Josepha (Josie) Dietrich is an English immigrant to Australia. She lives in Brisbane in the home that she and her partner built on Passive House principles. After coming out of a long reign of being a carer, shes worked as a research assistant for universities on projects to improve psychiatric discharge planning and womens wellness after cancer. Her prior long-term work was in the After Hours Child Protection Unit, assessing childrens risk of harm alongside the Sexual Offences and Child Abuse Unit of Victoria Police. To remain sane during this period, she flitted off overseas for months at a time to climb cliff faces while sleeping on beaches or in abandoned shepherds huts. After her cancer treatments finished and in light of her experience caring for her dying mother, Josie joined the advisory committee of CanSpeak Queensland as a cancer and consumer advocate.
For my mother
Heather Mary Dietrich
21.02.1949 25.12.2005
Contents
Prologue
My mothers breast cancer was diagnosed when she was 45 and I was 21, an unwelcome third character in a story that, until then, had been ours. Just the two of us, friends and confidants, two moons circling each other. We shared everything.
From that day onwards my adult life was shadowed by the disease. It emerged every two to three years. Mum conceded to surgery but not to the chemicals. She sought solace in alternative therapies: Vitamin C infusions, a German non-chemical chemotherapy, psychic surgery and psychological work. They didnt save her.
But my mothers death saved me.
Four years after I buried her, my mothers cancer reared up in my own body. The minutiae of her experience doctors waiting rooms, hospital stays, waking up after a general anaesthetic with her breast off and a purple slash, the weighted realisation that her doctorate would never get submitted, the reckoning of a life clawed deep into my own cells. Yes, I thought then, we did share everything.
Except for this: by then I had a child of my own, and I refused to share my mothers choices. Instead they galvanised me. I would fight for life with every piece of medical ammunition available. Chemical, surgical, atomic. In the end I had every female organ removed that could generate cancer, apart from my brain. Im standing, still.
Diagnosis: will I live?
Cancer was named for the crab, because a cancer tumour sends claws out into the surrounding tissue.
Kathleen Jamie, Pathologies
It was 6 p.m. on a Friday. I had Bolognese sauce boiling on the stove and the aroma of its red meatiness was in the air. The telephone burred.
When I answered, my GP didnt waste words. Josie, your results are in: you have ductal, invasive breast cancer. Ive gone ahead and booked you in to see a breast surgeon on Monday.
I sat down at the kitchen table, my world now the size of its rectangle of silky oak. A tremor ran from my hand to my feet. A few days before, I had shaken uncontrollably as a doctor dug into my right breast with a fine needle, its journey guided by an ultrasound machine. I remember her authoritative voice warning me, This will sting. She pushed and the needle slid deeply into my breast. The sonographer, a well-kept woman in her early 50s, assisted. Something in that sonographers manner and voice made me trust her immediately.
It turned out I needed both types of biopsies that day. The needle that poked in and out of the tumour to capture its adolescent cells, as well as a core biopsy, where a thicker needle shunted in and out to take tissue like getting your ear pierced.
A support person, someone from the front desk or a training doctor, I never found out which, had stroked my hair back. She had a brown bob and a plump figure. You wouldnt notice her in a crowd unless you knew her and then youd gladly rush over to share a confidence.
Youre doing well, Josie, shed said.
I wasnt. Not really. Id wanted to say, Im scared, I cant get a grip. My mind raced, looking for a way to escape what I knew then was coming.
Here you go, honey. She pressed a tissue into my hand.
Id sobbed throughout the entire procedure, thinking of my mother, wave upon wave of memories lifting off my chest. Like me, shed faced this painful procedure alone and later, like me, was alone when she heard the news. Did she think of her own death then, as I did now? The future and the present colliding, like the words of that faux Buddhist phrase on caf walls: Live like this is your last day on earth.
Thats what I read now in the aged, honeyed grain of the wood in front of me. Id be dead in ten years, like my mother. And younger than she was, the flame of fate turned up high to reduce my lot.
I phoned my partner, B, at work and told him the results.
There was a pause and then he said, Im on my way. He told me later hed left his computer on with all his sustainable building projects unfinished. I pictured him like a missile on a radar screen, making his way closer and closer to our home.
While I waited I phoned my father without checking what time it was in England. When he answered I burst into tears. I dont want to die like Mum, I sobbed. My life is only half-baked. Theres so much I want to do.
My fathers faint Nottingham accent calmed me. I know, he said gently. I know, darling. But listen. Your mothers fate doesnt have to be yours.
I barely let him finish. But what if it is?
My father couldnt answer that question.
Celso stirred in his bedroom, pulling me out of myself. My nine-month-old boy had strawberry-blonde curls and a cherubic face, the high colouring only Caravaggio knew how to paint. I was still recovering from his traumatic birth, which wed both only narrowly survived. His tiny body struggled, but he maintained a sunny sweetness. Would I live to see him grow? How would Celso, who so relied upon me to literally survive every day at this point in his short life, cope without the unconditional love of his mother? A similar question arose when my mother was dying. How would I cope without her unconditional mother love?
Celsos movements rustled the sheets around him. I went to him and plucked him from his cot, careful to avoid tugging on the tube that went up his nose. His skin still radiated the narcotic new-baby smell of fresh, warm straw. Its a powerful drug, designed to keep mothers bonded to their babies. I breathed him in and wondered if my mother might have made different decisions if Id been an infant when she was diagnosed.
I placed Celso on his domed play mat and returned to the stove to stir the Bolognese. The window above the kitchen sink shone a rectangle of sharp light onto my hands.
B hadnt arrived home yet, but he was close. I saw myself as the large target on the screen with B about to connect.
When were you diagnosed? asked the paediatric surgeon.
Last Friday, I said.
Celso was on Bs lap with the blood pressure cuffs black cord in his hand. He was tugging at it. I was taking off my faux-Burberry trench coat and feeling businesslike. Were here to talk about my sons undescended-testicle operation, not my cancer.
My lumpectomys tomorrow, I continued.
His head reeled back. Whats your treatment going to be?
I told him my plans. We got onto the subject of chemotherapy baldness; he relayed the story of a colleagues wife who had alopecia and how people often mistook her for a cancer patient, so she wore a real-hair wig at home when guests arrived.