Jeffersonâs office had a cancellation this afternoon. You can go at three oâclock if youâd like.â
She nodded, as though he could see. âYes, I might as well get this over with.â
âIâm sure youâll have a lot of questions,â he said. âIâd recommend that you take a tape recorder with you so you can remember everything later. You might take a friend, too, just to be there with you.â
Her hand trembled as she brought it to her forehead. âIâm not ready to tell anybody yet. Iâm going alone.â
âWhatever you think is best. And, Sylvia, call me if you have any questions. Harry, too.â
âI will.â
She hung up the phone and decided that she didnât have time to stare into space. Her problem was in her breast, not her brain. She had a tumor, and it could be removed. She might not even need a mastectomy. Lumpectomies were just as successful these days. Maybe they could quickly pull it out on an outpatient basis, and she wouldnât have to have radiation or chemo or anything. The sooner she took care of it, the sooner she could return to Nicaragua and pick up with her work as if nothing had ever happened.
But as she prepared for her appointment she realized that that probably wasnât the case. Poorly defined margins . She knew what that meant from dealing with her motherâs cancer. It meant that the cancer wasnât contained in a bubblelike wall. It had seeped out, into the tissue. It wouldnât be as easy to remove as it would if the margins were well-defined.
The phone sat on the desk before her, like a live being challenging her. She needed to pick it up and call Harry, but she knew he would panic and drop everything to come home. No, she needed more information before she called him. She would wait until after the appointment with Sam Jefferson. She looked in the mirror, struggling with the surprising anger that her body had betrayed her in such a way. Her intuition had failed her.
Pulling herself together, she drove her rental car to Radio Shack and bought a little handheld recorder to take with her.
The doctorâs office felt like Montreal in January. Though it was August, and the thermometer outside read eighty-five degrees, Sylvia wished sheâd worn her coat.
Sam Jefferson seemed pleased to see her. âHow have you and Harry been?â he asked as he ushered her into his office.
âWeâve been fine.â She took a chair while he settled behind his desk. She tried to keep her voice level, polite. âWorking hard, though.â
âYeah? Harry practicing cardiology down there, or has he branched out?â
âHeâs more of a general practitioner now. He has a medical clinic that takes care of everything from sore throats to gangrene. He puts in about twelve hours a day. Weâve really come to love the people.â
The doctor smiled and looked down at her chart. âWell, you guys really have guts doing what youâre doing. Iâve thought of doing a medical mission trip. It sounds really rewarding.â
âIâm sure Harry would love to have you come to León for a couple of weeks if you ever want to.â
She was stalling. She knew that, but she wasnât sure she was ready to jump into this discussion. What if she couldnât handle the truth?
But they couldnât go on making small talk forever.
Finally he got around to the subject at hand. âSylvia, Iâve looked over your X rays and your biopsy report, and as I see it, we have several options.â
She got out her recorder, switched it on, and set it on the chair next to her.
âWith many of my patients I offer the option of a lumpectomy or a partial mastectomy to preserve as much as we can of the breast. Thatâs certainly an option for you, but because of the irregularity of your tumorâs margins and the type of cancer cell it is, I canât recommend that. I