She dropped her head to look down at her lap but didn’t say a word.
“I can’t predict the future, Jena. All I can do is be completely honest in telling you I want to marry you. And I give you my solemn vow to try my hardest, to respect you and take care of you and the girls for at least five years so you meet the terms of your trust.”
She stiffened.
He rushed to add, “Does that mean I’m planning to run out and start divorce proceedings the second your fifth check clears? No. Does it mean we’re going to live out our entire lives in wedded bliss? I hope so, but I just don’t know. What newly married couple does?”
“Did you know my mother died of cancer?” Jena asked.
Finally she spoke. Totally off topic but he’d run with it. “No. I thought she died from pneumonia.”
“Secondary to metastatic lung cancer that spread from her breast. I’d been so busy providing her day to day care after the traumatic brain injury, I had no idea the cancer had returned.”
Justin had a vague recollection of Jaci mentioning her mother’s breast cancer in passing maybe back in seventh or eighth grade.
“From the time of her first diagnosis mom and dad’s relationship changed. Cancer wasn’t pretty. Cancer showed weakness. Imperfection. Mom tried to maintain life as we knew it but dad started spending more and more time at the office. Chemotherapy made her sick, surgery made her sore and radiation therapy made her too tired to do much of anything.”
Justin listened but had no idea where she was headed or what her mother had to do with them getting married.
“At the age of thirteen I took over managing the house and the staff and taking care of mom.”
While Jaci spent hours after school and on weekends hanging out with him and their friends.
“When her beautiful blond hair started falling out clump by clump I helped her find ways to hide it. I accompanied her to treatments and held the basin while she vomited and retched. I saw my father, who’d once loved her dearly, look at her with distaste and regret. I watched helplessly as my vibrant, loving mom retreated inside of herself, trying to hide from the sickness and fear, growing more and more depressed as her life spiraled out of control. I gave up my teens to take care of her, and while I wouldn’t have had it any other way, I refuse to put my daughters in the same position.”
Wait a minute. Justin moved to sit beside her on the bed. “Are you trying to tell me you have breast cancer like your mother?” At the age of twenty-four? Were they doomed to months instead of years? Would he have to raise their daughters without her?
CHAPTER SEVEN
“N
O
. G
OODNESS
, no,” Jena said, feeling very naked and self-conscious with him sitting next to her.
“Thank God.” He sounded relieved.
Unfortunately the story didn’t end there. “But I tested positive for the BRCA2, commonly referred to as the breast cancer gene, mutation, which means I have an increased lifetime risk of developing breast and/or ovarian cancer accompanied by an increased risk of developing those cancers at an early age.” Before menopause.
She stood and walked toward the door, trying not to think about him watching her naked butt jiggle.
“Hey. We’re in the middle of a conversation here. Where are you going?”
“To get my clothes.” She came to her turquoise lace bra hanging off the back of a black leather recliner chair first and slipped it on.
“I’m trying real hard to understand, but I think I’m going to need some clarification, small male brain and all.” Justin strolled into the living room wearing a pair of navy boxer briefs and nothing else, his body absolute perfection, a total distraction. “What exactly does your mom having cancer and you taking care of her have to do with us getting married?”
Did he honestly miss the part about her having a significantly increased risk of developing the disease, too? Jena pulled up her matching lace panties, stepped into last night’s scrub pants and glanced at the clock on the microwave in Justin’s kitchen. “I have time for the short version.” She tied the string at her waist.
Justin sat down on the couch, leaned back calm as can be and crossed his ankle over his knee. “Go.”
Jena picked up her scrub top.
“You know I think I’d enjoy what you’re about to tell me a lot more if you kept that off.” He smiled.
She pulled it over her head. “I found the first painful lump in my breast at age twenty.”
His smile vanished.
“Since that first lump I’ve found two more for a total of three in four years. The most recent five months ago.”
“Jena.” He sat up, Mr. Relaxation transformed into Mr. Concern. “I had no idea.”
She cocked her head. “You know this will go a lot quicker if you save all comments and questions to the end.” Please just let her say what had to be said without making her discuss every detail.
“Sorry,” he said, leaning back. “Go on.”
“That’s three painful lumps, three rounds of repeat diagnostic testing, and three needle biopsies, the second one followed by a small lumpectomy, which were all negative, thank goodness.” She bent over to slip on a sock.
“But each time, from finding the lump until I got back the final laboratory report, I spent day and night in a state of panic. What if it’s cancer? What stage is it? What are my treatment options? My prognosis? My life expectancy?” She slipped on the other sock. “This last time was particularly rough.” Being pregnant with twins, away from home, and unable to visit her regular doctors.
