At first, they were nothing but trouble.

“I want her to wear a shirt from now on,” my father barked at my mother. He refused to address me now that I had the smallest hint of breast development. 

A short time later, as my tops clung to my chest and my flat torso became round and foreign, I felt weird and ugly. 

By my mid-teenage years, I began to recognize the power they bestowed on me as men and boys stared. It was as if I was doing something clever by developing breasts.

The benefits continued. 

“I adore your body,” my boyfriend, who eventually became my husband, said admiringly. We were law students walking hand-in-hand in Central Park. It was a hazy, hot, and humid night in July. I was in a body-hugging tank top. I held his hand a little tighter.

“I’m married to a goddess!” my husband said when I became pregnant, marveling at his role in fertilizing my body. My boobs inflated and my stomach remained flat. 

As my breasts and belly continued to expand beyond what I considered reasonable or even possible, my husband and I debated names over dinner. We chose boy names and girl names knowing we could reserve our favorites for the future. Those were the days when I confidently mapped out our lives. I would continue to work four days a week and we would have two children, preferably a boy first and then a girl. They would be planned four years apart because the pregnancy and child-rearing books said that a four-year age difference was the ideal amount of time to allow for secure attachments.  

I sketched our future as if I were planning a vacation. Steven, busily building his career, paid my chatter little heed. If I was happy about our lives, he was relieved. It was a pattern that would stick.

On October 29th, when Max was delivered by emergency C-Section, my body was thrown into chaos. Ripped open and sewn back together, bleeding and weak, I only cared about a primal love I could never have anticipated. I felt my need for him in every cell of my being. 

 Despite my father’s earlier admonitions to cover up, my top torso became constantly naked and on display. 

“Is he latching?” asked family, friends, nurses, and strangers as they paraded through the hospital room. I nodded yes and fumbled to attach my new son’s mouth to breasts which dwarfed his features. My breasts were the center of the show. Staring at Max meant staring at my exposed flesh. Aware that I should be more modest, all I cared about was Max. Milk, my milk, white and creamy looking, dripped out of his satiated mouth as he drifted to sleep on my breasts. I was madly in love. My breasts replaced the umbilical cord and connected me to Max. Three months of maternity stretched endlessly.  

“He’s in a milk coma.” I laughed as my husband watched Max droop and release my nipple from his lips. 

“He adores you,” Steven said with awe.

I learned to time Max’s feedings. With the help of a caregiver, I was able to leave Max for a few short hours, trying to pack too many errands into the stretches between feedings. My breasts ached for my baby. I had a limited amount of time before they would harden. At the first sight or sound of any baby, my breasts would start to leak into my nursing bra. I raced through the time we were apart, eagerly awaiting Max’s mouth’s embrace when he latched on greedily. I credited his solid growth and health to a combination of the nurse’s good judgment and my lavish milk production.

One morning, when Max was twenty-seven days old, the baby nurse walked into our bedroom and woke me.

“He’s dead. I killed him,” she said simply. The digital clock radio said 7:23 am. The apartment was oddly silent. Max wasn’t screaming for food and I had slept through his scheduled 6 am feeding. Steven and I followed her into Max’s room. My heart seized up at the sight of his tiny body dressed in a pale blue onesie, lying in his bassinet frozen in rigor mortis. My breasts keened. In those beautiful, dreamy first days of Max’s life, their only purpose had been to feed this now-dead baby. Nursing had joined us completely. At the sight of his stiffened and distorted body, my mind and my breasts rebelled. 

“No, no, no,” I screamed at my husband, pounding his chest as he squeezed me tight and stopped me from shattering into irreparable shards of sadness.

“I was tired,” the nurse said, “I didn’t feel well, and I took him into bed with me and accidentally smothered him.” 

Later we learned from the police that her sleeping body had rolled onto him, rendering him airless. He was asphyxiated. The police report called it an accident.

During every minute of that tragic morning, as our apartment filled with family, friends, and our rabbi, my breasts sat engorged on my chest. I felt the milk forming into hard bumps. There would be no baby to nurse that morning - no release of hardening milk or heartache. My industrial-sized, rented nursing pump remained on the side of the bed. I could have used it to manage the reversal of nursing begun by Max’s death. But I couldn’t bear the thought of milk coming out of my body that would not be used to bring him back to life. 

My husband’s aunt whispered in my ear, “Wrap them in cabbage leaves to help the release.”

My sister-in-law brought cabbage to the house. I took the leaves into my room and layered them under my bra.

The next day, as cemetery workers lowered him into the ground, heavy rain poured down on Max’s tiny, white casket. The pain in my breasts was unbearable as I read a eulogy of goodbye.

