• Read this article to learn about my experience of participating in a research project studying Mindfulness Based Art Therapy for Women with Cancer. Find out how mindfulness meditation, yoga and art helped in my recovery from breast cancer.  One Breath at a Time  

• A story of a dear friend facing her death from ovarian cancer with dignity and an open heart. Midwifing Into Death

• A mythic tale, redolent with metaphor, that seeks answers to eternal questions in a lush inner journey.  The Garden of Beautiful Flowers

• An article about some of the ways that the philosophy and practice of yoga helped me through the challenge of breast cancer.  Yoga as a Path of Healing: Recovery From Breast Cancer

• And now a story for cat-lovers:  LeLe, The Guru Cat

Close To My Heart 

by Alison Hammer Winans

     I was ready to take my clothes off after enduring a day of Philadelphia’s oppressive July heat wave. My shirt clung to my back, while my bra felt like a bridle, bit and saddle all in one, making red welts where it dug into my ribs. Perspiration trickled down from my right armpit, but the left one had not perspired since the surgery five years ago. Dumping the groceries in the hot third-floor kitchen, I kicked off my sandals, heading straight to the air-conditioned bedroom where my husband, Tom, greeted me from his computer. I tore off my sweaty outer clothes, then the bra, surely sturdy enough in construction to haul boulders or to be a slingshot hurling weapons of mass destruction. Slipping my silicone breast prosthesis out of my bra, I dropped it, smiling, in Tom’s lap.

     He kneaded it absentmindedly like a sleepy kitten suckling, but then fully surfacing from his reading and noticing that I was nearly naked, he jumped up to appreciate my bare flesh. “Mmm, you still have plenty of squeezables,” he murmured, sliding his hands down to my buttocks, too large and saggy in my judgment, just perfect according to him. We kissed, and he stroked the left side of my chest, remembering to be gentle over my thin, pale scar and the ribs unprotected by mammary fat, “Mustn’t forget to give this side some attention.”

     I sighed, “I love it when you do this, but I’m too hot to hug.” We laughed; it had been one of our jokes since the hot flashes started. I thought Too Hot to Hug sounded like a book title. He went back to the computer, and standing on tiptoes, I stared at my top half in the small mirror on the wall. My body smiled. One breast an open, droopy eye, while the lack of a breast winked at me, my belly button was the nose and the crease under my little roll of flab was the mouth. I pulled on a tank top and shorts, going without my bra, not minding if Tom saw me lopsided. I wiped the sweat off my prosthesis, stored it in the cardboard box with an inner plastic cradle to maintain its shape, and let my thoughts drift back to the time I acquired my first prosthesis.

*   *   *   *   *

       We were temporarily living in rural Oklahoma in a new age community east of Tulsa. Ten days or so had elapsed since my surgery on June 4, 2002, when my left breast, along with a tumor the size of a golf ball, was dissected off my chest. I was wearing a pink paper blouse and sitting perched on the exam table in my surgeon’s office with my feet dangling in the air. The doctor pulled out the drain (a plastic tube inserted underneath my skin) and ripped off the small steri-strip bandages, smiling as she said, “You are healing faster than my patients usually do.”

       Looking down, I said, “I can’t believe it, it’s so tidy and there aren’t any stitches.”

       “They dissolve under the skin. You’re doing great, so you can start your stretching and strengthening exercises. I’ll write a slip for you to get a permanent prosthesis.” I’d been wearing a temporary prosthesis that was like a bag filled with fluffy comforter stuffing. It wasn’t very useful, as it tended to get squashed and misshapen. After hugging someone, imagine saying, “Excuse me while I reshape my boob.” I never did have the guts to say that though.

       Because I had no medical insurance, I made an appointment with the American Cancer Society in Tulsa and drove there to be fitted for a donated prosthesis and bra. Two kindly women volunteers in their 70s, with grey hair, glasses and elastic-waist polyester slacks greeted me and took me into a back room with walls of cardboard boxes. They both had their mastectomies in the old days when everyone got the Halstead radical mastectomy, which removed muscles as well as the breast, leaving the chest hollow. Seeing that they were still around doing useful work gave me hope and inspiration.  Closing the door, one said, “Okay dear, just strip to your waist.” Although I was forty-eight, I felt as if I was their granddaughter getting my first bra. Gesturing at my solitary breast, she said to her cohort, “Look, hasn’t she been blessed.” I wasn’t sure if I was blessed because my bosom wasn’t too big or because it wasn’t too small, so I just smiled at them. It seemed like a quaint Bible-belt phrase. I dubbed her Miss Blessed.

