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But worst, by far, were the lumps in my breasts. Even now, I don’t feel entirely comfortable talking about it. I’ve shared this experience with very few people, and it’s difficult to break that silence. I don’t want anyone to look at me as less than a complete woman or, even worse, some kind of fraud.

Of all the things in my life—the alcoholic husband, the welfare, the surprise hysterectomy—my double mastectomy was by far the hardest. The worst part wasn’t the procedure, although it was probably the most physically painful thing I’ve ever endured. The worst part was the decision. I agonized over it for more than a year. I traveled to Sioux City, Sioux Falls, and Omaha, more than three hours away, to consult physicians, but I couldn’t make up my mind.

Mom and Dad encouraged me to have the procedure. They said, “You have to do it. You have to get healthy. Your life is at stake.”

I talked to my friends, who had helped me through the end of my marriage and so many problems since, but for the first time they didn’t talk back. They couldn’t deal with it, they admitted later. Breast cancer hit too close to the bone.

I needed to have the surgery. I knew that. If I didn’t, it was only a matter of time before I heard the word cancer. But I was a single woman. I dated fairly regularly, if not particularly successfully. My friend Bonnie and I still laugh about the Cowboy, whom I met at a dance in West Okoboji. We met up in Sioux City, and he took me to one of those country places with sawdust on the floor. I can’t tell you about the food because a fight broke out, someone pulled a knife, and I spent twenty minutes huddled in the women’s bathroom. The Cowboy graciously took me back to his house and showed me—I kid you not—how to make bullets. On the way back, he drove me through the stockyards. He found it romantic to see the holding pens in the moonlight.

And yet despite the flops, I still hoped for the right man. I didn’t want that hope to die. But who could love me without my breasts? It wasn’t losing my sexuality I was worried about. It was losing my femininity, my identity as a woman, my self-image. My parents didn’t understand; my friends were too scared to help. What could I do?

One morning there was a knock on my office door. It was a woman I had never met. She came in, closed the door, and said, “You don’t know me, but I’m a patient of Dr. Kolegraff’s. He sent me to see you. Five years ago, I had a double mastectomy.”

We talked for two hours. I don’t remember her name, and I haven’t seen her since (she wasn’t from Spencer), but I remember every word. We talked about everything—the pain, the procedure, the recovery, but mostly the emotions. Did she still feel like a woman? Was she still herself? What did she see when she looked in the mirror?

When she left, I not only knew the right decision, I was ready to make it.

The double mastectomy was a multistep process. First, they took my breasts. Then they installed temporary implants called expanders. I had ports under my arms—literally tubes that stuck out from my flesh—and every two weeks I received a saline injection to expand the size of my chest and stretch the skin. Unfortunately the dangers of silicone implants exploded into the news during my first weeks of recovery, and the FDA placed a temporary ban on new implants. I ended up keeping my four-week temporary expanders for eight months. I had so much scar tissue under my armpits that I got shooting pains down my sides whenever the barometric pressure changed. For years, Joy asked me every time she saw a dark cloud, “Vicki, is it going to rain?”

“Yes,” I’d say, “but not for another thirty minutes.” I could tell when the rain was coming to within ten minutes just by the level of pain. Once it reached crippling, the rain was almost here. Joy and I would laugh, because I was almost always right, but I really just wanted to sit down, right where I was, and cry.

Nobody knew my pain: not my parents, my friends, or my staff. The doctor dug inside my body and scraped out every ounce of flesh he could find. That hollow, sore, scraped-out feeling was always with me, every minute, but sometimes the pain would wash over me so suddenly and so savagely that I would drop to the floor. I was out of the library, on and off, for most of a year. Many of the days I struggled to my desk I knew I shouldn’t have been there at all. With Kay in charge, the library could run without me, but I wasn’t sure I could run without it. The routine. The company. The feeling of accomplishment. And most of all, Dewey.

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