Breast Cancer

This poem is a homage to every brave woman I have ever known.

 

 

 

 

 

 

 

 

 

 

 

 

Youthful temptress, aging oracle,

Nymph-like debacle, Gorgon spectacle,

Retreat from retribution’s precipice,

And a transient victory wrought by avarice,

To listen to a parable

Devoid of the empirical.

 

Several centuries ago in the land of the Saracen,

You were born to a tribe called the Bedouin.

Clad in hijab to protect you from knowledge that is carnal or ecstatic,

Your elders were quite emphatic

In their desire to imbue you with virtue

In languages derived from Aramaic.

Rules were enforced by the prevailing patriarchy,

Who were keenly aware of lust in the presence of your budding sexuality.

 

Nature’s sculpting of your cherubic form

Into a Circe with Djim-curved breasts

Straining against material meant to cocoon a figure otherwise ethereal,

Did little to maintain the moral norm.

Codes of the West and codes of the East,

Dictated restriction or punishment for unleashing a Beast

Called unrestrained passion, robbing Man of reason,

Paralyzing Zeus with snake-like tendrils spewing poison and hissin’,

Only the strength of family kept you safe from the abyss

And the sword of Perseus,

Albeit temporarily.

 

In the ensuing years

Your inevitable rebellion as an uncontrollable hellion,

Sent you scurrying in a soulless desert from the puritanical to the heretical,

Falling for a secular encyclical

Promoting the hype of the perfect male archetype.

The rush of intellect combined with tingling nerves and tissue erect,

Anesthetized your senses

And blinded you to fragile mental fences,

Especially your own…

 

Now, in your twilight years,

Forced to face your deepest fears,

You gaze into a mirror,

To inspect Aphrodite with a wrinkled body all-a-quiver,

Sagging breasts with shriveled aureoles publicly wrapped in fashionable frills-

Fatty tissue feted by paramours over whom you once held sway,

Rose-tinted nipples electrically bonded to Venus’ mound in her heyday,

Now drooped untouched below a proud visage lined with pain

And experience in surviving life’s interference.

 

As you caress your naked loneliness,

And pause to touch a cancerous mass,

In life-giving organs soon to be disfigured by modern medicine,

In its quest to heal every lesion,

Your heart yearns for a cloak to shield your fading womanhood.

But inevitably you muster the strength,

To find your own identity and carry on the fight,

To any length, even to death’s finality,

For you are now fearless

And ready to show your true beauty and grace in the face of adversity.

 

Zarah and Shireen (First appeared in The Norwalk Patch)

Imagine no possessions

I wonder if you can

No need for greed or hunger

A brotherhood of man

Imagine all the people

Sharing all the world…

( John Lennon, 9 October 1940 – 8 December 1980)

Zarah

Zarah left the doctor’s office in a daze, with only the iPod-sounds of the ex-Beatle in her ears as a consolation. The brown leaves on the street reminded her of nature’s constant rhythms and the pumpkin spice latte warming her hands spelled normalcy. However, her life was never going to be the same again. She had just been diagnosed with breast cancer and had listened in silent shock to her doctor’s voice detailing care and referrals to specialists. Now she understood that the varied tumors collectively termed breast cancer, consisted of subtypes that were defined by the presence or absence of cellular biomarkers e.g., estrogen receptor-negative (ER-), progesterone receptor-negative (PR-) and HER2/neu-negative. The basal-like invasion of her best physical assets was known as triple-negative breast cancer, i.e. a frequently aggressive tumor lacking all three biomarkers. She remembered an aunt who had the disease and worried about her daughter. Would an Angelina-Jolie-like intervention or potential vaccine save her youngest child from her own uncertain health outcome?  It was time to reach out to the specialists at a premier New York institution. It was also time to call her family.

Shireen

Shireen, a Pakistani woman from a disadvantaged neighborhood, was experiencing similar emotions. Shireen and her father, Ali, spoke Urdu and just enough English to successfully operate the falafel stand on the edge of Zarah’s neighborhood. She did not wish to explain the family’s narrow escape from the Taliban and only wanted to improve her circumstances in her adopted homeland. Her journey from the Swat Valley in Pakistan to America was not marked by the accolades afforded another women’s rights champion from that region, Malala Yousafzai. The activist fervor of her youth had been replaced by the sobering reality of crafting a life filled with mastering a new culture, immigration paperwork and economic unknowns in the land of opportunity. The fact that she had no health insurance to take care of the searing pain in her breasts contributed to her stress. She waited until a kind neighbor agreed to accompany her to a doctor.  The neighbor had read about an empathetic doctor who focused on cancer care for poor patients. Given the autumn chill and her personal circumstances, she could use empathy after puzzling over the doctor’s diagnosis. A patient navigator translated the bad news. She had been diagnosed with invasive ductal carcinoma, a disease accounting for about 80% of all breast cancers. This meant that the tumor had spread from the milk ducts to the surrounding breast tissue. Shireen appeared dazed and distracted in the elevator. She ignored the stranger next to her who was humming a John Lennon tune. The neighbor would have to help her understand the complex treatment and her father would have to use his savings to help pay the medical bills. Like Zarah, she was determined to head to a premier cancer institution to seek additional medical opinions.

The oncologist

The oncologist was a tech-savvy humanitarian graduate from an Ivy League university. She worked at the premier cancer institution and her electronic medical records were as impeccable as her academic credentials. She wanted to arm her patients with the latest facts about breast cancer. She was also a believer in the use of artificial intelligence aka IBM Watson, to process ever-increasing mountains of medical data in order to personalize care. The computer had been a Jeopardy! TV quiz show champion and, according to some reports, could accurately diagnose disease and suggest appropriate management. The Watson dashboard flashed the medical histories of her first two case studies: Zarah and Shireen.