I expect a look of alarm, but Doctor Ellison doesn’t flinch. ‘Why do you think that?’
With a shuddery inhale, I unload to her about my symptoms. Lindsay’s comment about my breasts, the bleeding between my periods, and the persistent cough.
Doctor Ellison squints at her computer. ‘When was your last pap smear?’
My heart bunches in my throat. ‘It was around two years ago. They said I didn’t need to come back for five years.’
‘That’s good. And what makes you think these symptoms mean cancer?’ She almost smiles when she asks the question, but it doesn’t feel patronising. She actually has the same sort of calming aura as Christina.
My fingers twist in my lap. ‘Both my aunt and my grandmother died of breast cancer.’
‘I’m sorry to hear that. Why don’t you come over here, and I’ll have a look.’
My entire body stiffens before I drag myself over to the examination table, struggling for breath as the doctor feels around both breasts with her gloved hands. When she gently presses over my lymph nodes, I tense up even more, but it’s been a year since the overly swollen gland reduced back to normal by itself.
When Doctor Ellison says, ‘I don’t feel anything out of the ordinary,’ relief streams into my chest with such speed that I could almost pass out.
Thank god.
‘Do you know if your aunt or grandmother had the BRCA gene?’ she then asks from her computer as I tug my shirt back down.
‘I’m pretty sure they didn’t.’ I settle back into the chair beside her.
‘Great. Well, given there’s no indication of the BRCA gene in your family, and you don’t have multiple first-degree relatives with breast cancer, the truth is that you’re really at no higher risk than the average woman. You’re still very young, and your breasts feel completely normal to me.’
‘First-degree relatives?’ I repeat faintly.
‘Let’s say you have a mother and two sisters who have had breast cancer. That would put you in a much higher risk category than having an aunt or a grandmother with breast cancer.’
I nod blankly. Every time she says ‘breast cancer’, my tongue feels coated in sand.
‘You know, it’s a common misconception that family history is a prime factor in breast cancer diagnosis, but in ninety-five per cent of cases, it’s just bad luck,’ Dr Ellison explains. ‘One in eight women in Australia will be diagnosed with breast cancer at some point in their lives, and the reality is that we’re all at equal risk simply by being female.’
Her words sound right, but my brain spits them back out, telling me that I’m the exception, that I’ll be the one in eight.
I must look petrified, because she quickly shifts tone. ‘It’s no reason for panic, though. There are many treatments available these days, and with early screening, we’re seeing far more positive outcomes. But I feel likewe’re jumping much too far ahead with this conversation. I’ve heard nothing today that makes me feel worried. But if you are concerned, I could send you for an ultrasound just to reassure—’
‘No, no, that’s OK,’ I cut in. ‘Thank you.’
There are no bad results if there are no tests in the first place.
Doctor Ellison leans forward and studies me, resting her elbows on her knees. ‘There is clearly some anxiety over your health here, too, which is much more common than you think. Anxiety is a truly horrible thing to live with, but it is treatable. There are a number of things we can do to help you overcome it.’
‘But I have other symptoms,’ I protest. ‘The cough, the bleeding …’
‘And we’re going to look at those,’ she assures me. ‘The intermenstrual bleeding could be fibroids, it could be hormonal, it could be that your cervix bleeds more easily than others. Are you on any oral contraception?’
When I shake my head and then confirm that I couldn’t be pregnant, she rolls her chair closer to her computer. ‘If it’s OK, I’d like to take some swabs and blood. Just in case you have an infection you’re not aware of. We should do another pap smear, too, just to cover all our bases.’
‘OK.’ A pit opens up in my stomach.Here we go. Just because she can’t feel a lump, it doesn’t mean I’m OK.
After she’s taken the swabs, the conversation shifts to my coughing. Within minutes, Doctor Ellison hasconvinced me to have a chest X-ray and a pelvic ultrasound, making it clear that she’s looking for things like infections and fibroids rather than cancer. Whether she’s telling me the truth or not, my gaze slips to the white wall behind her shoulder, seeing all the possibilities, and her gentle, lightly accented voice returns me to the room.
‘I think you’re going to feel alotbetter when all this is over. And then we can treat what’s causing these symptoms and maybe talk a bit more about your health anxiety. It’s also smart to be vigilant about any changes in your breasts, so keep doing regular self-exams, and be sure to come in if you notice anything out of the ordinary.’
Her smile is reassuring as she hands me the referrals, a prescription for the pill to consider, and a script for Valium that I can take on the day of my tests if I need to.
‘Thank you,’ I manage, fighting an urge to hug her.
