Benign Until Discovery

A brief memoir exloring, on a surface level, an experience of fear and loss of human dignity in the face of modern medicine. On another level, this piece explores how human beings--more specifically, how nerds--deal with fear and social relationships.

Wikipedia describes it as smooth with larger bumps in the middle, oval in shape. Epithelial cells are apparently the main component, and its sudden appearance is unknown. I personally don’t hold Wikipedia as a paragon of truth, but since I’ve felt it myself, I guess I can corroborate it. It’s basically smooth with larger bumps in the middle, oval in shape. And its sudden appearance is certainly unknown.

“Forecasting and Predicting Weather Hazards. Timely and accurate prediction of severe weather events is extremely important if human lives are to be spared.  I imagine so. And I imagine that you have a lot to say about this?”  Sitting in the front seat of the empty car, I rippled through my Natural Disasters textbook and anxiously hoped the chapter came to a discernable end. “Only three more pages, beloved? For a chapter on severe weather, ending with forecasting is a bit of a low blow. Hmmmm.Even with improvements in satellite sensors and computer modeling…”

The back door swung open and Mom threw the Ocean State Job Lot bags in. Mom’s shopping trips had been getting cheaper and cheaper, and the parking lots I was forced to sit in consequently grew grosser and grosser. A generally disorganized man walked by and spat a whammy into a sewer hole. 

“Thanks for keeping me company shopping, honey.” Mom plopped into the driver’s seat.

“Not a problem, Mom. I don’t need to use the computer for the reading part so being in the car is fine. I just want to get the writing response done before that doctor’s appointment.”

 “If I run into A.C. Moore will you have time?”

“I think so…and the doctor’s appointment can always wait.”

“Ha. Nice try honey.”



            10/27/10  Source:      


Using the 2001–2003 National Ambulatory Medical Care and National  Ambulatory Medical Care Surveys, we identified visits to office (n=8,756) and outpatient (n=17,067) PCPs by women≥40 without –symptoms of the –



Waiting rooms are despicable places, and if I believed in purgatory, it would be the waiting room of a doctor’s office. With PSC255 “Natural Disasters” homework out of the way I didn’t have the comforting flop of my textbook to keep my hands, eyes, and brain occupied, and I sat in the pediatrician’s office like a slug chucked in with the larvae. A nurse walked by and gave me the pink form I’d filled out for approximately seven years straight. I galloped through the sex section (no, no, no), the drugs section (no, no, no), and the tattoo section (no, no, no). I chanced upon an exciting white slip on the bottom: My own personal asthma questionnaire! (Yes, yes, yes!) The bench was a little short for me. And the fish tank—it was getting old. Before I had any more time to contemplate, the nurse appeared with a clipboard.

“Melissa Caissy?”

Some people worry about yearly physicals, but I never do. I’ve always been told to eat more; I’ve always been blind; and I always scare away vaccine pain by telling graphic stories about giving blood. The nurse always laughs, I always laugh, and all’s right with the world. Chit chat is my magic charm, and it chases away any awkwardness. And for that matter, that’s what people are really worried about at a doctor’s appointment anyway.

As the preliminaries were being suffered—a cold rush to the scale in a Johnny, a breathing war with the peak-flow, and a special, pre-appointment visit from the flu shot—I desperately hoped that, whoever the pediatrician was, her laugh would not be as loud and brisk as Dr. Halle’s, the doctor I had seen for years but had finally managed to avoid.

Dr. Kristen Sullivan walked into the room, asked the usual questions, and we had a robust discussion about STDs and eating vegetables. Dr. Kristen Sullivan was completely forgettable. In comparison to Dr. Halle and her screeching, that is probably a positive. The only thing I remember about Dr. Sullivan is that her laugh was almost too soft; almost non-existent.  

If I sweat blood from nervousness, what would they do?  I was getting into the back flat position, which meant that I was lying on the table with my arms behind my head like a boogie board. That also meant it was time to think. Who does the Johnny laundry? Why do I feel like I am on a movie set? What is in those drawers, anyway?

Dr. Sullivan, washing her hands in the nearby sink, decided to ruin my panic mode operation. “So you’ve had a pretty healthy year?”