       Her sidekick said, “Oh, you’re blessed indeed.” So experienced that she eyeballed me instead of using a tape measure, she continued, “I’d guess you’re a size 4 or 5.” I’ll call her Miss Fit. After some searching she found a size 5. “We don’t have too many that small. Most of the ladies here are bigger.” The beige-pink prosthesis had a plastic “skin” filled with silicone gel, the same goop used in breast implants and gel-filled bras. Miss Blessed folded it and stuffed it into the left pocket of a bra for me to try.

       Looking down at my chest and also in the mirror, I thought it looked a tad bigger than the real breast. “I think a size 4 might be better.” There was no size 4, only the random sizes donated by all those big ladies. I pouted a little, and then remembered how lucky I was to be getting a free prosthesis when we had no money and growing debts. “Oh, I don’t mind, I’ll take this one. My left breast was always bigger than the right one anyway, so it’ll be the same as before.”

       They tittered. “You look beautiful, dear. Now we need to find you a bra,” said Miss Fit.

       I held the prosthesis in my palm—it was convincingly heavy, weighing about a pound—and squeezed it, glad that the silicone would be outside my body and not leaking inside me. “It feels so real and it’s even got a little nipple.” Then I held it by the top corner, letting it hang down, noticing how gravity altered the shape, creating a very convincing bottom curve. “It hangs just like a real breast. I love it.” What did disturb me though was a strong perfume odor impregnating the prosthesis, presumably from the previous owner, and I tried not to think about whether the prosthesis was donated because she died. I hoped she had simply gained weight.

       They brought out a ghastly selection of bras, with prominent seams that puckered and pointed tips like in the 1950s, so substantial I understood why bras were called foundation garments. These could even support a house. They explained that mastectomy bras had to provide a lot of coverage to conceal the horizontal scar running from the center of the chest to the underarm, and to hide the prosthesis itself. There were no half cup bras or anything remotely sexy. “Do you have any that look more natural?” Of course they did not. But with my active lifestyle, I needed a bra with a pocket to hold the prosthesis, so that it would not travel and end up under my arm or fall out when I bent over. I picked over the bras and chose the best.

       Miss Blessed said, “Now dear, remember to wash your prosthesis with soap and warm water, especially if you’ve been sweating, and when you wear it be careful that you don’t puncture it with a safety pin or jewelry, or the silicone will ooze out.”

       Miss Fit produced a sewing pattern and instructions, in case I wanted to add pockets to my own favorite bras. And for an extra bonus, my jolly sisters in survivorship threw in a foam breast form that could be pinned in a swim suit. With my finances in a mess, I gratefully accepted their donations, saving me about $260.

       Thanking them, I drove away wearing my new breast, sticking it out proudly when I got home. Tom gave it a quick squeeze saying, “Wow, just like the real thing. This gives new meaning to the phrase ‘putting up a false front.’” We wrapped our arms around each other’s slim bodies, giggling, as I told him about the cheerful volunteers and showed him the ridiculous cast-iron bra. He said, “Okay, where’s that sewing kit?”

       When I was diagnosed, we’d been married only fifteen months, and the blessing that I did understand was being able to laugh or cry with him and to be totally accepted no matter what I looked like.

*   *   *   *   *

       In our bedroom in Philadelphia, I smiled at the funny memories and reflected further on my relationship with my prosthesis and the choices it led me to make. When I had two breasts, I never worried about revealing a small amount of cleavage and did not have to be on guard when bending over. But post-mastectomy, if I bent over while wearing the prosthesis, the bra and its contents gaped away from my skin, and anyone peeking would see one normal breast, smooth contiguous flesh flowing into the cup, and one expanse of shadowy nothingness, a lonely chest wall separated from the fake full cup. Consequently, modest necklines filled my closet, no plunging necklines, no spaghetti strap dresses or halter-neck tops. As it would take a gargantuan stretch of the imagination to call me a fashion queen, these wardrobe limitations did not unduly grieve me. Besides, with all the time I’d spent hanging around ashrams, I was accustomed to dressing rather modestly.

