The Reality of Getting a BRCA Test

I’m nervous for the appointment. They called me to schedule it after all. Ominous. I never intended to actually go when my doctor recommended it at my physical.

“Sure. That sounds good,” I said, sending the idea down the river. No intention of following up.

Damn.

I’m off work early and have time to go home beforehand. I pet the dog on the couch, change out of work clothes. For some reason I agonize over my footwear for the appointment. I want to look like I can pay for the test and also digest the situation. I don’t wear my Toms.

I put on my raincoat, arrive early. I circle around Mary’s House in the Sacred Heart complex. I think about her beautiful home, her stubbornness in not selling. Buildings looming above her craftsmen home. There’s a sign that reads “Mary’s Parking Only.” Two men smoke cigarettes in front of her spaces. Progress. Change.

Parking is ridiculous. I get lost and end up parking in a lot I know I don’t have cash for. Ever the responsible adult, I pop a single dollar bill into the slot, knowing I’m short two dollars. I silently judge any parking meter maid ticketing at a hospital and think, “I dare you to give me a ticket today.”

I’m outside the cancer wing and I don’t give a shit. Not today. A preventative mastectomy exceeds $100,000, after all.

When I arrive at the office I’m greeted by framed national park posters and a Tibetan prayer bell falling off the wall. I’m instantly comforted and learn my genetic counselor is a climber.

I wait. I recognize her. Thin, freckly, clog-wearing. We shake hands. I mention the climbing gym and she’s taken off guard. All business.

There’s a notepad on a small circular table. She writes percentages, draws pie charts and explains my risk, eyes shining with excitement.

There’s BRCA1, BRCA2, my family tree, our combined illnesses. The page is scribbled with ink and she’s running out of room. There’s an increased risk of ovarian cancer too, she explains.

“Do you want kids?” she asks. “You can get your ovaries out after your childbearing years, you know, 35 to 40,” she says lightly.

I’m 31. My eyes glaze over.

“There isn’t a test later,” she chuckles.

The genetic counselor’s intelligent; not cold but not warm, either. Like an engineer with light social skill deficits, excitable over numbers and graphs. Judgmental when I bring up a mental health component to my mom’s illness.

“You can’t tell a geneticist that someone can think themselves into cancer,” she tells me.

“You didn’t live with her,” I think.

I tear up at one point. She’s very late on the tissue box pass across the table, and slides it over dejectedly. She makes a climbing-BRCA metaphor joke. “There’s more than one way to clean a climbing anchor,” she says.

There’s only one way to pass this test, however. I’m high risk. Mom was too young. Just 36. I’m a slam-dunk for the test regardless of my otherwise bare family tree and my 90-year-old grandmas.

“Insurance will approve it. Its preventative in your case,” she says. “Oh good,” I say quietly.

Then its talk of life insurance, the possibility I’ll be rejected for a million dollar policy tomorrow if I test positive today. The possibility I’ll have difficulty getting insurance later with a pre-existing condition. “There are so many changes in our medical system and insurance right now,” she trails off.

“I don’t really care,” I mutter.

I don’t have any children. I don’t have a mother. Just these tiny, worthless, potentially hazardous breasts.

After the medical assistant with mild chin hair and Minnie Mouse scrubs takes my blood, it’s follow-up appointment time. I’m pale after the blood draw, dizzy. The crook of my left elbow pulses where the needle stabbed me. The geneticist has jury duty so I’m pushed out another week for scheduling. I accommodate.

“Four weeks from now,” the receptionist clucks. “June 5 at 11:15 a.m. OK?”

“Fine,” I say.

You died that day, 15 years ago.

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Getty Images photo via mrljanica