My Dearest Baby Sweet Pea, I have to say goodbye now. I love you my baby and I always will. When I held you in my arms, it was my greatest pleasure. You have left me with a great gift. I understand the value of life and what’s important in a way I could never get to on my own. I’ll hold in you in my heart forever. Sleep well my child, sleep well.

For days afterward, walking the streets with Steven was my only salve. It was impossible to stay inside our apartment. Outside, the occasional cry of a newborn caused the familiar clench of breast tissue. A fresh flood of milk and tears released together. 

“Imagine a huge ocean wave washing over you,” coached Dr. Emerson, our grief counselor. “The wave will recede leaving you feeling cleansed.”

 “Deep cleansing breaths,” said Steven, echoing her words. I would breathe through the waves of pain and sadness until the intensity lessened, just as our counselor said it would.  At times, my husband cried while I stayed calm.  

“The waves will come farther and farther apart over time,” Dr. Emerson said.  

The breast milk eventually dried up. My breasts and body returned to normal size, no longer visual proof of motherhood. I wanted my son back. 

With the help of a kind and talented fertility doctor, I became pregnant with twin girls. Two years after their birth, we conceived on our own. A son again! My breasts expanded and fed these three gorgeous children. I was a mother again and yet, I relentlessly mourned the son I lost. 

My breasts helped me heal. They bridged the gap between his death and life. Every cracked nipple, every tug, every new suck connected them to me and to Max. New joys and pleasures gained territory in my heart.

It's been twenty-two years since Max died. His siblings have grown. I have gratefully experienced the full arc of mothering. Several years ago, I felt small tugs inside my breasts that reminded me of the first days of nursing Max. I treasured the tugs and blithely forgot to schedule my annual mammogram. When I finally went for a mammogram, I relaxed while resting comfortably in the dressing room at my radiologist’s office. I curled up with old newspapers and the New York Times crossword puzzle, waiting to be summoned for a sonogram. It was hard to say which was worse, the deeply painful but quick mammogram or the half-hour long swirl of sonogram jelly over my breasts as the technician probed and captured endless images on the computer.

After dressing and paying, I walked down the hallway to the radiologist’s dark office. As usual, she was staring at her computer screen with the office lights turned off. The only glow in the room came from her screen.

“It’s probably nothing,” she said. “I see calcifications on your left breast and I want you to have a biopsy.”

It was Thursday. They scheduled my biopsy for the following Monday. 

I interpreted their extraordinary kindness as a bad sign. I panicked. Shallow breath after shallow breath made me think I might faint. I lost the ability to breathe deeply.

I underestimated the pain of a mammogram-guided biopsy.

“Please try not to move, I know it’s hard,” the doctor said patiently as she poked a needle in and out of my breast. The pain burned. Tears formed in my eyes and fell on my chest. I willed my mind to focus on a happy memory. I left with instructions to lie down for the next twenty-four hours and apply ice every twenty minutes, keep the area dry for five days, and wait to hear the results. There were no instructions about how to manage the panic and fear that I could die.

The phone rang thirty-six hours later. 

“You have DCIS. Left breast. I want you to have an MRI of both breasts and you need to schedule a lumpectomy. I’ll give you the name of a breast surgeon. You’ll be fine,” my radiologist added. 

If by fine she meant alive, she was correct. A diagnosis of DCIS, Ductal Carcinoma in Situ, also known as stage zero breast cancer, took dying off the table. 

After two more weeks of multiple breast MRIs and more biopsies, my radiologist called again.

“You have a bilateral, multi-focal point, grade three DCIS. A lumpectomy is off the table because your DCIS is grade three which is considered aggressive.  You need a double mastectomy. You’ll be fine. Call me over the weekend if you need me.” 

Her tone was cheerful and she hung up quickly as if we were simply discussing a change in the weather. 

I felt anything but fine. My grandmother died of breast cancer when she was fifty-four. My mother had a double mastectomy at seventy-five. Although my mother and I both tested negative for the BRCA gene, my family history dictated its narrative. My breasts, which had linked me so powerfully and happily to my husband and my children, which had brought me such pleasure and power were now inexorably pulling me back to the reality of my family’s history. Breasts equaled cancer. Also, my breasts held the history of my grief. It made sense that they were diseased. 

When my radiologist called with the news, I was driving along an unfamiliar highway on a Friday late afternoon. I pulled over to a rest stop and called my husband. He could barely understand me through my sobs.

“Stay where you are,” he said. “I’m coming.”

I was scared of dying, horrified by the doctor’s cavalier attitude, and overwhelmed by what lay ahead. But I recognized that I was okay when I couldn’t imagine waiting in a rest stop while I waited for my husband to drive in rush hour traffic on a Friday afternoon from Manhattan to New Jersey. Besides, I had the car.

