A Case, Diagnosis, and Its Findings


This year, in the days before the diagnosis, while I dragged myself from appointment to appointment, my husband, Preston, ambled along with me. He brought books to read in the waiting room. He called the insurance company and the clinic’s pre-certification office on my behalf. When the doctors allowed him into an appointment, Preston sat beside me. When the doctors handed over brochures, I listlessly handed them right to him without looking at them, and he stuffed them into his orange backpack and toted them to the next stop, and the next. At night, he read them, then served as a sieve of information, straining out the overwhelming from the necessary.


Fifteen years ago, the first time I was seen by a breast specialist, my ex-husband, Rob*—we were then married, of course—was with me. His face lost its color as he waited, silent, seated in the corner of the doctor’s office while the doctor pressed his hands into each of my breasts, feeling for the lump I’d reported through tears. Maybe I made Rob go with me. That’s more than likely. He wasn’t one to want to go to doctor’s offices, with or without me. When I sliced open my thumb while cutting sweet potatoes in the first months of our marriage, it had been a friend who drove me to the ER. Rob had been at work when it happened, forty minutes away—you’ll bleed too much until I can get there, he had said, and he was right—but I must have stayed out in that waiting room at least that long. I looked for him. I wanted to see him come through the glass doors and find me, sit beside me in the bucket chair too hard to give comfort. Not that he had ever promised anything of the sort—not that I had asked. Both of us were often silent in our longings. Instead, my friend held my hand as the ER nurse stitched my thumb together. She also went with me the one time I had a cyst removed from my shoulder, but that was a regular appointment, not an ER visit. I can’t remember why Rob was not there, only that he wasn’t.


Fifteen years ago, the doctor assured me the lump was nothing. And it was, but what continued was a series of scares, of biopsies and needles and doctors pointing at scans and screens and showing me possibilities. I was labeled high-risk due to history and biology.

When the next scare came, a couple of years later, I was newly divorced. I remember believing the cyst had developed because my heart had been squeezed like a concertina, one that had lost its ability to play. Or like a star on the verge of gravitational collapse. There was nothing open about my heart; my chest tightened, threatening to implode.


My appetite rises and falls in rhythm to my stresses. In my family, we are stress-starvers, meaning when worried or blue, we push away the plate of food, or at best, pick at it. When this happens, we have a term for it: we say, “My stomach has closed.”

In the fall semester of my freshman year of college, my weight ran the opposite of others who were putting on pounds due to starchy cafeteria food and too much alcohol. I endured a difficult breakup, and I lost weight. By Thanksgiving, I was thin enough to blow away.

diagnosis 2

If I am happy, or momentarily forget that I should be worried, or if I am eating pho at a Vietnamese restaurant (in which case all bets are off), I eat heartily. But when I am stressed, most foods make me nauseous. When this happens, some foods are more palatable than others. Fruit is easier than, say, meat or bread or milk.

When Rob and I split up fourteen years ago, my stomach closed altogether. Two months later, I had lost fourteen pounds.


There are people who feed love, and others who starve it. I suppose you can overfeed love, make it bloated and big, saying I love yous throughout the day as if the person needed to be reminded. I used to do that. Maybe I still do.

When we were still married, Rob told me I needed to say I love you less to him because then it might have more meaning. Perhaps he was right. Or maybe he was trying to tell me to stop saying it altogether.

The truth is that, for a long time, I believed in something I did not know I believed, that was only evident upon reflection: love was a currency. If I gave love, I would get it back. I expected an equal exchange. When I did not feel enough love, I gave more. (Whatever “enough” is. Back then, it was never enough.)

It was sort of like putting coins in a broken soda machine, then banging a fist on it because it won’t drop out a cold can of soda, then inserting more and more coins. Not that I am calling Rob a broken soda machine. My system of love was what was broken.

Most things broken can be fixed. In the end, they might be better with repair. I did not know that then. When I got divorced, I simply wept.

And stopped eating.


Earlier this year, before a biopsy of my breast, the doctors had me wait alone inside a small and spare room and watch a video on MRI-guided biopsies, and I remember thinking, I just want to get up and walk out of here. Can I do that?

