The Body Geographic
title essay in The Body Geographic, a collection of essays and poetry​

          I finger the knotted skin in the crease of my neck, the one just above my collarbone. The lump's not there anymore; it hasn't been for years. There’s no sign now of how hard it was, or how much it hurt when I pressed it.
          It was 1974, January and freezing. Gusts of cold wind encircled my neck as I waited for the tube at Kings Cross. A train drew up to the platform, heading north toward home as I absently stroked my collarbone. My fingers stumbled over a bump, went back and stumbled again. I'd never been sick, not even as a child; I was the only one of seven kids not to get chicken pox, measles or mumps. Alarmed, my fingers rush to the other side to see if the same round ball lay on the other side. I was just about to turn nineteen and still getting used to the shape of my body. My heart started racing as my fingers found the muscle smooth beneath taut, flat skin as the train shrieked to a standstill in front of me.
          My GP thought it was tuberculosis and sent me with a pink paper slip to St. Mary's in Paddington. There I was prodded and poked, needles stuck in my arms and between my toes as a team of doctors tried to figure out what was wrong with me.
          I had never been touched so much. Their hands were everywhere: my neck, my head, under my arms, my elbows, the inside of my elbows, groin, hips, back of the knees, ankles and feet. Cold steel was tapped against my bones and I drank thick, chalky white fluid before standing in front of a blue machine to be X-rayed. Then needles were stuck between my toes and my feet slashed so tubes of dye could be shoved in while I screamed "Fuck! Shit!”
          A nurse held my hand to calm me down. She smiled at how I was swearing like a sailor while interns watched a TV monitor that traced the blue ink through the web, rivers, deltas of glands that were supposed to cleanse toxins from my body, but instead may have been obstructed by clumps of angry, immovable cells.
          Geography, my body metamorphosed in an instant of fumbling into a map. I felt white inside, prickly, like an explosion of needles was charging up through all the oceans and continents of me. Later, I pissed and shit green as they told me I would. That night, my head on starched hospital pillows, I dreamed my body didn't have any skin, I was only muscles and veins swimming in green and blue gunge.
          The morning after the lump in my neck had been removed, my mother came to visit from her house in Surrey.
          "Hi, Mom," I said dully, glancing over at her nervously. She wore pink shag, orange lipstick and white boots with a fringe. I tried to look like I didn't know her. I knew my mother was crazy. Her erratic moods and swing shifts with Valium and electric shock treatment was ample proof, let alone the way she looked, and I didn't want anyone to think I was.
          "Here," she said cheerfully, her eyes vacant as she drifted over to my bed. "I brought you some tomatoes."
          "Thanks," I said, feeling guilty. "That's really nice of you."
          I bit on the gleaming red skin and sucked the juice from the pulp. The sweet liquid shot into my mouth, strewing seeds down my throat. This might have been the closest my mother could get to love; she knew tomatoes were my favorite food, and I gnawed on them greedily.
          My mother settled herself into the armchair by the side of the bed like a made-up rag doll, her legs not long enough to touch the floor.
          "Dad's away again," she began with a sigh, her lips flattening into a frown. "I don't know why he never asks me to go with him. He just dumps me here with the kids as usual. Like I'm just a stick in the mud." She looked at me, mystified.
          "Why don't you ask him, Mom?" I said, trying to be helpful, wiping juice from my mouth.
          "Why should I?" she snapped, her face knotted in sudden fury.
          I bit my lip, a hot itch at the back of my throat. "Maybe it would help . . ." my voice trailed off weakly.
          "He has a nerve." Her dark eyes narrowed as she swung her legs against the legs of the chair. "All my married life, all he ever did was dump me somewhere and leave. What does he think I am?"
          She was working herself into a rage and I lay there helpless before the force of it. The sheets felt sticky and the air stifling, the smell of ether and floor ammonia rising in waves. I tried to think of what to say that would make her feel better. It didn't occur to me that she should have been asking me how I was, and whether I needed anything. She had brought tomatoes; that showed she cared.
          I was let out for the weekend after a second week of tests. The doctor with a kind face and round, steel-rimmed glasses made me promise to go to the specialist hospital written on the pink referral slip he handed me. He stroked my shoulder and patted me on the back and told me not to worry, that everything was going to be all right. I smiled at him for being kind to me, not sure why I was being sent to another hospital.
          On Monday, I caught the train from Waterloo to Belmont in Surrey, to the Royal Marsden Hospital. The doctor I’d been sent to was called Professor Peckham. He was built like a giraffe, with long legs, dark brown hair and a closely shaved, angular face. After reading silently from a folder, he asked a few questions, then gazed at me from across the desk, his face expressionless.
          "Well," he began. His slim sun-tanned hands were clasped together, his nails slender white crescents. A cold breeze made the windows rattle softly, and I glanced over to see twigs collapsing onto the wet ground outside his window. "You have tumors in the neck and chest . . ."
          "Tumors?" I choked, interrupting him. "I don't have tumors." I knew tumors meant cancer. If I had cancer, someone would have told me.
          He looked at me, bemused. "Didn't anyone tell you?"
          "No." I burst into tears.
          He gazed at me silently, then said, “It’s called Hodgkins Disease. It could be fatal if it’s not treated.”
          I cried louder, holding my hands up to my face.
          “You’ll have to come in and have your spleen taken out.” Professor Peckham stood up and came round to my side of the desk and lay his hands on my neck from behind my chair.
          “While we’re in there,” he continued, his cool fingers pressing in a steady roll of movement from under my ear to my throat. “We’ll take a piece of your liver and your stomach glands and a piece of your hip bone to see if it spread. Then we’ll start you on radiotherapy to the mantel area." He came around and pointed to my neck and chest. "That will get rid of the tumors that we know are there.”
          He sat down again at his chair and began making some notes with his fountain pen. Then he looked up.
“If we find more, we'll treat them as well. We'll also move the ovaries behind the uterus in case we find more tumors and have to radiate down there, too. It shouldn't affect your chances of having children. And we’ll see how you respond to the radiation. If you respond well, you won’t have to have chemotherapy.”
          He tapped the lid of the fountain pen closed with a finger. "You’re very fortunate," he said, clasping his hands again. "Four years ago there was no cure. Dr. Kaplan in Stanford, our sister hospital in America, developed it." He took out his pen again and scribbled something on a small green pad, then tore off the piece of paper and stood up to hand it to me. He touched me lightly on the shoulder. “Take this over to the In Patient Admissions, there’s an opening for you on Wednesday.”
          I stumbled into the corridor and began weaving in circles through the Out Patient reception area, walking straight into a row of plastic chairs where people were waiting. A hand reached out and grasped me. A woman's voice said, "Can I help you, dear? Are you lost?"
          "I have to call my mother," I said thickly, barely registering the elderly woman with wiry gray hair as she guided me to a phone box next to the wide revolving doors of the hospital entrance.
          In the phone kiosk my hands shook so much I kept missing the round numbered holes in the dial. Then fast pips and I dropped a coin in the slot. My mother's voice came over the line. "Hello?"
          "Mom, it's me," I said, bursting into tears. "I have tumors! Can I come and see you?”
          "No," she answered. "I think it's better for you to go home."
          I didn’t notice the row of ambulances parked in a long row outside the revolving doors as I came back out of the phone kiosk, or the cluster of drivers hanging about smoking by the entrance. Light gray gravel covered the crescent of driveway beyond them, beneath a thick mist of rain. I didn’t know which way to get to the street that would take me back to the train station. I took a left but found myself wandering among rows of parked cars, so I turned around and arrived back in front of the hospital. The building was long, with two separate entrances, and I headed for the door furthest away so I didn’t have to go through the revolving doors, back to the cold left by my mother. But no one was inside to ask for help, so I came back out.
          Small yellow entrance lights had come on, etching little haloes on the gravel. The sky was almost black but as I tripped back towards the driveway, a sudden thick swatch of road appeared that seemed to be going up a hill. I followed it, trying to remember if I had come down a hill to get to the hospital. A white sign speckled with rust at the end read Belmont Station. I couldn’t find my return ticket but there was no one in the ticket booth so I went upstairs to cross over the tracks to wait for the train home.
          When I arrived at the bedsit in Crouch End where I lived with my boyfriend, I told him the doctor said I had to go back to the hospital on Wednesday. Thomas was only twenty-one and didn’t have much of a reaction. It might have been the way I said it; I thought I would be in for a few days and that would be that.
 
