Work Text:
Now look objectively. You have to
admit the cancer cell is beautiful.
If it were a flower, you'd say, How pretty,
with its mauve centre and pink petals
She finds the lump on a Tuesday.
It's the time of year when winter is grudgingly giving way to spring. On her morning runs, she watches the sun rise, listens to the day-birds waking with all their voices.
That morning she finds a small sparrow dead on the path, its body still warm. She stops to move it onto the grass and is astonished at its softness, the nothingness of its weight. In the cup of her palm its belly is a tiny hill of fluff and she has a sudden visceral memory of holding Joy--fingertips steepled to support the fragile neck, one little foot kicking her chest.
All the way home she feels the delicate feathers against her skin.
*
Once a month Lisa Cuddy lies naked on her bed and examines her breasts for changes. She has scrubbed away the sweat until her body tingles pleasantly. She has smoothed lotion in long strokes over her legs, arms and belly. Her hair is cool and wet against her scalp.
After more than forty years, she knows her body well. The serendipity of genetics and the discipline of effort have kept her limber and graceful, but the human body, she knows, tells its own time.
She begins with her left breast, palpating with the pads of her fingers, working inwards toward the nipple in a spiral. Part of her mind remains engaged in measuring the texture of skin and tissue, but the rest runs quickly ahead through the day. What she will wear. The quarterly budget review. The empty yellow room down the hall. House kissing her.
House. Kissing her.
Switching to her right breast, she allows herself to dwell on the yellow room, on House and the confusion on his face that night. She allows herself to imagine kissing him, and laying him down on this bed, and letting him put his big hands all over her one more time.
Then the lump. And a short, sharp pulse of fear. They register in her consciousness so closely together that she almost cannot say which one comes first.
Lemony sunlight streams through the curtains; birds call. The curve of her breast in her palm is the shape of the sparrow's belly.
She palpates again, more consciously, feeling for depth and breadth. The same area of her left breast is subject to a second examination for comparison.
In the last month this cluster of cells has grown large enough for her to feel with her fingers. For her brain to recognize it as something new, something that should not exist. It is firm and hard, deep in the center of the tissue, behind the nipple. A bad place for surgical options.
Even though she knows the small likelihood of the mass being malignant, the idea of it causes a pang inside her, like the sound of a stone dropped into an empty well. Like this lump is a stone that has lodged in her chest.
For a few minutes, she allows herself to be afraid. Then she puts it firmly from her mind while she dresses, dries her hair and drives to the hospital.
*
At 7.30 she's behind her desk, armed with her morning coffee. It's early enough that House won't be in for hours yet. Waiting for her computer to boot up, she calls Oncology and asks the nurse to notify her when Dr Wilson arrives.
At 8.15 her phone rings. She takes the stairs and doesn't think about how it's a brief and futile delay. It is, instead, good cardiovascular exercise, and excellent toning for her legs and ass.
Wilson's door is open, but she knocks anyway. "Dr. Wilson, do you have a moment?"
His smile falters as she shuts the door behind her. "Something's wrong," he says, slowly. "And since you're not yelling, I assume it's not about House."
"I found a lump this morning," she says. "In my right breast."
He takes a long, deliberate breath and leans back in his chair.
"There's no family history of breast cancer," she continues. "I don't have atypical hyperplasia or LCIS."
"Any visual changes or discharge?" he asks.
"No."
"When was your last mammogram?"
"Eighteen months ago."
"It's unlikely to be cancer, Cuddy," he tells her.
She nods. "I know. But I'd like your opinion anyway. Just in case."
"All right." He rises to stand in front of her, the composed and reassuring doctor that all his patients must know. "Do you want to do the exam now?"
"If you have the time. I'd like to have it done before--" A pause. "While it's still early." Neither of them mentions House.
Ever the gentleman, Wilson escorts her to an exam room. While he washes his hands - warm water, she notes - she removes her jacket, blouse and bra, and dons the standard hospital gown.
Lying down, she is acutely aware of her own vulnerability; of how long it's been since anyone's hands but her own have touched her.
Wilson's touch is gentle but firm, clinical. The warmth of his fingers is soothing against nipples that are hard with chill. He performs his examination in silence, for which she is grateful. They are both aware of how awkward this is, as friends, as colleagues, as employee and employer. She envies him his cloak of professionalism. Prone and half-naked, she is without her usual armor.
"It's a palpable lump," he says, confirming her own findings. "It's highly likely that it's a benign mass." Wilson's using his patient voice: soothing, confident. It makes her want to snap at him that she knows; she's a doctor, too.
Instead, she says, "Yes."
"You'll need to have a diagnostic mammogram."
"I'll check my schedule."
He nods and shuts the door gently as he leaves. Unpeeling the stiff hospital cotton, she is grateful to sheath herself in the familiar softness of her own clothes. In the small mirror above the sink, she inspects her hair and face, searching for a sign that anything is amiss. There is nothing.
For the rest of the day, she pushes it out of her thoughts. She makes phone calls, fills out paperwork, argues with House about his latest case, avoids Wilson's overly solicitous offer of lunch. In the evening, she goes home to more paperwork over tea and lamplight. Before bed, she removes her makeup and moisturizes with her usual care. She turns the lights off before changing into her pajamas, touching herself as little as possible.
