Maybe it was the morphine. Or maybe it was being on the other side of a surgery that I had been both desperate to have and dreading. But I felt so much relief as I regained full consciousness in my hospital room, surrounded by my family.

My parents, sister Michelle, brother Robert and younger son, Benjamin, and bestie Jenn LeBlanc all looked intensely relieved, too. The frozen section of the sentinel node biopsy had shown no cancer in my lymph nodes. What we didn’t know then was that the deeper pathology would later show random cancer cells in one lymph node — which means nothing and is the same as a negative node — and a 1 mm micro-metastases in another. The third node was 100 percent clean.

What does a 1 mm micro-met mean? No one has really been able to tell me. Some doctors say it’s the same thing as a negative node and shouldn’t be counted. Others still hold to the older, more traditional belief that it counts as cancer. So...

But we didn’t know this on June 5.

We shared our relief that the surgery was behind me, that I most probably had no cancer in my lymph nodes, that the worst might be over. Having them all with me meant so very much.

But I’d just had major surgery. I had a morphine pump the button of which glowed green when I was able to push it again. The pain relief was good, but not total. I felt like I’d been stabbed in the side, the result of incisions created for drains that were threaded beneath the incisions to drain off excess fluid. The drains were to become (and still are) the bane of my existence post-op.

I hadn’t slept the night before, and with both morphine and anesthesia in my system, I was extremely drowsy. But relatives aren't allowed to push the button, nor are medical staff. Self-administered pain relief has to be just that. This basically meant I couldn't sleep, as dozing off meant my pain relief vanished in a relatively short period of time, leaving me wide awake and hurting.

My family tried to help, telling me when the light turned green again. They would point and say, “Green! Green! Green!”

But that still meant I had to be awake every 10 minutes to push the damned button.

My nurse that day was a wonderful, fun woman named Laurel. She checked my vitals at regular intervals. She also gave me a bolus of morphine to carry me through several rounds of button pushing, enabling me to doze for a while.

Of course, then I had to pee.

The cool thing about peeing after getting a sentinel node biopsy is that the blue dye they inject into your breast to light up the sentinel nodes turns your pee blue. I don’t mean a hint of blue. I mean full-on Papa Smurf blue. In my morphine state of mine, I found this hilarious and wanted to show my pee to everyone. It’s a wonder I didn’t take a photo of it with my cell phone.

Laurel, the nurse, helped me into and out of the bathroom, and it was in the bathroom as I was about to pee again that I learned she’d gone to my website to read about my books. Either my sister or I had mentioned I was an author, and she’d taken the time to check me out online.

I wished I’d had a book to give her. Alas, I hadn’t brought any to the hospital.

At one point, the physican’s assistant who works with my surgeon came to check my surgery site. This was a sobering moment that I remember.

“I don’t want to see,” I told her.

“You don't have to see. Only I have to see,” she said.

Of course, that wasn’t true. Eventually, I would have no choice but to see.

But lying there in pressure bandages only a few hours post-op, I didn’t yet need to face my changed body.

Then came the absurd part of the day where they told me to breathe. My oxygen saturation rate kept falling. My mother, a respiratory therapist as well as an RN, coached me in how to breathe. But no matter how deeply I breathed, I couldn’t get my oxygen levels up. Then someone discovered that 1) the oxygen had been shut off somehow and 2) the clip on my fingertip wasn’t working. Once the oxygen was on again and the clip had been changed, I was suddenly fine.

As the day wore on, my brother and son left for home, both of them having to return to work in the morning. My mother and father left at suppertime. And so my sister settled in to spend the night with me.

The night shift

That night is a bit vague to me.

Laurel went home, and a kind woman named Lori took over as my RN.

I know my sister went to get some supper at some point, while I feasted on broth and Jello, clear liquids being all I was permitted to eat.