          Pinkham Ward, a series of open rooms, four beds in each, was on the third floor of the Royal Marsden. Unlike the institutional green at Eltham Hospital, where I’d had an abortion at fourteen, and St. Mary’s, where the lump in my neck had been taken out, cheerful pastoral scenes in pastel pinks and yellows covered the walls. I was assigned to a bed by the door, though a few days later the woman across from me, Ruby, who was in to see if she had breast cancer, said they usually put the ones who were going to die near the door.
          "First out, know what I mean?" she winked with the kind of gallows humor people with cancer have. She was in to have an exploratory operation to see if she had breast cancer and was asked to give permission that if cancer was found, the surgeon could remove one or both breasts. She woke up without any breasts. Her husband, a large burly man, visited her every day; he sat by her bed for hours, holding her hand cheerfully chatting while she lay smiling up at him, adoring the way he doted on her. One day she said, "It's not that bad, do you want to see?"
          “Okay,” I said, curious, and went over to her bed. She lifted her shirt. I tried not to show how shocked I was. Instead of breasts - and she must have had large ones because she was a large woman - two ugly massive scars ran to the center of her chest, almost to where her ribs separated. They were purplish red and raised like sabers, with small slitty scars on either side. It was like a horror movie, being gashed like that, those thick knotty scars in the place of beautiful, voluptuous breasts.
          Once dressed in a hospital gown, I was called into the head nurse's office. It was three o’clock and the venetian blinds were drawn against the winter sun, casting stripes across the walls. Her name pin read Sister Williams.
          “Read it and sign it at the bottom,” Sister Williams said, indicating I should sit down in the chair across the desk from her before handing me a piece of paper.
          I read the form slowly, scanning the words spleen, appendix, stomach glands, liver, hip bone and ovaries.
          “Why does it say ovaries?” I asked anxiously.
          “They’re going to move them behind your uterus so they won’t get damaged from the radiotherapy,” she said. She sighed as she rose to her feet. “The doctor’s been through all that with you.”
          “He didn’t tell me,” I said argumentatively. “Why are they moving my ovaries? He just told me about my spleen and this other stuff they’re taking out.”
          She looked annoyed. “You can go over all that with the doctor later. Just sign it.”
          “But it says I might not be able to have children afterwards. No one told me that.” I looked up at her, scared. “I don’t want to sign it.”
          Sister Williams’ face tightened. “Don’t you want to get better?”
          “The doctor never told me I’d have to sign anything,” I protested weakly.
          “Well, if you want them to help you, you have to. And hurry. You’re not the only patient here.” She handed me a pen. “Sign at the bottom.”
          “Fuck you,” I muttered under my breath as I signed it.
          On my way back to bed, I passed by a small room with its door ajar. Inside was a girl of about my age, with long blonde hair and a yellow face. She caught my eye and struggled to sit up.
          “Hello,” she called out.
          I went in. “Hi.”
          Her pale pink nightgown dotted with tiny roses hung limply from her shoulders, emphasizing the yellow of her neck. The whites of her eyes were also yellow. Her hands shook as she tried to prop herself up on the pillows. "What's wrong with you?" she said in a Lancashire accent.
          "I've got Hodgkins Disease," I said. “What about you?”
          "Me too," she said. "I had to leave school just before my mock exams." Her breath was labored as she fell back against the pillows. “I’ve got jaundice, that’s why I’m all yellow.”
          Professor Peckham had told me it would be dangerous if I got jaundice because then I wouldn’t be able to live without my spleen. But even if there was a risk of jaundice, he said, they still had to take out the spleen because that was part of the cure. He said if the tumors got into the spleen, I would die. But if I got jaundice, my liver couldn’t compensate for the function of the spleen. My head was spinning. But this girl had it, and she seemed to be surviving.
          “Oh, I see you’re met Alison,” said a nurse bustling in. “Margo’s in for Hodgkins, too.” She reached for a plastic bag high up on a metal fixture that was attached to Alison’s hand with a plastic wire.
          “I know,” Alison said thickly. Her head fell back, eyes rolled slightly upward.
          The nurse turned to me. “Come back later, after Alison’s had her nap.” She winked cheerfully. “Not so bad, eh? A nice new friend for you.”
          Alison wasn't in her room when I shuffled by a few days after my operation, only on my feet because the nurse had forced me to get out of bed. “You’ll get pneumonia if you don’t. Come on, ducky, give it a try,” she urged, pulling back the bedcovers.
          Alison’s room was bare and the bed was being stripped by a nurse. When I asked where she was, she said without looking up, "She was taken to another hospital. They’ll give her more suitable treatment there.”
          I didn’t realize this was the only place she could be; this was the specialist cancer hospital. That was why Alison had traveled all the way down from the north for her cure. After here, there was nowhere.
 
          When I first awoke from my operation, knives of pain stabbed the two halves of my torso that had been sliced open and sewn together. My head filled with gray gauze, my fingers fumbled for the buzzer for something to stop the pain. A wave of gray clouds came over me, pushing me back into unconsciousness as I moaned in anguish.
          "What do you want?" The voice pelted me, stones flying through the air. "You rang the bell," said a nurse, peering at me through the fog. A sharp dull point throbbed at the back of my hand. "No,” she scolded, "Keep your hand still or you'll pull it out."
At the side of the bed stood a tall metal pole with a plastic container of round water. I traced the thin line of wire to my hand. "What's that?" I asked thickly.
          "Never you mind," the nurse said. "Now sit up for me like a good girl, I have to take your temperature."
          "I can't," I mumbled. Then, "I think I have to go to the bathroom." Near the burning poker in my hip where the tip of my hipbone had been gouged out was a hot tickle.
          I gasped at the icy metal of the bedpan and cried as she gripped my sides into a sitting position so I could pee, but nothing would come.
          "For Annie's sake, think of a waterfall," she said brightly. Her voice lilted and fell, Scotland, round hills, blinding mist and thunderous downpours. A little dribble and I was done.
          I drifted in and out of sleep. Sometimes the clinking of aluminum against china woke me, sometimes the sound of a visitor’s kiss of the woman in the next bed, sometimes it was a nurse who rolled me over to one side with a quick, “Hold steady now,” before plunging in a needle to stop the pain.
​          The night nurse woke me to a pitch black ward. “Sshh,” she whispered. “You keep yelling for your mother and you’re waking everyone up.”
          I opened my eyes sometime the next day to the bed rocking. “Oh, look, she’s awake,” said my mother’s cheery voice. She was sitting on my bed, waving her arms about and shaking her legs to emphasize how well I looked. Unbeknownst to me, Professor Peckham had told her I had a fifty-fifty change of surviving. My oldest sister was there, too, leaning against the wall with a worried look on her face. She was too scared to tell my mother to stop, that the rocking was making the pain worse.
          The next day a group of men appeared from behind a curtain pulled around my bed. Observed by seven or eight residents, Dr. Montreuse, the surgeon who had introduced himself just before my operation, lifted the bedcovers and began stripping away bandages. “What a brave girl you are,” he said kindly, “there you go.”
          The young resident, all men, peered over his shoulder at my stomach. "See, here, the incision is crooked," Dr. Montreuse said, his cheeks jowly and his eyes gray behind square wire glasses. "But that doesn't matter, this isn't a cosmetic operation." The others nodded their heads, murmuring. "It's really quite good what we can accomplish. Smith, come closer, feel under the rib, see?"
          They prodded me in turn, some asking a question here and there. When they were done, Dr. Montreuse came back to the front of the group with a smile. “Do you have any questions?”
          “Did you find any more tumors?” I asked nervously. Professor Peckham had said everything depended on that, whether I had to stay in hospital longer.
          Dr. Montreuse lightly patted my shoulder. “We’re still waiting to get the results. The doctor will come up tomorrow to let you know. Try not to worry, just think about getting better.”
          When they began passing back out through the curtains, I suddenly blurted, "When can I have sex again?"
          Dr. Montreuse stopped, then he broke into laughter as he turned round to face me again. I flushed in embarrassment as the rest of them started laughing as well. But I was scared my boyfriend would break up with me if I couldn't have sex. If I couldn’t have sex, I wouldn’t have a boyfriend and if I didn’t have a boyfriend, I would be nobody. I would just float away into nothing.
          Dr. Montreuse looked down at me affectionately. "Some doctors will tell you to wait for a few months, but I'm French so I say whenever you feel like it."
          The sound of laughter carried on all the way to the elevator as the men trailed out of the ward. When a nurse drew back the curtains, the woman in the next bed was grinning from ear to ear. "You’ve made my day!" she said. And when her husband came later, I heard her whispering and laughing. I closed my eyes and thought furiously, ‘Fuck off, you bastards.’
 
