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Illustration by Mary Kirkpatrick
The phone rang as I was on my way out of the door for my first COVID-19 vaccine. No one ever calls on the landline. I was bracing for bad news as I ran back in. It was my family doctor. She had called to finally give shape to that nagging feeling that I had carried around for six weeks. The biopsy confirmed the findings of the mammography. I had inflammatory breast cancer.
The cruelty of the diagnosis came wrapped in the family doctor’s kindness. She had called me at 8.30 a.m. on a national holiday to reassure me she had already referred me to the cancer centre, that she would be there for me, and that I should hope for the best even though the news was not good.
At that moment my last shred of hope – maybe it is not breast cancer, after all, as I had no lump – was lost. Inflammatory breast cancer develops when cancer cells block the lymph vessels in the skin, causing the breast to become swollen. I realized now the lack of the lump had been no reason to feel reassured. Inflammatory breast cancer is rare and extremely aggressive. It develops more often in younger women and women of African ancestry. Being young – and in the world of cancer, 44 was young – means you have a greater risk of reoccurrence. I had gone from being a geriatric mom to an ingénue on Planet Cancer. All inflammatory breast cancers start as Stage 3 since they involve the skin, and breast conservation surgery (lumpectomy) is not considered.
I said goodbye to my breasts that day, long before I sat down with a surgeon. I also planned the things I’d do with my toddler while I was still healthy.
These dark thoughts held the tears at bay as I pulled into the COVID vaccine drive-through clinic and rolled down my window. The young volunteer, perhaps noting the sheer panic on my face, patted me on the shoulder. You will be okay, she said with a smile as she jabbed me on the upper arm. See, it’s nothing, not even a mark. Her hand rested lightly on my shoulder, the comforting touch of a stranger at a time of trauma. I thanked her for her kindness; she had said I would be okay.
In the 15 months that followed, I would encounter and cherish many such gestures. I spent several hours in the cancer ward every two to three weeks. With the pandemic restrictions, no family or friends could join me. Instead, the nurses became my support team: small gestures and routine queries felt like warm hugs; gentle touches as they noted the changes to the skin or the nails; probing inquiries into the less visible side effects; smiles of recognition as they bustled around between patients; compliments on the scarves covering my bald head, and then on the grey fuzz that had replaced dark curls.
Other strangers became intimates, too. I have never seen my social worker’s face, but we have chatted on the phone for hours. Only she knows how afraid I was in those many months when I took long walks to fake my way to health. Shared anticipatory grief turned strangers in support groups into kin. A Toronto chef running a session on cancer and diet felt, for a moment, like a long-lost sister bearing soup and good advice. The fitness instructors for my online exercise group for cancer patients saw me through physical transformations that I wouldn’t share with some of my closest friends as I turned off the video during our online chats.
My friends from near and far held me up, of course. They brought me warm meals and treats to comfort me. They sent letters and gifts to cheer me up. They walked with me and made plans for the future. But the alchemy of cancer also makes caregivers of complete strangers. I received pretty, handmade objects made by kind folk I would never meet. The receptionist at the cancer centre offered me the pick of the warm hats. I received knitted knockers – or “foobies” – to fill out that space where my breast used to be. On the day of the mastectomy, the nurse brought me a cheery-looking pillow to rest my arm, and a tiny handmade bag to hold surgical drains, both made by a talented stranger.
But, perversely, there were times when I felt like I missed random strangers with their petty cruelties that I had encountered before cancer. Like the woman at the café, months before my diagnosis, who’d noted my brown skin and decided she would not understand my accent. Or like the couple that wondered aloud why I was “loitering” in the public space outside their waterfront condo. I wondered if cancer had erased the aspects of my identity that triggered my strong responses to these varied and often cruel words. Had I lost myself and become the kind of person who must be forever buoyant about the kindness of strangers? Would I never again suffer and protest small indignities as I turned into someone who was grateful to be alive? Had this grasping for happiness eviscerated my right to be enraged?
I was reassured that everything was back to normal during the week I prepared for my second mastectomy. A friend hoping to visit me from India for the last steps in my long treatment had her visa application rejected. Her request to visit Canada was refused, the letter explained, because the immigration officer wasn’t convinced she would leave at the end of her visit.
Anger surged through my body at the outrageous insinuation that my friend would abandon her family and home to flee to Canada. I would protest. Not because I want special treatment as a cancer patient, but because I have the right to be surrounded by more than the kindness of strangers. I would fight this till my friend got her visa to visit me, some time in the next few years.
And just like that, I knew I would be okay.
I was back. Outraged and ready for action. But maybe also a tiny bit grateful to that stranger who’d refused my friend’s visa for making me whole again.
Ishita Pande lives in Kingston, Ont.