That call began a journey of discovery and appointments that included four breast surgeons, three plastic surgeons, and one oncologist. They all confirmed the need for a double mastectomy. The only choice facing me was who would do the surgeries. The decision was enormous. All considered the best in their fields; they differed widely in their approaches. 

“The nipples must be removed,” said one head of her department. She explained how she would cut from underarm through each nipple in a long arcing slice that would leave a huge scar bisecting each breast horizontally.

“Implants under the muscle,” said the plastic surgeon she worked with. When I asked why I couldn’t have implants placed above the muscle to avoid having my breast muscle pulled away from my chest wall, he said it was impossible. “Above the muscle implants don’t look good.” 

“How about using my fat to create breasts?” I asked, searching for the correct language to describe autologous transfer and microsurgery.

 “You are not a candidate,” he said, squeezing my tiny amount of stomach fat and pointedly ignoring my ample supply of thigh fat. “Besides, it can be up to a sixteen-hour surgery.”

I booked the slash and replace surgery, fretting about the decision.

“Come to a bra-decorating party,” a friend said, inviting me to the office of a plastic surgeon who gathered her patients together annually for makeovers and rose wine. Everything pink and flowery greeted me as we joined strangers to drink and eat pink food. In one exam room, several women wielded glue guns to attach butterflies and other decorations to bras; the wilder the better. The bras were displayed on every wall. We were urged to vote for our favorite bra. After casting my vote and placing bids on silent auction items, I wandered room to room until I stumbled upon the plastic surgeon deep in conversation with another doctor. When I apologized for the intrusion, they both greeted me with huge smiles. 

I booked an appointment for the next morning.

During a four-hour consultation, and a follow-up with a breast surgeon, the two women doctors explained all of my options in great detail. Yes, I would need sentinel nodes removed. No, my nipples did not have to be removed; it would be a decision made on the surgical table by the oncology surgeon while I was under anesthesia. No, I didn’t need a long horizontal gash across my chest. The breast tissue could be removed with an under-the-breast cut. If the nipples needed to be removed, the doctor would use a lollipop cut. There was no reason to ruin the shape of the skin sac with the horizontal slice. And finally, yes, I was a candidate both for autologous transfer and above-the-muscle saline implants. They offered suggestions; the choice was mine to make. I felt confident this was the right team for me. 

I canceled the surgery I had scheduled with the other team. On November 6, 2017, I had a double mastectomy along with the beginnings of reconstruction with my new team. Two weeks later, my husband and I met with my breast surgeon.

 “The DCIS was widespread but non-invasive,” she said. “The pathology is clean. There is no need for further treatment.”

We cried with relief that my nodes were cancer-free. We thought we were close to the end of my health crises. But my body had other plans.

I developed seromas, cysts filled with fluid, as my right breast rejected the foreign implants. I had chosen above-the-muscle implants which required a greater amount of cadaver skin to envelop the implants. It seemed like a great plan. My body disagreed. For four months, I wrestled with drains and wound-vac machines, struggling to sleep or rest comfortably.

Then, early one Tuesday morning, after an extra surgery to replace the expander on my right side, I spiked a high fever. Crying in pain, I begged my husband not to leave me for work. He covered my freezing, sweating body with his own in an attempt to keep me warm while we waited for the ambulance to arrive. Within hours, I was under general having both of my expanders yanked out. Shingles followed and then more autoimmune problems. My doctors told me to wait before having replacement surgery again. My friends urged me to let my body rest. 

“Leave me alone,” my body was saying. “Don’t do any more surgery.”

I listened. 

When Max died, well-meaning friends assured me I would have new children to replace him. They were partially right. My three amazing children have expanded my life beyond my imagination. They couldn’t and didn’t need to replace my child that died. 

When my doctors told me that I would need a double mastectomy, friends and family assured me I would have great-looking, new breasts. But having new breasts was out of my reach. Lately, the news is full of reports about a minority of breast implants causing Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), as well as various autoimmune problems. 

I am flat-chested, healthy and grateful to be alive. My doctor was right. I am fine. I can never replace my breasts just like I could not replace my son. They marked my entry into the world of marriage and motherhood, and they joined me in disease to my mother and her mother. I am fortunate to have caught my disease at an early stage. I am made aware constantly of those who battle the disease and live under the shadow of fear. I face a future without breasts and full of promise.

-Valerie Feigen

Valerie Feigen is a fiction and memoir writer and cookbook author. She co-authored A Taste of Cuba with her childhood friend, Cynthia Carris. Valerie blogs under the name Recipistsdiary.com. She is the mother of three young adults and lives with her husband and four dogs.