She will need the distance if her body has betrayed her.
or if a cover for a pulpy thirties
sci-fi magazine, How striking;
as an alien, a success,
all purple eye and jelly tentacles
and spines, or are they gills,
creeping around on granular Martian
dirt red as the inside of the body,
One of the advantages of being Administrator is having overriding authority over scheduling. Her pride won't allow her to go to a different hospital, so she takes a deep breath and holds her head up as she removes her clothes for yet another employee.
Later, sore and discomposed, she sits in Wilson's office. He passes her the radiologist's report without preamble. Holding the paper in her hands feels comforting, ordinary.
"The mammogram indicates pleomorphic microcalcifications. It also indicates two other suspicious lesions."
It is easier to treat this as a consult, as just another patient. She retreats into the formality of medical discussion that concerns itself with theory and numbers, not with bodies. Not with her body.
"I'll need a biopsy," she says. "Vacuum-assisted?"
Wilson nods. "We have two experienced radiologists."
"All right." She places the chart on his desk and straightens her jacket. "I appreciate you taking the time for this."
Wilson moves around the desk to take her hand and squeeze it. She stiffens slightly, an instinctive recoil she can't control.
"If you want someone to talk to, you know where I am," is all he says.
She nods and pulls her hand away, not meeting his eyes. Standing, she smooths her skirt. Wilson retrieves the file from his desk.
"I'll make the arrangements for tomorrow."
"Thank you."
*
At home, she leaves the light off in the bathroom while she washes her face. Her entire body is one more shadow in the dark.
while its tender walls
expand and burst, its spores
scatter elsewhere, take root, like money,
drifting like a fiction or
miasma in and out of people's
brains, digging themselves
industriously in.
The sting of the lidocaine is followed by a muted, shifting sensation. She focuses on breathing evenly and remaining still. Her mind is carefully blank.
After the biopsy, she dresses, reflecting with no small amount of irony on the number of times she's been undressed at work in the last few days. The puncture site throbs dully, a reminder of damage and what is growing inside her so insidiously.
Even in her own hospital, wielding the utmost discretion, there are so many people privy to the happenings of her body. She goes back to work, thankful that House has a case.
*
Wilson's face tells her first.
"Malignant?" Some might be impressed with the steadiness of her voice. But then, she's had a lot of practice.
"I'm so sorry, Lisa," he says, handing her the pathology report. Her rarely-used first name is a slightly discordant note.
She scans the document. "Ductal carcinoma in situ."
"Grade 2 comedocarcinomas."
It could be worse. It could be much, much worse. "Treatment recommendations?"
"Lumpectomy with radiation or a total mastectomy." He pauses for a moment and then meets her eyes. "We could do a partial mastectomy, or a quadrantectomy, but the amount of tissue to be removed would be extensive, given the number and placement of the lesions."
"I think a total mastectomy would be best," she says. As if she is not talking about cutting off her own flesh; as if this has nothing to do with her at all.
"You should take some time to think about this, Lisa." His tone is mildly reproachful - he is talking to her as a patient - and it rankles.
"Do you honestly think I haven't thought about this, James?" She places deliberate stress on his own first name.
Wilson runs a hand through his hair, his expression slightly wounded. "I just--"
The door swings open. "Jimmy, are you having a play date without me?"
"House, do you ever knock?"
"I assume that's a rhetorical question."
Cuddy rises from the sofa and hands the file to Wilson. "Thank you, Dr Wilson. I'll get back to you about that patient later today." As she walks down the hallway she hears House's overly loud voice. "Consorting with the devil again, Jimmy?"
The lab technician
says, It has forgotten
how to die.
She leaves work early and wanders barefoot through her home, unable to settle. In the bedroom she examines her wardrobe, the clothes in drawers. All the pretty bras she's bought to shape and enhance, to reveal and conceal.
In the mirror she examines her naked self. There is no outward sign of the clustered tumors in her breast. Her face and body are still attractive, even beautiful on a good day, and she long ago learned how to use them to her advantage. She takes no small amount of pride in her appearance; she hones it and wields it like any useful tool and, occasionally, like a weapon.
Now the weapon is inside her.
In the bathroom, she searches for bath salts and knocks a box of tampons from the shelf. Every month her body moves through its useless menstrual cycle, preparing for the fetus she cannot seem to carry, that she has almost given up on. Almost.
House was wrong.
But instead of an embryo, she has cancer. She cannot help thinking of this as her own failure. Despite all her knowledge and experience as a doctor, the thought of what is growing inside her fills her with revulsion. She feels contaminated.
The room becomes hazy with scented steam as the tub fills. She lights candles and sinks into water hot enough to sting. Lying back, she lets her arms float, watches her breasts rise in the buoyancy of the water. If she closes her eyes she can almost imagine the flat, puckered surface of the mastectomy scar, like a crater on the moon; like House's thigh.
