Danielle Steel - Lightning

“Just exactly what does that mean?” Sam asked, feeling sick, just asking him the question. “You took the mass out of her breast?”

“Obviously. We took the breast too, of course. It's the only way you can be absolutely sure there won't be a local recurrence. You can't have a recurrence in a breast that isn't there. It could recur in the chest wall, or travel elsewhere, of course, or metastasize, but that will depend on how advanced the tumor is, and how many lymph nodes are involved. But eliminating the breast solves a lot of problems.” Alex had understood that.

“Why didn't you just kill her? Wouldn't that solve the problem too? What kind of barbarian bullshit is that to just chop off her breast so it wouldn't spread? What kind of medicine do you people practice?” Sam was livid, and shouting.

“Cautious medicine, Mr. Parker. We endorse aggressive attacks against cancer. We don't want to lose our patients. And just so you understand, we did some axillary dissection too, which means we removed her underarm nodes, but I'm hoping she doesn't have a lot of nodular involvement. That will be confirmed by pathology in the next few days, and we'll have the results of her hormone receptor tests in about two weeks, and then we'll have a better idea how to treat her.”

“How to treat her? What else are you going to do?” He was still shouting at him. With one stupid move, they had butchered poor Alex.

“Depending on the lymph node involvement, we're probably going to have to do some fairly aggressive chemotherapy, just to make sure that there won't be a recurrence. There could be an issue of hormone therapy too, but we don't know that yet. And at her age, it's doubtful. Since we took the breast, there's no need for radiation. We won't be starting chemo for a few weeks. She'll need time to get on her feet, and we need time to assess her situation. Our tumor board will be meeting to discuss her case, of course, once we have all the pathology reports. I can assure you that your wife's treatment will be given very serious consideration.”

“Just like you gave her breast?” How could they do that to her? He still couldn't believe it.

“I promise you, Mr. Parker, there was no choice,” Peter Herman said quietly, he had dealt with outraged husbands before, and frightened ones, and those who just couldn't cope with the reality, like this one. The husbands were no different than the patients. But he had a feeling that Alex Parker had understood all the dangers better than he had. “We did a modified radical mastectomy on her, which means that we took the entire breast, and breast tissue, extending toward the breastbone, collarbone, and ribs, and her minor pectoral muscle. This means that she'll be able to have reconstructive surgery in a few months, if that's her wish, and if she's up to it during the chemo. If not, she can wait, and wear a prosthesis.” He made it all sound so simple, and even Sam knew it wasn't. Dr. Peter Herman had changed everything with a single stroke of his scalpel. And just listening to him now made her sound like a mutant.

“I can't understand how you could do this.” Sam stared at him in uncomprehending horror, and Peter Herman realized that it was just too soon for him to absorb it.

“Your wife has cancer, Mr. Parker. We want to cure her.” That said it all, and there were tears in Sam's eyes as he nodded.

“How good do you think her chances are for survival?” It was a question Dr. Herman hated to answer. He wasn't God. He was a man. He didn't know. He wished he could give them all guarantees of long life, but he couldn't.

“That's hard to know right now. The tumor was deep and large, but the whole purpose of radical surgeries, and aggressive treatment afterwards, is to wipe out the entire cancer. If we even leave point zero one percent, it could eventually do her grave harm. That's why we can't afford to leave the breast once it's diseased to the extent that hers was. And sometimes finding it early enough, and attacking it radically, can mean the difference between success and failure. We hope that we got all of hers, that it was contained, that it has not infiltrated, and that her nodes are not too excessively involved. We hope that, for her, radical surgery was the answer, and chemotherapy will be the additional guarantee she needs. But only time will tell us if we've been truly successful. You're both going to have to be very strong, and very patient.” She was going to die then, Sam decided as he listened. They were going to butcher her piece by piece, cut off one breast, then the other, scoop her insides out, and boil her guts with the poisons in the chemo, and then she'd die anyway. He was going to lose her. He couldn't stand it. And he was not going to hang around and watch her die, just as he had his mother.

“I don't suppose I should bother asking what your success rate is with these kinds of cancers?”

“Sometimes excellent. We just have to be as aggressive as your wife can tolerate. But she's in good health, which is in her favor, and she's a strong woman.” But not a lucky one. At forty-two, she was going to have to fight for her life. And there was a good chance that she wouldn't win it. He just couldn't believe it. It was like one of those bad movies where the heroine dies, and the husband is left alone with the children. Just like his father, and it had killed him. But Sam already knew he wasn't going to let this kill him. He couldn't let her do that to him. His eyes filled with tears as he forced himself not to think of her body the way it had been, and the way it would look now. The words were all so ugly …reconstructive surgery …prosthesis … he didn't even want to see it.

“Your wife will be in the recovery room for the rest of the afternoon, I'd say. I think she should be back here by about six or seven. I think she might do well with private nurses for the first few days. Would you like me to arrange that?”

“That would be fine.” Sam looked at him coldly. The man had destroyed his life in a single moment. It was impossible for Sam to accept the fact that the doctor hadn't given her the cancer, he had tried to cure it. “How long will she have to be here?”

“I'd say until Friday. Possibly sooner, if she does well. A lot will depend on her attitude, and her recovery. It's actually a fairly simple operation, and there's less pain than one would expect, especially in a case like hers where the involvement was mainly ductal. That's more the ‘plumbing' of the breast, and there aren't a great many nerves there.” Sam felt sick hearing about it. He'd already heard a lot more than he wanted.

“Get her round-the-clock nurses, please. When can I see her?”

“Not until she comes back from the recovery room, early this evening.”

“I'll be back then.” He stood looking at the doctor for a long moment, unable to thank him for what he'd done. He might as well have killed her. “Will you be seeing Alex again today?”

“This evening, when she's a little more awake. If there's any problem before that, we'll call you. But I don't anticipate any complications. The operation went remarkably smoothly.” Sam's stomach turned over as he heard the words. To him, the only thing that was remarkable was that they had butchered Alex.

The doctor left the room then, well aware of Sam's hostility, and Sam left his office number and the number at La Grenouille at the nursing desk, and then he hurried out of the hospital, feeling frantic. He needed air, he needed room, he needed to see people who hadn't lost anything, who weren't sick, or dying of cancer. He couldn't stand being there for one more moment. He felt like a drowning man as he gulped the cool October air, and by the time he found a cab, he felt slightly more human.

He gave the driver the address of La Grenouille, and tried not to think of anything Peter Herman had said about Alex, about how little they knew, and how much they hoped, and nodes, and tumors, and tests and biopsies, and metastasis, and chemo. He didn't want to hear another word about it. Ever.