“Yes, I guess so.” My sighing laugh went up to the ceiling, which was dreadfully bare. Why don’t they decorate the ceiling?

“Except for the mass Dr. Halle reported in the spring. How is that?” Dr. Sullivan was drying her hands and walking over.


 Flashback to Dr. Halle’s knife-like hand smashing the center of my sternum and slicing my breast like a bonbon.

“I’d say it’s about a fourth, probably a fibroadenoma, nothing to trouble about.” Dr. Halle bellowed.


“Uh, uh, uh, um, well…it’s back again. I found it in the spring but Dr. Halle said it was nothing, and I didn’t really pay attention over the summer because things got busy, but then last night I remembered I was supposed to stay on top of that and so I checked real quick last night and, and, and….it’s back again.” Dr. Sullivan didn’t seem fazed and I followed suit. “With the camp I work at over the summer, I just don’t have time to deal with lumps, you know?”

“Lie completely down, please.” I did. “Can you tell me where?” I pointed. 

Dr. Sullivan began her gruesome investigation under my Johnny, and my eyes, vigorously scrutinizing the ceiling, began to shed layers of lubrication. 

 “She’s going to think I’m a nerve bag if she doesn’t find it,” I agonized. “I think I’m a nerve bag. I think she needs to stop!”

She found it.

I used to think the tables at the doctor’s office were so tall. At my ten-year-old physical, when I found out the hideously true and, thus, face reddening fact that all girls want bras, I remember clambering up the table without the stool to make the doctor impressed, and most of all stop talking about things I didn’t want to hear. It worked then, and with a half-smile at the memory, I slide down from the table with a bit of panache. Aside from sweaty underwear, the scoliosis touch-your-toes thing was going to be the proverbial cakewalk.

“Didn’t Dr. Halle tell you to come to the office if the lump came back?” Dr. Sullivan’s brows were sporting an irritating, pinched look.

“She probably did, but I didn’t really bother to pay attention. As I said, summers are busy, you know?”

Dr. Sullivan gave me an absent nod. “I am going to refer you to a breast health clinic. Breast masses,especiallyif they reoccur, have to be dealt with immediately.”

“Oh, okay,” I assured her, mentally trying to figure out how I could adjust my underwear without her noticing. “That’s no big deal.”

There was a settling pause in the room while Dr. Sullivan wrote notes—probably some appalling diagram of my chest—and I laughed to fill the space.

“Dr. Halle said it was nothing.”

Dr. Sullivan kept scrawling.   


11/1/10 Source:

It causes stress or embarrassment—Hospitals therefore employ strict policies relating to the provision of consent by the patient, the availability of chaperones at the examination, and the absence of other parties, in order—


The November rains had begun, sending professors scuttling to class with wind-shook umbrellas and mixing with the fluorescent classroom lights in one large academic drizzle. My professor, after taking off her dripping hat and combing her hair, attempted to give youthful angst to Spenser’sFaerie Queene.

“Spenser really was quite the revolutionary,” Marcia primed, “right up there with Shakespeare and Sir Philip Sidney.” The class, shuffling through doodled notebooks, almost looked studious. “His depictions of empowered women are incredible, especially for his times. Take Britomart, for example—” Bill lifted a sagging eyebrow, Kate re-folded her hands under her chin, Esther stopped texting. “She just got up there, thrust her spear, andker-pow!” Marcia animated the battle and the class smiled indulgently. Upper hand gained, Marcia went on. “According to Petrarchan poetry, women in the sixteenth century were…” The class sighed and chairs began to creak. “Even his spelling is rebellious!” Marcia pleaded, but the class had glazed over. I too, sat with my shoulders hunched, but I was waiting; I was about to have a rare brilliantmoment. Just how could I make it sound stunning?

By scaffolding his poem with Homeric epic, Spenser effectively created parallels that give his poem a rich depth which allows the reader to fully explore his new, explosive, view of women. By delving into theIliadas a parallel, the reader discovers traditional masculine brotherhood resulting in death, and the stereotypical mourning mother who weeps and comforts her son; inThe Faerie Queenea reader encounters a similar picture of motherhood, but one whose limited role and idea of women is the cause of the same type of sacrifice Patroclus becomes for Achilles.

Yes, that was what I would say. I was scratching my head to facilitate a subtle hand raise when Homeric motherhood called.