I also know that I tried to go for a walk, and that the IV had infiltrated my right hand, making it blow up like a balloon. I was down the hallway away from my room when the IV was disconnected. With it went my pain relief. By the time we got me back to my bed, I was in serious, awful pain. Fortunately, relief was just a new IV and a bolus of morphine away.

Did we watch TV? I can’t remember.

My sister managed to fall asleep at one point. Dependent on that boost of morphine every 10 minutes. I couldn’t sleep without the relief it gave, and if I fell asleep it wore off.

I listened to my sister sleep. Sometime in the course of the night while she was sleeping, I took this awesome selfie. Note the glazed eyes and the fabulous hair knot.




I watched the hours go by and tried hard not to have to pee because I didn’t want to wake my sister up. Also, the CNA who was assigned to me for the night wasn’t very good. Though I wasn’t supposed to be left alone out of bed, she would help me out of bed, then rush off, leaving me to get back in myself, complete with a massive IV pole. She didn’t chart certain things, and left me to figure out how to put on my oxygen again.

I waited from four AM to six AM to pee because I didn’t want to wake my sister. Rather than calling for the CNA, I went by myself. As I predicted, it woke my sister. By this time, the blue was gone, and I was back to ordinary yellow pee again.

Outside the window, the sun began to rise on another Friday morning.

At this point, I hadn’t slept since getting up Wednesday morning. I was tired, in pain — and hungry.

Soon, Laurel was back, and things were done right again. The surgeon’s partner checked me on rounds and told me I was being discharged. Some part of me wondered if this wasn't grotesquely soon. But at least I was allowed to eat again. I ordered breakfast — an omelet and potatoes — and did my best not to worry about what came later.

I can’t remember who brought me that first latté — my sister or my mother. But damn! That was too good to be true. Jenn showed up soon thereafter with another. And before I knew it, I was being given discharge information and told it was time to go.

In truth, I was being rushed out the door. I’d had a bilateral mastectomy and was being discharged in 24 hours.

My mother helped me dress, which meant removing the hospital gown to face the pressure bandages that wrapped around my flat and hurting chest. The post-mastectomy camisole I’d bought wasn’t comfortable. Fortunately, my mother had bought a smock with Velcro down the front. It was loose and had pockets for the infernal drain bags.

By the time I was dressed, I was in tears. Pain, exhaustion, tension, trepidation about going home where I would have to face what had been done to me — it overwhelmed me. Jenn, my sister and my mother were with me as I was rolled to the front exit in a wheelchair, where my father had his SUV waiting for me.

We drove for 1.5 hours to my parents house, where we arrived to find that the motion of the drive — those bumps and curves — had started a surge of bleeding. Blood had filled the drains and drain tubes, spilling out of the incisions in my side and down my skin. I was also in a great deal of pain.

What happened next was a mini-nightmare.

They had prescribed Dilaudid for my pain. Not only did the drug not work for me, but it gave me a terrible allergic reaction. My entire body began to itch horribly. My face turned red and began to swell. My lips started to go numb.

My mother gave me Benadryl, and we got back in the SUV for a long, arduous, horrible drive back to the hospital’s emergency room, where it seemed at first that they would make me wait in the waiting room.

“I just had a bilateral mastectomy for breast freaking cancer! I have no pain relief, and I'm having an allergic reaction. I am NOT sitting in the waiting room!” I shouted at the medical intake guy, who seemed more interested in getting my financial info than hearing what was wrong with me.

By then I was exhausted and in tears. Fortunately, my mother and sister were more than up to the task of advocating on my behalf. My sister can get angry when pushed. If she raises her voice, watch out. Soon, the head physician of the entire ER was attending us. I was given IV Ativan, morphine and Benadryl. And I pretty much drifted off while my mother dealt with the rest of the medical stuff — getting a new pain med RX, figuring out a way to get me home that would be less painful, and so on. I barely remember the ride home.

Between Oxycontin, Ativan, and Benadryl, I managed to sleep a little that night.