          The cloying scent of my father’s Old Spice wafted over as he glided in shiny leather shoes to my bed.
          "It's very nice in here," he said. His soft blue eyes gazed at the other beds, the ceiling-high windows and waxed floor. His lips curled at the corners, his jaw smooth and freshly shaven.. "You really couldn't ask for more, could you, even if it is the National Health."
          I found out later that my father had tried to persuade Professor Peckham to put me in a private room. “But I told him you’d have a better chance of recovery," he said, looking puzzled by my father's request, "if you were with other people and not in a room by yourself.”
          My father placed a paper bag of grapes on my bedside table and reached down to kiss my cheek. I closed my eyes and held myself still so he wouldn’t blow away like a dream.
          "Mom tells me you're doing very well," he said. "Just keep doing what the doctor says and you'll be fine." He hoisted up his pressed trousers at the knees and settled down in the brown armchair by the bed. He lit a cigarette. "So what's new?"
          "Um," I began, but was interrupted by the day nurse who came over to inject my periodic painkiller. "Could you please wait on the other side?" she asked my father and swished the curtain around my bed. By the time she pulled the curtains back and he was back at my bedside, a rush of scalding ice was exploding in my stomach, whooshing up and out of my throat. My eyes felt heavy as iron; in my throat erupted a ball of cloud tasting of ash and metal. Behind my lids started up reels of film, spinning footage of people dying in concentration camps, their sunken eyes gaping holes in their paper-thin faces. The pictures kept rolling in black and white, surrounded by a deathly silence. The people's skin was yellow, and then there was a mountain of eyeglasses piled high and children screaming as they were torn from their mothers. There were more bones, the images running faster, blurry, people stumbling into gas showers, bodies collapsing on top of each other, the silence bursting with their gashing screams. My skin crawled with panic. Was I tripping again?
          I forced my eyes open and grabbed my father's hand. His palm was firm and warm, wide like a river.  The strength of it, his decisive squeeze, the golden glow emanating from his skin made the film reels retreat and the light turn bright again. I kept my eyes on the shiny wave in his hair, his cleanly pressed suit and the red carnation tucked inside his breast pocket.
          "Dad," I blurted. "Am I going to die?"
          He smiled, his blue eyes warm. "Of course not," he said, giving my hand a squeeze.
          The nurse passed my bed, smiling at my father.
          "What was in that injection?" I asked weakly.
          "Why?" she said. "Did you see pretty pictures?"
          My father laughed, then he left.
 
          “Do you take any drugs?” Professor Peckham asked when I’d first gone to see him.
          “No,” I answered innocently. “Just aspirin once in a while.” I knew better than to tell adults I took drugs. But fourteen months before the lump popped out of my neck, I had dropped a tab of acid, a pink square so tiny it could have fit six times into my thumbnail. A tremendous force had coursed up through me, choking me as it passed through my throat and up and out of my head. The next wave followed right behind it, a thick pillar of lightning making the room grow mustard yellow and pink while green lizards slithered out of the walls. I clamped my body down, clenching my hands to make it stop, but the waves kept coming. I fled my friend’s house to make everything normal again, repeating to myself in a mantra, It’ll go away when I get outside. But outside cartoon color cars whizzed up and down the road, spraying arcs of technicolor rainbows through the oily air. ‘Look up at the sky, that’ll make everything go real,’ I reassured myself, spidery rivers and streams crawling down my back. I snapped back my head into the night sky, shivering in panic, to escape from the images. But the sky was a gigantic tidal wave crashing down on me. It’ll stop when I see John, my feet beating the pavement, it’ll stop when I see John, it’ll stop, it’ll stop. The thought rippled in concentric circles as I soaked in a bath of sweat, my clothes sticking to me like melted plastic. But when I got home my boyfriend at the time was all head as he appeared at the front door, yellow crooked teeth collapsing behind his lips like a deck of cards. His forehead was wide and thick, like a beachhead, and his chin pointed like a knife into his vibrating chest. I crawled into bed like I was sick, shivering like a wet dog. I pulled the covers over my head to make the yellow and orange Paisley patterns on the walls stop. John put on my favorite album, JJ Cale, to help me come down but the twanging only made the air shimmer more violently. John had turned into a horse, eating alone at the table across from the bed, his mouth hanging open and his teeth massive and brown, lips thick and purple as his head bobbed up and down with each bite. My scalp crawled with terror as I staggered into the bathroom to try to shit it out. The black and white tiled floor bucked and kicked like a zebra as I brought all my muscles down into one heaving motion, straining against my body. Nothing came. I stood up and turned around, bending over to try and vomit it out. It was useless. All I could do was wait it out as it passed through my veins, arteries and pipes, just like later I would be powerless to stop the cancer flooding my lymph glands.
          For months, every time night came, tiny Indian patterns would start creeping from the walls. I would stare in terror, my stomach so knotted up I couldn’t get out of bed or eat, too frightened to go outside in case the sky would come crashing down on me. I became scared of everything, scared to go out, scared to be in, to take buses or tubes or airplanes, scared to be with people, scared to be alone, scared to eat in case someone had spiked my food, scared to wake up in the morning in case the walls would be vibrating. I broke up with John, as just seeing his face reminded me of the trip and he’d start looking like a horse again. I slept with someone else, then someone else, moved bedsits, then moved again, into one flat then another, then from city to town, changing Glasgow for Guildford. Then I met Thomas at a party in London, moved in with him and tried to get on with things. I took a shitload of Valium to calm me down until any feeling of drugginess sent me into a claustrophobic panic; eventually the flashbacks stopped.
          As I lay on my bed on Pinkham Ward early one morning, staring out at the sparrows that flitted along the telephone wires, a thought floated lucidly through my mind. "I had my mental breakdown, now I'm having my physical one.” The acid trip and cancer seemed to go together as naturally as tea and milk, as if for every mental breakdown, there had to be a physical one.
 
          Two days after my father visited, I was still waiting to hear whether the Hodgkins had spread and whether tumors had been found in my spleen, stomach, liver or hip. On her rounds of the ward, Sister Williams answered flatly, "The doctor will be here tomorrow. It's not their clinic day today."
          "But you said that yesterday," I complained. "They're supposed to come and tell me what they found."
          "Be patient, they'll be here tomorrow.” She put back my chart and moved onto the bed opposite.
          "They never bloody come," said Nancy, the woman the bed to my right called over. She took another swig from a bottle of Guinness. "I've been waiting all week to see mine."
          Nancy was thirty-nine and had just had all her insides removed, uterus, ovaries and fallopian tubes. A scarf was wrapped around her head because all of her hair had fallen out. Her husband had visited the day before carting a six-pack of Guinness.
"Doctor Peters says it's the next best thing," he’d winked at me. "She can't eat a thing and unless her waterworks start flowing, they ain’t going to let her out of here."
          When I couldn't hear the swishing of Sister Williams' nylons anymore after she left the ward, I muttered, “Bitch,” and slowly inched out of bed. I limped painfully to the elevator where I slumped against the back wall as it rode down to the reception area two floors below. Shuffling to the desk with the waist of my gown bunched in my hand so it wouldn’t open, I begged the dark-haired receptionist to call the doctor. A few minutes later, a pale-faced man with closely cropped auburn hair and gold-rimmed glasses came out, helped me into a wheelchair and wheeled me down a long corridor.. Once inside a small white room, he sat on the corner of the desk and said, "What can I do for you?" He spoke in an American accent.
          "I've been waiting to see the doctor but he never comes,” I said looking up at him anxiously. “Someone was supposed to come and tell me what the results of the surgery were.”
          He adjusted his glasses and smiled warmly. "I'm sorry," he said. "Someone really should have come by now. It's just that we're so busy. I'll put your request in, and someone should come up and see you some time this afternoon or early tomorrow. Will that be all right?"
          "Thank you," I stammered, ashamed to make such a fuss.
          He was from Utah, he told me as he stood to examine my torso to make sure the bandage was still tight.
          “I’m American too,” I said, wincing as a sharp pain shot through my side.
          “I know,” he said, “I’ve read your file. You’ve been here since you were eleven?”
          I nodded, flushing with embarrassment that he was being so nice.
          “Do you like it?” he asked amiably.
          “I hate it,” I said.
          He chuckled. “Oh well, maybe when you’re out of here you can leave, what do you say?” He drew my gown back together. "Okay, then," he said kindly. "I'll get a nurse to bring you back upstairs." He patted my shoulder. "You're doing very well for someone's who's just had such a big operation. You should be proud of yourself. You're responding very well."
          A gray curly-haired nurse came along and guided me back upstairs in the elevator. "You shouldn't worry so much," she said. "It’s not good for your health.”
          "Either is waiting,” I snapped resentfully. "They were supposed to come two days after the operation to tell me what they found."
          "I wouldn't know anything about that, love," she said mildly.
          When the lift doors sprang open on my floor, there stood Sister Williams, her cheeks flamed in rage. She grabbed the handles of the wheelchair and spun me around. "You can go now," she ordered the nurse. As she pushed me down the corridor, she said harshly, "Who said you could leave the ward? Now get back in your bed."
          When a nurse came with the next round of pills, there was a new one on my tray, small and blue with a tiny line in the middle. When I asked her what it was, she said glibly, "It's part of your medication."
          I knew the look of Valium all too well, first from stealing it from my mother's medicine cabinet when I lived at home and then later after the acid trip. When the nurse wasn't looking, I wrapped it in a tissue and slung it into the bin. ‘They’re not going to sedate me, the bastards,’ I thought.
          The doctor did come, early the next morning: Professor Peckham with three of his team. He had good news for me. "There was no trace of it spreading further than your chest," he said. "Your odds of recovery are very good."
          "Will I have to have chemotherapy?" I asked in a tremulous voice. Nancy’s bald head terrified me. Plus she threw up all the time. Once, when one of the blue nylon-coated volunteers delivered our meal on a tall steel cart with a cheerful, "Today it's Chicken Surprise," Nancy took one look and threw up in the rubbish bin between our beds.
          Professor Peckham smiled. "We'll try the radiation first. If you respond well, we won't need to use chemotherapy. Just do everything we tell you, and you'll have the best chance of survival." He explained that I was to have five weeks of radiation to my neck and chest, two minutes a day on each side, and then I’d have a month off. When I came back, I would have another four weeks when my stomach, front and back, would be radiated.
          His voice was kind. “We’ll have those bandages off for good in a few days. Keep up the good work.”
 
