Double Helix, Clear Margins

I wrote the following piece while waiting to talk to the surgeon for more information. But first, a brief preamble, including a hoped-for outcome to the waiting.

File under: Your doctor is not going to call you to say, "Hey, you know, I've been thinking about you."

A month or so ago, I scheduled an appointment with my primary care doc. I had two items to discuss with him.

One was weaning off of my antidepressant, really as an experiment (it's going surprisingly well).

The other was to have him look at several moles.

My follow-up appointment was a week ago. I had two moles removed in my doctor's office. I learned last Thursday that one of them, near my right elbow, was melanoma.

I was lucky. The mole was shallow and the margins were 100% clear. I do not have cancer. But I did. And the only reason I found out about it was that I initiated the skin check.

Tomorrow I'm having surgery to buffer the margins and remove two additional suspect-looking moles. The surgeon is awesome and after several days of uncertainty, I'm feeling relieved and deeply thankful.

We are our best, and sometimes only, advocates.

Trust your instincts, my friends.

We call it a double helix, our friendship.

Two women who don’t share DNA yet feel like sisters in the oldest sense. Above my bathroom mirror, a small piece of art — it’s from a much bigger painting, so it’s like a close-up. It contains names of Biblical women. The ones who we don’t learn about, or whose stories are peripheral or maligned. Some, like Vashti and Ruth, are familiar. Others — less so.

When I moved to Vermont in the spring of 2000 with my husband of six months, she and I went out to breakfast. We connected because she was on the board of UVM Hillel, where I was the new director. We met at Penny Cluse, a popular Burlington breakfast spot on the corner of Cherry Street and South Winooski, just a few blocks north of my new house, built in the 1860s but lovingly tended by Matt and Ingrid Malmgren, who sold it to us by owner.

The moment Deb and I met, she said, “I been waiting for you!”

She is one of those people who makes everyone feel special, and means it.

Since I moved to Amherst in 2012, we have seen each other a handful of times. She was my “person” at my wedding in 2014, serving as a sacred witness whose name is on my ketubah, or marriage document. But life is busy and our orbits don’t naturally intersect much, so getting together is a rare treat.

This past week, a number of things conspired to keep her from attending Pearl’s bar mitzvah. But it turned she’d be in my relative neighborhood later in the week and we made plans for her to come through Amherst for an early dinner.

Meanwhile, I was recovering from a wicked cold that came on 24 hours before the bar mitzvah. The weekend was amazing, and if losing my voice was the worst of it, I counted myself grateful that my son had such an affirming, beautiful experience of entering Jewish adulthood in the midst of proud and loving family and friends.

I launched into a full week after that, starting with a small procedure in my doctor’s office to have two moles removed, one above my right eyebrow (at my request — I didn’t like the way it looked), and the other just above my right elbow (his call — he didn’t like the way it looked).

I had initiated the mole check a month before, along with a conversation about weaning off of the antidepressant I’ve been on for years. I first went on Zoloft at the age of 21 during a scary bout of existential depression. I went off of it during my pregnancy with Aviva, then back on, then tried to go off of it early in my pregnancy with Pearl, only to determine that compromising my mental health was more dangerous to the fetus than a tiny dose of Zoloft. I switched to Celexa at some point. My doses have gone up and down within a small window.

At this point — I am 45 — I’d come to question its efficacy. The only way to find out if it was “doing” anything, if it was the right drug or if I even still needed an anti-depressant at all, was to wean off of it.

So we made a super slow and steady plan for this — going down by 10 mgs every 3-4 weeks (by the way, 30 and 20 went fine, and I’m about to drop to 10) — and then my doctor did a mole check, examining legs, arms, back, neck, face, torso.

I have moles everywhere. Big ones, little ones, flat ones, protruding ones, faint ones, dark ones. And, apparently, at least one that was irregular enough looking that he said, “This one’s gotta go.”

In the month between that appointment and June 17, the day of actual procedure, a lot of life happened. We went to Israel for nine days. We scurried to get all of the final details taken care of for the bar mitzvah. We witnessed my boy on the bimah, on the threshold of young-manhood, utterly composed, beaming. And I signed a lease for my first-ever office, ordered and assembled furniture, and announced to my community that my physical door is now open, in addition to the virtual one, for writing groups and private coaching.

In a word, it was an incredible spring. Busy, full of purpose, grounded, joyful, stressful, tiring, satisfying.

As sad as Deb and I were that she and her family couldn’t make it down to celebrate Pearl, we were equally excited to have some one-on-one time later in the week. So I’d been looking forward to Thursday.

