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In Between and Far Away, an Essay by Katie Annarino

Photo by the National Cancer Institute

The large wall of windows on the fifth floor of the Stefanie Spielman Comprehensive Breast Center overlooks the corner of a congested intersection: Third and Olentangy. Parallel to the intersection is a jammed, elevated highway hoisted up on round, cement pillars. Above, trucks lurch forward, belching black smoke. Below, the edges of the mud-brown Olentangy River rush over loose stones and cement debris.

I’m 40 years old and apparently, that, combined with the brown discharge coming from my right breast, were reasons enough for my OBGYN to send in a referral for my first mammogram. For the past two weeks, good sleep has been more of a wish than a reality.

As I take a seat by the windows, I offer up a question to the other women in the waiting area.

“So, how much does this hurt?” The shuffling of bodies in and out of exam rooms is the only sound that dares disturb the penitent silence until one stranger offers solace.

“It’s not that bad,” she whispers.

She’s my age but looks older. Tired eyes. Dry, dirty blonde curls wrestled into a ponytail, gray that’s winning. She rises from her chair and moves closer to me. We chat across a glass coffee table.

“I’m a mess,” she says. She has cancer.

“My family, we don’t talk about it much,” she shrugs. “What do I even say?”

She is sitting like me: legs tightly crossed, elbows bent, her right hand propping up her head at the temple.

Inside the room, all the women wear the same mundane white robe. Some of the women don a green rubber bracelet with a locker key and clutch a dark green plastic bag for the belongings that didn’t go in their locker. The lockers and bags are courtesies provided by the center as well as coffee from a Keurig, a few bags of chips and one small, fallen water bottle inside the mini-fridge. The forced informality hits me sideways, like small talk with an awful coworker who plops down beside you before a big meeting. Like that coworker, this room knows you can't scoff, tell it to get bent and move your chair to a more favorable location. So, I try to give myself over to it and its artful, sanitized sameness like a trapped insect admiring the creator of the web, surrendering to the one who may be its undoing.

The woman has two children: six and eight; the youngest is a girl. They don’t talk about it.

“I don’t want to prolong the pain,” she says. Her gaze is dull and distant, the look of someone refereeing a daily grudge match between hope and despair. I picture her going about her day: a full laundry basket on one hip, a busy but concerned husband who is rarely more than an earshot away, kids charging back and forth. They know. They know most of it. Because sick bodies speak without words: a wince followed by a shallow gasp, a groan radiating from the belly and escaping out the mouth, a clumsy stumble, red-rimmed eyes and phantom tears—wiped away before they could leave a trail. Bathrooms are good for crying. They usually have locks.

I picture my son, a seven-year-old boy with pale blue eyes and a dimple in his right cheek. He knows this language too well.

“I have Lyme disease,” I say, offering my condition like a credential, proof that I am well-educated in suffering.

“I’m sorry,” she says.

Outside, red and white construction cranes loom on the horizon like metal-necked giraffes. Twisted cables hang over the intersection, anchored by metal poles. I stare at the cars zipping around the curved highway under a cloudless sky. At any moment, a downward glance or a daydream can extract them from the game, yet they fly around the hardened loop, happy to ride the thin, tender marrow between daydream and oblivion. From this distance, they look like a child’s toys.

In high school, I was in a bus crash. We were headed to an amusement park. While driving north on a two-lane highway flanked by Ohio farmland, we were sideswiped by a dozing truck driver. During a life-or-death moment, time doesn’t freeze. It moves frame by frame, each frame a tunneled picture with blurred edges. It happened over 20 years ago, and I can still remember the hollow, thunderous cracks of metal on metal and the infinite fractals of glass floating slowly overhead, catching and tossing light in vibrant flecks of orange and yellow—terror and wonder dancing in lockstep.

The impact sent us speeding into a dirt field. There were no major injuries on our bus, but the truck driver went to the hospital. That night, we were on the evening news: a potentially fatal head-on collision avoided.

