Sins of Innocence (8 page)

Bob had followed her, his hand on her backside.

“Yes. May I help you?” She tried to ignore the rush of warmth between her legs.

“Hang up,” Bob whispered.

P.J. laughed.

“Ms. Davies, this is Dr. Reynolds’s office.”

Bob’s lips were on her ear. She fought to concentrate. Dr. Reynolds. Her gynecologist.

“Yes?”

“Ms. Davies, you were in for your checkup Tuesday?”

P.J. gently pushed Bob’s hand from her breast.

“Yes.”

“The doctor would like to see you this afternoon.”

“What? Why?”

“He’d like to go over your tests with you.”

Tests? They’d said the pap smear wouldn’t be back for a couple of weeks. She looked at Bob, nuzzled against her.

“What time?”

“Can you be here at two o’clock?”

P.J. glanced at her watch. It was 12:45.

“Yes.”

“See you then.”

“Don’t tell me you have a meeting,” Bob said after she had hung up.

“Looks that way.”

He groaned. “Who?”

“Sound Tech,” she lied. “They need to go over the video sync on the Boyer’s spot.”

“Today? It’s Friday afternoon.”

“And I still haven’t gotten the final word on the partnership,” she reminded him. “Until then, business first. Now out! Let me get my stuff together.”

“What about lunch?”

“I’ll grab a burger on the way downtown.”

“That’s no way to treat that gorgeous body.”

“You let me worry about my ‘gorgeous body.’ ”

He turned at the door. “Are we still on for the Island this weekend?”

P.J. and Bob were supposed to go to his place in Oyster Bay. His two daughters would be there with their families—a weekend of domesticity that P.J. usually enjoyed, as long as it was confined to two days at a time. “Let me see how it goes this afternoon,” she said. “I’ll call you later.”

“Right.” He waved and left her office.

P.J. fell into her chair. Dr. Reynolds. Why did he want to see her? She’d only had her usual physical. Blood test. Pelvic. Pap smear. Mammogram.

Mammogram
. Had something shown up on the mammogram? She touched the fullness of her breasts. No, she thought, not possible. Her breasts were still youthful, perfect—firm enough to go braless, though she preferred her lacy silk bras. No, she thought again. It can’t be my breasts. Maybe something in the blood test … anemia or something. P.J. sighed. Whatever it was, she was certain it would amount to nothing. God, how the medical field
overreacted to everything today. Besides, she couldn’t have cancer. She’d quit smoking more than three years ago.

It had been a long time since she’d felt her palms sweat. P.J. sat in Dr. Reynolds’s waiting room, staring at the coffee table, which was scattered with ragged magazines. It was hard to believe she’d been here only four days ago, sitting calm as could be, proud of herself for having finally worked her checkup into her schedule. She’d already canceled two earlier appointments and had been several months past her yearly date—maybe even a year. No big deal, P.J. had thought. Lots of women, she knew, didn’t bother for two or three years at a time.

“Ms. Davies?”

The doctor’s receptionist stood in the doorway. P.J. rose and followed the woman down a corridor. Everything about the woman was tall. Tall and flat. She looked like a cartoon character who’d been run over by a truck: stretched too tall, and flat from her face to her feet. The only thing missing were the tire marks.

“Have a seat in here. The doctor will be right with you.”

P.J. stepped into Dr. Reynolds’s office and sat on an uncomfortable Victorian settee. The entire office was exquisitely furnished with antiques; a sharp contrast to the sterility of the white painted walls and the silver-framed diplomas. She squirmed on the hard sofa, wondering how long this would take. An “about-to-be” ad-agency partner had no time to waste sitting in doctors’ offices.

The door opened. Dr. Reynolds walked in and sat behind the oak desk, which P.J. assumed was from some previous century. He folded his hands and looked at P.J.

“Ms. Davies. I’m glad you could come in.”

“I take it you think there’s something wrong with me, Doctor.” P.J. needed to get this over with, to get back to the office, then home to pack for the weekend.

The doctor rested his chin in his hands. “I’ll get right to the point,” he said. “Your mammogram shows what appears to be a lump on your right breast.”

She stared at him, knowing he was mistaken.

“… and I think we’d better check it out,” he continued.

Oh, sure, she thought. Modern technology strikes again. She peered across the desk and looked squarely into the magnified pupils behind his bifocals.

“What are you talking about? You examined me. You said there were no lumps.”