I wrapped things up at “headquarters,” as I’ve been affectionately calling my office in town, and walked home in the light rain, about a half a mile. The phone rang halfway down Amity Street and I didn’t recognize the number — Barre, MA — but answered it anyway.

“Jena,” a male voice said.

“Yes?” I answered.

“It’s Bob Weitzman.”

My heart sank.

“This is not good,” I said to him.

He didn’t argue. He proceeded to tell me that he’d received the pathology reports. As he expected, the mole above my eyebrow was nothing. The biopsy from the other one was why he was calling. He spoke in his usual, calm, direct tone.

Cancer. The “bad” kind. (To be fair, I’m not sure he said this. But it’s what I heard.) Melanoma.

He emphasized the good news: We’d gotten it early. The margins were clear. But he wants to take a very cautious approach. It took me a minute to comprehend what he meant — not that we would be cautious about the approach, but what our approach would reflect taking extra measures to make sure I was in the clear.

He told me he’d already called an excellent surgeon at Cooley Dickinson in Northampton. “I think you’ll really like her,” he told me, emphasizing her warmth. This man has known me since I was a teenager, so I will give him that — he knows a good bedside manner is high on my list, probably just one notch below excellent surgical skills. I should expect a call from her office shortly, to schedule an in-office visit with her.

She will critique his work (the six stitches I was, and am still, sporting from the excision in his office). and discuss and schedule next steps (surgery with wider and possibly deeper margins, maybe some imaging further up my arm). He expects all of this to happen next week, acknowledging that waiting is, indeed, the hardest part.

I listened intently, aware of my shock, taking things in. I arrived home while we were still talking and sat down in my usual spot at the kitchen table. I started writing things down, just to do something, knowing that I’d remember every word.

The we hung up and I began to cry.

Moments later, Deb pulled into my driveway. I looked down from our second-floor windows and saw her get out of her car, the VT plates, and headed down to meet her on the porch. We hugged and then she took one look at my face and said, “Wait, what just happened?”

I swear, God has a way.

(Just as I wrote that, a cardinal swooped over to the feeder, his red flapping wildly as he came in for a precise landing.)

I told her everything. “Do you see how strangely calm I am?” she asked. I did see that, and I joked that Mani would probably be similarly calm when she got home from doing errands and I told her the news. (I was right. She was a midwife for many years and has one of the highest thresholds of anyone I’ve ever known for news of all kinds.)

Deb drove with me the 30 minutes into the boonies to pick Aviva up from a babysitting gig. It was so sweet to see them together, talking about Israel and life. We dropped her off at the synagogue garden, where she’d committed to doing some work, before scooping Pearl up from a friend’s house. We stopped by my office for Deb to see it in person, then the three of us ate middle eastern food and talked about Pearl’s bar mitzvah over fries and falafel.

The timing of her visit could not have been more amazing.

When I got home, I asked Mani if she wanted to go with me to Target to pick up thank you cards for Pearl. She knew this was partly code for, “Let’s go out and have a few minutes to process this and just be together.”

We sat in the Target parking lot, speaking our reactions, a jumble of emotional and rational. Mani’s mother died of cancer in 2011, and naturally a rush of memories and fears had immediately risen up. But we both also knew that this was, in all likelihood, not that. Skin cancer is highly common, and melanoma, caught early as mine was, has a 98.4% survival rate. Still, we are both writers with over-active imaginations, a blessing and a curse at times, or it neither of those, something to reign in when fear is on the table.

I got a call the next morning from the surgeon’s office. My appointment with Dr. Helms is Monday at 11:45. I wrote a little about the news in some of my online groups; I told my sisters.

When I stopped by my parents’ house Friday afternoon — my mom had sewn a few more small pillows for my office, with the soft grey fabric we’d picked up earlier in the week — I debated telling her and my dad about Dr. Weitzman’s call and this latest news. As we chatted away about lighthearted things, I decided against it. Better to wait until after Monday’s appointment, when I have more facts and details and specific next steps. Why worry them for the entire weekend? I applied this same logic to the kids. There would be nothing useful about them having three extra days to worry, which I knew of course they would.

Friday night. Bed. Mani and I put down our phones. “What was your high point?” I asked.

We’d begun a nightly ritual sometime after I returned from Israel, of intentionally connecting with each other at the end of the day rather than just falling into bed, scrolling on Instagram, watching a show, and going to sleep. (Now we fall into bed, spend time together, then watch a show and go to sleep!)

We finished an episode of The Handmaid’s Tale — we’re watching Season 3. Then Mani turned out her light and pulled me in close.

“I’m scared,” I whispered into the dark room, then started to cry.

She tightened hold on me.

“It’s ok to be scared.”

And we slept.