Facing myself in the mirror

It’s been a week since my bilateral mastectomy. Diagnosed on April 21 with cancer in my left breast, I waited 45 days for the surgery to remove the deadly invasive ductal carcinoma from my body.

To say I was afraid the night before would be a gross understatement. It wasn’t just the surgery or the idea of losing both breasts that distressed me, but also the possibility that they might cut me open to find that the cancer was much more advanced than they had believed. No, I didn’t sleep. I couldn’t.

I got up at 4 a.m. and showered, knowing it would be the last time in a while when I’d be able to shave my legs, wash my hair, or feel truly clean. It was also the last time I would bathe with my body intact. I stood there in the hot water, tears pouring down my face, my hands instinctively reaching to hold the part of me I was about to lose.

My sister and younger son Benjamin got up with me and prepared for a day at the hospital. We left my house at 5 a.m. and reached the hospital at 5:30. The sun was up, light spilling over the plains onto the mountains as we took a few minutes just to sit in the parking lot, where I did my best to gather my courage.

Robins sang in the trees. The sprinkler system kicked on, water spraying out over the asphalt and not onto the grass. Typical. We joked about making use of the off-kilter sprinklers to give Benjamin’s car a bath. And then it was 5:45. Time to go inside.

Facing my worst nightmare

The surgery center was busy and staffed by medical assistants who seemed far too cheerful to me. Did they not understand how afraid I was or how damned angry I was to be facing a bilateral mastectomy? I’m sure they intended to be professional and polite, but to me their attitude felt like cold, corporate indifference. I was sure they didn’t give a damn what was happening to me, and I wasn’t about to let anyone hide behind a superficial smile.

“Pamela Clare reporting for mutilation,” I said to the one at the desk, unable to keep the tears out of my eyes.

She blinked, clearly taken somewhat aback, then returned to her script. “Show me your ID. Gimme money. Sign here. Sign there. Blah blah. Nice weather. Please have a seat over there. Blah blah blah. Someone will be out to get you soon.”

My parents arrived a few minutes after we did. My mother smiled and gave me a hug and a kiss on the cheek, but I could see the grief and fear in her eyes. She didn’t look like she’d slept much either.

A nurse came for me in a few minutes and led me back to a room, where I took off everything that made me feel like me — clothes, earrings, ring. Those things were replaced by two hospital bracelets, one of which was mostly a bar code like you’d find on a box of Corn Flakes.

We quickly came to the first thing I’d been dreading. A man from radiology came in to inject radioactive isotopes into my left breast near the tumor. The isotopes were supposed help the surgeon identify the lymph nodes that the tumor was draining to — the sentinel nodes. I’d gone to great effort to research practices at various hospitals and had made it clear to my doctor that the injection would not happen unless I had numbing medication first.

And yet despite guarantees that I would get lidocaine as patients at most hospitals do, I discovered that the lidocaine was mixed with the isotope solution. In other words, I wasn’t really going to be numb before the injection. The lidocaine was just there to take the edge off during the injection.

I was pissed. I really don’t understand why the medical profession doesn’t do all it can to eliminate unnecessary pain. How people feel ought to be of supreme importance to all medical staff. It wouldn’t have cost but a few minutes to numb me up first. Why couldn’t they take that extra step given what I was going to go through that day?

When the radiology tech did the injection, I let him know exactly what I thought of his apparent indifference to causing me pain. “This is fucking bullshit!” I said, squeezing the heck out of my  mother’s hand.

So far, the morning was becoming the nightmare I had feared.

The nurse promised I’d get sedation as soon as I signed consent forms. She started an IV, hooked me up to a bottle of lactated ringers, and left us alone.

I lost it for a while. Anxiety from six long weeks of waiting had taken its toll on my emotions. Combine that with lack of sleep...

I cannot tell you what it meant to me to have my parents, my sister and Benjamin there. They held my hands while I cried, kept their arms around my shoulders, and just generally surrounded me with love while we waited together.