The pupils blinked. “And I believe I also told you we can’t always feel them. Please, Ms. Davies, don’t be alarmed. It could be nothing. But I’d like you to see Dr. St. Germain. He’s a surgeon.”

“A
surgeon?
”

“He will mostly likely schedule a biopsy. It’s routine, though. Nothing to worry about.”

“A
biopsy?
”

“I think my nurse has arranged for you to see him now.”

“Now?”

“His office is right down the hall.”

She stared at the doctor again, thinking that someone must have left a door open, for there was a sudden chill in the room. “Dr. Reynolds, are you trying to tell me you think I have cancer?”

The doctor smiled. “I repeat: There’s no need to alarm yourself. Eighty percent of all lumps which show up on mammograms are benign.”

She looked at her hands in her lap. “Well,” she said, “then why bother with a biopsy? Wouldn’t it be better to wait until we’re sure it’s there? Until I can at least feel something? I really don’t have time.…”

Dr. Reynolds leaned forward. “Ms. Davies, you are an intelligent woman. Surely you know one of the advancements in treating breast cancer has been that mammograms enable us to remove lumps at an early stage.”

“But you said eighty percent are benign.”

“Precisely. And twenty percent are not.”

She studied the edge of the oak desk. She didn’t know what else to say.

“My nurse will tell you how to get to Dr. St. Germain’s office.”

P.J. stood up. Her legs seemed heavier than when she’d arrived. “Thank you, Doctor,” she said, and left the room.

She left the limp cotton gown open in the front, as the nurse had instructed. P.J. sat on the hard examining table, feeling the stiff paper crinkle and stick every time she shifted positions. She knew it was absurd to be here: There was no way she had cancer. No one in her family had ever had it; hadn’t she read somewhere that almost all breast cancer was hereditary? Damn the medical advancements. P.J. didn’t care what the doctor said—she knew that there were too many tests done today. Too much money was spent, and too many nerves were being frayed, all in the name of preventive medicine.
I never should have bothered with my physical
, she thought.
I should have been like most women and said the hell with it until next year
. She twisted again on the table. The paper crinkled beneath her. God, it was freezing in here.

The door opened. “Ms. Davies?”

“Yes.”

He moved forward, a file folder clutched in his left hand. He offered his other hand to P.J. “I’m Dr. St. Germain.”

“Nice to meet you.” She realized how stupid that sounded. It wasn’t nice to meet him at all. He was tall and skinny and wore thick glasses. Even worse, he was younger than herself. And his hand was as cold as it was in this room.

“You’re a patient of Dr. Reynolds?”

“Yes.”

“Well, I’d like to do a quick exam, if that’s okay.”

If that’s okay? What did he think she was doing here?

“Of course.”

He set the file down on a stool, then began checking her neck. “Why did you see Dr. Reynolds?”

“Just my regular checkup.”

“Okay. Lie on your back, please.” The paper crinkled again. “Was anything bothering you?”

“No. I don’t know what all the fuss is about.”

He told her to raise her arm. “First mammogram?” He started pressing in small circles on her breast.

“Yes.”

“How old are you?”

“Forty-five. I’d have had one sooner, but I never seemed to have time.”

“Un-huh.” He turned her arm sideways.

“Look, Doctor. I don’t understand what you expect to find. Dr. Reynolds didn’t feel anything.”

He raised her other arm and pressed around that breast, then went back to the right side and started pressing under her arm. P.J. felt as though his fingers were going to poke through the other side. She focused on the ceiling, wondering why she felt so humiliated, wondering if maybe—just maybe—there was a chance she had cancer.

He pressed again; then, abruptly, he stopped.

“Okay, Ms. Davies, all done. Get dressed, and I’ll meet you in my office. The room next door.”

He was gone.

P.J. lay on her back, unmoving. She reached over and touched her breast. There was no lump. She knew there was no lump. Why couldn’t this skinny kid doctor just admit it? God, where were all the old, gentle doctors? The ones you always knew you could trust? Tears spilled out of the corners of her eyes, past her temples, onto the crumpled paper table cover. Was it really possible that she had cancer? God, would they cut off her breast?

