Most people think they have a basic understanding of what radiation therapy is, but until you become a cancer patient, you don’t really know the half of it. The extent and manner in which they can deliver radiation nowadays will blow your mind. After the hysterectomy, they asked me to consult with a radiation oncologist. Because my uterine cancer was at a very early stage (IB), and they had successfully gotten it all with the hysterectomy, I fell right on the borderline criteria for needing radiation. The first thing my radiation oncologist said when she walked in the door was, “We’re both 35. I normally see grandmas and I don’t like the fact that you are here. It’s too close to home.”
Dr. V had long, wavy dark hair and a fantastic bedside manner. On our first visit, she presented the facts to me regarding my case and my decision, but she also inquired about how I was doing emotionally. I disclosed to her that I was still a virgin at 35 and just how broken I was feeling by my diagnosis. Dr. V didn’t even blink. She was empathetic and understanding. She felt more like a friend than a doctor at that brief moment. She went on to explain radiation would be delivered vaginally and it can cause vaginal stenosis, a condition in which the vagina becomes narrow and shorter due to the formation of fibrous tissue. To prevent vaginal stenosis, I would have to use vaginal dilators on a regular basis afterward. I would later learn that this was actually a significantly better option than alternatives, which included full pelvic radiation every day for 5 weeks or radiation delivered via long needles inserted into the vagina in the operating room. On the positive end, it would reduce the risk of my cancer recurring in the pelvic cavity, but the benefits were hardly on my mind walking out of her office. It felt like I had to choose between the lesser of two evils. Risk getting cancer again or risk my future hope of a good sex life.
My lady parts had already seen enough trauma, so the idea of a dry stiff cooch sounded, well… dreadful. Suddenly I imagined trying to have sex and a penis hitting my vagina like it was a brick wall. In my head, I heard that line in Lord of the Rings where Gandolf yells, “You shall not pass!” Now, I may be conservative and religious, but I’m not a robot, and this was hardly the stuff my best fantasies were made of. I had successfully managed two gynecological surgeries, the first of which fixed the physical cause of painful pelvic exams and accidentally discovered my cancer – resulting in the subsequent hysterectomy. The reality was my brain hadn’t caught up with my body yet. I still associated any pelvic exam with extreme pain, so after deciding to go ahead with radiation, I braced myself for torture.
On my first treatment, I was terrified. I walked the long hall to the locker room, changed into my gowns, and waited for a technician to come and get me. In the radiation oncology unit, there are two waiting rooms. One for patients being examined or consulted with and another for patients being treated. After changing, you sit in the second waiting room with other patients waiting for their treatment. It was bizarre to go commando under the gown in a room full of people. As a woman, the breeze down there feels so abnormal. Sometimes, other patients would strike up casual conversation. I met one mother who was commuting all the way from Ventura to bring her son for treatment. I always brought an extra blanket from the locker room to drape over me for modesty’s sake while I waited, but the reality of not having any underwear on felt like a big flashing neon sign over my head while we chatted about trivial things like traffic and the weather.
Dr. V met me in the prep room equipped with a CT scanner and other machines I had never seen. Nothing about the room was remotely warm or inviting. It was cold, metallic, and dark, apart from the bright pop of blue scrubs the technicians wore. Dr. V immediately read me like an FBI profiler and kicked every male tech out of the room. She could plainly see just how nervous I was. She sat me down and gave me a quick pep talk. I don’t recall what exactly she said to me but it worked. I laid down on the table and lifted my knees up. Dr. V said, “Okay, here we go. Cold and wet.” I flinched as she inserted what felt like a long probe into my vagina. I was desperately trying to relax, but still bracing myself for the pain when she said to my surprise, “Okay, that’s it.” After the tube was placed, she took several steps back and looked at my lady parts like a painter evaluating their latest masterpiece. I could almost picture her in a painter’s smock with an outstretched hand as if trying to judge whether or not she had the right perspective.
I then had a quick CT scan to check the position and they wheeled me off to another room that looked like a bomb shelter. They hooked up various long wires from the tube to another machine and asked what music I would like to listen to. Drawing a blank, all I could think to say was, “Frank Sinatra?” They failed to warn me about one last part of the treatment. After the technicians left, a strange man in a suit came in with an odd handheld machine that looked a bit like one of those big yellow flashlights with a handle. Without saying a word, he pointed it at my vagina and around the room and then promptly left. A nurse would later tell me he was the physicist checking the radiation levels. A heads up sure would have been nice. They locked the doors and I said a quick prayer for my lady parts, not exactly something I ever thought I would do.
I was now alone in this sterile room, counting the ceiling tiles, desperately trying to distract myself from both the idea of treatment burning the inside of my labia and my need to pee as I had to maintain a full bladder for treatment. A red light on the door went on to signal treatment was beginning. A slight warming sensation filled my vagina and Frank came on over the loudspeaker, cheerfully crooning, “I’ve got the world on a string sitting on a rainbow.” I couldn’t help but laugh at the absurdity of this song at this moment and the string-like wires attached to my vagina. The deep tension of my first treatment lifted and I recognized I could manage this. The anxiety that had been so acute for the past few years of my medical journey didn’t magically leave at that moment. Instead, I recognized that I wasn’t looking at “Mount Everest”. I was just looking at a staircase and I could climb a few more steps.
On my last treatment, I brought with me a thank you card and a $100 Coffee Bean gift card for the staff. In it, I explained that although my medical team was aware of my physical history, none were aware that I was among the many women that identified with the #metoo movement. I had been a victim years ago and had long since struggled to find my voice. I had also been deeply pathologized and made to feel like I was crazy when I first started having symptoms of cancer. I was told my painful pelvic exams were just because I was a virgin and nervous. For that reason, I was profoundly grateful for the extra care and respect they had shown me during my first treatment. Dr. V gave voice to what I needed without judgment and without me having to ask. She came in after my CT scan and put her arm on my shoulder and said with a glimmer in her eye, “I do not appreciate crying at 8:30 in the morning on a workday.”
Years ago, someone gave me a book called A Grace Disguised. It’s about how you grow through loss. I love the idea that there can be hidden nuggets of grace in our deepest seasons of pain. In the initial stages of my cancer journey, I had already suffered so much loss, yet I was starting to see I was much stronger than I realized, both emotionally and physically. There was a mountain amount of grief, but I somehow found the grace to laugh at the more insane moments. There was also grace hidden in my virginity. Let’s face it, we all have insecurities about sex, and prior to cancer and radiation, I had two big ones on the list. I had a #metoo story and I could hardly endure a simple pelvic exam without excruciating pain. Although my lack of success with dating was a deeply painful source of heartache, I think it could have been even more traumatizing had I been physical with men prior to my cancer. As crazy as it sounds, after treatment, I actually saw some hope for my sexual future. I have no delusions of perfection, but I can only hope another grace hidden in my cancer journey might be that my first time is just a tad less awkward. After all, it has to be at least a little bit better than radiation therapy.