In the days that preceded the biopsy, as I sat or lay down in doctor’s offices while wearing a pair of blue gowns, or as I sat in those same gowns in waiting rooms as HGTV blared in the corner, I had the feeling of wanting to disappear. I did not want to fill out papers—Again? I thought, You’re asking me these questions again?—I wanted to not be in doctor’s offices period, not get my breasts squeezed between two plates, not get scanned nor have to lie face-down and be slid into the bore, the cylindrical opening of the MRI machine, to hear its knock-knocking and buzzing and clanking. The morning of the biopsy, as I sat in that spare room alone, I imagined getting up and going, flying down the hallway in my three-armed blue gown, white ties like contrails behind me. Everything in my body said, Run. Now.

diagnosis 1And that’s when I thought of Rob.

I thought of how, fourteen years ago, it seemed as if he had hightailed it out of our marriage, and I thought about how angry I was for so long that that he did not want to hang around and fix it. I thought of how frightened he must have felt of whatever tests and trials we needed to endure to stay together, how enormous they must have looked. Although on the day of my biopsy I remained sitting in that small and spare medical office until two attendants came and walked me down the hallway, I knew how freeing that decision must have been for him, to simply get up and go.

I used to think our young marriage was simple. Only as the years passed did I come to understand our own complications, how, like cells that have yet to be graded and categorized, we were still without complete understandings, or understandings at all, of what made the other work, of what the other wanted and needed, only that we were failing in our abilities to give each other those things.

Now it’s clear. He yearned for a lifetime of adventure and freedom. I yearned for a lifetime of security and love.


If you look for something long enough, you will find it.

Around a decade ago, in the sky of my breast scans, a star appeared. Its radiating pattern was what made my radiologist tell me she thought there was a good chance I had breast cancer.

I asked what percentage of a chance. She knew me well enough to know I’d rather be told the bare, bald truth.

“Eighty-five percent,” she said.

I focused on the fact that I had a fifteen percent chance of having nothing, and then proceeded with a biopsy, which came back free of cancer.

Eight years ago, I had to have another biopsy, the kind where they put you under anesthesia and someone has to remain in the waiting room then drive you home, administer pain medication. Preston and I were newly dating, and he lived four hours away from me, and my parents had offered to drive in for it.

“No,” he said. “They don’t have to. I’ll take you.”

That biopsy, too, came back cancer-free.

I ended up lucky that time, as I had been and would be year after year, through other biopsies and mammograms, ultrasounds, MRIs. But that’s the thing about luck: you don’t know how long it’ll stick around.

I suppose that’s true of anything, and anyone.


Earlier this year, I got the call about the diagnosis while Preston and I were traveling, still a few days from home. He pulled the rental car into a parking lot, and we got out of the car and put our arms around each other. We reminded each other the cancer was early and could be plucked out. A system broken could be fixed.

diagnosis 3After the diagnosis, my stomach closed. Preston took me to eat Vietnamese again and again at different restaurants—Pho Chau, Lotus, Quang—even when he tired of it.

But there were other meals, of course. By coincidence or luck, it seemed that a little bowl of fruit accompanied whatever meal Preston ordered—an omelet, a sandwich, no matter the time of day. It became the perpetual “side” instead of a salad or fries. He did not ask why, nor did I, but there it would appear bearing a couple of pineapple chunks, some melon slices, a twig of grapes.

Sometimes I did not order anything, or I ordered something small and manageable, or I picked at what I had—eating a third of a sandwich, then laying my napkin over it as if it had expired.

For each of those meals, Preston, without saying a word, pushed his little bowl of fruit to me.

Without a word, I picked up a spoon, and I ate.


*Name has been changed.


Shuly Xóchitl Cawood is the author of four books, including the forthcoming story collection, A Small Thing to Want (Press 53, 2020) and the memoir, The Going and Goodbye (Platypus Press, 2017). Her poetry collection, Trouble Can Be So Beautiful at the Beginning, won the Adrienne Bond Award for Poetry and will be published in 2021 by Mercer University Press. You can learn more about Shuly at www.shulycawood.com. More from this author →

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