“Melissa, is your phone going off?” Marcia looked shocked.

“Oh! I am so sorry Marica! Nobody ever calls me! It must be something rather important...” I fled out of the room and silenced my fuzzy ringtone.

“Hi Mom.”

“Hi honey. I just wanted to let you know that I scheduled an appointment with the breast health clinic.”


“It’s for next Wednesday morning.”


“Love you …don’t worry.”


            When I got back into the room the class was preparing to leave, and I started zippering up my backpack, stowing my exciting analysis away for another time—an essay, perhaps. Marcia must have noticed my corrugated forehead; she walked over in scarf-swooping elegance.

            “Melissa, is everything alright?”

            “Um, yes….yes it is. I just will probably have to have a….just maybe a minor surgery soon.” Marcia’s hand touched my shoulder.

            “Oh, my dear, I am so—”

             “Ooooh! Surgery on yourbrain?” Britomart and her magic spear, in the form of a classmate, decided to join the conversation.  

            “Ah…um…not really.”   

            “Well, get your psycho brain checked out anyhow—you need it.”Ker-Pow.

            “I…” I’d never seen Marcia look angry before. She took her hand off my shoulder and shoved a finger at the door. 

“Yasmine, get out of here!” At Yasmine’s crestfallen look, she gushed, “But have a lovely weekend, darling!”

Was that Homeric or Spenserian mothering?  


11/3/1 Source:

These lesions in young women constitute 0.5% to 2% of all f—, and are rapidly growing masses that cause asymmetry of the breast, distortion of the overlying skin, and stretching of the nipple. Histologically, they appear to be more cellular and have less lobular components—


Contrary to the image of monks secluded in prayer rooms, Christian conferences are not the place to find solitude. Especially not when your cousin, new to the social event, sticks to you in a super-glue of insecurities. I shoved my chair back as far as it could go in the seething dining hall and shouted over the clatter of forks.

“I’m going to go to the bathroom, so don’t eat all the bacon without me!” I slid by my friend Irene and had just been trapped by the oatmeal line when I heard a voice behind me.

“Wait! Wait!” I turned around; my cousin was battling the crowds with panic.

“I decided to join you.”

“To thebathroom?”

“Well, you know….there’s a lot of people out here.”

“I see.” The number of people in the bathroom is roughly equal to those out of it at this sort of retreat, but of course Tasha didn’t know that. Tighter and tighter I was about to scream.

With a click of joy, a stall finally opened and I slammed it shut with relief. While the girls next to me talked about the high peak of the divine revelation, I shoved my hand up my back and undid my bra.

“Were you ok in there?” My cousin Tasha asked, as we, reunited once again, waited for a path to open to our table.

“Why wouldn’t I be ok?”

“Well, you were in there a long time.”

“Oh, it was nothing! Absolutely nothing! Just uh….just…my dream of witnessing a natural disaster….coming true.”

“Seriously Melissa, are you ok?”

“Seriously Tasha, it’s just the high peak of Thoracic Cavity….peaking.

 “It’s a good thing I accept the fact that you make no sense sometimes. If I didn’t, I couldn’t bear with you.”

“That’s so? Huh.”

Tasha nodded seriously.

I struggled for a bite of conversation. “Have I told you my road trip theory?”

 “What’s that?”

“I thought of it while we were driving here, and I was thinking that road trips are the most romantic things—almost like plane trips. You start off in one place, move without moving, and end up in another place. You know?” I vainly hoped she knew.

“Melissa, you’re so cute. What am I going to do with you?”

            “I can’t imagine. Irene! Did you save me any bacon?” We had finally reached the table again.

When I got home from the retreat the invitation from Belkin House had arrived, the image of a curvy woman emblazoned on the top left corner. The house itself was a three story island off  Faulkner Hospital with its own concrete garage and set of carpets which could have used investment; Febreze at the very least. My personal letter gave Belkin House its distinction: Breast Health Clinic.

“Hurricanes. The Saffir-Simpson scale measures the strength of a hurricane in terms of wind velocities. Category 1: 74-95 mph. Chance of survival: Good. Category 2: 96-110 mph. Chance of survival: Probable with precautions. Category 5: 154 mph and higher. Chance of survival: Poor.” Every set of hands in the waiting room held a magazine. Every set of hands wished they had a textbook because that would mean they were young and had a better chance of survival. “Hurricanes begin as tropical depressions.”

