Dr. Madhu Muralee is a surgical oncologist at the Regional Cancer Centre (RCC), Trivandrum. It would take one more year for the doctor to meet Lalitha just because of her decision not to reveal her secret to the world.
“I don’t think the lump Lalitha saw 13 years ago was malignant. But if unexamined, such harmless swellings can turn dangerous,” says Dr. Madhu.
Even though Lalitha’s hunch about her swelling was spot on, she didn’t hear the first rumblings underneath the dead volcano. She failed to pick the sudden ticking of a time bomb apart from her ancient heartbeats.
“But when the technician at Gokulam medical college saw it a year ago,” says Dr. Madhu, “I think that was a crucial moment. “Most women do not know that breast cancer is almost curable at that stage.”
“They wait, I don’t know why!”
Preetha Rajan, social worker and active member in a Cancer support society, says that women do not give any priority to themselves. “It is not at all a matter of lack of awareness. They just don’t want to throw a spanner in their family routine by introducing a problem. Even the upper middle class women do not consult a doctor when they spot a swelling or discoloration on their breasts. Some are afraid of the treatment.”
At the beginning stages, a cure from cancer is not any more a miracle. A small surgery takes out the malignant swelling. No breast removal, no chemo, no radiation. You can walk home cured from cancer!
But Lalitha went home from Gokulam medical college that week with her malignant lump intact. The technician took the ECG, helped Lalitha as she put her dress on, and went to the canteen to take his evening cup of tea. He failed to report what he saw to the doctor or Lalitha’s family waiting outside.
Back home, she found her mind a simmering cauldron. Come what may, I will tell, she decided. In the bathroom, at the kitchen, at the veranda, everywhere Lalitha rehearsed her lines. And when the day came, Lalitha was sitting on the sofa, wringing the hem of her saree.
She knew it would be double blow to Divya, whose father-in-law was already going through the pangs of chemotherapy. Every week she came to tell her mother of what she saw at the RCC, as she accompanied her father-in-law. “Amme, I have only one prayer, don’t give this to even our enemies. You should see those women with shaven heads moving in wheelchairs,” she said with tearful eyes. Lalitha would sit with semi-pervious ears. She felt her long, lush flowing hair already a stranger to her body.
Right from her youth, Lalitha was admired for her hair. “Nallathonnum amma njangalku thannilla,” her daughters used to complain as they stroked her hair.
Lalitha will tell her secret today, she was determined.
She got up, plumped up the cushions and slowly limped towards the bedroom; but had to limp all the way back when she heard the telephone bell (the limping came after the surgery). “Sughamano amme?” It was Dhanya from Saudi Arabia. “Amme, I have some good news. I am carrying now.”
“Why are you silent, amme? Aren’t you happy? Lallu wants to talk to you amma.” She gave the phone to her husband. “Amme, the doctors want her to take rest. She is coming next week.”
When her husband came back from the market Lalitha knew what should wait. “Kochumol is pregnant. She will come next week,” she said and limped to the bathroom. She wanted to see how long the game would last.
The pain on her back was piercing, but the last thing that Lalitha wanted in the house was a servant to take care of her pregnant daughter. She limped from room to room getting things done. Ammu, the eldest of her grandchildren, was perturbed. Her ammamma was no more hugging her tightly. “Maybe I am now too big for that,” she thought. She was surprised at the way, Lalitha flinched and got annoyed when Ammu reached for her thin necklace another day. She pushed her away.
Poor girl, she didn’t know how sensitive a 13-year-old lump her grandmother wore on her heart could be. Lalitha guarded it day and night.
It was time for Dhanya to go back to Saudi with her newborn. She was a bit piqued as she saw her mother smiling. “You don’t look sad when I leave.” Lalitha smiled and reminded her to call in the evening. She didn’t come out of her house to see Dhanya off.
Next day, Babu took his wife to a doctor when she found it difficult to get up from the bed. “We need an MRI,” the doctor said broodingly. The death of Divya’s father-in-law delayed it further.
