Nicole sat alone in the quiet confines of her doctor’s office, afraid to stay and afraid to leave. She’d received the dreaded phone call weeks ago, when a nurse masked the bad news behind a pleasant, yet insistent, appeal to discuss the mammogram results in person. Nicole wanted answers on the phone and disputed a follow-up appointment, citing bad timing, bad weather, car problems, a crazy work schedule, and anything else she could think of to prompt an immediate dialogue and avoid another sleepless night pondering endless what ifs? But for every imploration she threw over the fence, the nurse persisted with steadfast commitment to have the doctor discuss the lab results in person.
She wanted to call her mom again, but she dreaded the condescending lecture from a high school dropout who could barely string coherent sentences, let alone offer meaningful advice about cancer. And with Leland focused on his own ambitions, she had no one to confide in except her stepbrother in Reno with his five kids and an ex-wife with a gambling addiction. Or her married friends embroiled in their own problems—or by teenage coworkers she could barely trust to cook an egg let alone discuss her personal life. That left the studio musician who dropped by at lunch every other day for the same combo meal, with apple slices instead of fries, and some serious flirting on the side. After several attempts, the bad boy drummer had coaxed her cell phone number and continued his pursuit with spoony text messages. She’d obliged with daring snapshots of her cleavage, appeasing any semblance of immorality by engaging in nothing more than a virtual relationship with another man. A relationship she quickly carried beyond the illusory realm to a series of brief, but intimate, encounters. At times, she hated herself for cheating on Leland, but she needed the release.
She tightened her posture in the plastic chair, facing a gun-metal desk with a twenty-seven inch iMac and a goose-neck lamp bent downward. She checked the caduceus wall clock for the tenth time in five minutes. Her gut instinct told her the painful bean-size lump was bad news. Now her heart pounded in her chest with the tempo of a vigorous run. She’d survived the first mammogram. Then the follow-up imaging and ultrasound, which led to a simple biopsy procedure, as the doctor described it.
She sat upright when the man of the hour arrived in green scrubs and a pair of orthopedic clogs. “I really need to get back to work,” Nicole blurted, half way out of her chair before the young physician could close the door for privacy.
“Sorry to keep you waiting,” the doctor offered in a mildly apologetic tone.
“How bad is it?”
The doctor uploaded the pathology results on his computer. “Let me pull up your records.”
“I have no family history of breast cancer. I don’t smoke. I exercise three times a week.”
The doctor tapped the mouse to open a second window. “Your biopsy results show atypical ductal hyperplasia.”
The color slowly faded from Nicole’s face. “How bad?” She imagined a horrific mastectomy followed by rounds of chemotherapy. Hair loss. Nausea with persistent vomiting followed by months of emotional pain and suffering.
The doctor retrieved an anatomical mockup of a woman’s breast from the cabinet behind his desk. He pointed to the plastic milk duct modeled beneath the transparent nipple. “Alveoli cells within this region feed the milk ducts in the breast. In your case, we found irregular cells lining the milk duct region of your left breast. Pathology determined these particular cells are not cancerous.”
Nicole let out a deep breath. “So this is good news?”
“With atypical ductal hyperplasia,” the doctor continued, “malignant lesions can exist elsewhere in the breast and are often invisible from the screening mammogram. Your diagnostic mammogram showed micro calcifications, which can represent calcium deposits in malignant tumors.”
“What are you saying?”
“The data is inconclusive. I’d liked to schedule you for a second biopsy, but from a different region of the breast this time.”
“Do I have cancer or not?”
“I’m not saying you do. I can’t say for certain you don’t. I won’t have a conclusive diagnosis until we run some more tests. You could have benign abnormalities or infiltrating ductal carcinoma.”
“I’ll know more from the second biopsy.” The doctor rolled his chair back. “My staff can set up the appointment for you on your way out.”
“I’m not sure if I can get more time off from work.”
“I strongly suggest you do.” The doctor checked his pager. “If you’ll excuse me…”
Nicole remained in the office, mentally processing the news as neither good or bad but somewhere in between. She wanted to run away from her life as she knew it, but running never fixed her problems—a lesson she’d learned more times than she cared to remember. Nothing made sense anymore. Not the doctor’s inconsistent analysis or her taste in men. And especially not her move to Nashville with a boyfriend who spent more time playing guitar than he did with her. She needed an exit strategy. A fresh start away from everything and everyone. She wanted more than a new beginning. She wanted a brand new life.