To My Daughter on the Eve of My Mastectomy: Letting Go

Tonight, I hold my daughter, running my fingers through her blond wisps of hair as her two brothers watch Frozen. Though she is largely oblivious to television, she becomes riveted when Elsa begins singing her ballad, "Let it Go." Talia is 10 months old, and I think of her as I contemplate what lies ahead for me: tomorrow I will take a life-changing step as I elect to remove my breasts and my ovaries to prevent myself from getting cancer. This letting go requires tremendous courage, and I am scared.

When I was eight months pregnant with Talia, my father discovered that he had the BRCA2 mutation. At my post-partum OB visit, I presented my doctor with paperwork documenting my father's mutation, and she arranged for me to get tested. Then, when Talia was a little over 2 months old, I learned that I, too, had the mutation, at which point I was referred to the appropriate oncological surgeons. On the basis of the genetic mutation, my family history (breast and ovarian cancer), my age, and the nature of my breast tissue, the surgeons made clear recommendations to me: Have the mastectomies as soon as possible, follow up with an oophorectomy within the next few years at the latest, and stop nursing Talia immediately to prepare for the mastectomies.

The doctors' words echoed in the sterile office. I was speechless, and my arms, which held my nursing baby, locked and began to tremble, a million tiny hairs spiking from a million tiny follicles. I looked down at Talia, her little hands gripping my breast, eyes partly closed as she soothed herself to sleep, and gasped as I felt this tender moment slipping away from me. How could I, a mother of three young children, just days past my 34th birthday, lose it all in a single moment -- the sweetness of nursing my beautiful infant, the dreams of future children, and these parts of my body that were integrally intertwined with mother- and womanhood? I looked up and realized I was inside the swirling storm.

I attempted to claw my way back by snapping into problem-solving mode: I went through the motions of seeking second opinions, planning surgery logistics, dealing with the incredulous reactions of friends and relatives, all while feeling numb. Looking at these surgeries from four months out, I had hoped that I would be able to fast forward my way through my grief about this experience, to end up on the side of rainbows and girl power and pink ribbon solidarity. I wanted to feel like Elsa in Frozen, proud and determined as she stares adversity in the eye. I wanted a sense of resolve, a deep-seated confidence stemming from the knowledge that what I was doing was right in some cosmic way, and for this to silence the fears and the sadness. But instead, I felt regret, for the moments when I failed to cherish my body for all that it had given me. I regretted the critical scrutiny with which I approached my body, first in high school when I thought I was flat-chested and then, later in life, ironically, for having large breasts. I wished I had been able to fully appreciate all that I had while I had it, to savor the perfection of my imperfection.

A throng of fears came crashing down on me, only some of which I could name. I feared that I had passed this condition along to my children. I worried most about Talia, for the mutation's threats are greatest for women. I feared that I wouldn't recognize my body after my surgery, that it would feel alien to me, and that this would create a barrier between my husband and me. But most of all, I feared that my recovery would be challenging, and that Talia and her brothers would hurt alongside me. That she wouldn't understand the reasons I couldn't embrace her, or tickle her, and that this would be painful to her.

Equally strong were my feelings of gratitude. What a tremendous gift that I was able to have Talia, and her two older brothers -- to carry them in my womb, to hold them inside and feel them growing and stretching. I said little prayers of thankfulness for having been headstrong enough not to listen to my academic advisors who suggested waiting until I got tenure to have children, because I might have entirely missed the opportunity to do so. I felt deeply appreciative for the fact that I'd been able to nurse all of my children, to fill them up with pieces of my love for them. And, of course, the one that's almost too scary to say -- grateful to have dodged these horrible diseases that have ripped so many other mothers from their children. Thankful that I have the choice to continue to be here for Talia and her brothers.

And these feelings churned over and over within me throughout the months that followed. Though I was able to incrementally gain fragments of control over this process, here I am, in the final hour, petrified about all that lies ahead. Tomorrow, I will march headfirst into the fear, letting go of all control. I hope that my physical and emotional strength will surprise me as I navigate life post-surgery. I hope that living through this experience will invigorate my appreciation for my health, for time with my family. That it will allow me to refocus my life on what really matters to me.

And I've finally realized -- Elsa was scared, too. It's not that she abandoned her fears to move forward to a new life, but that she embraced who she was in spite of being afraid. And it occurs to me that the greatest outcome of this entire ordeal is that I will send a powerful message to my children: when faced with the most terrifying things in life, their mother is the type of person who, despite feeling immense fear, marches forward. That my children will see me as a woman who values myself, my life and my family more than my accoutrements.

So for you, Talia, who has a 50 percent chance of inheriting this mutation, on the eve of this radical transformation, I make one wish -- that by the time you and your brothers are adults, there will be a simple cure for people who carry this genetic risk. But if this doesn't happen, that you, too, will be able to let go.