Regret Not a Moment (58 page)

"The lump is definitely suspicious,” he was saying, his manner one of professional detachment, “but I’m afraid that the only way to give you an accurate diagnosis is with a biopsy, Mrs. Somerset-Smith. We can check you into the hospital tomorrow and perform the surgery the day after.”

Devon’s eyes, full of apprehension, met those of the smooth young surgeon who had just examined the small knot in her left breast. Her family doctor had referred her to him. Had called him “the best man in the region.” Why did she need the best man in the region?

Because there was something ghastly and foreign invading her body. Something that didn’t belong there. She hated to touch it, hated even to look at her breasts nowadays. She just wanted the hard little lump gone. At first, she had awakened each morning and felt the spot, hoping that it would miraculously
be
gone. But it was still there. The same. Or was it just a little bigger? Was it growing? She had to know. And ultimately, the horrible anxiety had driven her here, to Dr. Donatello.

Now, practically speechless with fear, she was able to utter no more than the word, “Tomorrow?”

“I believe it’s advisable,” said Dr. Donatello formally.

Devon stared numbly out the grimy window behind the doctor’s desk. Despite the dirty panes, the bright spring sunshine poured in through the little opening. Yet Devon was shivering. This is a nightmare, she thought. She had the feeling she was being pushed through a dark tunnel.

Finally, Devon spoke the words that were spinning in her head. “So you must think it’s…” She couldn’t complete the sentence, holding to the ancient, irrational superstition that to avoid the mention of cancer was somehow to avoid the disease itself. Cancer, always spoken of in whispers. Oh God! Was that what was in store for her? She stared at the doctor, unconsciously shaking her head no, urging him to deny her worst fears.

The doctor did not answer her directly. He looked up from the clipboard he was studying, seeming to focus on her as a human being for the first time. This time he spoke more gently. “Do you have any family with you today?”

The words, and what they implied, were like a physical blow to Devon. For a moment she forgot to breathe. The color drained from her face. Struggling to maintain her equilibrium, she replied in a trembling voice, “I came alone.”

Devon had been too afraid to discuss her problem with anyone. If she told Francesca and Laurel, they would interrogate her endlessly, push her toward action, urge decisions on her. She needed time to adjust to the possibility that the terrible disease had invaded her body. A disease of withering, wasting death. Slow and filled with excruciating pain. Was there enough time in all eternity to adjust to such a blow?

The voice of Dr. Donatello invaded her thoughts. “Let me explain to you the procedure.” Devon nodded dumbly, desperate to find some shred of reassurance in his words. “Our first step is to biopsy the lesion. We can’t be sure it’s malignant until we’ve done that. We take a frozen section to the pathology laboratory while you’re still under anesthesia. Also a sampling of your lymph nodes. If there is a malignancy, we excise the lesion and perhaps the surrounding musculature and tissue. It depends on the extent of nodal involvement. If there are no lymph nodes involved, we would only remove the breast, not the surrounding muscle.”

“You can’t mean you’d remove my breast the day after tomorrow?” Devon cried, fighting to control the fuzzy sensation of faintness that was making the room spin around her.

“It’s standard procedure when we discover a malignancy, Mrs. Somerset-Smith. That way, you only undergo one operation, one anesthesis, one recovery. Provided, of course, there are no complications.”

Now panic swept over Devon. What was this cool young man saying? Complications? Standard procedure? That she could wake up with her breast gone? Devon clamped her eyelids shut. She had to suppress the urge to run screaming from Dr. Donatello’s office. Unable to respond to the doctor, Devon slumped forward, one elbow on the edge of the doctor’s desk supporting her head.

“Mrs. Somerset-Smith.” Dr. Donatello’s voice came to her, distant and tinny. “Perhaps you don’t realize that many people who have had cancer go on to live normal lives. That’s why I recommend quick action in cases like yours.”

Devon could not speak. Her body seemed to be made of rubber—weak and wobbly. She did not have the strength to do other than remain as she was, her face hidden in her hand, as though the darkness could provide an escape from reality.