          "You're going to be all right. Isn't she?" said my older brother turning to his boyfriend, stopping in for a visit during their brief stay in London from their home in Manchester. At the end of my bed, Kirk looked as darkly handsome as he always did, with his muscular body, strong white teeth, reddened cheeks and curly black hair.
          "Ay, of course she will," said Jim. He grinned broadly at me, his fair hair contrasting with his ruddy skin. “My spleen ruptured so they had to take it out. Here, look," he said as he lifted up his shirt to show me a massive white scar running down his torso. Near his bellybutton was a ropey round thickening, like a bruised flattened bowl.
          At my look of shock, Jim said, "It burst so they had to sew it up again. But I'm all right, see? You'll be, too."
          “See, Margo?” Kirk said reassuringly. “I wanted you to see it. Come on, Jim, let’s go.”
          My younger brother, Fig, appeared at my bedside a few days later with a bag of grapes. The nurse smiled at him as she removed a thermometer from my mouth. "It's time for her walk. You want to go with her?"
          "Okay, yes."
          Fig hugged me gingerly and crawled at my pace down the long bridge that joined the two wings of the hospital, a barren area of white linoleum floor and aluminum-framed windows. I walked doubled over, still in pain from the surgery. He grasped my arm to help me along.
          “Is everything okay?” my brother asked.
          I started crying. "The doctor said I had to be here for three more months.”
          "It'll be over before you know it," Fig said, gently squeezing my arm.
          I was crying too hard to keep walking. "Fig, I can’t bear it. I can’t stay here anymore.”
          His eyes darted nervously. "But you have to for your treatment," he stammered.
          "But I’m going to die if I have to stay in here. I can’t take it anymore.”
          My brother stared down the tunnel of corridor, his fingers twitching. “But you have to,” he insisted.
          I shook with panic. "But I've got to get out of here.” I felt completely trapped. My choice was clear. If I stayed I would die. If I left I would die.
          My brother kept silent as we continued our snail's pace. Finally, he patted me awkwardly on the arm. "Don't worry, it's going to be okay."
          Back in bed, I watched forlornly as Fig softly turned the corner and disappeared. He got glandular fever after that, according to my mother, so he didn't come back.
 
          "Thomas, it's me," I said sullenly into the portable phone, black and heavy on a small table wheeled from one bed to another, its long rubber wire plugged into the nearest jack. Even though all I could see through the night-filled window was the cemetery next door and oak trees across the way, I imagined the pink-orange glow of streetlamps in London. Way up and over I could see Thomas through the brick wall of our house, smoking a roll-up or a joint, feet splayed on our nubby brown bedspread, fingers stained blue from his job at a rubber stamp factory, the fireplace smoldering with coals.
          "Why don’t you ever visit me?" I wept.
          “I don’t get off work until six and it’ll take me an hour and a half to get there,” he said sounding peeved. “You know I can’t get there in time for visiting hours. I’ll come on Saturday.”
          “It’s not fair. I can’t stand it in here. It’s just a bunch of old ladies, everyone’s sick, it’s horrible, I hate it.”
          Thomas cleared his throat; I could hear him inhaling smoke. Someone giggled in the background.
          "Who's there?" I said abruptly, prickling with suspicion.
          "Oh," he said casually, "that's Marina. She's come to visit for a few days."
          A ripple of anxiety coursed through me. "You never told me she was coming. What's she doing here?"
          Marina couldn't have been more attractive, a thin blonde woman from Germany with beautifully shaped breasts that she promenaded braless through a thin cotton shirt. She wore the kind of skimpy pants I could hardly get my foot into, and black leather boots. Her skin was completely pure, not even one blemish, and her eyes crystal blue-green.
          Thomas answered in a tone as distant as usual, almost pompous. "She's thinking about moving to London so she's here to go on some interviews."
          I started crying again. “You don’t care what happens to me. You couldn’t care less. All you care about is Marina.”
          The curtain around my bed pulled back and my mother appeared. She stood there in her white boots, waiting expectantly.
          “I have to go,” I said miserably.
          “What’s the matter?” my mother asked, handing me a bag of tomatoes. The veins in her hands looked ropey against her mother-of-pearl nail polish.
          “I miss Thomas,” I sobbed as she arranged the tomatoes in a bowl next to rotting grapes. “He never visits me.”
          “Oh, men,” said my mother, flapping her hand. “You should see what I’ve had to put up with Dad. They’re all a pain in the neck.”
          I called Thomas the next night. “I’m sorry,” I blurted. “I was just depressed.”
          “That’s all right,” he said calmly.
          Thomas and I would stay together for another two years, until I found out about all the cheating he did, but we stayed friends and decades later he apologized to me for not being more present when I had Hodgkins. But he was only twenty-one, how could I blame him.
 
         A porter arrived at my bedside at nine in the morning, a robust red-faced man with great big arms, and piled me into a wheelchair to wheel me down to one of the rooms behind the reception area on the ground floor. In the cool airless cave with black-shielded windows where he dropped me off, the only light came from tiny, sharp white spotlights.
          "Hello," greeted a woman in a white coat, her brown eyes friendly and warm. "We're going to get you all mapped out today." She patted the table, her bob of auburn hair stranded with gray bouncing a little, then picked up two poster-sized sheets of paper, a pen and a ruler. "Remove your gown and come and lie down, there’s a good girl."
          I shivered as my flesh contacted the cold surface of the table. Shining an overhead light on my body, she placed an icy L-shaped metal ruler on my skin. She measured my neck, my chest, then my stomach and abdomen, coming to a halt at the join of my legs. I crooked my head and watched as she drew lines on the paper with a black felt-tip pen.
          "What are you doing?" I asked.
          "It's for the radiotherapy. We have to do it just right so that we only radiate the parts that should be radiated. We have to make sure we don't get your lungs or heart, or any of your other organs."
          From a large table in the middle of the room, several feet away, she brought the papers over and laid them on my front and back to check her measurements. "Now we’ll tattoo you."
          "Tattoo?"
          "We have to mark you up so that they know the field in which they're working.”
          I felt a sharp prick, a stinging in the middle of my back that made my eyes tear. Then another one.
          "Sorry pet, just a wee spot of ink so nothing goes wrong. Come now, roll over and we'll do your front."
          I lay on the table for hours, while the technician measured and drew, drew and measured so lead objects could be crafted to protect my organs. In spite of all that, I was still to have exposure to my heart and lungs and thyroid and breasts; it’s what's called the scatter effect. It wasn’t shared with me what Dr. Kaplan, the designer of the cure for Hodgkins, said, as an oncologist later told me, “Secondary cancer is the luxury of the cure."
          When the technician had compared her measurements for the last time, she said, "Okay, dear, you can get off the table now and get your gown on. I'll call you back down if we need to." She nodded encouragingly. “You’re a good patient.”
          The next day I was moved to the ward upstairs, where patients were sent during the treatment phase. I got dressed in the jeans, shirt and sweater I had arrived in and, for the first time in weeks, I felt human. The scale read twelve pounds lighter than when I’d been admitted to hospital, but my clothes were tight because my stomach was still swollen from the operation. I felt a stab of pleasure; I was thinner, more desirable. Thomas would fancy me even more now.
          In the treatment ward at six o'clock the next morning, prison hours, fluorescent rods blinded me through my closed lids. Time for a breakfast of rubbery eggs and margarine toast, and then at ten, a porter appeared for my trip to the basement where the Radiotherapy Department was housed way at the back, concealed in a catacomb of rooms. Radiation departments of hospitals are always in the basement, as if to lend protection from the scatter of lethal rays to the floors above.
          The porter deposited me into a chair that lined a wall in the corridor beside a row of other patients who sat and waited for their turn. I looked listlessly at the others, but no one caught my eye but stared blankly at the wall or floor. Everyone looked colorless; some were hairless, some looped in hospital gowns. It reminded me of being on the tube when it got stuck in a tunnel on my way to a temp job a few months earlier. One minute we’d been racing along hundreds of feet underground, the car throbbing with noise, then without warning the train slammed to a standstill. There was dead silence, like we’d been dumped in a tomb. Several passengers sat silently across from me, gazing blankly ahead.
          I’d giggled nervously, “I hope we start up again soon.”
          Every one of them stared at me without responding. I started sweating profusely in fear, still recovering from the acid trip and terrified lizards would start jumping out of the walls. Twenty minutes later, the door between cars banged open and a conductor appeared, carrying a wrench.
          “Do you know when we’ll be moving?” I said shakily, soaked in sweat.
​          He grunted and kept moving to the back of the train, slapping his wrench against his thigh.
          "Margo Perin?" someone called from an open doorway. Inside lay a steel table overhung with an apparatus looking like a gigantic 1950s hair dryer. The technician guided me over to the table and told me to lie down. I gazed blankly into the black mouth of the machine while she whisked back and forth, setting things up. Thin brown hairs on her forearms stood up as she attached a lead circular plate dotted with holes to a divider between me and the machine’s mouth. Then she placed small oddly-shaped leaden objects on the plate; two looked like the letter G, another more like an O.
          "What are those?" I asked, curious.
          Her voice sounded maternal, reassuring and efficient. "These little pieces of lead will protect your lungs and heart from getting radiated," she said. Her cold fingers moved repeatedly between the objects and my chest and neck, measuring that they were well placed. Her expression was stern but kind. "When I give the sign, you must lay completely still for two minutes. If you move at all, we're going to hit your organs. Do you understand?"
          "Yes.”
          "Right," she said, moving to an interior alcove at the side the room, walled by glass. "When I give you the warning, lay perfectly still." After a few clicks, her voice floated over. "Right, perfectly still."
          I held my breath and then a whirring, buzzing sound came from the hair dryer above the lead plate, which would become as familiar as my hands over the next several weeks. There were no lights, no heat, no bombs going off, no visible rays buzzing through my skin. There was only a faint whirring sound and having to keep perfectly still. Over the weeks I felt discombobulated to see my underarms turning leathery, crying when I found thick chunks of hair from the back of my head strewn across my pillow, the radiation sending me into a fatigue so deep even my depression became numb. But under that machine, I never felt anything at all.
          My father appeared at one o’clock, after I climbed pale and shaky out of the elevator back into the ward.
          "Hi, Margo, why don't you get dressed. I want to take you somewhere."
          Feeling dizzy, I got dressed and followed him back downstairs into a cab. "I think you're really going to like this woman I'm taking you to see," he said.
          "Who is she?" I mumbled.
          "She's been treating people for a variety of diseases and she's had some great results."
          I rested my head against the backseat of the taxi as we wove up and down hills until we arrived at a Tudor house in the middle of Hertfordshire. A nondescript middle-aged woman with tiny red veins in her cheeks came out of the house. She made tea, during which she explained that she could cure anyone of anything with radio waves that she called radionics, led us to the bottom of her foggy garden. She picked up a black box with wires sticking out of it that had been lying in the shed and held it up. "My son had cerebral palsy and I cured him of it," she said, her eyes and hair as gray as the sky.
          I listlessly watched my father chatting with her about the box, my father looking impressed, the woman so ordinary and sure of herself, as if she was giving my father a demonstration of a TV set.
          "Do you want to be treated by her?" my father asked in the cab on the way back to the hospital.
          "No," I said through a nauseous haze.
          My father visited one more time, after I'd been having radiation for several weeks. He strode in shiny black shoes to my bedside with a grocery bag full of natural vegetable juice in brown bottles that were becoming popular in Britain with the advent of health food stores. Placing them on the windowsill near my bed, he advised me of their merits and left after a short while. Over the next few weeks I watched them turn black one by one in the sunlight that filtered in through the window, too nauseous to touch them.
 