       What did impact me was not being able to discard my bra, and this frustrated me endlessly. I matured at university during the nascent women’s liberation movement, when droves of us rebelled against the fashion industry and male ideals of beauty, abandoning our bras, make-up and high heels. Before my mastectomy, I frequently enjoyed the comfort of going braless or, when I did wear a bra it was a minimal support lacy crop-top or some equally flimsy piece of lingerie, quite adequate to give natural support to my good-sized B-cup boobs.

       Post-surgery, during the winter when loose jackets and layers of clothes covered up the difference, I got away with going for a hike in the park or even to the store without my prosthetic disguise. In the summer it wasn’t so easy—during the cloying humidity was exactly when I abhorred extra constrictive undergarments. My right breast jiggled when I walked, like breasts are supposed to do, and without a bra stood out a good inch and a half further than my left chest. It was difficult to hide. Usually in my life I’ve chosen comfort, but in this respect I was not willing to sacrifice my appearance for my comfort. It wasn’t that I felt less of a woman because of my loss, (although naturally I was sad to lose a part of my body I always liked); my neurosis has always been that I didn’t want to be different, to stand out and attract attention.

       Think about it, have you ever seen a one-breasted woman walking blatantly on Philadelphia City Center streets? Imagine a lone mammary bouncing around, outlined by the clinging fabric of a summer top. Would I be brave enough to be the first one to do it, to be a trendsetter? I wasn’t that bold, but I wish I was. I never believed it when people said, “You could do it. No-one would notice.” But don’t people notice if someone has only one eye, one arm or one leg? Was I the only observant person who could count the number of breasts under a woman’s tank top? Summer was indeed the time when I wished that my remaining boob was like an aspirin on an ironing board.

       Tom was reabsorbed in his reading, and I, grateful for our cool bedroom, put on some Ravi Shankar music with Sanskrit chants and lay down on the bed to relax. Drifting into reverie, I recalled the time when I listened to an inspirational tape about getting your life together, and the narrator surprised me by talking about the ways she knew she had recovered from breast cancer. One item on her list was that she no longer stared at other women’s breasts. “Oh good, I’m not the only one who does that,” I thought. But by that standard, I wasn’t yet fully recovered. My eyes were still drawn to other women’s cleavages. I envied women with perky little breasts who didn’t need a bra. I didn’t live as easily in my body as I used to. I couldn’t just throw on a tee-shirt and get up and go. Or I could, but I would obsess about what others thought about my lopsided look.

       People may wonder why I didn’t have reconstructive surgery to avoid all these issues. Nearly all the post-mastectomy women with whom I’d discussed the topic chose to have it. Periodically when I looked wistfully at other women’s cleavages and ease of dressing, I thought, maybe I could still have reconstruction. But I reminded myself why I made the choice that I did back in 2002.

*   *   *   *   *

       It was early May, before the summer tick population exploded in the Oklahoma oak forest, so Tom and I were enjoying a walk looking for fauns and baby wild turkeys. As usual I wore my lavender cotton sunhat to protect my bald head. “Tom, y’know the mastectomy is in early June. I need to decide if I want reconstruction.”

       “You could still have a spontaneous remission and not lose your breast.”

       “Yes, I’m hoping and praying for that. But I need to be prepared for whatever happens. Some women really love their reconstructed breasts, but I looked at photos on the internet and they were funny shapes, blotchy and different sizes.”

       “You wouldn’t want to go through the extra trauma to your body and end up with something like that.”

       I couldn’t agree with him more. Coming from a world of natural medicine, having chemotherapy and considering surgery already put me in foreign and scary territory. Just having a mastectomy would be asking enough of my body. But I had to be informed of all my options. “I found out that one way of doing reconstruction is with an expander. It stretches the skin of the chest, and then they put saline implants under the skin. It sounds painful, and I wouldn’t want to live with something that’s not me under my skin.”

       “It would probably be smaller than this luscious piece of flesh,” he said, slipping his hand up my tee-shirt. We stopped for a quick smooch by a white flowering dogwood tree.

       “The other method moves a chunk of tissue from the abdomen up to the chest. Look,” I said, as I bunched up the flab of my belly, “If this were made into a boob, I’d have a flat tummy as a bonus.”

       Tom always said the right words. “Ali, you’re such a svelte little thing. You don’t have enough fat there to match the other one, so your right side would end up being bigger. Besides, cutting into your belly would weaken your tummy muscles and compromise your bad back.”

