“Why not? You're the doctor.”

“Because there are choices to be made, involving more or less risk, and more or less discomfort. It's your body and your life, in the final analysis, and you must make the decisions too. But with early detections such as these, I almost always suggest a mastectomy. It's a great deal wiser and surer. You can always have reconstructive surgery within a few months to restore the appearance of the breast, if you wish to.”

He made it sound like having a fender put back on a car, and not a breast on her body. And she didn't know it, but his preference for mastectomies as the surer cure was what had earned him his conservative reputation.

“Would you do the biopsy and the mastectomy on the same day?”

“Normally not. But if you prefer it that way, we can. You seem to be a very busy woman, and it would save you time, if you're prepared to entrust me with that decision. We can work that out beforehand, in the event of certain findings. We would have to plan that carefully.” Of course, she thought of Sam, to avoid a lawsuit. And then she thought of something else.

“What if I turn out to be pregnant in the next few weeks?”

“Is that possible?” He seemed surprised, and she felt faintly insulted. Did he think she was too old to have babies, just tumors?

“I've been taking Serophene and trying to get pregnant.”

“Then I would think you'd want to abort, if you were, and proceed with treatment. You can't afford to let something like this go for eight or nine months. Your husband and family need you, Mrs. Parker, more than they need another baby.” It was all so coldblooded and so simple, like the razor-sharp edge of a scalpel. She still couldn't believe what she was hearing. “I'd like to suggest that we schedule your biopsy for a week from next Monday and you come in to see me before that to discuss the options.”

“There don't seem to be very many of those, or am I missing something?”

“I'm afraid not, at this point anyway. First we have to see what you've got there. And then we can decide what to do about it. But you should know that my preference is almost always mastectomy in the case of early cancers. I want to save your life, Mrs. Parker, more than your breast. It's a question of priorities. And if you have a malignancy that deep in your breast, you may be a lot safer, and better off, without the breast now. Later, it may be too late. It's a conservative stance, but it's one that has proven to be reliable over the years. Some of the newer, riskier views can be disastrous. Doing a mastectomy early on could well be a great deal safer. And if indicated after the surgery, I'd want to start an aggressive course of chemotherapy four weeks after the surgery. This may sound frightening to you now, but six or seven months from now, you'll be free of the disease, hopefully forever. Of course, I can't recommend that to you now. We'll have to see what the biopsy tells us.”

“Would I still be able to …” She could hardly bring herself to say it, but she knew she had to. She wanted to know, since he had been so free about suggesting an abortion if she were pregnant, “…would I be able to conceive afterwards?”

He hesitated, but not for long. He had been asked this question before, though usually by younger women. At forty-two, most women were more interested in saving their own lives than in having babies. “It's possible. There's about a fifty percent sterility rate after chemotherapy. But it's a risk we'd have to take, of course. It could do you grave harm not to have it.” Grave harm? What did that mean? That it would kill her not to have chemo? It was a nightmare. “You'll have time to think about all this, during your trial. And I'd like you to make an appointment whenever possible. I'll try to accommodate your schedule as best I can. I understand from John Anderson that you're a very busy attorney.” He almost cracked a smile, but not quite, and Alex wondered if this was the “human” side John Anderson had referred to. If so, it was very small in comparison to the cold-blooded technician and scientist he was the rest of the time, when he was not being “human.”

He scared her to death with his icy factual explanations, but she also knew of his excellent reputation. What she needed was an excellent surgeon, if it turned out that she had a tumor and it was malignant. And she could have Sam to boost her spirits.

“Is there anything else I should explain to you?” he asked, and surprised her with the question. But all she could do was shake her head. It was worse than what she'd heard the day before, and he had completely overwhelmed her. She could already imagine herself without her left breast, and undergoing chemotherapy. Did that mean she would also lose her hair? She couldn't bring herself to ask him. But she had known women who had been through it, and worn wigs, or had the shortest of short haircuts. She knew what everyone did, that if you had chemotherapy, you lost your hair. It was just one more affront to a rapidly growing list of terrors.