Laughter and acts of kindness

At 7 a.m., my priest arrived — and everything began to change.

Rev. Susan has a lovely voice and a beautiful presence. I met her in January after my former mother-in-law’s sudden death made me want to return to my spiritual roots at St. John’s Episcopal Church. Thanks in part to my cancer diagnosis, Rev. Susan and I got to know each other quickly, trivialities swept aside for the deeper discussions that happen when one is facing serious illness.

She entered the room, a sympathetic smile on her face, and hugged me. I sobbed on her shoulder, and she didn’t let go. When I had gotten the tears out of my system, she introduced herself to my parents, greeted Benjamin and Michelle, and listened empathetically while we talked.

The surgeon came with papers for me to sign. When he saw I was with my priest, he left us in peace.

Rev. Susan guided the conversation to a spiritual plane, bringing her perspective to my worst fears — losing a precious part of myself, facing prolonged illness, possibly facing death. She talked about God’s love and the Resurrection of the Flesh and what that means for those of us who’ve lost parts our bodies in this life.

“Jesus holds these precious parts of us in trust until we are resurrected. We’re reunited not only with our loved ones, but also with parts of our bodies that we lost,” she said, her hands curving into cups. “If you can imagine Jesus holding this precious part of you... ”

And we all burst into laughter. Jesus holding my boobs?

It felt so wonderful to laugh, so much of the tension I’d been carrying dissipating in shrieks and howls.

The surgeon opened the door, perhaps wondering if we’d all gone insane, and came in to listen.

Rev. Susan finished the point she’d been trying to make, then she invited my surgeon to join hands with us in prayer. Her prayer was beautiful, helping to fill me with the sense of peace I’d needed all morning. She anointed my forehead with oil and blessed me, and then stepped aside so that the surgeon could go over the consent forms with me.

The anesthesiologist, a woman from Australia, was right behind him. She asked some medical questions, had me sign some papers, and then told me to tell everyone goodbye. “Once I give you the sedative, you won’t remember anything, so it’s better if you say goodbye now.”

I hugged Rev. Susan, my father, my mother, Benjamin and my sister, each one of them finding different words to offer me reassurance, my mother and sister with tears in their eyes.

Then the nurse injected a powerful sedative into my IV and ...

I do remember being wheeled from the room and into the operating room.

“Can I please wear lipstick during the surgery?” I asked the anesthesiologist.

I have no idea why this was suddenly important to me.

“I don’t see why not,” she answered.

She reached into my bag of belongings, fished a tube of lipstick from my purse, and helped me put it on. “Is that good?”

“Yes,” I said. “Thank you.”

And then she put the mask on my face, and I was out.

She could teach that radiology tech a thing or two. Just a little touch of kindness here and there can help a patient feel like a person.

In the recovery room

As I slowly regained consciousness a couple of hours later, I felt a stabbing pain in my sides and pain across my chest. I heard voices — a couple of nurses — talking about the dose of medication a patient needed to receive. They were trying to do the math.

I can’t do math to save my life — unless I’m semi-conscious and on morphine apparently. I saw the numbers behind my closed eyelids and spoke the answer out loud.

The voices stopped.

“She’s right,” said one.

“You must be a math whiz,” said the other.

Me? Hahaha! A math whiz? I barely survived college algebra. I have math phobia. I hate math.

I drifted in and out for a while. I told someone I was in pain and asked over and over again whether they’d found cancer in my sentinel nodes.

At first nurse’s voices and then my surgeon’s voice told me that the surgery had gone well and that they’d found no cancer in my lymph nodes.

I cannot tell you the relief I felt when that news finally sank in.

The pain was bad. The surgeon gave orders for more pain medication — morphine. And then he stood there beside my bed, one hand holding my right hand, the other pressed against my right forearm.

“Everything’s okay,” he said in a reassuring voice. “You’re going to be okay.”

