Everything was going well until one day in the month of October during the year 1983. That day, my husband discovered a hard nodule in my right breast. I looked at my breast in the bathroom mirror; it was the same that I was looking at every day after taking my bath, but now when I touched my breast and, yes, a hard nodule was there. Nothing was more different than what I was dreaming or what I was expecting. That was not in my plans to find a hard nodule in my breast. After only three years in the United States, being at the very entry level in everything, and it could be cancer that I had. I felt devastated.
In the afternoon of the same day, I went to visit a Cuban friend who used to live in the same building but on a different floor. Her youngest sister was studying medicine. The three of us discussed the situation, and after a phone call I went the next day to a gynecologist. I don’t have a good recollection of that interview. But what I clearly remember is that before any type of test, or even the basic mammography, just based on his touching, he was writing a referral for surgery. Neither Pepe nor I accepted his referral but wanted to have a more scientific referral.
That day was October 20, 1983, just twelve years after my marriage and three years and one month after entering the United States, and the saddest situation of all: I had a ten-year-old child. I remember climbing the stairs of the entrance to the building with a lot of thoughts and fears inside me. When I entered our apartment, I went to our room and stood in front of a cross. I closed my eyes and desperately tried to pray. After a few attempts, I was able to say an unusual prayer: “God, I just ask for time, just a few more years, because I desperately need time to continue taking care of my only child.” It was probably the most sincere and faithful prayer of my whole life. I didn’t remember for how long I was asking God again and again to give me time. What I do remember is that at the end I felt peace. I was totally sure that I had made a deal with God and I trusted Him, because He is really good “in this type of business of faith.”
The next day my husband spoke with the owner of the travel agency where he was working. She recommended a surgeon, Dr. Cartaya, and I got an appointment for that same afternoon. After a thorough examination, he prescribed an X-ray and mammography tests. Dr. Cartaya’s secretary set the appointments for the next day. Thus, at the end of that second day I had scientific proof: there was something wrong in my right breast. That something could be cancer, but that could also be a fibrocystic nodule since the mammography and the X-ray of both breasts revealed the presence of fibrocystic tissue.
The surgery was November 1. The day before I entered the hospital, I went to church and talked with the priest, who was a friend of mine from Cuba. He administered the sacrament of anointment. At the hospital, I went through the pre-surgery tests and X-rays. I also signed the authorization for a mastectomy in case it was needed. After that, Pepe left me in my room, and went to pick up Pepito from the house of Finita. That night I used all my knowledge to remain calm and to relax, but it was not easy. I could not stop my thoughts; I could not stop looking back my life. At forty-five, I could not afford a diagnosis of cancer. I fought back my recurrent thoughts because I didn’t want to host any source of negativity.
Early in the morning I took a shower and looked into the mirror for a while. There was me with my two breasts. I touched them; they were mine. In my mind, I anticipated the image of my body lacerated and tears came out of my eyes. After the shower, they took me to the surgery room. Dr Cartaya was waiting for me. He explained again the procedure and the possible scenarios. I said to him, “Please explain this also to my husband.” He answered, “I already did.” So I asked, “What was his answer?” With a smile, Dr. Cartaya told me, “He says he loves you with two, with one or without breasts.” I smiled too and said to myself, God bless you, Pepe. I love you!
My next memory image was Dr. Cartaya telling me, “Everything is all right. The biopsy done during surgery is negative. You will only have a small scar in your right breast.” I cried and gave thanks to God for His merciful intervention. No doubt, He was a very good partner to do business with. The next day, Pepe went to the hospital and brought me home, but first we went to Finita’s house to pick up Pepito. When I embraced him, Pepito asked me, “Mami, te quedastes con las dos tetas?” (“Mom, do you have the two breasts?”)
As I mentioned before, just a week later I went back to classes at St. John’s University. The medical report allowed me to go back and to continue the classes. But something inside me had changed. I had lost part of my motivation, my drive. I even wondered if it was intelligent enough to continue with that stress—I mean, learn English, work, study, home—if in just a minute your whole life could be in jeopardy. After I finished the semester, I decided to rest for a while.
Slowly, the experience of just “touching” the possibility of having cancer began to give me new energy to move and achieve certain economic stability for the family before a new health challenge came back again. After a few months of post-surgery follow-up tests and consultation, I regained the energy necessary to move further.
For years the shadow of cancer didn’t bother me, until January 2003. Twenty years later. At that time, it was my fault because I had skipped two annual mammographies, mostly because I was not paying attention to myself due to the tense situation I was living. The Friday I went for the test, I had poor physical and psychological energy. I felt tired—the appointment was after I finished the extended day program. While I was in the waiting room I was contemplating the possibility of canceling the meeting when I was called. I did the test and was asked to wait. A new set of tests was conducted. And I was asked to wait, again. After I was dressing up, the radiology doctor told me that the tests were suspicious of cancer and recommended for me to visit the referred physician next Monday.