She left his office in a daze, and when she got back to her own office, she wasn't even sure what the doctor looked like. She knew she had spent an hour with him, but suddenly his face was blank, along with almost everything he had said except the words tumor and malignancy, mastectomy and chemotherapy. The rest was an indistinguishable blur of sounds and noises.

“Are you okay?” Brock walked into her office almost as soon as she got back, and he was shocked at how she looked again, and very worried. “You're not getting sick, are you?” She already was sick, probably, according to her doctors. It seemed incredible. She felt perfect, nothing hurt, she wasn't ill, and they were telling her she probably had cancer. Cancer. She still couldn't bring herself to believe it. Nor could Sam.

She told him that night, when she got home, everything Dr. Herman had said, and Sam just brushed all of it off again, with the same calm, easy insistence.

“I'm telling you, Alex, these guys are protecting themselves against malpractice.”

“But what if they're not? What if they're right? This guy is the biggest breast surgeon in his field, why would he lie to me just to cover his own ass?”

“Maybe he has a big mortgage on his house, maybe he needs to take so many boobs off every year to cover it. What do I know? You've gone to a surgeon, he's not going to tell you to go home and take an aspirin. Hell, no, he's going to tell you that you need to take your boob off. And if nothing else, he's going to scare the hell out of you, to cover himself, just in case you do have something there, which I don't believe for a minute.”

“Are you telling me he's lying to me? That he'd do a mastectomy even if I didn't have cancer?” Cancer. They were saying it now like “Kleenex,” or “microwave,” or “nosebleed.” It was a dreaded word that had become part of her daily vocabulary, and she hated hearing it, especially when she said it. “Do you think this guy is a complete charlatan?” She didn't know what to think now, and Sam's attitude was making her crazy.

“Probably not. He's probably basically responsible, or Anderson wouldn't be recommending him to you, but you can't trust anyone, not doctors anyway.”

“That's what they say about lawyers,” she said glumly.

“Baby, stop worrying. It's probably nothing. He'll make a little cut in your breast and find out there's whipped cream in there, sew it up, and tell you to forget it. Don't put yourself through this in the meantime.” He was so purposely blithe about it that in some ways it made her even more nervous.

“But what if he was right? He said that masses like this, this deep in the breast, are more often malignancies. What if it is?” She kept trying to make him see what was happening, but he just wouldn't.

“It won't be a malignancy,” Sam insisted doggedly. “Trust me.” He absolutely refused to hear what she was saying. He seemed to be shielding himself from the realities with optimism and good humor. His insistence that nothing would happen to her made her feel suddenly lonely, and although she desperately wanted to, she didn't entirely believe him. All he had done was shake her faith in both Dr. Anderson and Dr. Herman. So much so that on the second day of the trial, she used a brief recess to call one of the other doctors Anderson had recommended.

She was younger and had published fewer articles, but she was just as respected, and reputed to be just as conservative as Dr. Peter Herman. Her name was Frederica Wallerstrom, and she agreed to meet Alex before court the next day, at seven-thirty in the morning. And when Alex met with her, she wanted Dr. Wallerstrom to be the solution to all her problems. She wanted her to be nurturing and warm, tell her that her fears were in vain, and that more than likely the tumor would be benign, and none of the horrors she had heard would apply to her. But Wallerstrom looked extremely stern, said nothing at all as she examined first Alex, and then the films, and when she spoke, her eyes were cold and her face entirely without emotion.

“I'd say Dr. Herman was being quite accurate in his assessment. You can never tell of course, at this stage. But my guess would be that it's probably malignant.” She didn't mince her words, and she seemed unconcerned with Alex's reaction. As she listened to the woman with the cropped gray hair and powerful hands like a man's, Alex felt her own palms grow damp and her legs start to tremble. “We could be wrong of course, but you develop a sense of these things,” she said coolly.

“And what would you recommend if it is malignant, Dr. Wallerstrom?” Alex asked, trying to remind herself that she was the consumer here, that she was auditioning this woman, and she still had options and choices. But she felt like a child, helpless and without knowledge or control, as the other woman eyed her with dispassion.