“I can’t even imagine,” he said quietly, more to himself than her, so she let it slide.
“I’m a mother now. A single mother responsible for two babies. What happens to them if I get sick and can’t care for them? What happens if I die?” And per usual, whenever she thought of her daughters growing up without her, Jena’s chest burned with sadness and a lump of despair balled in her throat.
“I—” Justin started.
“No.” Jena held up a finger and cut him off. Because for the purposes of her decision making, the issue was not who would care for the twins, only that if she did not take action to decrease her risk of developing cancer, it might not be her wiping their tears, kissing them goodnight, or cuddling with them before bed. It most likely would not be her talking to them about boys or shopping for their prom dresses or planning their weddings. And no matter how loving her replacement might be, the overwhelmingly distressing fact that it would be someone other than Jena left her heartbroken.
“I can’t live with the threat of cancer looming,” she went on. “Feeling like I’m on death row, my days on earth numbered, not worrying about
if
it will strike but
when
. I need to take control of my life. For me. For my daughters.” She slipped her feet into her clogs, walked to the recliner, and sat down facing Justin. “I’ve researched my situation and learned about genetic testing. I spent hours with a geneticist—which is largely responsible for maxing out my credit cards—discussing the risks and possible outcomes of testing, addressing why I wanted the test, what I planned to do with the information, and convincing her I wouldn’t allow a positive result to negatively affect my life and my relationships.”
“Yet you
are
letting it negatively affect
our
relationship,” Justin pointed out.
Maybe, but to protect them both. “Well we didn’t have a relationship at the time. And it’s not affecting our relationship in the way you think.” How to explain... “People handle the results of their genetic testing differently. I’ve decided to take a proactive approach. I have two first degree relatives—my mother and her sister—who were both diagnosed with breast cancer before menopause. My aunt found her first lump around age twenty-five. Stage three. She died before her thirtieth birthday.”
Justin looked stunned.
Try sharing genetics with a woman first diagnosed at the age Jena would be turning in two and a half months.
“My mom didn’t make it to fifty, granted she had other contributing factors. As for me, at a young age I’ve been diagnosed with dense breasts, another risk factor for developing breast cancer, and I’ve tested positive for a harmful genetic mutation. Yet instead of feeling doomed, I feel empowered.”
His mouth opened but nothing came out.
So she kept the conversation going. “Because based on my research and evaluation of my cancer risk and the results of my genetic testing I can make a rational, educated, informed decision on how I want to proceed.
Before
cancer invades my life. I’m in control.” Jena took a deep fortifying breath in preparation for the next part. “Which is why I’ve decided to undergo bilateral prophylactic mastectomies with immediate reconstruction and, at some date in the future, after I decide for certain I don’t want any more children, but no later than age thirty-five, a total abdominal hysterectomy.”
Justin stared at her blankly. Information overload. Understandable. Been there.
“Prophylactic?” he asked.
“As in preventative or protective. Removing the breast tissue will significantly
reduce
my risk of developing breast cancer.”
“Does it eliminate the risk?”
“No.” She shook her head. “Because it’s impossible to remove all the breast tissue.”
“So.” He stood. “Just so I’m sure I understand.” He crossed one arm over his waist, rested the elbow of the other on his wrist, and traced his goatee in a downward motion with his index finger and thumb. “You’re planning to have two major elective—am I correct in assuming they’re elective?” He looked down at her for confirmation.
She nodded
“Two major
elective
surgeries that will disfigure your body and put you at risk for any number of surgical complications, because there’s a chance that you
may
, at some point in the future, develop cancer.” He moved both hands to his hips. “And you honestly think
you’re
in control not the threat of cancer?”
“I can do without your sarcasm, thank you very much.” Jena stood, too. “I knew you wouldn’t understand and that you’d completely miss the point and focus in on the breast surgery and nothing else. Because heaven forbid the woman you marry didn’t have big, beautiful,
real
breasts. They’re your favorite part of the female anatomy, after all. And that, in a nutshell, is why no, I won’t marry you. Bottom line, it’s my body, and I decide how I will take care of it. You,” she pointed, “don’t get a say.”
She turned to leave but stopped short to look over her shoulder and add, “And for the record, deciding to have surgery to significantly decrease my high risk of developing cancer gives me a control I wouldn’t have once the cancer cells invade my body. No chemotherapy. No radiation therapy. No living with the threat of dying,” she ticked each one off on her index, middle then ring finger, “day after day for months while waiting to see if the treatments were effective. You don’t know what it’s like.” Tears leaked out of her eyes and ran down her cheeks as she remembered her mother’s torturous battle against the disease. “As long as I have the choice, I choose life. And if choosing life means I have to live it without a pair of breasts and a uterus, then so be it.” Jena continued on to the door, had to leave or she’d collapse to the ground exhausted by this journey, trying to be strong and independent but feeling so very alone.
