Big, Freaking Rock: A Cancer Biopsy

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My experience with a cancer biopsy.

image of Angela Patterson

When I had my breast biopsy prior to my second diagnosis, it was my first time to experience a biopsy. That’s because the first experience was atypical and the need for bravery was shifted.

The first time, I was 36 weeks pregnant when diagnosed. The lump I discovered was surrounded by fluid, according to the ultrasound (the only imaging that was safe to perform on a pregnant person). The fluid around the tumor gave my breast surgeon the impression I had an infection rather than cancer. It wasn’t until we were in surgery to remove the “benign mass caused by pregnancy hormones” that she recognized the mass as cancerous. She got a sample of the tumor confirmed as cancer while I was sedated, then she performed a lumpectomy.

So, for my first diagnosis I went into a simple procedure for a benign, mystery mass and woke up from general anesthesia to receive a cancer diagnosis. It was a bad, bad day and a complete shock followed by childbirth, chemo and radiation.

The second time, a mammogram caught the cancer in the other breast in the earliest stage (DCIS), prior to forming a tumor breaking out of the ducts where it originated. Before we had any details on pathology or could make a plan for treatment, we needed the biopsy to confirm that it was cancer.

In some ways, biopsies are harder than surgery. You’re awake. The local area is numbed but you can still feel pressure. Most importantly, you have to remain very still while something is done to you and the urge to run away can be strong.

As I approached the room with the equipment and the personnel, I keenly felt a wave of fear. My husband wasn’t even allowed to be in the building with me because this was 2020 and COVID was gripping the world. Nobody could stand in my place, and I couldn’t sleep through it. I needed something to help me cope.

I read Frank Herbert’s Dune ages ago. On the day of the biopsy, I thought of the Litany Against Fear that the Bene Gesserit would recite. I misremembered some of it, but the jist was that you are some kind of bulwark. Fear is separate from you. It can crash over you, around you, and through you, but it cannot defeat you. Once the fear has gone, only you will remain.

The thought of fear washing against something that did not move reminded me of big rocks in a fast-moving river when I did a bit of white-water canoeing years ago. That image brought the Litany Against Fear to life and suddenly I had not only a coping mechanism but a path to ferocity and defiance.

Yeah, water may wear down a rock over time, but for this procedure on this day, I, the big, freaking rock, would remain. (I might have used a different word for myself that begins with “f” and ends with “ing,” but I settled on “freaking” as the perfect word I could repeat in mixed company.) Who needs full reality when you’re grasping an image to manage fear?

When I had to get into position on the stereotactic table, had to stay still while the needle injected local anesthetic (which stung), had to remain as still as possible while the special needle made a series of tissue cuts for the biopsy, I imagined myself as a big, freaking rock with my fear crashing against me, around me and over me. I imagined my fear as water at first flowing through me and then the water draining away so that only I, the big, freaking rock, remained.

I thought of being so big and so strong that the water would have to reshape itself to accommodate me and the imagery brought fierceness and fortitude. I remembered to breathe. I resisted the impulse to run away. I actually smiled a little. And I got through the biopsy.

When I had to later endure another round of breast biopsies, this time with the aid of an MRI so things took much longer, that was more difficult. Still, the image of the big, freaking rock helped.

Later, right before my second lumpectomy, I had to stay still again in a mammogram machine for them to thread a wire through my breast that would guide the surgeon later. I used the big, freaking rock image once again.

We tend to look back at complicated experiences like school, relationships, weddings, pregnancy, childbirth, buying homes, getting new jobs, etc. And we assimilate the mountain of tiny details, mushing them altogether into generalized memories. We forget how many times we had to focus on one small step at a time, and how hard some of the small steps really were.

I am that big, freaking rock. After the fear is over, after the waters of trauma have receded, I may be bloody for a while, but I am fierce. I will endure. I will remain.

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