I met with the plastic surgeon. It was awful.

This week, Michael and I went to talk to the plastic surgeon. I haven't decided for sure whether or not to have a mastectomy at all, nor when to have it if I do, not whether I will want reconstruction if I do, so this was merely information gathering. I almost wish I hadn't gone.

We didn't get in to see him until 40 min after my appointment, and having waited all that time, I had to run to the bathroom right away. While I was gone, the doctor came in, and when he saw I wasn't there, Michael said he looked very annoyed. This was our first sign. When he came back, I hadn't yet had an opportunity to put the gown on because the resident was talking to me, so before he even let me introduce myself, he said, "Can we get you in a gown?" Hi, my name is Johanna. We're going to be having an intimate conversation about my boobs in a minute. Nice to meet you, too. (This was our second sign.)

When I was finally properly clothed and in the right place, and the doctor, two residents, and I had been introduced (no one asked who the heck Michael was), we got a brief introduction, then the doc did an exam. Then he said, "Okay, go ahead and take off your robe, I'm going to get some pictures." Not, "Is it okay if I get some pictures? I need them for such-and-such." Not, "Is it okay if all these people are in the room while I take topless pictures of you?" None of that. Just pictures of my topless self at all angles in front of all those people. Okay.

I put the gown back on (would have been nice to be able to get fully dressed, given that I was clearly cold), and then began the powerpoint presentation. A 2010 New York law requires that people be informed about reconstruction options, so this satisfied that requirement. He asked if it was okay to look at some pictures of mastectomy patients, and I said it was. I thought I could stomach it, but it is hard to look at pictures of women who have had mastectomies, especially when you imagine yourself looking that way. And it really started wearing on me, and especially when it went along with learning about the grueling surgeries that brought women to this point. Don't get me wrong - they can do amazing things, and the final product looks pretty darn similar to a real boob. They can tunnel tissue up through your torso, they can disconnect it and reconnect it, they can swing it around, they can combine with implants, or do implants alone... So many different ways to reconstruct.

And so much information to take in. About a quarter of the way into the presentation, I could feel the color had drained from my face, my brow was furrowed, my eyes stung, and all I could focus on was not crying. If I'd had any more strength, I would have said, "You need to stop talking," (which was all I could think) "and you need to give me a chance to process what you have already said." But all I could do was bite my lip. At one point, I did speak up. He was talking about using cadaver skin (don't remember what for), and at the top of the slide, it said in parentheses, "Pig skin." I thought, "Pig skin? Is that the kind of cadaver he's talking about?" So I said, "Are you talking about human cadavers?" Yes, he was. I said, "Because it says pig skin on your slide." He said, "Oh, yeah, that's a typo. It's been brought up a few times. I should fix that." I said, with considerable force, "I would put that on the
TOP of your to-do list. That is a terrible typo." "Yeah, yeah, I should..."

Finally, at one point, I did have real tears in my eyes, but I did not get the impression this was an okay place to cry, so I held them in with all my might. He did finally notice this, and moved a box of kleenex closer, and then proceeded. I learned in CPE that giving someone a kleenex when they cry is like saying, "Wipe up those tears. This is not the place for crying." Now I totally get it. The box made me even more upset, upset at the utter lack of compassion. Don't give me kleenex! Give me time! Ask if I'm okay, or if I have any questions. Ask if I need a minute to myself before shoving any more information down my throat. Ask if I'd like him to step out for a minute. But don't tell me it's not okay to cry when I'm looking at pictures of scarred and mangled breasts, and the scarred body parts that donated their tissue to the cause of recreating a fake boob. Don't give me a f***ing kleenex!! (Yes, I was very upset.)

After all was said and done, he turned off the presentation, gave me a sorry excuse for a sympathetic look, and said, "So. What are you thinking?" I said, "I'm thinking there is no part of me that wants to do this." He said something lame like, "I know it's a lot of information." I started asking questions about recovery time. He couldn't really give me a straight answer, just kept saying it depended on how I manage pain. I said I get 90 days of disability each year, and he said, "Take it all." I asked what is the best option for me. He said really the only option for me, given my physique and medical history, is to swing a latissimus dorsi flap around and put in an implant for a mound. I asked how one is to recovery when there are major surgery sites on the front and the back, and he said he probably couldn't do both sides at once. So now we're talking two major surgeries, that may take as long as 12 or 15 hours each and require a few weeks recovery for basic tasks, longer for more strenuous ones, probably 2-3 months away from work each time, since I can't drive on narcotic pain killers. All this for putting on some fake boobs that won't even have any feeling anyway. I asked how long before I would be able to bear children, until my body would be healed enough to sustain another life, and then push it out of me (especially if they are taking some muscle tissue for this procedure). He said, "We don't really have a lot of pre-childbearing patients." Can you make a guess? "Less than 5 years, more than 6 months." Oh thank you, that's very helpful. He said, "We'll let you think about it. We'll give you a call in about a week." Now I sort of exploded (insofar as I ever explode). "A week?? I'm not even sure I'm going to do this at all! [Something I had told him at least 2-3 times already.] If I do, it will be at least 9 months from now, and I may not even do reconstruction, but could be as much as 5 years from now! A week isn't going to cut it!" He said I could just call when I was ready. Oh, okay. Thanks.

After they all left, I just stood in the middle of the room and cried. Michael held me, and I cried and cried. On the way out, the girl at the front desk looked at me, concerned, and said, "Do you need a tissue?" - a question I didn't mind because she asked with some concern. I said I was fine. Michael and I went out for ice cream, except I was freezing so I got chili (not chilly, har har). I hadn't been able to articulate any of my feelings, until Michael said, "I couldn't help but think he was in this for the money." And that set me off, and everything came pouring out. I didn't want to do this. No way. He said, "You know, you don't have to get reconstruction." True, and I loved him for saying that. But looking at nothing the rest of my life... would that be worse? I don't know.

But, I already decided I wouldn't do this until after we're married. So it is back on the back burner. And if I do, I will find another plastic surgeon who doesn't make me cry and who has some bedside manner.   But we'll cross that bridge when we come to it.

In better news, I told some of my female friends about this today, and they were appropriately sympathetic, then said that if I decide to do away with boobs forever, they would throw a boob funeral party for me. We would make a boob cake, and eat it all up. We could embrace our inner hippies and burn all my bras. This could be a blast.

By the way, if you can stomach it, there is a site for The Scar Project that has a series of artistic pictures of women who have had mastectomies. They are beautiful, though also difficult. Have a look here if you are interested.