          Natalie dropped by for a visit after I'd been in hospital for a month and a half. She looked overly thin in her jeans and long-sleeved army shirt, pale and drawn because the man she wanted to go out with and had sex with a couple of times wasn't interested in her anymore.
          I listened as intently as I could, leaning against the back of a beige couch in the day room. The weeks of radiation had sent me into a fog so dense I couldn’t read anymore. All I could do was sleep, or lay in bed shrouded in fatigue. I nodded and mumbled of course she was right to feel like that.
          When Natalie sighed and said, "You're so lucky to be in here. You don't have to deal with all this stuff," I nodded weakly in agreement, too grateful she was visiting to realize that, in fact, it was the reverse. Ava, another sister, said years later, after her own first operation, the repair of a rotary cuff injury in her shoulder, "For the first time, I have the slightest inkling what that must have been like for you. None of us could help you, everyone thought someone else was dealing with it. We were all zombies by then."
          I traveled to the basement of the hospital for treatment after treatment, sludging through a muddy haze back upstairs for the rest of the day, then down again the next morning. Finally mid-April came, time for my month off between treatments.
          “If you can get away, that would be best,” said Professor Peckham. “Try to take a holiday. It will take your mind off things. You’re responding very well, by the way.”
 
           Thomas and I took a trip to Germany during that month to visit his mother and friends. I could barely function, being so tired and depressed. I learned a few phrases in German, Ich bin mode (I’m tired) and Wo ist das klo (Where is the loo), but mostly I fell asleep at cafes and bars, even after double mochas, and tried to make conversation with Thomas’s mother and friends when they were willing to speak English. Everyday I felt more depressed than the one before, dreading our return and my date back in hospital.
          As we drove from Berlin back to Munich, Thomas and I stopped by the side of the road to have a picnic in a field of bright green grass. He laid out a blanket and we took out cheese sandwiches on French rolls we’d picked up at a Bäckerei. I lethargically unwrapped my sandwich, wondering why I didn’t just kill myself so I didn’t have to go back to hospital. The thought was like the lip of a black mouth slipping open into an abyss, like the crack in the floor I had dreamed about when I was a child. In the dream, my mother had been ironing while Rock, my youngest brother, played on the floor next to her. A slit in the floor between my brother and mother widened and my brother disappeared inside. Just as quickly, it narrowed again. My mother didn’t notice, but kept on ironing. But now it was me disappearing, dissipating into a void, a black cavern, a tunnel. While Thomas sat across from me eating his sandwich, I thought over and over again, why don't I just kill myself?
          Even though I was in such a fog from the radiation, so exhausted I waded through each day like an automaton, my thoughts were crystal clear. Nothing had meaning, there was only the meaning we made up. So why bother to live? My life was unbearable, I couldn't live anymore, knowing I had to go back into hospital and miss out on all the fun everyone else was having, lying under an indifferent machine everyday, surrounded by indifferent people, ignored by my family, except my mother who didnt' see me and drove me mad with all her complaints, and being forced to live away from my boyfriend who was probably cheating on me.
          I stared at a fat oak tree, the words making circles in my head: This field means nothing, no one means nothing, the car means nothing, London means nothing, the hospital means nothing, I mean nothing. People only pretend things mean something. It is we who put meaning to things, nothing means anything without our making it mean something. The sun filtering its rays and making the road shimmer up ahead means nothing but only what I say it does, this man next to me means nothing unless I say he does. In complete detachment, I gazed at the way Thomas’s nicotine-stained teeth tore at a morsel of meat, then cheese, then bread and how he blinked each time he swallowed.
          Suddenly Thomas glanced at me and smiled. I smiled back, involuntarily. I didn't mean to, it just happened. With a shock, I thought, if nothing means anything, why do I smile?
          I couldn't have put it into words, but that smile showed me there was something in life that had intrinsic meaning, that it had nothing to do with what we think. If we can smile involuntarily, it must mean that there are things outside our control, outside the meaning we attach to them. It has never made any more sense than that but, since that moment, I have always known I will never kill myself, however much sometimes life’s discouragements might make me feel like it.
 
          Garish white squares of light emanating from the windows of the hospital lit the driveway gravel as I made my way back to the hospital entrance. Upstairs in the ward, fluorescent tubes blazed overhead as a woman with a red lumpy face called out to me on my route to my assigned bed.
          “Oh, you’re so young to be in here,” she said, her voice dripping with sympathy.
          “I think it’s worse if you’re old,” I sniped viciously and stormed to my bed in the corner, hauling the curtain so loudly around my bed the rings crackled.
          My first week back, I lay on the metal bed in the radiation room, white spots dancing in the air, always there after the machine stopped whirring, breathing slowly as the nurse advised to try and stop the dizziness. The back of my head was bald and my armpits angry swatches of leather, my stomach flushed red. The crooked line that sealed the two halves of my torso together blistered and pulled between the stitch lines. I was too tired to cry, too drained with grief about losing hair, too depressed to notice that the doctors said I was responding well after taking X-rays, holding them up to the light to show me. I lay under the hair dryer in a radiation-drunk haze, scared I couldn’t think anymore, that I would never be able to think again. Back in the ward, all I could do was stare at the wall or flip lifelessly through pictures in the women’s magazines my mother passed onto me when she was done with them.
          Everyday in the treatment room it was completely silent besides the click and whirr of the machine, no one fussing about, no white coats surrounding me with their stares. Sometimes it was so silent I could hear thin buzzing vibrating through the air. Under me the table was so hard it melded into me, squeezing into my bones and muscle. My body splayed out on the table was the table, the table was the air, the air the blackened walls, the walls the sides of my tomb. I could disappear into them and when staff came back to tell me it was someone else’s turn, I would have vanished.
          If I had believed in God, I would have known that he was toying with me. I was trapped in that boxcar of a room, like a rat, headlights as invisible as the rays jetting out of the machine. I’d never get out of there, I’d be imprisoned in that hospital forever, in that room hidden in the basement, with everyone in the world living their lives without me.
          Since fleeing my parents’ house three years earlier, I had drifted in a downward spiral, interchanging boyfriends and bedsits, countries, cities and towns, ending with the acid trip and its aftermath. I’d cleaned a cinema, took phone orders at a record warehouse, sales assisted at three different stores, temped at offices, cleaned flats. I’d even signed up for a job training as an international telephone operator, only lasting four days. In Glasgow, where there were no jobs, I’d ended up on the dole, spending most of my waking hours, which weren’t many, smoking dope. And now here I was, disappearing altogether.
          When I was a little girl, I had asked my mother what I should be when I grew up. She looked up from her magazine and said, “You should be a teacher. They have great vacations.”
          I hated all those schools I’d gone to in my childhood, and I used to swear resentfully that I would be a better teacher than them all. So whenever anyone asked me, “What do you want to be when you grow up?” I’d answer, “A teacher.”
          One day in the ward, clothed in a thin cotton hospital gown shortly before my treatment was over, aware that I would soon be going back home, I started thinking about what I was going to do. I was going to go back to school and I was going to become a teacher. I had spent six months buried in a hospital, cordoned off from the outside world, flattened and invisible. I was sick of being a nobody. I was going to get out of hospital and I was never going to come back. I was going to drag myself out of the abyss and I was going to make something of myself. No one was going to leave me on a table to disappear. I was going to be a somebody.
 
