"I've got a lump," my wife says. "Feel." I'm watching the Sunday afternoon match and still have an eye on the game as she directs my hand to the outer curve of her left breast. It is the 67th minute. There is a lump. "What does it feel like?" We are in the bedroom now. She has stripped to the waist. I palpate the breast as if I am expert at detecting cancerous growths. "What do you think?" she says. "There's a bump," I say. "It's more of a bump than a lump."
The GP is reassuring at first, but develops doubts and will organise a referral to the breast clinic. Kate returns tearful. We both need cheering up so we drive to the coast, half an hour away, stopping to buy sandwiches on the way. It's a fine day. The tide is low and the sea is a hard blue. It feels good to be alive. Later, in the pub, it's my turn to be tearful. The second beer helps.
Thursday week, the day of the appointment. We sit in the grey-blue waiting room at the breast clinic. There is a television set in the corner with the sound muted. A television chef is baking a birthday cake. No one is interested.
Our turn. Through to the examination room, my semi-naked wife looking fragile as the surgeon prods and palpates and gets to work with his blue marker pen. He doesn't say much. The nurse does most of the talking. She's lovely.
Our turn again. Yes, there is something suspicious on the X-ray, the surgeon says. He's going to do a core biopsy. Seven slamming shots of the silver gun, and each time he holds up the phial to inspect the maggoty plugs of flesh. He's not quite getting what he wants. We'll have the results in a few days. "But you don't like the look of it," I tell him. "No," he says. "You think it's cancer." "Yes," he says. The nurse specialist has joined us, bad news personified. The surgeon leaves and it's the three of us in the examination room, Kate's tears hot on my shoulder. The nurse sits quietly. I have my back to her, which feels like a discourtesy.
It's a nasty, sticky word: mastectomy. I don't like the sound of it coming from the surgeon's mouth. We are back in the consulting room. He is plotting the likely course-surgery, chemotherapy, and radiotherapy, not necessarily in that order. We don't go straight home. We stop by the riverside and walk in the woods. I can't remember the last time I wept like this.
A week on. They're setting it up as a Bad News consultation. They have grave-jolly faces-professional wistfulness. But we know already. There isn't much by way of preliminary. The surgeon squints over his spectacles. It's a malignant, invasive, ductal carcinoma, he says, with a trace of apology. Is there anything else we want to know? Kate asks about the histology. Are the cells well, or poorly, differentiated? Poorly, he says; grade three. It's a bad one. He replays the likely treatment scenario: four cycles of neoadjuvant chemotherapy over three months; mastectomy, followed by radiotherapy. The plan is provisional because if the chemo fails to shrink the tumour they'll bring the surgery forward. Arrangements will be made for bone and liver scans. We can do bloods and a chest X-ray straight away. I keep saying "We."
How odd this is. Worse news, but a sense of relief. I have already pictured the surgeon slicing off my wife's breast. I have imagined it being thrown to waste, seen it rising in smoke through the incinerator chimney. Yet there is comfort in the thought of getting on with treatment. Whatever it takes. It almost feels relaxing to walk out across the main concourse of the hospital-like a departure lounge with its caf? and shops; this place I know in a parallel, professional, life. Out into the sunlight.
This time we don't go to weep by the riverside or walk in the woods, but head for the supermarket. A familiar-looking man in shorts and T-shirt is loading his shopping into the back of a Volvo. It's a famous television newsreader. I want to tell him our news. Back home we drink beer, eat curry and watch football.
We are handed over to another surgeon, one who specialises in breast reconstruction. Kate sits on the edge of the bed. The surgeon strokes his chin, looking at her bust with the eye of a sculptor. He stoops, presses and probes the diseased breast, then stands back for a fresh view. He takes out a little ruler and starts measuring. He's thinking on his feet. Yes, he says, we could go for a wide local excision instead of mastectomy. Despite myself, I find that I'm playing devil's advocate. I've read the latest New England Journal of Medicine and understand that, all things being equal, less radical interventions are just as effective. But I need to hear it from the wizard in the dark suit.
Five months on, post-chemo, Kate lies on a hospital bed, draped in drips and drains, recovering from her second operation in a month. The first was to remove the lump. This one has restored the breast to its original shape, although we have yet to see the sculptor's handiwork. She is swaddled in a "bear hugger" blanket, filled with warm air to aid the perfusion of blood. With her hair just starting to grow back, she looks like Roy Keane, but much prettier. And infinitely tougher.