       “You’re right. And the other option uses shoulder tissue, another place I don’t want to weaken. I don’t want to put my body through unnecessary trauma, so reconstruction isn’t for me.” I raised my voice, “But the alternative is to wear a bra and prosthesis all the time, or not wear one and feel like a one-breasted freak. What a hassle! It really pisses me off that women’s bodies have to conform to a certain image.”

       “Whatever you do, I support you.”

       “I really feel that one surgery is enough.”

       “You’re going to be just as beautiful without this lovely squeezable, but I will miss it.” Tom nuzzled me softly. As we      held each other, the flock of wild turkeys came up over the hill, a good omen for my decision. Surely I could learn to love myself with only one breast.

*   *   *   *   *

       As the music came to an end, I stretched out on the bed, pushed the memories aside and groaned at the thought of making dinner in the kitchen that was like a sauna. But it was too hot to get dressed, put the bra on and go out. I still felt that the decision to avoid reconstruction was the right one, appreciating that my prosthetic breast allowed me to hide my asymmetry, to pass in public as a normal two-breasted woman.

       When it was placed in a good mastectomy bra, and I finally obtained comfortable ones with molded cups from my fitter in Philadelphia, you would have to give close scrutiny to notice any disparity. I silently chuckled on the occasions when the conversation led me to tell an acquaintance or co-worker, “Yes, I had a mastectomy,” and I saw their eyes dart, almost like a reflex, to scan my chest surreptitiously and then back to my face.

       “I wouldn’t have known,” they said, or even funnier, “Well you’re looking really good.” Did that mean they saw the healthy glow in my cheeks, the light in my eyes or were they referring to my attractive bust line? And were they trying to figure out which one was false?

       Some women name their prosthetic breasts. Mine is simply my boob. It’ll probably be my lifetime companion, although there may yet be times when I am brave enough to go without my boob in public. Would I say without reservations that I feel affection for my prosthesis? Maybe not, given my ambivalent feelings, but what I know as truth is that my prosthetic breast is, and always will be, close to my heart.

August 2007

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The Garden of Beautiful Flowers

by Alison Hammer Winans

Written nine days before she passed, and dedicated with love to Jeanne Ayesha Lauenborg

7/27/1945 – 6/18/2007

      There is a sanctuary where I go during guided meditations when the leader says, “Go to a place where you feel safe.” And sometimes I go there alone to seek replenishment and an escape from our cramped lodgings.  My inner landscape used to be an empty windswept plain, a clearing in the woods or an open sunny meadow.  But ever since my recovery from cancer it is a lush garden, humming and pulsing, a magical garden redolent of northern California, Hawaii and England.  I say this garden is paradise, not because lions are lying down with lambs, but because there are no mosquitoes, and the mugwort, orchids and primroses flourish in unison.  It is everything I want it to be.

      Today I want answers to eternal mysteries.  This morning as I held Ayesha’s bony hand, she said, “Ali, I need to…”  She drifted off, then re-opened her eyes and tried again.   “I want to establish reality.  Am I here?”

       “Yes, you’re here, my friend.”

       “Am I in my body?”

       “Yes, you’re in your body.”  It is her body, although skin stretches over her skull like the head of a drum and loose flesh on her limbs flaps like prayer flags.

       “Am I dying from cancer?”

       I faltered and then said simply, “Not yet.”  But when does she stop living and start dying?  Where is that line?

      Now I lie on my bed, close my eyes and invite the image of my garden.  So grateful to be lying down, I relax my muscles and pass into another reality between the two guardians, grandmother banyan trees, broad-leaved and entwined with medusa-like vines.  Bird-of-paradise flowers and glossy red anthuriums stand strong.  Under the canopy there is a flash of color, a parrot’s squawk, the constant whirring of cicadas, the moist earthy smell of frilly orange fungi.  Every springy step releases the fragrances of pineapple weed and pennyroyal, fruity and medicinal.  A tropical heady scent draws me deeper into my favorite arbor.  Jacaranda trees are dripping with tubular blue flowers and tiger orchids growing from the bark, while trellises of white plumeria, jasmine and trumpet vine buzz with bees and provide a resting place for monarch butterflies lazily opening and closing their wings, intoxicated by the perfumes.

