Beating Breast Cancer and the DMV

Many people know October is Breast Cancer Awareness Month. There are walks and marathons fundraising for research. There are stories in the news about the latest screening guidelines or treatments. Pink ribbons abound. Even my Ralph’s coupon flyer was filled with inspiring stories of survival.

Never have I been more aware that October is Breast Cancer Awareness Month. That is because I had become one of the 231,840 women who were diagnosed with breast cancer in the United States in 2015.

On July 4th, 2015, I felt a lump in my right breast. A biopsy confirmed I had invasive breast cancer. I was devastated.

“I will do anything to see my little boy grow up,” I cried to my husband. “I don’t care about surgery and chemo. I just want to live,” I pleaded.

Shortly after my diagnosis, I underwent a painful double mastectomy with reconstruction followed by chemotherapy.

It felt like my body had been tossed into a rough sea for months. Damaged by an outside force of great magnitude. The pain of surgery paled to the collateral damage produced by chemotherapy.

Fatigue, tingling toes and fingers, liver damage, chemically induced menopause, immunosuppression, and isolation.

And, of course, the hair loss.

The funny thing was, hair loss was what bothered me the least, if at all. I had an almost sick curiosity about how I would look bald. I had decided I would “own” it, not care if people stare. I wouldn’t need a wig. I would get some cute scarves and stand this thing down.

The day I woke up and found my pillowcase looked like a fur coat was the day my husband and I buzzed it off. My husband told me (bless his heart) that I actually looked “kind of good” bald.

My mother looked at me and said, “You know Annie, you look very distinguished bald.”

I replied “Yes mom, you are right. A woman with no hair is, by definition, distinguishing.”

And just when I was owning my baldness and standing cancer down, the DMV intervened.

It just so happens my birthday is in October. It just so happened my license was expiring that October and my previous two renewals were online. I was not eligible for another online renewal.

When I got my notice to renew, I panicked. I was worried about being in the crowded DMV in my immunocompromised state. I spoke to an annoyed supervisor on the phone to see if I could get an extension.

“I have cancer and am on chemotherapy, my immune system is weak. I shouldn’t be in public. If I get sick, it could become life-threatening,” I said.

The supervisor wasn’t interested. She told me I didn’t qualify for the renewal service they offered to “bedridden” people only. I had to go in or let my license expire. Resigned to my fate, I made an appointment to renew in person.

I had a good friend come with me. I put on a cute scarf and a mask and walked into a crowded DMV. The appointment line was as long as any other. I was tuned in to every cough and sneeze. Thankfully, my girlfriend quickly adapted her roll from moral support to keeping my place in line while I could wait outside.

My final step was the picture. I got to the front of the photo line and stood in front of the camera. “You have to take off your scarf,” the lady behind the counter said.

“I can’t,” I replied. “I’m on chemotherapy and I don’t have any hair.”

The supervisor came over. “It doesn’t matter,” she told me, “You have to take it off.” She then whispered, “Why don’t you come back later when no one else is here and take your picture then.”

But she didn’t get it. I didn’t care about being bald in front of her or all those other people in line. Thats when I realized it was the idea of that picture on my license, bald and sick. It would serve as a reminder of breast cancer every time I took it out of my wallet. I then realized I was not standing this thing down when it came to looking at myself.

And I almost started to cry. Almost.

“I can’t take my scarf off for religious reasons!” I blurted out.

The supervisor and her employee paused. After a few minutes of confused activity, they presented a two-sided paper with multiple sets of instructions on both sides. “Fill this out and sign here. I will take care of the rest,” the employee said.

I quickly wrote my purpose with a shaky hand, signed the paper and took my picture with a scarf on my head. I turned to my girlfriend and sighed. “I hope I didn’t just put myself on some watch list.”

I could go on about how cancer changes your life. The abrupt face-to-face with mortality is a shock to the system. A shift of this concept from abstract to palpable is a powerful catalyst for change.

Cancer slows you down and makes you reassess everything you thought you knew to be true. But just when you thought all of your thinking has helped you come to terms with and accepted your cancer, this disease can surprise you.

The creative little ways cancer reminds you that it is in your life, forever, are innumerable. I hope that sharing my experience can add to the conversation about breast cancer awareness.

The DMV is a nightmare on your best day. The DMV should change its policies, focus on empathy and spare everyone in a similar situation this painful reminder of their illnesses and all of its battles.


So here I am, two years later, reflecting on all of the little reminders that I am a breast cancer survivor. They are peppered into every day of this powerful month of October. I can now say that my driver’s license picture, with my big smile and scarf, still serves as a reminder, but not of my weakness.

Anne Koch drivers license image

This picture serves to remind me of my fight and how I not only beat the DMV, but also beat this terrible disease.

Disclaimer: This is a personal essay, produced in my own time and solely reflecting my personal opinions. These statements do not represent the views, policies or opinions of my employer, past or present, or any other organization with which I may be affiliated.

This post was originally published on Medium.

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