          At last the day arrived. On June 20, 1974, more than six months since I had first found the lump in my neck, Professor Peckham came by to see me in the waiting room of the radiology department. “You’ve done a fine job,” he said. “You’ve responded as well as we had hoped.” He laid his hand on my back, sending a shiver of warmth through me. "If you don't get it back in five years,” he said looking down at me from his great height,  “we will consider you cured.” He smiled confidently. "We have every reason to expect that in your case."
          He told me I’d have to have monthly, then three-monthly, then six-monthly and finally yearly check-ups for the rest of my life. “That way we can keep an eye on things.”
          Just before he began walking away down the corridor, Professor Peckham turned back to me and said, “You have your whole life ahead of you, the best thing you can do is put it behind you.”
          On the surface, I was good at putting things behind me as I moved back to London and signed up at a community college, dazed by the throbbing hub of cars careening around corners and crowds pulsing to and from work at Kings Cross, and I didn’t tell anyone about the Hodgkins Disease, except once, briefly, to a new friend, Denise, a woman with warm violet eyes and olive skin who had come up to me in the black and white tiled bathroom at college one day to say, “I love your outfit.” But months later when I told her, after her look of shock and her “I’m so sorry,” we didn’t talk about it again. I dressed quickly in multi-colored tapestry skirts, peasant blouses and navy blue and orange cardigans, not stopping to look at the new slits in my skin, not letting myself feel bad about the way the scar tearing up from my belly to my sternum separated my body in half, and how my life was now split between a before-cancer and after-cancer.
          I continued to put it behind me as a couple of years later I entered the stone walls of the London University’s School of Oriental and African Studies near the full green-leafed oak trees looming over Russell Square and pored over heavy clothbound books and wrote essays on tribal life in Kenya, unaware of the connection between their coming of age scars and mine. I studied day and night in a bedsit I rented after Thomas and I split up, not knowing whether it was day or night as I paused for a few moments to look up from my books.
          Putting things behind me was a family tradition. Every time my father had hightailed us out of where we were living to escape the law, there had been no more friends, no more school, no teachers who liked or hated me, no more neighborhood I was familiar with, sometimes not even the same language. Every year or two, sometimes after only a matter of months, I’d had to start all over again, with a new name, a distorted identity, no ethnicity, no history my parents would admit to or we could talk about. This was good training as far as leaving the experience of Hodgkins behind.
          Except that as I continued on silently through college and university and then the gleaming concrete and glass-layered of London University’s Institute of Education for my teaching degree, at every pimple that appeared on my face I’d freak out, staring in panic at the mirror in wood-paneled bathrooms, seeing mutant cells spreading before my eyes beneath high white-skyed windows. I worried. And worried and worried. I became a hive of worry. I worried every time I had a headache, every time I was in bed with flu: Was this it, was this cancer again? When my period was late, when it was early, when my skin was dry or too moist, when I was tired, when I got cold sores. Is this it? Is this it, is this it?
          “You’re just a worry wart,” I berated myself. “Why are you thinking about that again?” I would hear my mother’s voice echo in my head, her voice vibrating with annoyance.
          “Don’t be ridiculous,” I scolded myself in her voice as I lay open-eyed at four in the morning, icy air breezing in through gaping slits in the molding window frames. No one gets cancer twice.
          Beneath it all, I knew it was worry itself that kept me safe. Worry was the way I could stop it happening, by its standing guard at the gate. As long as I was worried, it meant I was being vigilant, it meant I had my eyes and ears open for the next disaster heading my way. As long as I was prepared, as long as I was on the lookout, it wouldn’t happen. That was my guarantee, like carrying an umbrella ensuring there won’t be rain. As a child, I couldn’t stop everything disappearing but, as an adult, if I worried every time I left my house, I might be able to get back. Before I got cancer, I never thought about cancer and I’d gotten it. So after it happened, as long as I worried about it, it wouldn’t happen again.
          In my early thirties, I moved to San Francisco and there I found a semblance of the happiness that had always eluded me. I stopped sleeping with men and turned to women. I began writing and became committed to therapy. I made new friends, building a new life, brick by brick. I found Marci, the first lover I ever had who loved me as much as I loved her, and important after my discovery that the ethnicity hidden from me was Jewish, was my first Jewish lover. I moved into her apartment, furnished with raw marble tables on concrete bricks and a striped couch where we lay for hours gazing at each other. Marci brought me to religious services at a Jewish temple, Yom Kippur, where I cried and called out the name of my paternal grandmother, whose name I had just learned, and the culture I was never allowed to be part of because of my parents’ pathology. I created my own teaching and editing business, I traveled to Mexico, the Pacific Northwest, Italy, France and New Mexico; I made more friends, everything I wanted I had. The farther I got away from my family, the better I felt.
          “The past is behind you,” said the Italian-American therapist I had stared seeing, a woman who suddenly changed her name mid-session from Joan to Fiorenza to get in touch with her roots. “All you have to do is heal from it,” she said, flipping her long dark hair back as she indicated the session was over.
 