The doctor was accustomed to reactions like Devon’s. People did not understand that great strides had been made in cancer care. He leaned forward and spoke slowly and deliberately, offering what he thought to be encouragement. “When the breast is removed early enough, and with proper follow-up care, we have had very positive results.”

There was a moment of silence as the doctor’s words penetrated the mind-numbing fear that gripped Devon’s consciousness. Slowly, she lifted her head and stared at him. “What… what do you mean, ‘positive results’?” she stammered.

“I mean no recurrence of the disease.”

Impossible, thought Devon. Cancer was a death warrant. In a voice filled with bitter disbelief she said, “But everyone I’ve ever known with cancer has died!”

“That isn’t so any longer,” Dr. Donatello said firmly. “If the disease is found in the early stages, then I think you have a good chance to make a full recovery.”

Devon straightened in her chair, so that her eyes were level with the doctor’s. She searched his face for the truth, wondering if what he said was possible. “You mean,” she asked incredulously, “I won’t have cancer anymore?”

He gave her a half smile that did not touch his eyes, then said carefully, “Well, sometimes the disease recurs. Sometimes not for five or ten years. But people quite often go on to live a normal lifetime.”

“Normal…” Devon tried to digest the meaning of Dr. Donatello’s words. “Do you mean,” she asked, her voice tremulous with hope, “that people are able to do whatever they did before?”

“Yes, for the most part.”

Devon stared at the doctor as she tried to organize her thoughts. She was coming to the realization that the lump in her breast would not necessarily kill her—if she entrusted herself to this man. Yet for all this, there was another aspect that she found shattering.

“There’s something I don’t understand,” she began, reflexively folding her arms across her chest as though to defend herself from an assault, “if I only have a lump, why does the whole breast have to be removed?”

Dr. Donatello seemed interested in the question. He tapped the eraser of his pencil on his desk as he explained, “There are, I’ll admit, some advocates of removing only the lump in cases where there is no involvement of surrounding lymph nodes. But it’s a maverick outlook. In another decade or so, we may have studies indicating that a limited procedure results in a survival rate comparable to mastectomy. But for now, accepted practice is to remove the entire breast as a precaution against further spread of the disease.”

Devon’s face clouded with frustration. He was talking about her body but she didn’t understand what he was saying! “What are these lymph nodes you keep talking about, for God’s sake?”

“Under your arm, throughout your body, really, lymph nodes act as the filters for infections and other so-called invasions of your immune system,” the doctor said calmly.

“But you’ll remove the ones under my arm if you find… cancer in them?” Devon’s voice rose again in alarm. “Then what will happen if I get a different disease? How will I fight it?”

“It’s true that the risk of infection on that side of the torso will be greater,” the doctor admitted. “But we must balance that risk against the greater risk of cancer.” The doctor looked at his watch and stood up. “So that is my recommendation, Mrs. Somerset-Smith. If you’d like a second opinion, I can give you the name of a good man.”

Why did doctors always say “a good man” when referring to one another, Devon wondered bitterly. Dr. Donatello seemed like an automaton, not a “good man.” Still, if her family doctor believed that Dr. Donatello was the best, why delay? As it was, she was living almost every minute in fear and suspense. At least if she knew the truth, she could move forward with a remedy. And there
was
a remedy—Dr. Donatello had said so.

“No,” Devon said finally, taking a deep breath for courage. “Let’s go with the schedule you suggested. I just have one question: If my lymph nodes are all right, then am I going to live?”

For a brief moment, something like sympathy seemed to touch Dr. Donatello’s features. And Devon found that expression more frightening than anything that had preceded it. “I don’t know,” he said softly.

Devon felt a sickening thud at the pit of her stomach. But she wasn’t ready to die! She was only fifty-seven years old! There were so many things she wanted to do yet!

“Mrs. Somerset-Smith, will you be all right?” the doctor asked.

Devon looked up and met his eyes. “That’s what I just asked you,” she replied wearily. Oh, she felt drained. Drained from the tension that made every muscle tight, every nerve raw.

“Mrs. Somerset-Smith, if it’s any comfort, I have performed this operation a multitude of times. If we find that the lump is benign, or that the disease is contained within the lesion itself, then there is every likelihood that that will be the end of it. Or we may recommend radiation therapy. We’ll know more after the operation.”