“The lady at the front desk is really nice.” Mom observed, dropping her magazine.

“That’s always a good thing.Hurricanes begin as tropical depressions.” 

“Are you worried?”

“Nah.  Chuck’s reading quizzes tend to be pretty easy, so long as you’ve read. Hurricanes begin as tropical depressions.”

“Is it ok if I come in with you?”

“Mmmmm.Hurricanes begin as tropical depressions. The next phase is tropical storms. Tropical storms can pose a risk to communities that do not …” I thought about the waiting room’s community of women. They all had shaking hands.

I knew a lot about what hands could do. A shabby, fourth floor desk at the Wheelock College library, located where two radiators and a stack of windows intersect near a bathroom, is my favorite place to work, and houses all of my notes. Cloistered off from the rest of the library by the desk’s wooden walls, it was here that I did the research that sent blood to my cheeks.

11/5/10        Source:

CBE. Clinical Breast Exam. With arms relaxed at the side, visually inspect—for symmetry, dimpling or retraction and discoloration. Continue search with arms raised, and with shoulders shrugged and hands on hips. Lay the patient down with arms raised. Inspect each breast with the pads of the fingers in a vertical pattern moving—mid axillary line to sternum in dime-like circles increasing pressure for varying densities of tissue—


11/8/10 Source:

CBE generally continues to be recommended by many groups as a component comprehensive—screening and is performed by large numbers of US physicians. The way in which it is performed varies considerably.2,28 While the sensitivity and specificity of CBE were generally comparable across the—and screening trials, these levels of performance –


 “Fill out this form, Ms…Key-aaa-sy?” A secretary strained, smiling thinly above a bulky welcome desk.

“Like K-C, ma’am.” I said apologetically, leaving my textbook to grab the clipboard.

“Oh, ok Ms. KC, you need to fill out this form before Dr. Lawler sees you.”

“Thank you.” I hesitated, “I really like your shirt, by the way.”

“Why, thank you! Kohles, 30% off! You know, it’s nice to see someone as young as yourself in this place.”

“Doubtless.” The survival rates ticked off in my mind:Category 1: 74-95 mph. Chance of survival: Good…..

Pre-Assessment Form. It began with the date, moved to date of birth, and ended in social security number. Chief complaint? Check all that apply! Breast pain? Soreness? Tenderness? Nipple Discharge? Lumps? Thickening? Perhaps lumps under the armpits?  The section ended in graphic triumph: Please Describe. Now: Family history? Surgical history? Social history? Last diagnostic study? Current Medications? I GIVE THE PROVIDERS OF THE BREAST HEALTH CLINIC PERMISSION TO EVALUATE AND TREAT ME. 

I followed Dr. Margaret Lawler’s billowing white coat and blunted hair down the carpeted floors of Belkin House. She had given me her hand, introduced herself, and glimmered with a smile that came and went too easily. I ignored her voice and watched her massive shoulders swing as she walked. I rubbed my right hand on the sleeve of my sweater and fingered the familiar knit. Her hands, as substantial as her shoulders, held my clipboard.

Typical clinician style: hands writing notes while I answered a question she asked like she was a store clerk: “What can I do for you today?”  Like a neon light she radiated artificiality and familiarity; she was behind the desk before I even had the opportunity to sit. I watched her non-committed smile and wondered if she got bored asking the same questions. Perhaps she thought the daily probing of mysterious masses was a continual adventure?

Dr. Lawler’s simper had disappeared. “And you said that over the past two weeks you’ve noticed it’s grown larger?”

The insides of my stomach began to collapse on one another and I looked down at my lap, Natural Disasters textbook glowing with pen stain. I rubbed the corner with the palm of my hand.

“Your great aunt died of breast cancer?” She pressed on.

“Yes, but everyone dies of something at ninety-six.”

She did not smile, and said, “I see,” and wrote something on my clipboard. I couldn’t imagine what it was, but I began to circle around the pen blob near the textbook title. Her pen dropped; I flung back into awareness. Brilliant smile before me she tried to look inviting.

