He wants me to do the DIEP. “You have the perfect stomach for it” – a DIEP involves removing the entire lower stomach and moving the muscles / fat / skin and vascular system to the chest to make a breast.

What he means is I have a mom stomach. I have a “great” c-section scar and some loose skin. It makes for a little pooch that I hate. I want him to lipo it for my fat transfer. That’s not actually fat he tells me. Once again. “You’re very lean, thats loose skin, I can’t get fat from there” he says as my body dysmorphia and self doubt roars in the back of my head.

He thinks I’m making a silly choice with my implant only reconstruction. “It’s a free tummy tuck and perfect breasts” women pay me 30g in cash for the same procedure, it’s like a mommy makeover”

I protest again. “I don’t want to be of the gym that long” He rolls his eyes. His sense of humor likely off putting to others but meshed perfectly with my sardonic side.

“R! Who cares about a few months out of the gym! You’ll be back by summer!”

I widen my eyes in false alarm and state that summer means swimsuits and that means the gym! I’m not a masochist! He rolls his eyes again. The rest of his face doesn’t move so it’s relatively discrete. He may be a good surgeon but remind me to never trust him with botox.

What I don’t actually acknowledge is the single factor. A factor that has set me apart from most other women I’ve met in the cancer community. I’ve always harbored a feeling that my circumstances are unjust or unfair, but kept the knowledge that feeling that way is equally unfair.

Most women take time off work to battle cancer. Most women have a financial and emotional caregiver. Most women don’t run from 8 hours in the office to radiation, to picking up their child, to helping with homework, to dinner, to dishes, to crying as they lather on the aquafor before crawling into bed alone. Most women get to sleep, to focus on treatment. Most women have someone to say “it’s ok, I’m here”. The person who shared my bed through half of my treatment was physically there but lacked the emotional EQ to respond to any of my fears or provide any type of emotional comfort. Emotionally and financially I’ve done all of this alone. I am my own caregiver.

In Anne Boyer’s book “The Undying” she notes what it is like to being a single working mother battling cancer. She reflects on how she is sick, yet she must still perform her roles. She must still work, for the budget doesn’t allow for time off. She must stay on top of cancer treatment, complete the forms, raise her daughter, clean the home, earn an income. She writes about what it is like to do all of this alone. She is not a child with parents to dote on her, not married or partnered with anyone significant. She is a caregiver without a caregiver.

As Anne Boyer writes:

It should be no surprise that single women with breast cancer, even adjusting for age, race and income, die of it at up to twice the rate of the married. The death rate gets higher if you are single and poor.

Everyone understands as a matter of fact that unless you are currently entered into this world’s customary romantic partnership, or unless you have lived long enough to raise devoted grown children, or unless you are young enough to still be in the care of your parents, you are, on the occasion of aggressive cancer in the conditions of aggressive profit, rarely considered worth enough to keep alive.

The DIEP is no easy procedure. It’s 4 nights in the hospital. It’s two months of intensive recovery. It’s not driving. It’s not working. It’s not moving.

It’s not running on empty 15 hours a day trying to keep up with the demands of being a caretaker.

I can’t wrap my head around how I could ever make that work. Perhaps someday. If I’m ever able to make a partnership work. Perhaps then I would consider it. But it’s not a reality in my current life.

“I just can’t be out of the gym that long” I repeat.