I knew this time I would not escape. At home I checked all the symptoms. Yes, it appeared that this time cancer was going to hit me. And that was confirmed on Monday by the gynecologist, who referred me to a surgeon. On Thursday of the same week the surgeon checked the films and explained to Pepe and me what they revealed.
The biopsy was the following week and confirmed the diagnosis. The meeting with the surgeon was more informative: lumpectomy or mastectomy. If I selected lumpectomy, the follow-up was chemotherapy for a while. If I selected mastectomy, the follow-up was a silicone replacement implant. That suggestion never crossed my mind, but Dr. Gonzalez firmly told me, “No mastectomy without the replacement. You are young enough to continue your life after surgery. The replacement will be part of the recovery—physically and emotionally.”
Thus, before the surgery I visited the plastic surgeon. We discussed the possible replacements, their pros and cons. And what the cost of the different treatments would be, and what the insurance would not cover and must be paid in advance.
The surgery was Wednesday, February 12, 2003. The night before, I was unable to sleep. I was too afraid. I listened to the relaxation tapes, the preparation to surgery tapes, but I could not calm my spirit. Near sunrise I finally caught sleep but Pepe woke me up after just one hour. I took my shower without contemplating my body; I didn’t wanted to see what I had and what was not going to be there in just a few hours. At 5:00 am Pepe and I went to St. Mary’s Hospital in Hoboken. The previous days had been snowing heavily so from the garage to the entrance of the hospital I had to walk through snow and ice—the noise my boots produced while crushing the ice gave me cooling chills. Before taking the elevator I went to the chapel. I didn’t ask for help, but offered myself to God in payment for the twenty years He had gave me—the time I needed to raise my child. He knew that I was good at paying my debts, too.
At the room, a nurse explained to me, again, what was going to happen and showed me her mastectomy and replacement done eight years before. Later came the surgeon, who explained to me what was going to happen and again asked me if I wanted a lumpectomy or mastectomy. And, finally, the plastic surgeon came to explain to me what was going to happen. He also took pictures of my breast in different positions. When the auxiliary members of the surgery came to pick me up, I looked at Pepe. He was there, avoiding eye contact. I kissed him and found tears in his eyes. Going to the operating room, there was a big cross on the wall. I looked at the cross again and said inside me, Thank you for the break you gave me twenty years ago.
When I woke up I saw Pepe at the door of the room looking at me, with my two nieces, Odalys and Ileana, near him. Soon I was moved to my room. There, I found the presence of Washington School and Union City Board of Education: flowers, messages, phone calls, and after 4:00 pm visits. Two days later, on Friday, February 14, I was released and went home. That night when I had to do my own cleaning of the drainages, the mirror reflected the truth: that scars are what I will have from now on. Even with the silicone replacement, I had and always will have a mutilated body. The following months were involved in preparing my body for the silicone breast that was inserted on October 10, 2003.
Is there a relationship between psychological stress and physical illness, and more specifically with cancer?
By psychological stress we understand the emotional and physiological reactions that we experience when we confront situations and demands that we cannot handle or that we don’t have the necessary inner resources to accomplish. The body reacts to stress by releasing the so-called stress hormones—adrenaline and cortisone. Stress hormones increase blood pressure, heart rate, and blood-sugar levels.
In the fall of 2000, just a few months after I discussed my dissertation and graduated with a PhD in psychology, I suffered for two months with chronic diarrhea and lost nearly twenty pounds. I went through all sorts of tests to conclude there was no reason to have chronic diarrhea. So I started medication to help my autonomic nervous system to handle my stress. (The autonomic or visceral nervous system is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness. It controls visceral functions.)
Five years later, in December 2005, I started to have spells of cough. We thought it was “allergies”. But when the cough was also followed by acute chest pain, I went to visit a cardiologist. After extensive tests the diagnosis was a prolapsed mitral valve with moderate to severe regurgitation. The possibility of surgery was contemplated but postponed with an aggressive treatment to maintain my blood pressure at its healthy lower level. Today I am suffering from cardiac insufficiency (my heart is having difficulty completing its work) and chronic high blood pressure, which have been damaging my heart and my body in many ways. Consequently, since then, I need frequent checkups of my heart and of its functioning.
I know that life itself is stressful. I know that I have faced enough difficulties throughout my life, some of them very intense. Also, I believe that I have been unable to handle the stress adequately. So stress has been part of my family package, part of the complex relationships that I choose, part of the needed accommodation and adjustment that comes with migration, part of becoming again a professional in a new country and with a new language and new set of rules and values.
For years I have worked to have my stress under control. At the beginning of my life I was convinced that I could handle whatever comes. At a subconscious level, I build up defenses against profound stress. So I was able to remain focused, I was able to cope with wrong circumstances, I was able to function, I worked very hard to maintain my spiritual vision of life—that spiritual vision which is (no doubt) my source of strength and my secret for relaxation.
Working to handle my stress has strengthened my body to resist, but stress has weakened my body too. I have been at so many peak levels and for such long periods of time that my defense system has eventually collapsed—headaches, prolapse of the mitral valve, high blood pressure, irritable bowel syndrome, and cancer.