“But if it is… malignant… you’ll still remove the breast?” Devon asked, hoping irrationally that this time his answer would be different. But it wasn’t.

“If there is a malignancy, yes.”

“It’s crazy, I know, but I never thought about Mother dying,” Francesca sobbed into her grandmother’s orange blossom-scented pillows. “She always seemed so strong. She seemed immortal.”

“Parents usually seem that way to their children,” said Laurel. She sat on the bed beside Francesca where the girl lay facedown on the down-filled comforter. Francesca felt her grandmother’s hand gently smoothing her curls, and the touch of the old woman quieted her tears somewhat. It was twilight, and Devon had just returned from Johns Hopkins to inform them of her news. With what had been for her an almost superhuman act of self-discipline, Francesca had suppressed her tears of panic until her mother had excused herself, professing a desire to be alone.

Then the flood had come, and Francesca had turned for comfort to one who needed it even more. For Laurel would never have believed that she would live to witness the death of her daughter. It was a possibility too heartbreaking to contemplate and she was grateful for the presence of Francesca. In searching for words of reassurance for her granddaughter, Laurel found she was able to find hope in her own heart.

“There’s no reason to be speaking of death,” said Laurel, “until we know what the situation is. The doctor told your mother that the operation might be the end of the disease.”

“But the word just sounds so scary. Cancer.”

“It
is
scary,” Laurel acknowledged, suppressing her own tears, “but your mother is strong. If anyone can fight it, she can.”

Francesca turned over to face her grandmother, propping herself on her elbows. “That’s true, isn’t it?” she asked hopefully. “Mother is the strongest person I know.”

“And she has you and Grace and me to give her even more strength.”

Francesca hugged her grandmother, burying her face in the silk of her dress. The old woman wrapped her arms around her. Francesca clung to the smaller woman.

“Think of it this way,” said her grandmother gently, “in forty-eight hours we’ll know what the situation is. Whatever the outcome, we’ll work it out together.”

Francesca lay awake, so worried that she was unable to sleep. She leaned over and turned on the lamp on her bedside table. Peering at the alarm clock, she saw that it was past two o’clock. She was normally up by four-thirty for her morning exercise rides. There was almost no point in sleeping now. Still, she turned off the light and squeezed her eyes closed, willing herself to relax.

Unbidden visions of a future without Devon invaded her mind. What would it be like? She would be an orphan. Her grandmother was old; soon she would die, too. Francesca felt completely alone in the world.

How she missed John! He had taken a post as ambassador to Belgium three years before, when Eisenhower had been president of the United States. It had been expected that John would be replaced when Kennedy took office in 1961, but the wheels of government often moved slowly, and John’s replacement had yet to receive Senate confirmation. It was a tribute to John’s exceptional qualities that President Kennedy had asked him to stay on in the post until the new man was sent. In contrast, the resignations of most other Eisenhower appointees had been accepted by the Democratic regime.

Francesca calculated the time difference between Virginia and Belgium. She had spent one month with him the previous summer and she could envision him breakfasting before the huge leaded windows that overlooked a courtyard lush with greenery. Then, reaching a decision, she leaned over and picked up the telephone.

Devon, in the foggy world of half-consciousness, could hear her father’s voice, sad, worried. His hand reached out and touched her foot. She tried to speak, but no voice emerged. Then she tried to move her foot. Oh, she hurt! Even breathing seemed to cause her agonizing pain. Why did she hurt so? Then she remembered. She had fallen while riding Sirocco. And more than just her body hurt. She felt as though her heart were broken. John. That was it. John Alexander had left her. Had gone back to New York without even saying good-bye. Tears streamed down her face.

“Is she conscious?” whispered John, leaning over Devon.

“She’s crying!” exclaimed Francesca. The sight frightened her. Devon looked so slender and vulnerable with the tubes going into her arms and nose! She must be in terrible pain, Francesca thought. She grasped her mother’s hand, but there was no responding pressure.

“When will she wake up?” Laurel asked the private nurse who stood quietly looking on.