Family History Of X
by Lori Jakiela

When I was diagnosed with breast cancer, my doctor, Dr. Johnson, who looked like the late great comedian Norm MacDonald and told late-great-comedian jokes and liked to draw stick-figure breasts on a whiteboard to show surgical options, asked, “Do you have a family history?”

Dr. Johnson had already drawn a pair of disembodied breasts before he asked this. The breasts and nipples were squared off, like they’d been built with Legos. 

“Like Doc Johnson?” I said. 

I may have giggled. 

I was in my fifties, too old to giggle, but old enough to confront my mortality with jokes. 

Two boobs and a cancer cell walk into a bar. A woman says, “I’ll have a double.”

Give it a minute. 

Words writers should not use, according to Pulitzer Prize-winning novelist Elizabeth Strout: giggle, chuckle, guffaw. 

If you don’t know Elizabeth Strout, read Olive Kitteridge. It’s brilliant.

If you don’t know Doc Johnson, the Proctor & Gamble of porn, the company that models its sex toys based on the anatomy of adult-film stars like Jenna Jameson and Jeff Stryker, give it a Google. I’ll wait.  

When Jeff Stryker became a writer, he tried to sue a nightclub because the noise kept him from concentrating enough to finish his memoir. 

Jeff Stryker sued for the rights to a sex toy called Jeff Stryker’s Cock and Balls, a dildo for which Stryker claimed intellectual property rights and called “an object of higher culture.”

As for Jenna Jameson, she’s fine.

“Questions?” the real Dr. Johnson, the man who would save my life, said, and pointed his dry-erase marker at me, like he was calling on a student, like he hadn’t heard that Doc Johnson thing hundreds of times, breast cancer being ubiquitous and all. 

None of Dr. Johnson’s drawings looked real. None of the drawings resembled my body, that traitor that was trying to kill me.  

“My daughter loved Legos,” I said as Doc Johnson drew another brick-breast and pretended, maybe, not to hear me.

Step on a Lego first thing in the morning, barefoot. Some days, that’s how parenthood feels, and when I say parenthood, I mean life.

I’d been warned about Dr. Johnson’s passion for sketching. When I called to make an appointment, Dr. Johnson’s assistant said, “Doc likes to draw a lot.” 

I had no idea what she meant, so I said, “Okay?” 

I said “okay” a lot back then. When another doctor showed me what she saw on my mammogram, tiny flecks that lined up like grains of rice in my left breast, when she called this concerning, a word neutral as oatmeal, I said, “Okay.”

When a nurse called to confirm malignancy, I said, “Okay.” 

I may have thanked her. 

I hope I did. 

“Manners,” the mother who raised and loved me said. “Remember. Your problems are not other people’s problems.”

My mother was a nurse. She was tough and lovely and she died. Breast cancer. 

I am adopted. My mother’s story is not my story. 

About family history, I said, “I don’t know,” and Dr. Johnson held his marker mid-air and said, “Explain.” 

Dr. Johnson may have been a great artist. Home with his wife, who he called Mrs. Johnson, as in “Mrs. Johnson requires my presence at a gala and so I’m not scheduling surgeries then because I fear death,” Dr. Johnson may have painted masterpieces. He may have painted happy little trees. But in his office, with his whiteboard, he was limited.  

I was limited, too. I couldn’t explain. 

Adopted people like me don’t know their medical histories. It’s something we must articulate on forms. Again and again.

History of cancer? 

Unknown. 

History of heart disease?

Unknown. 

History of, history of—unknown, unknown. 

I’d been adopted through Catholic Charities. When we met, my Catholic Charities social worker held my file—thick, redacted—though she couldn’t let me see inside. My file was so ordinary—a manila folder.

The social worker said, “Sometimes these things work out, like on Oprah. Most times they don’t.” Then she pushed my file across her desk, just out of reach.  

The short version: I found my birth mother. I asked for a medical history. Maybe I wanted my birth mother to care a little. Maybe I wanted her to love me, even. Or love me enough to let me know if something in the genes she handed down would kill me. 

My birth mother refused. Instead, she wished me dead. 

“I’m adopted,” I told Dr. Johnson, who said, “ah!” and ordered genetic testing, which the insurance company would cover, considering.

Dr. Johnson sketched a single mastectomy. Double mastectomy. Lumpectomy with chemo and radiation and so on. He drew an image, then struck an X through it, and moved on to the next, and the next. X. X. X. 

What I know about the first chapters of my life—X. 

What I know about my birth mother—X. 

What I know about what my daughter might face—no genetic predisposition for breast cancer. My cancer—likely environmental. 

Still. X. 

I decided upon a double mastectomy. 

“Don’t heal your pain. Amputate.” 

That’s advice I’d gotten years before from a poet who wanted to teach me to write what was true and not settle for easy conclusions.  

Later, when Dr. Johnson saw my husband in the waiting room before my surgery, my husband was reading a book of poems. 

“You’re going to need a bigger book,” Dr. Johnson said and winked. 

My surgery lasted 13 hours. It was the best sleep I had in years. 

“When I go into surgery, I am completely Zen,” a friend who has had many cancer surgeries told me later. “I feel peaceful. I feel fully myself.” 

One of my poet-teachers, Linda Pastan, wrote, “There is an age when you are most yourself.” 

Linda Pastan died, age 90, after complications from cancer surgery. 

Jenna Jameson, XXX. Jenna Jameson, born to a police officer and a showgirl who died from cancer when Jenna was two; Jenna Jameson, whose mother’s cancer treatments bankrupted her family and left Jenna and her brother to grow up in a trailer park, mostly alone;  Jenna Jameson who was raped and abused and went on to become the unapologetic queen of porn, said, “Ultimately what matters is not the experiences you have at a young age, but whether or not you are equipped by your parents, your genetics, your education, to survive and deal with them.” 

The double mastectomy I opted for included DIEP reconstruction. Dr. Johnson took away the cancer. My plastic surgeon, Dr. Gimbel, an elegant man whose staff looked like they popped from the set of “ER,” each one more beautiful than the next, rebuilt my breasts with fat he suctioned from my belly and hips. 

Not everyone can have this surgery. You need just the right amount of fat in just the right spots. I was—chubby, curvy—a good specimen. Genetics. Whatever. 

Before my surgery, I had to stand against a wall and be photographed naked from the waist up. 

“Don’t worry, these won’t show up on Facebook,” Dr. Gimbel said, and winked.

Dr. Gimbel had some trouble with his camera. The photos took longer than expected. I stood there, exposed. Then turned right. Turned left. 

“Posing nude,” Jenna Jameson said, “is one of my favorite things to do in this world.” 

“It’s all from the neck down,” Dr. Gimbel said to make me comfortable. 

My body, disembodied. No head, no face, nothing to connect it to me at all.  

 

 

Lori Jakiela is the author of seven books, most recently They Write Your Name on a Grain of Rice: On Cancer, Love, and Living Even So (Atticus Books, 2023). Her author website is http://lorijakiela.net.

Image source: Annie Spratt/Unsplash

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