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My Story

marker will direct Kim Grafton as she operates. Dr. Poplack wishes me good luck, and I'm wheeled back to the Same-Day unit.

Waiting, waiting . . . Margie Cole, the director of the Norris Cotton Cancer Center's Comprehensive Breast Program, pokes her head in to wish me luck. At last they wheel me into the operating room. A nurse covers me warmly and outfits me with puffy elastic knee-high boots, to help my circulation. I look up into a bank of lights, say a prayer . . . and I'm gone.

Kim removes the tumor and two lymph nodes. Everything goes to pathology for a thorough assessment. Is my cancer hormone-receptive? Invasive? Aggressive? Within the week, they had told me beforehand, I'd have a good idea of my long-term chances for survival. It still seems surreal. I feel perfectly fine. How can death be part of this picture?

Suddenly it's afternoon. I'm back on the Same-Day unit, in the recovery room. Kim and Carter come in to chat with me. I see a zipper-like crease in Kim's forehead from her surgical cap, which she's removed. Her long, dark hair is straight, parted in the middle, pulled back. She has warm, serious brown eyes. The three of us talk about books we've read recently. At some point, a nurse puts some warm blankets over me. I think I'm in heaven.

By mid-afternoon, I'm ready to leave. The nurse has me grab my IV bag and walk a few yards down the corridor and a few yards back, to check my stability. "Okay," she pronounces, "you can go." Rick is sent for the car; a wheelchair comes for me. We drive home and find a bunch of flowers, the first of many, waiting on the back steps.

I e-mail my friends at work. Subject line: "Just like Jiffy Lube!" It's over, I think. The cancer is gone.

The pathology report comes back. It's not gone. Not even close.

On June 11, five days after the surgery, Kim Grafton calls me at work, her voice sympathetic. The tumor was much larger than they'd thought; the cancer has spread to at least one lymph node. She talks about margins, says something about "five out of six involved." I don't even know what a margin is, but it doesn't

Hamel, right, works out regularly at the local River Valley Club with her "gym buddy"—fellow breast-cancer survivor Dani Ligett, left. They met through BeFriend, a Dartmouth-Hitchcock peer-support program for breast-cancer patients; it pairs newly diagnosed patients with someone who's been through the process already.

Soon everyone is greeting me with a sad-eyed smile, followed not by the usual "How are you!" but by a hesitant "How are you?" "I'm fine," I say. "Fine."

sound good. She concludes that a mastectomy is probably necessary. Just like when I got the "You have cancer" news, my mind shuts down. Kim says the tumor board will meet Wednesday, and she'll let me know their recommendation. I thank her. She sounds unutterably sad; I hear the pain in her voice. I want to embrace her and tell her it's okay—I know she did her best.

Choosing chemo
On June 12, I meet with Dr. Gary Schwartz, my oncologist. He is a man on a mission. He's serious, shy, and gives me the gentlest and most comforting exam I've ever had—lots of tapping and listening. He recommends chemo. Again, I'm told it's my choice, but I latch onto his recommendation like a drowning sailor clutching a life ring.

Gary talks about hormone drugs, radiation, side effects; he's very thorough, writing everything down. He rattles off statistics—this is a language

cancer patients learn quickly. Chemo plus tamoxifen, a hormone drug, will reduce my chance of recurrence to about 16%. An 84%chance of survival sounds good to me. I say yes to chemo.

But with great trepidation. I fear vomiting. Most of all, I fear losing my hair. Later, I realize this is a universal Big Fear for women with cancer. Why am I so petrified about losing my hair? God knows, it's not as though I really love it. As with every woman I know, my hair is something to fuss over, look askance at, sigh about, get cut, and then complain over some more. But the thought of losing it completely—being bald, in a world of tasteful hairstyles—makes me blanch. I'll feel just as naked as though I were walking around topless. I might, God forbid, stand out from the crowd.

But before I can start the chemo, I need to have my breast removed entirely. It's filled with cancer; my own cells have turned against me—traitorous tissue. Since my breast is about to be cut off, I work at cutting the emotional attachment, too. I come to a place of relative peace, take another deep breath, plow ahead.

And run smack into another decision. I'm asked if I want breast reconstruction, or a prosthesis, or nothing. What . . .? If I decide on reconstruction, I can have a

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Dartmouth Medical SchoolDartmouth-Hitchcock Medical CenterWhite River Junction VAMCNorris Cotton Cancer CenterDartmouth College