“What about Jaci?” Justin asked quietly, stopping Jena dead in her tracks. “What does she think about all this? What’s she going to do?”
Jena whipped her head around. “She doesn’t know and you can’t tell her. Promise me you won’t tell her.”
“You mean you have the deadly cancer gene and you haven’t told your identical twin sister who likely has it, too?” he chastised.
Like Jena would willfully, and with a total disregard for her sister’s wellbeing, withhold potentially lifesaving information. “It’s a genetic mutation and she knows I went for testing but asked me not to share the result. And I respect that. She knows her risk is the same as mine and she’s chosen regular cancer screening for early detection.”
“Which makes perfect sense.” Justin threw his hands up in the air.
“For her,” Jena stressed. “She hasn’t had three cancer scares in four years. She’s not a mother. Maybe when she has children she’ll change her mind, maybe she won’t. It’s
her
choice. And when our girls turn eighteen, I plan to be around to discuss their choices, as a living example that a strong family history of breast cancer and positive genetic testing isn’t a death sentence, as a role model for taking control and seeking options. I will help them get the most up-to-date medical and treatment information. Then I’ll support their decision regarding how they want to proceed.” So they didn’t have to go it alone like she had.
“If you wanted to keep the surgery quiet, why come home? Why not do it in South Carolina or anywhere but here?”
Because she needed to give Jaci time to get accustomed to caring for her nieces and make sure she’d be comfortable with the role of guardian. And she needed to be close by in case something went wrong with the surgery so Jaci could assume the responsibility immediately. “Some of the best doctors and hospitals in the world are within an hour of here. My doctor, who I trust implicitly, is here.” Jena turned to pick up her sweater. “Now if you’ll excuse me.”
“No,” Justin said. “I won’t excuse you.” He joined her in the entryway, crossed his arms over his chest and leaned his shoulder against the door, looking like he had no intention of moving any time soon. “So far you’ve been doing the majority of the talking and now I’d like a turn.”
Jena took her watch out of her pocket and checked the time.
“Jaci and or Mandy will take care of the twins if they wake up. Now answer me this,” he said. “What happens to
our
daughters if something goes horribly wrong during your surgery and you don’t survive? Don’t look at me like that. You’re a nurse, you know all about complications and surgical risks. Don’t tell me they hadn’t crossed your mind.”
Of course they had. The risks and benefits of going through with the surgeries had been clogging her mind for months. Day and night. “I’ve had legal documents drawn up, signed and witnessed in the presence of my attorney. If I should become incapacitated, Jaci has my power of attorney and can make decisions on my behalf. If I should...” thinking about it was bad enough but saying it out loud, actually hearing the words was excruciatingly difficult, she cleared her throat, “die, everything I have goes to the girls and the girls go to Jaci who’s agreed if anything happens to me she’ll adopt them and love them, provide for them, and raise them as close to how I would want them raised as she can manage.” Although she didn’t know it, Jena had left a guide of very detailed instructions with her attorney.
“Unacceptable,” Justin yelled.
“You have no say,” Jena yelled back.
“Now that’s where you’re wrong.” He lowered his voice and narrowed his eyes. “I may not have a say in how you treat your body, but I most certainly have a say in the lives of
my
daughters, and I refuse to allow you to put me in a position where I have to fight someone for custody.”
Jena grabbed the kitchen counter for support. “I didn’t think you’d—”
He leaned in, angry, crowding her. Jena took a step back. “Because apparently
you
don’t know
me
all that well, either. I’m not the boy you knew in high school. I’m a responsible adult, and I am determined to do what’s best for
our
daughters, which is why you
will
marry me and you’ll do it
before
your surgery.”
“But—”
“This isn’t about you or me, Jena. This is about doing what’s best for Abbie and Annie. It’s about them settling in here and getting comfortable with me, and me learning to take care of them before, God forbid something happens to you, so they’ll have the stability of familiar surroundings and at least one parent in their lives.”
Justin made sense, and she’d be lying if she didn’t admit a teeny tiny part of her may have, in private and without her permission, hoped for this very outcome. But, “There’s no way—”
“You need to get married. I want to marry you. Why are you making this so difficult? Do you find me so objectionable—?”
“If you’d let me finish,” Jena interrupted him. “Regardless of what either of us wants, there’s no way we’ll be able to get married before my surgery.”
Justin stood totally still. Watched her. Understanding dawned. “It’s already scheduled. How? You just got your money back. You have no insurance. And how did you plan to sneak off and have the surgery without Jaci finding out?”