“My prognosis is good,” the woman says. “I don’t think I’m going to die. Yet.” Her last word hangs above us like a prayer. They call her name. She gives me a wave, follows a female tech in scrubs and disappears.

An hour later, my mammogram and ultrasound, which they threw in for good measure, is done. The tech is explaining something to me, but I catch only bits and pieces.

“So what does it mean if the radiologist comes in for another look? Should I be worried?”

“I just told you it’s probably nothing to worry about,” she says gruffly. “Didn’t you hear me?” She is short and portly and wears glasses with black frames, the kind of person whose presence makes a room feel emptier.

“Maybe when people feel nervous and afraid, they don’t hear quite as well.”

“I guess that’s true,” she says with a reluctant shrug then exits.

Shortly after, she returns with a radiologist and resident who are wearing smiles like masks. Again, I cannot absorb all the words, but I do catch one: abnormality. Moments later, I am back on the table, once again a subject whose body parts are no longer her own. As the radiologist takes his turn dragging the handheld extension over my right breast, he pushes down hard and throbbing heat radiates within the already inflamed tissue.

Living with a chronic illness is full of trauma and every new pain applies pressure to corporeal landmines. In the body, the pain signals travel up the spinal cord. They are received by the thalamus, an egg-shaped relay station responsible for processing sensory information, and interpreted, in part, by the prefrontal cortex, which assesses the signals and determines the threat level by dipping into the brain’s collection of past painful experiences. In the brain of someone with a chronic disease, the prefrontal cortex has evolved to become hypervigilant as it processes pain, but it has also suffered the loss of gray matter, which makes pain control sluggish. In my body, this rapid assessment is a litany of nightmares that explode in fragmented pictures and sinuous fibers that burn hot after years of dormancy.

Monthlong, nighttime fevers.

Right knee swollen with fluid.

Atrophied, concave right quad muscle.

Shoulders and hands gnarled with inflammation.

Nerve pain lighting up the spine like an electrical storm.

Rapid weight loss, withered legs on the edge of the tub as water pours in.

Loss of appetite. Fighting the gag reflex to choke down food—each time

remembering how my grandmother did the same in the months before she passed.

A black cane stood at the back of my closet for years. That innocuous, curved piece of metal that resembled an incomplete question mark became the symbol of all my uncertainty: Will tomorrow be the day that I need my cane? Will this flare send me to the hospital again? Will the compassion of others, already sparse, wear thin and break after so much continued use? And the most terrifying question of all: Who will love me like this?

My body is a haunted place. On the table, all the ghosts come out to play. So, I trade resistance for compliance. Instead of exiting, I try to enter the moment more fully just as I did on that bus many years ago. I stare into the overhead light until my eyes lose focus, the light expands, and its edges blur. Every sound softens except my breath, which is deep, long and magnified. The bodies next to mine fade to the periphery, along with their sounds, then disappear. In this hyper-state of awareness, time unspools, and pain dissolves. Everything but that expanding, pronged sphere of light falls out of the frame.

I am not with my body anymore.

My surrender to my suffering accepting, without judgment or analysis, all its fear and pain and uncertainty is the cataclysmic act that delivers me from it. I am carried away and placed in that familiar otherworld where terror and wonder still dance, where meaning is no longer necessary and I am free to marvel at the wonderness of being and access that transient state of unknowing which unlocks the infinite ecstasy of the soul.

And I become aware of two truths: a hand, not seen but felt, is holding mine, and a solitary bead of warmth is tracing its way down my right cheek.

Slowly, the people return, their outlines come back into focus, their muffled noises fill the room, my breast throbs, and the light recedes until it is contained once more by the glassy, man-made orb overhead. I am returned to my body.

We are done.


Katie Maureen Annarino received a master’s degree in creative writing from Chapman University in 2013. She is a full-time Senior Copywriter, freelance journalist and an adjunct faculty member at The Ohio State University. Currently, she is working on a children’s book that helps children understand chronic illness using colorful characters and relatable metaphors. She resides in Columbus, Ohio with her 8-year-old son, Bodhi and distinguished feline, Moose.


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