refer you to a doctor who specializes in breast health and surgery,” Dr. Nolan says, placing her hand on my shoulder. “I’m also going to see if we can get you in for more testing today.”
My cell phone buzzes with phone calls and texts from Dean. I send him a quick still at appt text, but I don’t answer the calls. I can’t deal with his concern, not when Dr. Nolan’s nurse calls the radiology department at the Forest Grove Hospital and asks if they can fit me in for a mammogram.
I don’t like the fact that this lump seems to have given everyone a sense of urgency. There’s no way Dr. Nolan would have seen me today, or radiology would fit me in, if I’d called telling them I had a stomachache.
But “I found a lump in my breast,” and everyone is rushing to assist me.
I drive a few blocks to the hospital and go downstairs to the radiology department.
“Olivia?” A technician comes to lead me back to the exam room.
“Have you had a mammogram before?” she asks, handing me another gown to change into.
I’m thirty-six. Should I have had a mammogram before?
“No, I haven’t.”
“Okay, no worries. I’ll explain everything to you as we go along.” She heads to the door with her clipboard. “Go ahead and change, and use those wipes to remove your deodorant. I’ll be right back.”
This room is colder than Dr. Nolan’s exam room, and I start to shiver after I’m in the flimsy gown. The machine is huge, with wide plates that I assume are going to flatten my breasts.
The technician returns, almost too cheerful as she explains the procedure.
“Our radiologist is here today, too,” she says. “So if you want to wait, he should be able to talk to you about the results before you leave.”
I’m not sure I want the results at all, but I agree. I stand and let the technician position me near the machine, then I pull my left arm and breast out of the gown. With an apology for being “pushy,” she tugs and pulls my breast onto the plate before lowering the top plate and squeezing my breast between them. It’s uncomfortable, but not painful.
The technician performs the same procedure with my right breast, then tells me to dress while the radiologist looks over the images. I leaf through a magazine, attempting to suppress the nerves tightening in my belly.
I should text Dean again, but I don’t. Can’t.
“Olivia?” A balding, older man enters the room with my file, extending his hand. “I’m Dr. Martin, the radiologist.”
“Nice to meet you. Thanks for doing this so quickly.”
“Not a problem,” he replies, sitting at the desk and switching on the computer. “So I was looking at your images and you have what are called ‘dense breasts,’ which means your breasts are composed more of connective tissue than fat.”
“Oh.”
“It’s not uncommon,” he continues, gesturing to the computer.
I look at the X-rays of my breasts, which appear like oddly shaped jellyfish on the screen. Dr. Martin waves his hand over the images, explaining that the white areas are breast tissue that can obscure masses, which also appear white.
“So,” Dr. Martin continues, “that means your X-rays are more difficult to read in terms of detecting tumors.”
“So what does that mean?” I ask.
“It means that since you have a palpable lump, we’ll have to do further testing,” he replies. “An ultrasound, at the least. Possibly a biopsy.”
Biopsy?
All the air squeezes from my lungs as I imagine a needle stabbing into my breast.
“Okay.” I grip my phone. “When can I schedule the ultrasound?”
Dr. Martin glances at the clock. “I should be able to fit you in within the hour.”
I nod, trying to convince myself he’s being efficient rather than urgent. After he leaves the room, I stare at my phone and try to work up the courage to call Dean.
But I can’t. Because I have the sick feeling that something is…