A few afternoons ago, after dropping my son off at Hebrew school, I received a phone call from my OB-GYN. This was very exciting for me, since I’m so fond of my OB-GYN I once considered having another child just so I could hang out with him more. I hoped he was calling simply to chat—he’d never done that before, but maybe he’d been thinking of me?–but instead he was calling to express mild, almost paternal concern.
“So listen,” he said, “it seems like you haven’t gotten that ultrasound.”
“Oh,” I said. “Well, you know…” Man, I was so busted.
“Is there any particular reason why not?”
How to explain? I had recently turned 40 and gotten my baseline mammogram like a good girl, but when it came to the follow-up ultrasound–a test to make double extra-sure I didn’t have breast cancer–honestly, it had just seemed like too much. I’d been ignoring the reminders from the hospital breast center, recycling them with the advertising circulars. They’d been coming every three weeks like clockwork.
Look, I know, it’s not nice to ignore hospital breast centers. But I was only forty. There were no incidences of breast cancer in my family. Other women I knew who went to other practices were told they could wait until they turned 45 to start getting mammograms. And I’d read “The Emperor of All Maladies,” Siddhartha Mukherjee’s magisterial discussion of cancer, which suggested that mammograms before the age of fifty were probably pointless.
“Listen,” I said, “I read ‘Emperor of All Maladies.’ Which says I don’t need mammograms yet.”
“You’re taking medical advice from a book?”
“Well, it did win the Pulitzer,” I said. “Anyway, medical care in this country is out of control. Endless testing and diagnostics. Honestly,” I said, turning prissy with self-righteousness, “I don’t believe in overmedicalization.”
“Overmedicalization is not a word,” my doctor said. Then he quoted various studies from the American College of Obstetrics and other studies from the American Gynecological and Obstetrics Society, and it all came down to this: Ashkenazi women, once they turn 40, should have mammograms every six months and ultrasounds every six months after that. Mammogram, ultrasound, mammogram. Until forever. He said, let’s make it a habit. He said, I want to keep you going ’til you’re at least in your 80s.
My 80s! I was really very flattered.
But still: my 80s. As soon as he said that, I understood what my real objections had been–beyond just the thought of spending another morning in another clinic watching game shows in an ugly robe, waiting for someone to lube up my tits. My objections were larger than that, and more personal, although to say them out loud would have made me sound crazy to my doctor–and possibly even to myself.
But I’ve been thinking about those words ever since, what I would have said to my doctor if I wasn’t navigating post-Hebrew School traffic, and if I hadn’t been scared of sounding crazy.
I would have said: maybe I shouldn’t live to my 80s.
I would have said: I’m not sure there’s a need for me to go on for another four decades.
Maybe I shouldn’t fight with every bit of medical weaponry at my disposal to stay on this planet longer than my proper due. This earth is groaning already under the weight of so many people. The money and the work it would take to keep me alive for such a long time–with the ice caps melting and the nuclear threat ever-present–perhaps that’s not the wisest use of ever scarcer resources? Maybe the polite thing to do is raise my children, send them off into the world as best I can, and then allow other life, new life, to replace me in this world?
I would have said that, and I would have meant it, even though I know I would have been a hypocrite. Because also I want to live, of course. I know that were I to be diagnosed with cancer today or tomorrow I would be terrified, and I would fight like hell to stay alive. I mean every day I wear sunscreen and I did, after all, get that mammogram.
Moreover, my grandparents lived until their late 80s, and they were joys and inspirations to me. I was very close to all of them, and even though I was in my early thirties by the time my last grandparent died, I felt like both he and I were too young.
So living now: yes. Living tomorrow: yes. And probably, on the eve of my 80th birthday–should I be so lucky–I will feel very invested in living the next day, and the day after that. Still, I don’t know if I want or need to live to be a very old lady. I don’t know if the time for living forever has already passed. My grandparents were alive when this country still felt rich and abundant, full of life. Their time was the time to live to eighty, 90, even a hundred. My time–these years–feel like a time when you’re lucky if you get maybe 60 or 70 years without ecological or nuclear calamity. Take what you get, in other words, and be grateful for it.
Speaking of time, though, I knew my doctor’s was precious. “Thanks for calling,” I said.
“You’ll make that appointment?”
“Of course,” I said, like a good girl, and when I went home, I did. But not without wondering how long I really wanted to keep going, and not without wondering about how many years should rightfully be mine, and not someone else’s.