I don’t know how long he stood there, but it seemed like a long time. Maybe it was the anesthesia or the morphine or both, but I felt a kind of peace come over me. And in my mind, he became Jesus, standing beside me, comforting me, reassuring me that all was going to be well.

The worst behind me

I was still semi-conscious when they wheeled me upstairs to my room.

“Are all of these people your family?” one of the nurses asked. “I hear you have a lot of visitors waiting for you.”

My family. 

They were there — my parents, my sister, both sons, my brother Robert. They were all there except for my youngest brother and my sister-in-law and the kids. I felt so lucky and happy to be able to share the good news with them. The surgery was behind me, and now all I needed to do was rest.

I could feel pressure bandages across my chest, and I truly did feel like I’d been stabbed in the sides, the pain the result of incisions made to accommodate three drains.

I wasn’t certain how I was going to be able to face my new body, but given that I could barely open my eyes, I opted not to worry about that yet. I was just grateful to be free of cancer and to have so many of my greatest fears behind me.


Part II coming soon.

Tonight is my last night with natural breasts. It’s also my last night with the cancerous tumor that invaded my left breast. My emotions rock from relief that something is finally being done to combat this deadly disease to deep grief to be losing a part of my body that has meant so much to me.

My breasts aren’t the sexiest in the world, but our standards for “sexy” when it comes to breasts are so absurd that it’s the rare woman who can meet them without surgery. Still, I’ve always been happy with them from their shape to the fact that they’re small enough that I’ve always been able to go braless to the pale pink color of my nipples.

My breasts have given me so much sexual pleasure. I’ve gotten emails from readers asking why there is so much “nipple action” in my books. Some women don’t have sensitive nipples. Being licked and nipped and sucked does nothing for them. It has always made me melt. But after tomorrow morning, that avenue for sexual pleasure will be gone. Permanently.

Yes, there are procedures whereby doctors can spare nipples during mastectomy, but it largely depends on the shape of a woman’s breast and how close the cancer is to her nipple. And even if a woman is a good candidate for nipple-sparing surgery, she will still lose sensation in her nipples, as all the tissue beneath them, including nerve tissue, is stripped away and checked for malignancy. Also, there are no long-term statistics about the case of recurrence in women who’ve kept their nipples, and some surgeons refuse to do the surgery on those grounds. I will lose my nipples tomorrow morning.

My breasts went bare in Europe on beaches and public parks in Denmark and elsewhere. The feeling of sun on my bare skin was wonderful and so liberating. We have such a bizarre attitude about nudity, particularly breasts, in the US. But I was able to enjoy being young and beautiful in the sunshine without wearing a bikini top or shirt. That rocked.

My breasts also fed my children. Nursing babies is the purest, most beautiful expression of love I’ve ever known. It gave me time each day just to hold and cuddle my babies, time to relax and have eye contact, to smile and babble and coo together. I wouldn’t trade those memories to save my life.

I breastfed both of my sons for a longer period of time than most women. My older son was breastfed for 15 months, my younger son for about a year until hospitalization for an ovarian cyst led him to wean himself. I was heartbroken to have that connection severed so soon.

Breastfeeding is without a doubt the most natural way to nourish a child. I never had to bring bottles or formula. My kids never tasted the chemical concoction that is formula. They had my milk every day from birth until they were weaned. This has made me a big supporter of breastfeeding, a “lactivist” if you will. Breastfeeding should be encouraged, facilitated, and supported.

The breasts I fed my children with will be gone tomorrow.

I am in mourning for this. I think I’ve been in mourning since April 21, the day the radiologist walked in and said, “It looks like we have an early breast cancer.” He might as well have struck me in the head with a sledgehammer.

People say, “A woman is more than her breasts.” I know this, of course, and don’t need to be reminded. My breasts didn’t run the newsroom at the papers where I was editor. They never wrote a story or edited copy or did a single interview. They didn’t do homework with my kids or clean the house or plant rose bushes. They didn’t push for the bill that ended the shackling of pregnant inmates here in Colorado.