          Several months after I turned forty-three, Orren, one of my students, phoned. “Hey, Margo,” he said, “Why don’t you and Marci come to dinner on Thursday night? It’s being hosted by a pharmaceutical company at the Hawthorne. I’d love you to come. All you have to do is sit through a talk by an oncologist, then we’ll party. Several of my friends are coming.”
          “I don’t know,” I said hesitantly, scrunching up my fleece collar in our cold hallway with its unvarnished pine floors and draughty heating vent. “I have to get up early for work on Friday.”
          “Oh, come on, live it up,” he said, the enthusiasm in his voice vibrating over the phone. “It’ll be so much fun and I’d love you to meet my boyfriend. I’ve told him so much about you. Besides, my friend Claire is giving the talk and I’d love you to meet her too.”
          “I’ll talk to Marci,” I said tentatively, seeing myself stumbling exhausted into my classroom only a few hours after the party would have ended, getting a sore throat, waking up with the flu. Since I’d had Hodgkins, I had been taken out of life for several weeks at a time from frequent colds and flus, the effect of a compromised immune system from my cancer treatment, so I lived in fear of getting sick.
          “Why do you always look at the worst case scenario?” said Marci, two spirals of her ringlety gold hair sticking up like antennae as she washed her face for bed. “When was the last time you got sick when you stayed up late?”
          At the dinner Marci and I happened to be sitting next to Claire, the oncologist, after she had finished her talk on the effectiveness of certain chemotherapy drugs, manufactured by the pharmaceutical company hosting the dinner, on AIDS as well as cancer. “It’s amazing what we can do now to treat these conditions,” she said as she dipped her fork into the crème fraiche atop her smoked salmon appetizer.
          Over the flicker of candles in glossy silver holders, I thought about asking the broad-boned woman the question I’d tried finding the answer to, but quickly changed my mind. No doctors could ever answer that question. I’d even gone to a medical library perched on the crest of a hill in Pacific Heights a few years earlier and plowed through metal filing drawers searching for studies on the long-term effects of cancer and radiation. All I could find was that, in very rare cases, something like point zero zero zero one percent, radiation treatments could lead to cancer of the lining of the heart. This was in spite of the common knowledge that radiation could lead to cancer, from airplanes, TV sets, X-rays and computer screens, even the sun.
          But as Claire was sipping from her glass of red wine, the question slipped out of my mouth, almost as if it had disembodied itself. “Do you know if there are any long-term effects of radiation therapy for Hodgkins Disease?”
          "Yes, you’re more likely to get breast cancer," she responded, taking another sip of wine.
          “Oh, really?” I said casually. But that night, I stripped off my shirt as soon as Marci and I were tucked inside the door of our flat. I stood in front of the dresser mirror and touched my right breast. Above my nipple was an odd thickening, like a compressed muscle. When I raised my arm and looked sideways, my breast turned into a B shape, caved in and flat at the nipple. I knew my breast had been changing shape, but I had been putting it down to age. My mother’s body had turned flabby as she got older and I thought mine was taking the same path, a genetic map laid out before me.
          “Marci, look, do you think this is anything?” I said, scared.
          Marci put her thin wire glasses back on and gazed closely at my breast, the furrow between her brows deepening. “I don’t know. If you’re worried, why don’t you go to the doctor?”
          “It’s probably nothing,” said my nurse practitioner in her sunny office in the Castro, a woman only a few years older than me and capped by a thick swatch of salt and pepper hair. For two years she’d been telling me that my “lumpy” breasts were normal. "It certainly looks odd,” she said, her eyes unconcerned, “but it doesn't feel hard. Cancer is hard.” She wrote out a slip. “You might as well go and have it checked out at the breast clinic.” She smiled cheerfully. “You can use the phone in here if you like.”
          The clinic didn’t have any appointments for eleven days. "What about cancellations? Can I go on a waiting list?" I said anxiously.
          "There's no waiting list," answered the clipped voice. "But you can call in a few days to see if we've had a cancellation. You could certainly try. But it's a long appointment, so it may be impossible.”
          Over the next few days I called several times, but there were no cancellations. I eventually gave up, in spite of my panic. I also called a friend of a friend who was a researcher into breast cancer, hoping for reassurance. She spent an hour with me on the phone and quickly moved into the worst-case scenario.
          "When they get the diagnosis, some women have both breasts removed," she said. "It cuts down the risk of recurrence." She also told me peanut butter was a carcinogen, my daily breakfast food.
          "Do you eat it?" I asked.
          "Yes," she answered mysteriously.
          On the eleventh day, I went to the same breast clinic where I’d been having annual mammograms. The technician came back after taking the films and said they couldn’t see anything. She had permed blonde hair and a wide open face, looking more like a student than a health practitioner. She was the kind of person whom I always feel alienated around because she seemed so normal, so Anglo, so American, the kind that fits.
          "But look at my breast!" I said, showing her the strange B shape when I raised my arm.
          "Well,” she said reluctantly, popping her gum, “we'll give you an ultrasound to make sure you're not imagining it.”
She led me into the ultrasound room and told me to lie down to wait for the doctor.
          "Could you keep the light on?" I said. "I have some work to do." After years of doctors’ appointments, I knew it could be a long wait. Countless times, I had laid on a clinic or hospital bed staring at a black-handed clock on the wall, studying the way the second hand would take a step backwards before going forward, imagining the doctor was too scared to come back because the news was so bad. So now I always brought some work along, this time editing a manuscript for one of my students.
          "Okay," she said noncommittally, switching it back on.
          I worked perched on the bed for twenty minutes before the technician came back with a doctor, a woman in her late forties with half‑glasses hanging on a cord around her neck.
          “What are you doing?" asked the doctor, clearly annoyed to see me working.
          "I'm editing something," I said, putting it aside.
          "Hmm," she said, indicating to the technician to turn off the light.
          They sat side by side at the ultrasound monitor while the technician stroked my breast with a wand. They muttered unintelligibly to each other in front of the screen. After a few minutes, the doctor took off her glasses, stood up and started walking out of the room.
          "You have three things in there," she said, halfway to the door. "You'll have to come in and have them biopsied."
          I jolted up, my scalp tingling. "Wait a minute," I said. "I had Hodgkins Disease. Have you read my notes?"
          She turned back and looked at me, her glasses swinging at her chest. "No." She seemed surprised, even puzzled by my question. "But I don't think that matters," she said. She absentmindedly flapped her hand. "Make an appointment for the biopsy. Amy, show her where to go." The door clicked shut.
          I turned to the technician, frightened. "What does she mean, ‘things’?"
          "They're probably cysts, nothing to worry about," she answered casually. She told me to gather my possessions and follow her out to get changed and then go to the appointment desk.
          I threw my clothes back on in the changing room and sped to the appointment desk. The woman behind the desk was the same one who was usually there when I came for my mammograms, tall, thin, pale and wiry with an athletic crewcut and big round glasses. She was on the phone, her computer screen blue-white at her side. I stood right in front of her to make her hurry but she was good at this, like most hospital receptionists, and ignored me. I waited anxiously, sweating and hopping from foot to foot.
          Finally she hung up and turned to me, her face bland. "Yes?" she asked disinterestedly.
          "I have to schedule a biopsy," I said, trying to keep my voice friendly. "Can I have it this afternoon?"
          She laughed, throwing her head back. "Ooooh, noooo." She turned to her computer. "I don't think we have any appointments for a week." She examined the screen, pulling up the schedule. "Yes, a week," she confirmed, swiveling around again to write down the time.
          "I can't wait a week," I blurted. "Don't you have anything Monday?"
          "I don't do Mondays," she said.
          "What?" I said, starting to get angry.
          "What insurance do you have?"
          "Blue Cross."
          "I have to clear the insurance." Frowning, she scribbled Friday's appointment on a card.
          "Can I speak to your supervisor?" I said haughtily. Maybe trying to act with authority would work.
          "Yes," she said, not looking up.
          I stayed put, staring at her.
          After a few moments she looked up. "Yes?"
          "Yes, I want to speak to the supervisor."
          "Wait there," she said, pointing at the waiting area to the left of the desk. Nurses and other staff were rushing about. One hovered behind the receptionist, gazing at me behind her coffee cup as if anticipating trouble, looking ready to fly to the receptionist's aid.
          I moved a few feet, keeping my eye on the receptionist. A few minutes later, she called me over. She hadn't lifted the phone. "All I can do is call other patients and see if they'll switch with you."
          Now everyone, patients and staff alike, was staring dispassionately at me under the glare of fluorescent lights and vibrating white walls.
          "Can I talk to you in private?" I said in a low voice.
          "Okay," she said smoothly, unfazed.
          She led me to a room at the back of the reception area, lined with reference books and pamphlets.
          "I had Hodgkins Disease," I said in a forceful voice, "and I'm very anxious about this. There is no way I can wait for a week to have a biopsy.” My voice rose. “I'm going to get hysterical if you don't give me an earlier appointment."
          Her voice remained calm. "All I can do for you is to call other patients and see if they'll switch with you."
          "Someone is going to have to switch, because I am going to get completely hysterical and make a scene if they don't."
          "Come with me," she said. She headed for the door.
          I noticed a booklet on a shelf on my way out, "A Woman's Guide to Breast Cancer Diagnosis and Treatment,” its cover stamped 'For Reference Only'. I swiped it, shoving it into my pocket without her seeing. They might not give me the appointment I wanted, but at least I could help myself to the information.
          I followed her to another office, where she instructed me to sit in a plush brown leather armchair. She sat herself down across the room, behind a desk with a computer screen which she examined, picked up the phone and began dialing. The two women she called weren't home, and she left messages. Then she turned to me with a piece of paper. "Here's my home number," she said. "Call me tonight and I'll let you know if one of them switched."
          "Thank you," I gulped, thrown off guard by her sudden generosity.
          "That is, if I'm able to answer the phone," she added.
          “Well, I can leave you a message and you can call me back, right?"
          "No, I mean if I'm able to. I have epilepsy and if I'm having a seizure I won't be able to do anything." She didn’t seem disconcerted about the potential effect of the overhead fluorescents flickering on her eyeglasses.
          "My God, that's awful," I said, startled. "What kind of epilepsy is it?"
          "Grand mal," she said, gazing at me with a half-smile.
          "I'm sorry, that must be very difficult." I looked at her, concerned.
          "It's not too bad. I take medication for it. And if I go out," she said with a casual laugh, "usually it's okay."
          "Does it ever happen at work?"
          "All the time," she said. "They know it though, and usually someone helps me. Sometimes I have to take a couple of days off afterwards."
         "I'm sorry,” I said again, gazing at her in sympathy, feeling like her problem made mine of trying to get an earlier appointment pale in comparison.
 
