Social graces
I had registered my interest in social work training around the time I found the lump behind my right nipple. I started printing off research and articles ready for application forms. Three months later I was diagnosed with invasive breast cancer; I had just turned 35. During the month between diagnosis and my double mastectomy I spring cleaned and I got rid of the information I had gathered
– “I’ve got cancer so I can’t do that anymore.”
My surgery and healing were textbook; so, six weeks later my chemotherapy started on schedule. I was then three months on from my cancer diagnosis and working through the stages of grief: shock, guilt, blame, fear, anger. Somewhere amongst those first two cycles of FEC-T chemo I reached ‘bloody-minded’
– “I’ve got cancer; so what!”.
I filled in the Step Up to Social Work application form piecemeal; a few paragraphs when I was awake enough, not feeling too nauseous, and not in too much discomfort. On the final page of my application I ticked the box to say I have a disability for the first time, and waited. The assessment day was two weeks after my final chemo and was awful; the reasonable adjustments I had been promised didn’t materialise, and it was a baking hot day in July. On the train journey home, the train got stuck as the points warped due to the heat and after half an hour sweltering in the carriage, I took my headscarf off in public for the first time. When I attended for the interview day a week later, I walked in bald. I was self-conscious about it, but determined to be comfortable that time around!
One year on from my mastectomy I arrived at university for what would be the hardest thing I have ever done. I had signed up for a post-graduate social work diploma condensed into a 14month course, that required a 90 minute commute each way every day. I completely underestimated how intensive the workload would be, and how tired my body would still be when the course began six months after chemo.
Emotionally, I thought I was in good shape though. I’d ended the unhealthy relationship I had been in for years; I was positively contributing to the conversation around mastectomy, and I hadn’t cried since the day I’d been diagnosed. Then, eight months in (and after admitting that my body couldn’t manage the commute) I found myself staying in a B&B near university during term time. One evening I did a phone interview for research into body image after mastectomy. I always wanted to contribute to these because I felt so comfortable Living Flat. There were the usual questions: Why didn’t you want reconstruction? What did your partner think? Has it changed how you dress? Are you more, or less confident now?
Afterwards I walked to the shop to get something to eat and, for the first time since being bald, I was sure people were staring. The next morning lectures passed as usual, then after lunch we were introduced to the concept of the Social Graces – GGRRAAACCEEESSS. Each letter represents aspects of ourselves which may influence how we view ourselves and others.
Gender, geography, race, religion, age, ability, appearance, class, culture, ethnicity, education, employment, sexuality, sexual orientation, spirituality
“Pick three from the list and reflect on how they influence your view of yourself, and then we will go around the class and discuss them.”
Gender – I’m a woman who now can’t have children
Age – I’m only 35 and I’ve had cancer
Appearance – I have no breasts
I couldn’t get my mind to focus on any of the other words. I tried to pull myself together. Gender, age, appearance. I was literally discussing these things with a stranger the night before but the thought of opening up to my classmates filled me with dread. 10 minutes passed and everyone else was busy writing. A feeling of anxiety began to grow and I decided I would simply skip the activity by going for a five minute walk. I picked up my phone and walked toward the door, by the time I grabbed the door handle my chest was feeling tight and I couldn’t catch my breath. I walked down the corridor, gathering pace as I tried to fill my lungs to shake of the crushing sensation on my chest.
I lay on the ground in the middle of a park for over half an hour watching the clouds scud over me. My breathing returned to normal, and I realised I had just experienced my first panic attack. My oncologist told me this is very normal – some people address their anxieties before and during treatment, and some (like me) stick them in a box and work hard to ignore them. Then treatment ends, and one day out of the blue the lid on the box comes off and everything tumbles out. I had a couple of sessions with a clinical psychologist, put the lid back on my box, and learned how to keep it properly stored in my mind.
My diagnosis has meant I have been able to empathise more deeply with the families and adults I work with than I could have done without it. I have never mentioned my experiences to them, and they have never asked. Despite not wearing prostheses for the first five years, no one I have met at work – or worked with – has ever mentioned my missing breasts. I’ve worked with all age groups: toddlers, primary and secondary school age, and young adults – plus all of their family members, as well as adults aged from 18 to 100. And, under all circumstances, not one has ever asked about or referred to my physical appearance.
Maybe some can’t work out what’s missing. Maybe some don’t notice. Maybe some are too polite to look for too long. Maybe I no longer notice if they do.
What I do know is that the things that I am most proud of in my life have happened after breast cancer.