But my breasts are mine. They are a natural part of my body, a part of my sexuality, a part of what has always made me feel feminine and womanly. And I’m going to lose them forever. For months, I’m going to walk around with slashes on my chest where they used to be, long scars over skin that has been stretch flat and stripped of all underlying tissue.

There is no way to feel good about this loss, no way to gloss over what losing my breasts means to me. I am mourning for my mammaries. I am heartbroken, and I am angry. I hate this.

I know that one day they’ll be replaced with reconstructed breasts, either silicon implants or tissue from an abdominal flap (which also means a tummy tuck). But those breasts will be designed only to fill out a shirt and give me a normal appearance. They won’t feel anything. They won’t be capable of feeding a child. They won’t feel like mine.

They won’t have cancer either, and, yes, I know that. I’ve waited an unbearable and unforgivable 45 days for surgery. I’ve had to worry every one of those days whether the cancer has spread. I won’t know until the final pathology report is back whether this awful disease has sneaked its way into my lymph nodes. Those are questions that touch on my survival, my very presence on this earth.

I want to live. I want to make more memories with my grown sons. I want to enjoy lovers. I want to visit Paris and Denmark and Spain again — not to mention many other places. And that means my breasts need to go. Although the tumor is only in my left breast, I have chose to sacrifice both because women who’ve had breast cancer have a higher chance of getting it in the other breast than those who haven’t. I never want to go through this again.

My sister and I went into the back yard tonight. While I wore a sarong, she took some practice shots. Then I dropped the sarong, and we took photos of my bare breasts, trying to give me a way to remember them and all the life lived with them. I have a six-foot privacy fence, but I couldn’t have cared less whether anyone saw us. (I almost included the photos. I’m not shy, but some of you might be.)

I plan to do all I can to beat this terrible, brutal, violent disease, this sickness that steals so much from women. But I can’t deny the reality of my emotions.

In so many ways, life as I knew it ended on April 21, and I am just dragging along in pieces. It’s not just the loss of my breasts, but everything that will come with this — chemo, the loss of my hair, and ultimately the risk to my life.

I’m not sure I want this new life, but it is my reality now.

The fight begins tomorrow.


I want to thank those of you who’ve sent cards, gifts, and emails, sharing your support. Your warm thoughts and prayers have sustained me through this terrible time. My mother and sister have been my heroes, enduring my mood swings, my wild raging emotions. My brothers, too, have been there for me in their own way, which is to say they’ve made me laugh a lot when I thought I no longer could laugh.

But a special heartfelt thanks goes to all of you who donated to the Good Food Fund that author and friend Thea Harrison set up. Almost $7,000 was raised to provide me with organic, homemade meals that will be delivered to my door during my recovery from surgery and during chemotherapy. There is no way I can send cards or emails to all of those who contributed, but please know that I read your messages. When I heard how much it had raised, I burst into tears.

Deep, profound thanks to those of you who donated to the Medical Expenses Fund. The idea came from author and friend Courtney Milan, who helped spread the word about the Good Food Fund, too. Right now, I believe that fund has raised $3,800, every penny of which will go to my cancer treatments. Although the food account is on hold now, anyone who still wants to contribute can send a donation to the Medical Expenses Fund directly via PayPal via this email address.

You all are helping to save my life. Thank you for making me feel loved in the midst of this nightmare.


One last word before I get ready for tomorrow’s surgery. Please don’t skip a mammogram. And if you find a lump or a thickening in your breast between mammograms, get it checked and push for another mammogram.

This lump wasn’t found by my doctor. I felt a thickening, asked her to check it, and she said it was normal fibro-cystic changes. Months later, it shows up as cancer on a routine mammogram. If I had skipped this mammogram, I would be fighting for my very life.

Thanks again for your support, good wishes, and prayers.