An eye for an eye, a breast for a thigh, she thinks with a tiny huff of amusement. One huff becomes another and another and then a sob. Harsh, choking sounds ricochet off the tile as the animal part of herself succumbs to helpless terror and grief. Arms wrapped around her chest, she rocks, mourning the death of all her chances.
Cocooned in the soft, damp light of the bathroom and the gentle slosh of water, she allows herself to feel how much it hurts.
Hours later, dressed in her softest pajamas, she boils water for tea. When the kettle screeches, she fills a cup and cradles it between her palms.
There are plans she has to make, people who must be told. She reaches out for the phone and dials a familiar number. Waits.
"Mom, it's Lisa."
But why remember? All it wants is more
amnesia. More life, and more abundantly. To take
more. To eat more. To replicate itself. To keep on
doing those things forever.
The meeting with the Board is exhausting; she feels battered by the effort of remaining composed in the face of the appraising looks and cloying sympathy. She is, of course, expertly prepared for their questions and doubts. Yes, she has every confidence in her staff and her treatment. Yes, she has selected a number of temporary replacements for the Board's approval. Yes, she will still be an excellent administrator with only one breast.
That last is not asked aloud, but she knows they're all wondering.
On the drive home she finally has time to wonder about House. She knows from Wilson that he finished up his case more than a day ago. Yet there have been no complaints, no staff members storming in to her office threatening to quit, and she hasn't had to chase him down to do his clinic duty. She hopes, tiredly, that he's not doing anything illegal. Again.
When she turns into her driveway, she discovers that he is--if loitering is still considered illegal. She slams the car door more out of habit than any real anger. At least he waited outside this time.
"House, what are you doing here?"
"You have cancer."
She pauses in her effort to get the front door open and takes a steadying breath. There's no point arguing with him about privacy or doctor-patient privilege. "Thank you for the update on my health situation, but that doesn't explain why you're here."
He follows her into the house with his lopsided gait. "Well I was concerned that my friend had fallen into the clutches of the Bride of Satan and I was planning an exorcism. Had to get a hair sample for the voodoo doll."
She doesn't even bother to roll her eyes, just drops her bag to the floor as she hangs up her coat. Trying not to think about what happened the last time he was in her home, she faces him with an expectant look.
"Why didn't you tell me?" he asks. There is no accusation in his tone. It is just a question.
"I was going to," she says, looking at the floor. "It was important that I speak to the Board first, before informing hospital staff."
"I'm not talking about hospital staff," he puts a bitter twist on the words. "I'm talking about me."
And what about you? she wants to ask, but knows it would be hypocrisy. They are both aware of the rare, if unacknowledged, places they have in each other's lives.
"I don't know," she says, feeling raw and weak. "There's so much to do and I'm trying--I wasn't prepared for this, House." It comes out accusatory.
"No one's prepared, Cuddy."
"I am. I have to be."
He nods but doesn't say anything else. The throbbing in her temples eases and she feels the small muscles in her neck and face unclench. Without acknowledging or understanding it, she has been dreading this moment. And now it's over.
They stand together in the hallway for a few minutes. The evening is quiet. Occasionally she hears the sound of an engine, or a door slamming, or a dog barking. The shift of House's jacket and the rasp of her nylons seem both loud and intimate. It is a very ordinary silence.
"You could take up archery," he says suddenly.
She is much too weary to attempt to make the strange leaps of his brain with him tonight. "What?"
"Don't you know your ancient history, Cuddy? Herodotus wrote about the Amazons: women warriors who cut off their right breasts so they could hunt and fight like men."
The laugh that bubbles up inside her is as startling as it is genuine. She realizes that she hasn't laughed in days.
"Of course," he continues with a smirk. "The popular etymology of the word 'amazon' being from a-mazos, or "without breast," is an etiological myth. Which would explain a lot about you."
"I'm sure I don't want to know, but tell me anyway. Why?"
He leans in and looks pointedly at her chest. "Because you already hunt and fight like a man."
It is a compliment only House could give. She smiles and shakes her head at him.
"So when's the surgery? I want to make sure to be prepared to mourn the loss of one of the hospital's greatest assets."
This time she does roll her eyes. "Go home, House."
"I thought a black armband would be a nice touch. Of course I won't be able to do any work due to being prostrate with grief."
She shoos him toward the door. "You'll do your clinic duty or I'll sic Cameron on you."
"Ouch. Loss of body part totally trumps existing cripple. Devious woman."
In the doorway, he stops and turns. There is a look on his face not unlike the one he wore the night he kissed her. Cupping her head gently, he presses his lips to her cheek. For a moment they are suspended in a warm space made of breath, and she feels a sweet ache pierce her heart.
When he pulls back and looks down at her, there is such warmth in his eyes. "Goodnight, Cuddy," he says.
She leans up on her toes and presses her own kiss to his cheek, with a smile.
"Goodnight."
*
Lisa Cuddy dreams of sparrows, of speed and hollow bones. She hears the wind passing over their wings like keening, or triumph, or both. In her dream she holds the fallen sparrow and smooths the feathers on its breast. The bird's heart begins to flutter as she strokes.
Its tiny black eyes open to the light.
Such desires
are not unknown. Look in the mirror.