The best laid plans of mice and men often go awry

I know professionally that if you are in a fight the road is windy, you need to be smarter than your opponent, strategic, clear thinking and agile. You also need experts to assist you with decision making. It is important to realise that your experts know more than you do and their advice is independent and dispassionate. You need to listen carefully, do your own research, ask lots of questions, work closely together and most importantly you need to have trust and confidence in them.

From early on I have felt I was in the right hands.

The day before my appointment to make my surgical plan I worked from home. I had trouble breathing and my chest hurt. Rather than assume I was suffering from anxiety I convinced myself I had lung cancer. Look I confess that even I in that moment thought I was over reacting but I have a very busy mind and sometimes I have trouble keeping it in check. I have a lot of trouble maintaining focus unless I find something absorbing. I found my self diagnosis absorbing, terrifying, but absorbing.

When I visited Steve, my surgeon, on 21 April he asked me how I was and I told him I thought I might have lung cancer. Now this is the moment that I knew he was the right surgeon for me. He fixed me with a steady gaze and said “What was your first clue? Was it coughing up blood or the blue, grey pallor of your skin?”

I burst out laughing. If Steve was not my doctor I like to think he would be my friend. We appear to share a very similar sense of humour.

We talked, I asked him my hand written page of questions and we decided upon a partial mastectomy of the left breast and auxiliary node clearance. Surgery was scheduled for 5 May. I told him I had two trials - one in August and one in October. He told me I would probably be having chemotherapy until October. As an aside I have cried twice since my diagnosis, the first was before I handed over those two trials and the other time was when I heard the song “Cover me in Sunshine” randomly play on the car radio (listen to the lyrics). https://youtu.be/vGZhMIXH62M

Steve gave me his phone number and email, told me he was going on holiday the following week (as was I) and encouraged me to direct any questions to him. Poor man, he probably lived to regret that lapse of judgement.

Back at work I had flowers waiting. I steeled myself for a partners’ meeting where I knew I had to hand over all my files. I am so very lucky to have the team I helped create. I trust them and can rely on them. They swept in, took everything away and insisted I concentrate only on getting better.

The following days were spent letting clients, experts and other counsel know. I hoped that the information would trickle out, lawyers are notorious gossips, so I wouldn’t have to keep saying it.

I think the MRI scan on 23 April was the single worst medical procedure I have ever experienced. What the f#%k Is wrong with that thing? Why does it sound like a disintegrating aircraft? Does it need to be that loud? Why did my arms need to be in the air? Whose arms can do that without getting pins and needles, hurting like all hell and then going dead? If I wasn’t so pissed off about it I probably would have cried for the third time. Anyway I cannot emphasis enough how much I hated it - and at best it saved my life and at worst it saved me from an enormous amount of inconvenience and mortal terror. But we shall dwell on that later.

The following week I went to Wellington with Eva to tell my sister the news in person. I wanted her to see that I was well and fit and OK. On my last night in Wellington Steve sent me a text to see if I was free to discuss the results of my MRI at 8:40pm. There was more cancer showing on the MRI in the ducting of the left breast. The right breast was clear. It would mean a lot more tissue would be taken but for someone whose always wanted smaller boobs the most excellent news was that it would give me a breast reduction for both boobs. I was almost happy. My surgery was delayed by a week and I had another appointment with Steve on 6 May. Meanwhile I dreamed of jogging and thin strapped sun dresses.

On 6 May I was ushered into the ultra sound room with a grim faced Jeremy. The lovely breast nurse Julianne was there too. Jeremy was clearly looking for something. When he located whatever it was, he went to talk to Steve. Steve came into the room and they both stared intently at the ultra sound screen as they viewed the cancerous tissue from various different angles. They both looked grim. Now the thing I have learnt about doctors is they’d make terrible poker players. If you have doctor friends I suggest you invite them over for a card night, ply them with whiskey and take all their money. I wiped half a tube of gel off my chest, tied the easy access gown at my waist and followed Jeremy and Steve to the imaging room.

They showed me the main MRI image. It showed the lit up lump and the cancerous ducting. Sitting behind that image were lots of other images. In some of those images there was another lit up bit. That is what they had been looking for. There was a heavy silence. I broke the silence by asking “Does this mean a mastectomy?”. The answer was “Yes”.

Nothing prepared me for that answer. However, I was so over that homicidal boob I wanted nothing more to do with her. I might have been in shock but I wanted her gone. I could have a reduction of the other and a reconstruction. I wasn’t keen on an implant - I was about to take cancer out, why put something else foreign and potentially unfriendly, in? Alternatively a new boob could be made out of my own tummy fat. I preferred that option. Steve needed to check the plastic surgeon‘s availability as she was booked up. There was also the possibility of chemotherapy to shrink the tumour and preserve the breast. Steve needed to speak to the oncologist about that. He promised he would make those enquiries and call me later.

Still in shock I returned to work. I was due in court on Friday and I knew I could not do it. My work mates had been amazing at stepping in and taking stuff off me and enter stage left the first act of kindness of a member of my profession who simply agreed to adjourn the hearing.

It hurt to breathe again. The MRI had ruled out lung cancer but I entertained the idea for another minute or so. At least I could be grateful I did not have lung cancer.

While I was concentrating on breathing Steve had called and left a message. He had spoken to the plastic surgeon and she had had a cancellation in 5 weeks time. I knew I could not wait that long. Steve was 60/40 in favour of cracking on. I also wanted it gone. This was war and my left boob was about to become a casualty of war. I texted Steve back ”I am going to crack on with it”.

Steve called while I was driving home. My car is so old I don’t have built in Bluetooth. I told him I needed to turn the car stereo down. He asked if I was listening to ABBA.

”Not unless they have a farewell to your left boob song” I replied.

”They probably do” he said. It made me laugh. Later I conducted some research and they sort of do. https://youtu.be/tUh4u-lYEhM

Steve had spoken to the oncologist. In certain cases chemotherapy can be administered before surgery to shrink the tumour in the breast and lymph nodes. It can downsize a large tumour to make breast conserving surgery an option rather than a mastectomy. So far, clinical trials have not shown that giving chemotherapy before surgery increases or decreases overall survival as compared to chemotherapy afterwards. I do not know how to explain it except to say I had lost all love for my left breast, she was trying to kill me and we needed to break up. As ABBA had so beautifully expressed it, we’d had some good times together but now I felt the autumn chill. For my own sanity I needed the cancer out, gone, smote. So the decision remained the same - off with her breast!

The weekend before surgery I reflected on the gift Jeremy and Steve had given me. I was too shocked at the time to express my gratitude to them for finding the other lit up bit in the MRI images. They probably saved my life - or at the very least - saved me from another bout of cancer in the future. I will always be grateful to them. They are my dispassionate, independent experts and I trust them absolutely.

The road has been windy. We had three surgical plan changes but we were strategic, clear thinking and agile. We came to the right decision for me.

The title of this piece is a line from a poem by the Scottish poet Robert Burns. In a wee tribute to Steve I have quoted some of the English translation as it has a breast reference (unlike the ABBA song):

Little, cunning, cowering, timorous beast,

Oh, what a panic is in your breast!

You need not start away so hasty

With bickering prattle!

I would be loath to run and chase you,

With murdering paddle! -from To a Mouse by Robert Burns

Unfortunately cancer isn’t loath to run and chase me with its murdering paddle. But I’m not loath to chase cancer with my scapel wielding cancer murdering surgeon either.