When P.J. stepped inside his office, Dr. St. Germain was making notes on a piece of paper; a file folder was opened flat on the desk. He motioned for her to sit, while he finished whatever it was he was writing. She glanced at the paper, at an odd-looking illustration. He was drawing a
red circle on it. Suddenly P.J. realized what the picture was: It was two breasts. With red ink, he had pinpointed the breast lump to the right of what must be a nipple. My God, P.J. thought. That’s me. That’s my lump.

“I think it’s best if we take a look at this as soon as possible,” Dr. St. Germain said, as he reached for a large rubber stamp. He stamped it below the breast illustration. P.J. had spent so many of her early career years reading plates of type, she easily deciphered the title upside down.
PATHOLOGY STATUS
, it read. Beneath that were five points: Tumor Size; Nodes; ERA; PRA; Tumor Type.

“A biopsy?” Aside from Old Mac in the stripping room at Fletcher Printing, P.J. had never known anyone who’d had a biopsy. Old Mac had had lung cancer. He’d died two years ago.

“Yes.”

“When?”

“I’m scheduling you for Monday. At St. Mary’s.”

“The hospital? I have to go into the hospital? And why so soon? It’s not possible for me to go so soon.…”

Dr. St. Germain set down his pen. “Ms. Davies, the procedure requires anesthesia. It doesn’t take long, but you do have to be asleep. As for the hurry, we’ve found it’s better not to let these things wait too long.”

“It’s not possible,” she said. “I have plans to go to Long Island this weekend.”

“Ms. Davies”—he glanced at her chart—“Pamela—you can certainly go through with your weekend plans. But come Monday, I want to see you at St. Mary’s.”

P.J. swallowed hard. “Please,” she said, “don’t call me ‘Pamela.’ Everyone calls me P.J.”

“Okay, P.J.,” the doctor continued as he began scribbling on what looked like a prescription pad, “you’re to have a chest X ray and a CBC—sorry, some blood tests—this afternoon. The nurse will phone the hospital, and they will be waiting for you.”

“This afternoon?” P.J. glanced at her watch. It was already three-thirty.

He stopped writing and looked across the desk at her.
How could a man at least ten years younger than she make P.J. feel so foolish?

“I-I guess I’ll have to call my office. Tell them I won’t be back today.”

The doctor nodded and went back to the note. “Or Monday,” he said.

“We’ll have to make it Tuesday,” she said firmly.

He peered at her over his glasses. “Monday,” he said.

P.J. shook her head. “I can’t possibly have it done Monday. I’m expecting a big promotion at work.…”

“Monday,” he repeated.

P.J. felt her face flush. The rest of her body went numb. “It’s that important?”

“It’s that important. Nonpalpable lumps can be just as malignant as those you can feel. And there appears to be some microcalcification—calcium flecks—in the lump and around it. They could pose a problem. We need to know.”

She twisted in her chair. “Isn’t there any other way to tell if the lump is malignant—other than a biopsy?”

“Sure. Needle biopsy. But in your case, I’d prefer an open biopsy. This was your first mammogram. You had no baseline with which we could compare it. The open biopsy will show us proof positive of what’s going on—the size, the extent.”

Knife-happy
, she thought. “Can’t you see the size on the mammogram?” She detected a sigh.
Screw him. It’s my breast, not his
.

“Mammograms can distort the problem. The lump may not be as large as it appears.”

As large as it appears?
P.J. palms stuck together. “How large is it?” she quavered.

“It appears to be about five centimeters. The biopsy will tell us for certain.”

It was a moment before P.J. could speak. “Doctor?” she finally asked.

“Yes?”

“If it’s malignant, what are my alternatives? Would you do—what is it called?—a lumpectomy?”

He set down his pen and folded his hands.
“Lumpectomies have become popular, that’s true. But in your case, I’m afraid it’s not possible.”

P.J.’s mouth went dry. “Why not?”

“The size. To put it simply, it’s too big.”

“But you said it might be smaller than it looks.”

“It
might
be.” He shook his head. “I know this will be difficult for you, P.J., but we must be realistic. I rarely perform lumpectomies. I prefer the surest bet. The mastectomy.”

There is was. The word.
Mastectomy
.

“If you’re not comfortable with that, I suggest you talk with someone else,” he continued. “But I feel certain any competent surgeon will advise the same in your case.”

She stared at the doctor’s hands. They were so steady, so unemotional. His palms were not sweating, his nerves were not trembling. She folded her own hands and tried to stop them from shaking. “One more question, doctor. If it’s malignant, will you take off my breast before I wake up?”