“You can go into the examination room and change now. Take everything off, waist up.”

She went somewhere.

Bewildered by her smile and the complexities of cheap fabric, I put the Johnny on wrong. Instead of allowing the bulk of the material to fall over my back so that the flaps could sit near my front and allow easy access, I covered my chest with all the cloth I could find, and consequently put the back of the Johnny over my front. The examination table, as discombobulated as the gown, looked like a puffy lawn chair slightly tilted with too much room for the head and not enough room for the legs. I slipped onto it and the white paper crinkled under me in annoyance.

Dr. Lawler walked into the room doing what appeared to be hand warming techniques. She paused when she saw me and smiled. It wasn’t a disconcerting flicker but a constrained grin, crammed with unheard laughs in the corners. Looking down at my guarded chest and realizing my mistake I smiled back at her, and then longed achingly for my fourth floor sanctuary.

There is a girl I know whose eyes suddenly expand into moons without, seemingly, any stimulation. I watch her in class and wonder why she is opening them so wide, because the rest of her face remains perfectly still. That’s what I looked like, except I had no shirt on. Due to my previous misunderstanding of Johnny style Dr. Lawler thought it best that I wear nothing at all, and I was denied the privilege of gentle cloth. My jaw was about to lock.

“Relax your arms.” Dr. Lawler ordered, and I tried to look carefree.

“Raise your arms above your head.” Dr. Lawler demanded, and I tried to be nonchalant.

“Put your hands down and place them on your hips.” Dr. Lawler commanded, and I tried to make the drop look natural.

“Lie down and put both arms behind your head,” Dr. Lawler dictated, and I tried to push myself as far back as I could go. I ended up banging my head on top ridge of the table, my legs flapping off the other end. Dr. Lawler casually thrust an extension out of the bench for the unwanted extremities, blew on her hands, and honed in. If she doesn’t see my chest moving, maybe I can pretend I am a mannequin.

“You can breath,” she said, looking into my eyes gravely. “I will tell you if I find anything right away.”  Her hair was frighteningly close to my face. I put my hands behind my head, set my teeth, and pretended I was a mannequin with reckless abandon.

But mannequins don’t feel. They don’t feel palpitation’s vibrating plunder; don’t feel nipples being pinched for fountains of discharge; don’t hear the light sound of exhale; don’t see a cheek, close and porous, twinge with disagreeable discovery. Most of all they don’t drown under a rush of shame that rises from the chest and surges down the neck, pooling in the face as pink debris.

“There is a strange red flush over your breast area,” Dr. Lawler announced, looking up from my chest to my head. “Oh. Now it’s in your face.” She went back to her work and the red exposure roared into the roots of my hair.

Dr. Lawler went from right to left to right, and lingered on the right. I knew she had found it the first time. She didn’t tell me, and if I had had my choice, I would have spent a few minutes screaming.  

She finally looked into my eyes, and my blush drained slowly. “The left breast is fine,” she assured, “but I did find something in the right.” She stopped smiling. “It’s about two centimeters, which is fairly large for a breast mass.” My eyes answered hers with an expression I hardly know. She draped a Johnny over me and left the room with instructions for me to get dressed and see her in her office.

I left Belkin House for my desk having forgotten everything I learned about hurricanes. I re-read the chapter that afternoon, pulling breast diagrams and sheets describing the intricacies of fibroadenomas and phyllodes tumors out of my Natural Disasters textbook. I had tried to calculate Dr. Lawler’s sunshiny glints during the winding lecture in her office, but there seemed to be no pattern, and her smiles were disconcerting in their randomness. She had outlined my near future with a pensive boredom that left my fourth floor nook awash in the study of tears.

Wikipedia describes it as smooth with larger bumps in the middle, oval in shape. Epithelial cells are apparently the main component, and its sudden appearance is unknown. I personally don’t hold Wikipedia as a paragon of truth, but I guess I can corroborate it. When ultrasound probes mash your chest and foot-long needles steal your cells, when pathology reports haunt your phone line and doctors flicker into life to stamp the pads of their fingers where they do not belong, all I can know with certainty is that it’s basically smooth with larger bumps in the middle, oval in shape. And it's appearance certainly is unnown.

The End

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