Another month of pus piled up on her breast before an MRI was taken of her spinal cord.
The report looked normal to the untrained eyes of Divya and her husband who collected it from the lab, but for the word ‘metastasis’. Divya’s husband had seen it somewhere, but it could never be. One ordeal had only just finished.
Back home, Divya called her cousin, Dr Deepa, asst. professor in paediatrics in Kottayam Medical College, and read out the report. There was an uncomfortable silence from the other end. Then came a quavering voice: “Divya, she has cancer.” She dropped the word cancer gently, fully aware how it would detonate at the other end of the line.
Lights burned throughout that night in a few houses in Kollam and Trivandrum. There were stifled cries, sighs and murmurs. “She is such a good woman. Ennalum avalku ithu vannallo,” her relatives wailed.
Only Babu and Lalitha slept undisturbed for one last night at the eye of a storm one of them had weathered.
The sky remained cloudy next morning. It was time to let the couple know the news. “There is no point in getting emotional,” Dr Potty of Gokulam Medical College, took his eyes from Lalitha’s report and told Babu. “Your wife has cancer. These are bone secondaries. We need to find where it originates from, I mean, the primary. For that we need bone scan and biopsy.”
Babu heard only one word–cancer–and the world around him dimmed.
The biggest challenge came soon. Dr. Deepa called from Kottayam, “Be careful. Many patients never get out of the trauma when they learn that they have cancer.” Back home Babu and his daughter talked in muffled voices, answering phone calls, stifling their tears and emotions. Many times they were nervously embarrassed to find Lalitha looking at them from where she lay. They found it difficult to catch that pair of eyes which bore into them. None of them found the courage to tell Lalitha what her condition was.
What did the doctors say? Lalitha asked her daughter. “Oh, you need a small operation amme,” said Divya and hurried to the bathroom to hide her tears. She wept on the very same corner, her mother stood 13 years ago, on the eve of her marriage.
Babu and Lalitha didn’t know they were nibbling nervously at the two ends of one truth. They were mustering courage to tell the other the same news, but couldn’t. They were united and separated by one word – cancer – as they lay with open eyes in their bed that night.
Lalitha was admitted in the hospital, next day. An abdominal scan found her stomach running in mint condition. Liver normal. Uterus normal. Machines scoured every inch of her body except her breasts, “which is curious,” says Dr. Binoy, a physician later.
The family suddenly saw wisps of hope scuttling above. God is not so unjust, they thought. That evening, Divya and her husband were running excitedly to Dr. Potty’s room with the results of the bone scan. No serious damage. The technician at the DDRC had sworn upon his job that the compression at the spinal cord has nothing to do with cancer. “Had she fallen from some height?” he asked.
Dr. Potty smiled broadly, looking at the results. “Most probably this is not cancer. Let the biopsy results come to rule out everything. Perhaps a small surgery will be enough to get Lalitha back to normal life. A surgeon and a gynecologist will come and see her.”
Phone calls went berserk. At every end of the line, prayers and joyful cries went up the air. Divya reminded her father of his offer to do a pooja at Mahadeveswaram temple the next morning. Father and daughter spent a lot of time that evening outside the ward chatting and planning things they would do once Lalitha was discharged after the surgery. They had much to talk after days of gloomy silence.
“Thank God, we didn’t tell amma about anything,” said Divya. Babu smiled.
Inside the room Lalitha was on her bed with open eyes. She didn’t like a gynecologist visiting her. And, a surgeon.
Half and hour later, Divya saw her mother lying on her side with her face towards the wall. The poor woman was nervously tapping the railings of the bed with her spindly fingers. A small pool of tear had already collected at corner of her eye, about to trickle down. She turned her head when Divya put her hands on her shoulder.
“Mole…” she looked long at her daughter, turned her body slowly and then pulled down the sheet spread over her breasts. Never for a moment did she take her eyes from those of her daughter as she revealed the sore she had hid all these years.
What Divya saw was hardly the breast which suckled her with love and milk long, long ago.
“I am sorry mole, I have breast cancer.”