Wishing Well

Wishing Well JPG

The picture above is a wishing well in San Francisco’s Japanese Tea Garden. “Wishing Well” is also my title for an essay of mine that just appeared in the Washington Post. That’s a terrible title for our Internet age of tags and clicks and not caring whatsoever about clever titles with double allusions that mean nothing to anyone who hasn’t read the essay. Which why would they because what the hell is it about, anyway? Why take a risk on something that sounds confusing and suspiciously literary?

So the Washington Post’s title gets right down to it: “My legacy to my daughters: BRCA and cancer?” That’s right: My essay is about an unwelcome legacy in our family; what it’s like as a mother dealing with the fact that I might have passed on the gene that greatly elevates the risk of breast and ovarian cancer to my daughters; and how they feel about getting tested for the BRCA mutation. If you haven’t read my essay, you might want to do so now before reading the rest of this post. (In other words: “Spoiler Alert!”)

The essay ends on an ambiguous note, which prompted a Washington Post reader to ask, “But where is the ending? What about Emma?”

What about Emma, indeed? It’s so hard not to know what happened! At the time I wrote the essay, and at the considerably later time when it was accepted, we did not know Emma’s BRCA status because she did not want to know. Those of us who dwell in the BRCA land of No Good Choices in the Face of Risk swing back and forth between twin slogans: “Knowledge is Power” and “Ignorance is Bliss.” Emma chose the latter, as did I for a while, until my own uterine cancer forced me to come into knowledge I did not necessarily want to possess. So I understood Emma’s decision, even though it made me anxious. (If she had decided otherwise, I also would have been anxious.)

This is how things were for three years. Then Emma changed her mind about testing. Partly time softens us for readiness. But what really made the difference for Emma was an NPR report about how women who work with someone with breast cancer are less likely to get their own routine screenings because they are frightened seeing the disease up close and personal. Their denial snapped Emma out of hers (another reason you should support NPR).

Less than two weeks before my essay was published, Emma learned her test results. She does not have the BRCA mutation. We cannot believe our good fortune that both daughters have dodged this bullet. The wishing well granted my wish!

I debated long and hard about whether to contact the Washington Post editor to add an epilogue. After all, as the reader’s plea reminds us, we like to know how things end. We especially like a happy ending, and I feel a bit churlish to have withheld it.

But it so easily could have gone the other way. I had also seriously debated whether or not I would ask the editor to pull the essay altogether had Emma’s news been bad.

In the end, I decided to leave the essay as it stood. The point, after all, is that legacy is multi-faceted, we rarely know the ending of anything, and we must bear the anxiety of not knowing (especially as parents). The flip of the coin went our way this time, but it won’t for many facing the same dilemma, and it won’t for us other times. That’s just how life goes.

But for you, dear Shrinkrapped reader, I’m happy to provide a happy ending to this particular story, and happier still to have one to provide!




Good News, Bad News

Good news bad newsWhen my friend Sue met her future husband, she was eager—and nervous—to tell her parents she had fallen in love.

“There’s good news and bad news,” Sue  began. “He’s Jewish.”

“Oh, Sue!” Her mother exclaimed. “But we’re Catholic! Nothing against him, it’s just that we’re so different. It will never work.”

“Oh, that was the good news,” Sue replied. “The bad news is that he’s a Democrat!”

I, too, have good news and bad news, though it is not so charming as Sue’s (whose family, by the way, grew to adore her husband).

First the good news: I have been published in Salon! Making it into a major publication is a dream come true.

The bad news is that the essay is about what some, but not many, people already know:  I carry the BRCA mutation. This is the genetic defect that puts women at high risk for breast and ovarian cancer. It was made famous by Angelina Jolie, who wrote in the New York Times two years ago about her decision to surgically remove her healthy breasts to reduce her BRCA cancer risk. Just last week, the Times published another piece by Jolie about her recent decision to remove her ovaries and fallopian tubes to avert ovarian cancer.

Jolie’s first announcement came soon after I had finished nine months of treatment for a rare and aggressive form of uterine cancer, which was fortunately caught before the cancer had spread. My treatment included surgery (a complete hysterectomy, so the deadlier ovarian cancer threat no longer looms), radiation, and—just in case—six cycles of chemotherapy.

I had known well before my diagnosis that the BRCA mutation resided in a distant branch of my family tree and had mentioned it to my doctors, but did not pursue testing at that time. Two years later, my uterine cancer’s unusual cell type and the family history I had disavowed led the surgeon to suspect BRCA in me, not just in cousins I barely knew. So I met with the genetic counselor and went to the lab to have my blood drawn.

I got the results a week before my first chemo session in 2012. Sure enough, I tested positive for the BRCA2  mutation (a slightly less risky variant than Jolie’s BRCA1).

So I have something in common with Angelina Jolie! But there the similarities end, for I have chosen high-risk surveillance over prophylactic mastectomies. It’s actually the more common choice among BRCA-positive women, but you wouldn’t know it given all the attention to radical  surgery to remove healthy breasts. Neither choice is easy or risk-free. I felt I could contribute to an important conversation by writing honestly about what it is like to know that one’s body houses a potential time bomb as well as what went into my decision to go with the less-heralded surveillance option. And I am grateful that Salon agrees.

My BRCA mutation has been there all along. I have known about it since Halloween 2012. And now you know it, too. It is perhaps not the best way to find out, but I trust you will understand.


Please click here for the link to my Salon piece. I’ll be curious to hear what you think.