Walking To Gibraltar, Chapter 9: In Which A Cause Is Proffered

by Frank Indiana

   "I think you're a great candidate for a sentinel node biopsy," said Dr. Kartes.

They sat in the small, dark office. On the sofa, not touching. She still wouldn't take his hand.

Dr. Kartes wore snakeskin boots under his blue scrubs. He sat on the edge of his desk and explained the procedure. Injecting a dye at the site of the tumor and following it to a particular lymph node. "If the cancer's going to spread, it has to spread someplace first. We think the sentinel node is the place. So we remove it and test it. If we don't see cancer there, it was probably contained in the breast."

"Probably?" asked Astrid.

"Usually, I think it's fair to say. I still do some axillary lymph node dissections. But I'd recommend the sentinel node procedure for you."


"This is still new, Astrid. We've been doing them for about a year."

"So you don't really know."

"Look, I've done thirty of these," Dr. Kartes said. "I think it's right for you. I think it's going to be the standard of care one of these days. And you've got a lot to live for. You're young. The tumor was small."

"But aggressive," said Astrid.

Dr. Kartes nodded. "So it appears. But you also have to consider that the cancer has probably been in your breast for years. Maybe two years, maybe eight years. It's only just now big enough that you found it."

"Is that supposed to make me feel better?"

"It's your choice, Astrid. It's your cancer. I'm telling you what I think. I think you ought to have a sentinel node biopsy. I think you should let me go in and take that son of a bitch out. And then I think we should talk about your options for chemo and radiation. I think it's your best chance to beat this thing and have a normal life. But it's up to you."

Frank drove home. The light began to fade. Silence filled the car like mustard gas.

"What do you think?" he asked.

"God. I have no idea. Any suggestions?"

Clueless. He didn't know a fucking thing about breast cancer. Two of the top breast surgeons in the city didn't agree. How were a writer and a stay-at-home mom supposed to decide?

But "I don't know" didn't seem like an appropriate answer.

"I think he's a cowboy. I think he's going to go in and get the fucking cancer, and I like that," said Frank.

"Dr. Cowboy," said Astrid. "Maybe I should just have him take both breasts and all my lymph nodes and be done with it."


"And stop cursing, Frank. It's the sort of thing that got me into this in the first place."

"My cursing gave you cancer?"

"I think my relationship with you gave me cancer."