Masectomy.

I had never in my life seen anything like that before.

Large, angry, and sinister-looking, it was a textured canvas screaming with colour, red and bleeding from ulcerations and yellow with pus. It was smooth but full of nodules, like a cobblestone floor, and its edges gripped its sides like an angry, angry spider. Most of all, what shocked me was how large it was, how big it had become. It had grown to the size of your entire hand, fingers included, and I believe, it bled every single day.

A breast tumour gone wild.

The elderly lady whom it belonged to was admitted because of the massive blood loss from it one morning which knocked her out. And the saddest thing was, it had become irredeemable. It had infiltrated so deeply and grown so large that any attempt to excise it would pose a serious danger to her life.

So when I was presented to the patient for my test, to take her medical history down and perform a clinical examination for her, I was, to say the least, a little traumatised. Every single day we face suffering ( “Aiya, give me an injection so I can die!” says the old lady with a serious chest infection), grief (“Sayang (my love), look- they cut off my leg till my knee… Oh Allah…”), and bewilderment ( “I know it’s deadly but I didn’t want surgery because I want to keep my breast.”)

Sometimes, it can be too much to take. That day, after seeing some ten patients, one after another with serious illnesses and sad Stories, I went home to cry. Just when I thought enough was enough for a day, a neighbour stopped me before I walked into my home, “Hey, you’re a medical student, aren’t you? I’ve been wanting to talk to you. My wife passed away two weeks ago from an alcoholic seizure… Our whole family, she and my two sons, were holidaying in Disneyland in Tokyo when she got a fit… The helicopters had to come get her, our Disneyland holiday turned into a two-week stay at the hospital, and we had to cremate her there.”

What was I supposed to say. I’m so sorry to hear that, I said. I’m so sorry and will keep your family in prayer. I cried for over an hour that night.

It’s often said that doctors are often not sympathetic enough, and I now understand why. With this much disease, suffering and sorrow on a day-to-day basis, one cannot afford to be entangled and suffocated by the evil griefs of this world. There is a balance to keep, and our fancy medical jargon and metallic technical speech helps to prevent us from taking the risky foray into the real whirlpool every patient faces.

I looked into her eyes and wondered about the nature of her whirlpool, how far its ripples travelled, where they ended. What was her Story? It had grown on her for four years, like a heavy, growing burden eating away at her chest. I looked at the monstrous evil that the tumour had become and wondered why it was not removed sooner- it could have been easily excised earlier on. “They told me from the start that I had it, but I wanted to keep my breast. It’s a painless tumour, anyway.”

Painless, so she kept it till it was overgrown with mutated cancer cells and hard, nodular tissue, swelling with pus and spilling blood.

There was a faraway look in her eyes. There was no pain, so she kept it. Ah, the Gift of pain.

And I didn’t question her about it. I wasn’t even that bewildered, really. That breast, the one with the fungating tumour and ulcers bleeding so badly that she passed out one morning from losing so much blood from it, was the same one which saw her through adolescence, marriage, menopause. That breast- one of the curves her husband fell in love with, and looked upon with wonder and gratitude through their marriage, was the same one which nourished each of her four children. They told her it would save her life if she cut if off, and I wondered if perhaps she thought part of her life would be cut off, taken away from her forever, thrown away in a surgical towel and incinerated, if she allowed them to do so.

I didn’t question her about it.

And after my test, still slightly in shock and overwhelmed, I thought to myself- do we all have breast tumours, too? A tumour in the most intimate, hidden past of ourselves, so dear and close to us that we fear exposing it would cause us deep shame and embarrassment, a tumour that we allow to feed off us simply because it doesn’t hurt enough to cause pain. Are our problems like that, our sins like that, too? Pride, unforgiveness, lust?

So often, I think-if we would look at our problems early on, from the start, and be brave to get help, seek wise counsel, so many devastating consequences could be avoided. If only we had enough humility and courage to tell someone about our problem with our emotions- anxiety, worry or depression, or our addictions- to food, shopping or lust, then surely these problems, when nipped in the bud early on, would not grow to become the silent, lethal killers which take so many of us away, destroy so many of our lives.

But it’s too personal, we say. And besides, we’ve lived with it for too long to make it an issue. It doesn’t cause me pain. It’s like a malignant breast tumour, isn’t it? Personal, insidious, and painless.

Breast cancer is one of the commonest, most dangerous cancers in the world.

And if you leave it alone out of shame and fear, all you might be left with is regret. After all, when you leave the tumour to grow, it eats up the breast anyway. It eats it up and spreads to other parts of your body. In the end, you don’t win- still. You lose the breast anyway. And worse, you die too.

For all our fear of losing what we placed so much attachment to- cigerettes, lying, pornography- we lose anyway. It will eat us up if we let it.

So tell a friend, talk to somebody who can help you. We all have tumours anyway- but only the bravest dare to face the knife early on. It may be painful, you may be afraid of scarring, be afraid of the consequences of losing it, but know that it’s the better option, the braver, more right one, and ultimately, you keep more of yourself than you would if you had decided otherwise.

That’s how surgery saves lives.

But patient consent is needed.