          Marci’s face creased with tension when I told her what happened. She was perched at the edge of our white Danish self-assembled chair that leaned precariously to the side when I got home. “You’ve got to call the doctor and insist they see you Monday,” she said, handing me the phone.
          An hour after I called to plead with the doctor, the receptionist phoned back and said in an official voice—no sign of epilepsy now—I had an appointment on Tuesday. I guess she still didn't do Mondays.
          Over the weekend I read "A Woman's Guide to Breast Cancer Diagnosis and Treatment" from cover to cover. It seemed extra precious, my having stolen it, as though by helping myself to the booklet, I had also taken away my need to have it, just like the proverbial umbrella, or staving off disaster by worrying.
          Marci accompanied me on Tuesday. It was September 15, our ninth anniversary. “We’ll have dinner when it’s all over, to celebrate,” we told each other the night before, hugging tightly in bed.
          We woke early, getting to the hospital by nine for the needle and core biopsies. Afterwards in the darkened room, the radiologist bent over the specimens through his microscope and reported, "I'm not anticipating anything, this looks fine."
          His face stood in three-quarter view with the window behind. He turned to me and Marci, who had come from her chair to stand next to me, her hand tightly squeezing mine.
          "You'll have the results tomorrow or the next day, then I suggest you make an appointment with the nurse here and she'll show you how to do your self-examinations." He removed his plastic gloves and began washing his hands. "I'll call you with the results late afternoon tomorrow or the next day, as soon as they're in."
          "What about the radiation for Hodgkins Disease?" I asked shakily.
          "You are at a slightly greater risk so you want to be doing those self-examinations and keep coming in for mammograms." He paused, turning from the sink. "I'm not anticipating anything," he repeated in his deep, gentle voice. He patted my hand comfortingly, the kind of father I’d always wanted, and instructed the technician who had assisted him to give me the post-surgical instructions.
         At five-thirty the next afternoon, my hands shaking, I dialed the radiologist’s number, exhaling in relief at the doctor’s “Hello?” at the other end.
          "This is Margo Perin. I had a biopsy yesterday. I'm calling to see if the results are in yet."
          "Yes, they are," he answered in that same reassuring deep voice. "I already called your doctor. She'll call you tomorrow."
          "Can you give me the results now?" I asked, my voice quaking.
          "Yes, I have good news and bad news," he said. "The good news is that two of the areas were benign cysts. The bad news is that you have early stage breast cancer."
          “What?” I choked.
          "It seems to be 1.1 cm."
          “What’s early stage? What do you mean?”
          “It looks like it’s just over one centimeter,” he repeated.
          "Are you sure?" I said, frozen. He must have made a mistake.
          "Yes. But it looks like you have the best kind."
          "What do you mean, the best kind?" I said.
          "The least aggressive kind."
          I grabbed a torn scrap of paper on the dresser. "How big is it?"
          "Just over one centimeter."
          "What kind is it?"
          "Infiltrating ductal carcinoma."
          I scrawled a small list: Early stage breast cancer. Infiltrating ductal carcinoma.
          "Do I come back to see you?" I said in a dismembered voice. In the upstairs flat, someone was vacuuming.
          "No, your doctor will be dealing with this. I'm sure she'll call you in the morning."
          "Thank you," I said blindly and hung up the phone.
          I heard Marci’s car draw up outside. I ran to the front door and looked down at her from the top of the stairs as she slammed to a stop at a right angle to the street. She jumped out and looked up. I shook my head and ran down the stairs. Marci burst into tears, sobbing by the open car door. We stood in the middle of the street, clutching each other.
 
          I was about to lose one of my breasts, I could lose my life, and there was no point in telling the people who brought me into the world, who gave me this body, thinking with a childlike innocence they would help me. I hadn’t spoken to my mother in months. With the help of my therapist, I was on my latest binge of trying to come to terms with her not loving me. Once I stopped calling her, she didn’t call me. If I didn’t call, I didn’t exist.
          My father had long vanished, once he found out that I had met his family, his Russian Jewish family, whom he had abandoned and whose existence he denied. “To tell you the truth,” he had said the last time we talked, which happened to be during Beijing’s Tiananmen Square uprising, “I care more about the students in China than I do about you.”
          When I was three and on a vacation with my family in Virginia Beach, I had climbed onto a raft listing by the shore and began floating out to sea, happily dazzled by the blue water and sky. A stranger on the beach noticed that a little girl was disappearing into the horizon and got a lifeguard, who irately pulled me back in. My mother hadn’t noticed and yelled at me when I returned. Now I felt like I was once again floating out to sea without her or my father knowing I was about to drown, but I was an adult, and it didn’t feel mesmerizing or beautiful. I needed a rope to pull me back in. My friend Dov, who came up to visit from Los Angeles the weekend after my mastectomy, gave me a strand when he explained what biological parents were.
          “They gave birth to you, but they didn’t nurture you. The best thing for you to do is let go of them altogether. Just call them your biological parents and let go.”
          “But they’re my parents,” I cried, the drainage tube attached to my chest twisting painfully. “I need parents, everyone does.”
          “Margo,” he said patiently gazing at me in the sunlight filtering in thin rays through the window. “They can’t love you. They don’t have the ability. They probably don’t even know what they’ve done to you.”
          I had always resisted letting go. I floated through life, changing course every few years, new jobs, new lovers, new countries and cities, but I never let go of my childhood. If I let go, I was doing just what my parents had done, denying everything that was true about me. I hung onto the bits of my childhood like a raft. If I let them go, everything would disappear, I myself would disappear. It was what defined me, losing everything, and the pain kept me firmly secured to the raft. If I didn’t hang onto it, it meant it wasn’t true, it meant I’d made it all up, it hadn’t happened, just like my parents wanted me to believe. My parents created an identity based on who we were not, not who we were. Who I was was what happened to me, nothing more, nothing less. If I didn’t hang onto it, I would have no roots at all. And that also meant clinging to the belief that one day it would all miraculously change, I would have parents, and they would love me. My therapist wasn’t the only one who looked at me askance when I said, “No matter what, I love my father.”
          “Margo, you’re not alone,” Marci kept telling me as I shook with terror day after day before the mastectomy, too overwhelmed to get out of bed. Everyday I’d see 11:11 flashing green on the clock atop of the dresser across from the bed, barely registering that another day had passed. “There are so many people who love you,” she said, standing over me with a worried expression on her face. “You don’t have to feel you’re alone. You have a new family now.”
          Sixteen of our friends had come over to our flat on the Saturday before my surgery, laden with candles and food to wish me good luck. Susan, a friend whom I didn’t even see that much, organized a group of people to shop and cook for me and Marci. Every day for two months the doorbell would ring and there would be a three course gourmet meal at our doorstep. No one wanted anything back, only that I got better. Wasn’t that family, what family should be?
          Kaila played a lullaby for me on her violin that night, then counseled me on the phone every day for three weeks, throwing me one thick strand of rope after another to ride the waves of terror. Another friend, Lisa, said, “You can buy all your herbs and supplements at our store for wholesale. We just don’t feel right making a profit from your illness.” And this time, even my sisters and my youngest brother, who hadn’t been to see me at all when I had Hodgkins Disease, came through, sending me money and articles and books about cancer. My sisters called me almost daily. But still I felt alone, with the loneliness of not having a mother and father who loved me, as corny and self-destructive as that might sound. Having cancer for a second time without their being there to take care of me only reinforced all I had lost out on as a child. It felt archetypal. I tried to feel like I wasn’t alone, but I did. The original sin.
 
          Marci checked into the hospital with me. She sat in the room while a doctor injected radioactive dye into the tumor to trace its trajectory to the lymph nodes to know which ones to take out to test if the cancer had spread. Then she sat in the pre-operating room with me, covering me with a forest green fleece blanket that she had bought to comfort me. My sisters, Natalie and Marilyn, called while I was in there and the head nurse laughed, saying, “You are quite the Ms. Popularity!”
          Marci stayed with me while the anesthesiologist injected me, and had the company of a friend of ours after I fell asleep. When I woke up in the recovery room, a nurse handed me the phone. It was Marci’s mother, calling to see how I was. When the porter brought me up to my ward, Marci and two friends were waiting at the doors of the elevator so that when they sprang open, they were all there to greet me. Marci slept the two nights of my stay in the hospital room with me, and friends came with food. Everyone celebrated when we found out the cancer hadn’t spread. Gordon, who was almost seventy, just a few years younger than my father, sat with me for a few hours so Marci could take a break. He held my hand in his firm, warm grip, telling me not to talk but to sleep so I could get better.
          Marci was also there when the surgeon’s assistant took off my bandages a week later as I lay on the examination table with my eyes on the ceiling tiles, too scared to look.
          “It looks sexy,” was the first thing she said, her face beaming with love.
 
          Before I got breast cancer, I used to say that the first half of my life had been experiencing trauma and the second half getting over it. What a luxury that was, as if safety existed, that life has some kind of guarantee, a for-sure that nothing bad will ever happen again. Breast cancer showed me that, no matter how hard one’s life has been, no matter how much has been taken away, more can still be taken away. Before I got cancer for the second time, I had an innocence, a blind faith that vanished along with my breast, a belief that there is something called safety that existed just above the tidal wave. All I had to do, I thought, was reach harder to grasp it.
          Now I lived in a different house. I did get cancer again. Thinking I couldn’t live through losing another part of my body, especially not one of the most beautiful parts, the most sexy, desirable part, what society tells me makes me a woman, I did lose my breast. I was irrevocably changed, for better or for worse. But a window appeared where there hadn’t been one before. The door was no longer barricaded. The mastectomy was devastating, but I went through with it to save my life. If I ended up living in abject terror of getting sick or dying, unable to find a way through the forever-after onslaught of illnesses and conditions endemic to being a cancer survivor, it wouldn’t have been worth it. If I didn’t stop worrying, it wouldn’t have been worth it.
          I knew now that worry was no guarantee that it wasn’t going to happen again. And if I didn’t let go of the strings tying me to my past, to the toxicity of my parents and their acts of cruelty and sadism, blinded by the fact they were the only parents I had, not able to see that with parents like those it was better to have no parents at all, it wouldn’t have been worth it. If I couldn’t update my records and realize that I didn’t live in their house anymore, that I had created one of my own with so much love it radiated gold, I might as well have lost my life.
          I would never have my breast back, or my spleen, or the roots or culture that were my right to have; I would never have a feeling of safety, or the foundation of home, or the childhood or parents I should have had. But I was still alive, and I loved and was loved.
          Perhaps cancer has served as my rites of passage. The first time at nineteen when I stood on the threshold of adulthood, it showed me my will to live, and that I wanted to be somebody. This second time, at the entrance gate to elderhood, it showed me love. It showed me I am somebody.