Rites of Passage

There are the ones you get excited about. Turning 16 – the freedom gained from driving a car. Turning 21 – finally being able to drink legally. And there are the not-so-exciting ones.

When I went to my OB for the first time in few years a couple of weeks ago for a routine check-up, as I was leaving, she said, “Oh, Gizabeth. We need to schedule you for a screening mammogram.” She must be mistaken, I thought. I am eternal youth. I am 37. I informed her of this, and she said, “Screenings are recommended between the ages 35 and 40.” Hitting this particular mile marker is a little depressing.

You might think, since I am a doctor and all, that I had an actual clue about the process of getting a mammogram. I didn’t. Although I spent a week on radiology, quickly determining that me sitting in a dark room for a job might not work since I always wanted to fall asleep, and a week on breast oncology surgery, I have never witnessed a mammogram. I saw one of the breast radiology specialists describe it once, using her hands and her own breast to illustrate (through her clothing), when answering an oncologist’s question about the orientation difference between looking at a mammogram and MRI, but I still didn’t really get it. What would it be like? Since no one other than myself has touched my breasts (for self-breast exams and washing, of course, this is a G rated article, well maybe PG) for quite some time, I even wondered if it might be a little exciting. I was a little relieved, for my own sanity, to discover that it was not – far from it, in fact. I know many reading this have had a mammogram, but for those who have not, let me describe it to you.

They called me back into a cubicle to put on a paper gown. There was an advertisement on the wall claiming that if you went back to the front desk to pay an extra few bucks you could get this foam pad that was statistically proven to make the mammogram experience more comfortable. What about a mammogram experience requires a foam pad, I wondered, since there were no visuals or an explanation provided? Was it something to lay your head upon? I decided not to ask. I was going to go in cold turkey. I’m pretty tough. There was also an instruction card asking you to remove deodorant or powder from your breasts with baby wipes provided. Who puts deodorant or powder on their breasts? Is this something I missed in adolescent hygiene?

I was escorted into a dark room and saw what reminded me a little of a giant vertical George Foreman grill, minus the ridges, at about breast level. It was on a large post and could be manipulated up and down as well as rotate back and forth. The thankfully female tech looked at my breasts. “I think we need to switch out the tray.” She pulled off a large tray underneath the metal sandwich, I mean breast press, and reached down to the bottom rung of a shelf, grabbing a much smaller tray (haha, for the runts, I thought). One at a time, she used her hands to manipulate my breasts into very stretchy shapes I did not know were possible and squished them tightly between the metal plates, which she was closing in on my breast with electronic manipulation. All the while I was being instructed to “angle your head back this way,” “No, wrap this arm around the top of the machine that way,” and “push your shoulder back a little more” and I was oddly reminded of yearly school pictures. At one point she said “No, put your arm over here, I don’t want this to be awkward for you.” I laughed out loud, and told her, “I know you do this many times a day, but there is nothing to me about this situation could not be called awkward.” She smiled, “I guess you are right.”

She was nice. We chatted about kids and concerts throughout the process. When she had each breast sufficiently pan-caked to her preference, she instructed me to hold my breath so she could take a picture. When we were done, she said, “Do you mind if I get a picture of your left breast again? I didn’t get the nipple in profile and it is so much better that way.” I looked up at the radiographic images she had put on a light box, and gasped internally. I see these all the time in conference, but they were mine, and they looked so beautiful. I wanted to ask if I could take one home with me, but that would sound weird, and it’s not like it’s something you can just frame or display on the fridge and not get questions. The one with the nipple profile did look much better – the side without a nipple looked a little malformed, so I agreed.

I got called back for additional images the next day – luckily I was prepared by learning from a friend that this is common, not to worry – they just need to get a really good baseline to establish any asymmetry as most likely benign, and I was glad for her reassurance. But this did not help me from having a tiny panic attack in the waiting room cubicle once again – still did not buy the foam cushion, but at least I understood it now – because I have so much to live for, these days. So I was relieved when after more mammograms and then an ultrasound exam the radiologist, who seemed very surprised to see me as his patient – the name change is still throwing people off – assured me that everything looked all right. “We’ll see you in three years.” Whew.