      A ruby-throated humming bird chatters in a tree, then in a flash of iridescence flies a circle around me, and comes back to his branch.  “Hummingbird, when do we stop living and start dying?”  It seems like the right kind of question to ask the only bird that can fly backwards as well as forwards.  He kisses a vermilion trumpet vine, comes back to hover close enough that I feel the fanning of tiny wings, and then zooms through the gate between my eyebrows into my head.

      I am spinning out into the relative universe where life and death are the same, and my avian guide says, “It all depends from where you are looking and how fast you are moving.”  I feel that something important just happened, but I am not sure what it is.

      So I continue along the path, footsteps releasing the woodsy aroma of variegated and lemon thyme.  Sunlight streams between the oak trees, squirrels are chasing, bush tits are twittering, and a choir of warblers and vireos sing anthems.  I look carefully amongst the scattered acorn cups for signs of a fairy tea party.  When I was little, I wanted to be a fairy, and here I recognize their presence, as time seems to shimmer and a numinous stillness develops.  I sit on a moist moss-covered rock beside a constant flowing spring that creates a magical pool filled with leaping frogs, water lilies, giant pink-yellow lotus blossoms and koi, white with orange spots and orange splashed with white.  The spring burbles and the wind whispers through the leaves, “Ayesha.”

      In front of my eyes a robust caterpillar appears, lime green with horns and eye-spots, hitching a ride on a spider web. Catching it on a leaf, I say, “Caterpillar, what is it like to die?”

       “To me death is transformation.  You have to let the structure disintegrate and the elements come together in another form.”  My, this is a scholarly caterpillar.

       “Thank you,” I say, putting it down carefully.  But I still don’t know what death really feels like.

      Going deeper, there is a tall privet hedge that walls off a secret garden.  A squeaky wrought iron gate covered in cobwebs opens into an English rose garden with honeysuckle trellises.  Around a central fountain are beds with a joyful profusion of forget-me-nots, snapdragons, marigolds, sweet peas and delphinium, not in soldier-like rows but in nature’s ordered chaos. Every flower holds a memory for me—fragrant sweet peas climbing the wall and companion plantings of sunny marigolds amongst the vegetables in my California garden, carefully drawing in biology class the many-layered parts of purple delphiniums like a dancer’s fancy petticoats, squeezing snapdragons to open their “mouths” with my grandmother.   I carefully remove a honeysuckle flower and suck out the ambrosia.  My tongue is alive with sweetness.  A monarch butterfly alights on my arm.   “I’m sorry if I’ve taken some of your food,” I say.

      The butterfly dances around my head, then delicately sips from a flower and lands in the palm of my hand.  I must be forgiven.  “Butterfly, how do you fly so many miles without dying?”

      My royal friend unfurls and curls its proboscis, like a yogini rolling up from a forward bend, and says, “None of us could do it on our own.  We stay together to uplift each other.  Together we arrive at our destination, separate we would fail to reach the goal.”

       “Thank you.”  The butterfly joins its friends, while I continue walking between clumps of pale yellow primroses, breathing in deep the pungent aroma of grey-green mugwort leaves.  A skinny brown rabbit with alert ears hops in front of me nibbling on parsley and sage.  Her shiny brown eyes watch me as I say, “Rabbit, why do we suffer so much?”

      She comes close, her nose catching my tears as they fall and says, “I will show you.”  She hops along the path slowly enough that I can follow her outside the privet hedge.

      And then we are in a hot dry meadow where the lazuli buntings glean grain kernels and the crickets chirp and the violet-green swallows swoop down catching flies.  There is a spinning wheel with a woman singing, and this must be Ayesha in days gone by, with long red hair, clear grey eyes and a captivating smile.  She appears not to notice me as she spins piles and piles of straw into gold.  Understanding begins to dawn within me.  She works harder and harder, until I see yards of a golden gossamer cloth emerging, sparkling with ethereal colors, finer than the morning mist.  Ayesha stands, wrapping the cloth round and round her body, and she twirls and circles like a dervish, faster and faster until she dissolves into a column of golden light reaching to the sky and beyond.  I still hear her sweet voice singing, “Shemaya, the light of the universe, shemaya,” and I feel the ecstasy of her smile in my heart.

      Now I am ready to leave my sanctuary carrying the magical gifts of wisdom and beauty inside me.  I feel renewed and, for now, at peace, knowing that tomorrow when I hold Ayesha’s hand I will imagine her clothed in gold, singing, twirling, smiling.