loss

The scene: I am sitting on the lid of the toilet in my underwear, nervously running my sweaty palms over and over my knees, crying, while Jason stands, trying to comfort me, as we prepare to remove the bandages over the new scar where my reconstructed breast used to be. My new surgical drain hangs from a lanyard around my neck. I am sad, the sort of sad that comes from your bowels, that makes your legs feel leaden. I am still in shock. How did we get here?

Monday afternoon I went to the plastic surgeon's office to meet with a PA for a simple check up. A week prior I had gone in with fears that I had a mild infection. Since the signs of infection were no more and the transplanted skin looked the same (according to Jason, I never quite got to the point of being able to look at it myself), I assumed this was a quick appointment that did not necessitate Jason cancelling his dentist appointment and making the trek halfway across the state with me. I am an adult, and this appointment is of the easiest variety. I went alone.
At about 3:30 when the PA came in, he looked at the breast, prodded a bit with a sterile q-tip, and matter-of-factly said, "I can't tell if it's just the top two layers of skin that are dead, or if it's all of the tissue. I'll give you a prescription and you come back Friday when your surgeon will be in the clinic. Today he's in surgery." And my blood began to buzz in my head, my breath came fast and shallow, and I responded with quivering voice and eyes welling up, "You can't say that and then send me home. There are other doctors here. I want one of them to look at it. I will wait, but I'm not just going home." Amidst all my powerlessness in the doctor's office, as I lay back on an exam table, my possibly dying reconstructed breast unveiled from my papery hospital gown, I had made a demand and the PA took me very seriously, nodding as he left saying he would see who he could find.
He returned shortly with another plastic surgeon, oddly the first one we'd spoken to back in July when we arrived at U of M. At that meeting I disliked him. Among his first questions were, "What size would you like to be?" and when I said I'd like my breasts to stay the same size, he reacted a little dismissively. Monday, however, Monday I was floored by his kindness. He did the same prodding with a q-tip that the PA had done, but he reacted with urgency - leaving the room to call my surgeon, Dr. Momoh, actually pulling him from the operating room to ask about me. He returned, looking somber, as I suppose one does when a case looks serious enough to pull a surgeon from the operating room.
"We need to get you over to the main hospital for exploratory surgery to find out what's going on inside because what we can see on the outside doesn't look good."
I lost it, melted down right there on that fucking exam table in that fucking gown.
"Who is here with you?" His voice was gentle, one hand firmly on my shoulder, the other offering tissues.
"No one."
"Wow. You're tough."
I didn't feel tough. I explained that it was meant to be a check up, that my husband was at the dentist having a tooth pulled. He helped me off the exam table, into a chair, and crouched in front of me, how you might seek to make eye contact with a child. "I don't think you should drive right now. I think your car will be fine here, I'll talk to security about it. Call whoever you need to. I have to see two patients quickly and when I'm done with that, I will take you to the hospital myself. I'm headed there anyway."
So I set about making phone calls to Jason, to his mother because I couldn't remember the name of the dentist and because she was on call to drive him home if he was too groggy.
Meanwhile two nurses came in to wait with me. They talked about inane things that served to mitigate how hard I was crying. "Just remember," said the nurse with dark brown, feathered hair, "everything happens for a reason." Fuck that. Worst possible time to say some trite, semi-religious, nonsensical bullshit. What, exactly, is the reason for this? Because it wasn't hard enough when I had to go back in for more surgery two days after the main ordeal? Because it wasn't enough that the main surgery lasted four hours longer than it should have? Because I still haven't learned enough about loss? Am I too vain? What?! I wanted to scream, is the fucking reason? None, of course. These things just happen sometimes. I hadn't the energy to respond to them.
I talked to Jason. Talked to Sally. They were on their way. The kind doctor came to get me, and we drove. A pretty drive, past colorful houses and their lovely gardens, down tree-lined streets, the sky vibrantly blue, sun shining brightly.
"So your husband's on his way? I hope he isn't driving having taken narcotics. How long is the ride? He'll probably be here in less time than that, huh? I think a lot of men speed."
"I actually have quite a lead foot myself."
He nodded approvingly, "Good for you."
I thanked him for driving me to the hospital, and he said wisely, "I have learned that there are a few times in life when you just shouldn't drive. After the phone call when you learn you have cancer is one of those times."  He trailed off a bit, "I don't remember that drive at all." And we talked quietly about our respective experiences finding out that we had cancer. He talked about being angry, how it's so consuming, how it's temporary in the low stages.
He walked me to surgery admitting, wished me well and left to attend to his own patients. It was 5:00. I frantically sent text messages giving Jason directions to the waiting room, letting my mom know what was going on, filling out consent forms and forms identifying Jason as my power of attorney. at 5:30 they called me back to pre-op. A nurse who looked like a high school student waited impatiently as I scrawled a note for Jason, reminding him (unnecessarily) to see that his brother could go to the house to watch the dogs, telling him, "I love you. and I'm scared." Which, as soon as it was on this post-it seemed like a mistake. What if he gets here after I've already gone into surgery and he just has this note that says I'm scared? That would feel awful. I added a tiny "eep!" to keep things light.
I talked with my surgeon who looked disappointed, who rubbed his forehead and gently handed me a gauze pad instead of a tissue when I started to cry as we talked about being realistic, about how the transplant tissue looked bad, about his PA who was going to send me home until Friday. "He what!? That's unacceptable, just totally..." and the surgeon catches himself - keep your medical criticisms to a minimum while at the patient's bedside. Nurses and anesthesiologists came by, looked at me, introduced themselves and wandered off. "I will save it if we can, but I don't want your hopes up. I don't want you to wake up surprised or disappointed. If it's dying, it will make you very sick and it will have to go."
Jason arrived shortly before I was taken back to surgery, I'm sure to the infinite relief of the nurses who were undoubtedly sick of hearing that I really wanted to see him. Could we wait just a little bit to start the iv? He'll be here soon. He left at 4:00, yes, from Kalamazoo. Right, just a few more minutes. Thank you. Thank you. 
He was upset at not having been there, but how could we have ever predicted, ever even harbored such fear? Everything looked the same. This happened too fast.
Nurses tried and failed eleven times to get an iv into my veins. My hands and feet are pocked with their efforts. "You're so nervous" they said, "Your veins are clamping down, crying, no water..." They wheeled my bed toward the operating room as I turned back to Jason, "Get my phone from my purse. Call one of my aunts - tell her to call everyone else. Tell my mom what Dr. Momoh says."

I woke up sore, groggy, confused, asking for Jason, water, and pain medicine. "Soon," a sweet, elderly nurse assured me. I woke up with pain from my new surgical drain, with a raw sensation under my skin from where the transplanted tissue, that dying mass of fat and skin, had been scraped from my skin and chest wall, with only one breast.

It will be weeks before we can talk about a prosthesis, months before we discuss my remaining reconstruction option. In the meantime, I will set about healing, managing the loss, my anger and sense of waste at all that time, all that care-raking, all that healing and frustration, and figuring out how to disguise my lopsidedness so that I can go back to getting around in the world without wearing cancer so prominently.