Jessica is 34 when her big sister Molly is diagnosed with breast cancer. Jessica struggles to wrap her mind around such a thing, not believing the words out of the doctor's mouth, because Molly's only 36 and why would she have breast cancer?
The doctor explains that they caught it too late because Molly's so young and there's never been a reason for her to have a mammogram. By the time she developed symptoms, it was already too late. Jessica hears the ultimately damning words come out of his mouth, the crashing ton of bricks called reality falling all around her, and she can't hear another word that comes out of his mouth after that.
The doctor says "stage four."
–
Jessica dutifully gets an MRI and mammogram and transvaginal ultrasound and blood work and a variety of exams every six months.
The results are always the same: she's fine. But the spectre of Molly's life, and Molly's impending death, hangs over her head every time she goes through the process of testing- over and over again.
Her doctors tell her she's normal, young, and perfectly healthy every time the tests are inevitably negative. As though that's any comfort.
–
She's dutiful, but she can't face the thought of knowing, not yet. The idea that there might be a ticking time bomb in her body, that her sister's fate isn't just a complete fluke, isn't something she can wrap her head around. She knows the chances, she's not stupid: her sister having the mutation means there's a good chance she does too. But facing that reality is another matter altogether.
Jessica is attentive. She drives her sister to appointments, holds her hand through the series of bad news, fights her family when they try to talk her sister out of receiving hospice services. She's there for her sister in every way she can be, not that it'll amount to much in the end.
But the one thing Jessica doesn't do, can't do, is listen to her sister when she says "get tested." Because the unsaid, but known part of "get tested" is "so you'll know if this is going to happen to you next."
And Jessica's convinced that it can't possibly happen to her next. She's being careful, she's getting the screenings. If it happens at all- and she doesn't even want to think about that- it'll be caught early. This wont be her fate.
Harvey's the only one who knows about her struggles at home, the reason for her unexplained days off for doctor visits. She puts on her best professional face coming into the office every day and does her job, because she can't let this disease- and she doesn't even have it yet, change her life in any way.
–
Jessica is 36 when Molly dies.
–
Harvey guides her through everything after that. The funeral, any legal matters, all the minor details that Jessica shouldn't have to worry about now of all times. She shouldn't have to be dealing with this at all, he thinks to himself as he stands in a silent room and helps her pick out a casket. As though that matters, as though any of this matters.
Molly's son had already gone to live with his father during the last few months, and although they're divorced and were on far from the best of terms before she died, he attends the funeral. He mourns what was, what would never be again, the mother of his child. Harvey watches him hold is five year old son and cry as his world breaks, and wonders if one day he'll be the one crying over Jessica's casket.
There's never been any romance between the two of them, and Harvey's pretty certain there never can be. Jessica's his mentor, his guide, his best friend. It isn't anything more, but it shouldn't be anything more. They're perfect and right as they are, and although he doesn't have romance or a ring around his finger to prove it, Harvey knows his life would be shattered into pieces if Jessica went, if Jessica stopped being there to stop him from fucking up.
But Harvey knows that there isn't a word in the world he can tell her, a statistic he can cite to convince her, a gesture he could make to sway her, so he stays silent and supports her. He's not ready, but he'll wait for what happens- hoping beyond hope that it'll open on her terms and not the terms of the killer that might be lurking just beneath her skin.
–
Jessica's cousin dies a year later at 49, five months after being diagnosed. She doesn't leave much of anyone or anything behind.
–
Jessica finds out at three in the morning when her aunt calls her and tells her what's happened, tells her she ought to fly down for the funeral. Jessica offers her condolences and hangs up, immediately calling Harvey.
She doesn't give him a moment to complain about being tired when she calls and wakes him. "I've had enough, Harvey. I need to know," she says.
Harvey is at her place in 20 minutes flat, letting himself in still wearing his pyjamas and an old tshirt, getting under her blanket and into her bed, and holding her close through the night.
"Why now?" Harvey asks, breaking the silence.
"Because it could be me." Jessica replies.
Although she cries, through his fear, Harvey rejoices. Finally, they'll soon be out of the hellish place that is uncertainty.
–
Jessica doesn't go to the funeral. Instead, she stares at the card on her kitchen counter for the better part of the morning, Harvey at her side. She dials.
They give her an appointment two weeks from now, and yes, that's absolutely the soonest they can get her in. Jessica thinks that it's too long a wait.
Ray arrives with Harvey's suit in one bag and a matching pair of shoes in the other. There's not a single question on his face or in his words, because he'll never ask Harvey about this. They head off to work in his car.
In the office, Harvey doesn't say a thing. Jessica's still the boss, and even if life has changed for them in this very much grand way, work is work.
–
Jessica asks him to come to the first appointment with the genetic counsellor. She tells him that it's so she doesn't have to explain things to him after the test, even though they're statistics he's researched dozens of times over and she damn well knows it. Harvey doesn't say that to her, though. He just tells Donna to mark his calendar.
–
They're the only ones in the waiting room, which is a bit disconcerting until Harvey remembers that there's a very good reason for it. You don't make people waiting for the worst news of their lives deal with double booked appointments, not if you can avoid it. Nobody else should be waiting, this is their spot- her spot.
Jessica toys around with her cell phone as they wait. Harvey stares at the wall, and it offers him no answers.
–
They're all words she's heard before, words she heard as her sister died in front of her very eyes. She knows the statistics for her sister's mutation, her cousin's. She knows what's behind the door if she has this... this thing inside her. The counsellor is kind, and helping people through their emotions is indeed central to her job description. She sits across the desk and insists on explaining again because Jessica needs to understand before the testing can be done.
"You have the choice to leave this appointment and maybe never find out if you're a carrier. Close surveillance is a valid treatment option, and might work just as well even if you do have the mutation. Don't let fear dictate this decision for you," she says.
Jessica laughs a short and desperate laugh at her words. "People are dying all around me, and I'm not supposed to be scared? I can't keep putting myself through this hell forever, not for the rest of my life. You know better than I that there will always be many cases that aren't caught in time, especially for ovarian cancer."
"There's no guarantees," the counsellor concedes. "But there's equally no guarantees that any of your options if you're diagnosed will prevent the cancers, either," she adds.
Jessica nods. "I understand my choices. I'd like to know where I'm standing. If there's a genetic bomb waiting to explode in my body, I want it out."
"We'll get a blood sample taken today, if that's okay with you, and I'll get you scheduled for a follow-up when we get the results back in about a month," she replies.
"Let's get started."
–
Jessica receives the news in her genetic counsellor's office after a painstaking month of panic and worries about the what ifs of her situation. Jessica reminds herself that she's told herself, for all this past month, that she has to be strong. That she had a decision to make, and she's finally made it, and she can't let her emotions get in the way of staying true to it now.
Harvey sits next to her, his sweaty palm clutching hers. She jokes to him that it's the first time she's seen him sweat in years, as they wait for the counsellor to come in and deliver her fate.
–
Jessica is 37 years old when she learns that she has tested positive for the ?C4446T BRCA1 mutation.
–
She doesn't have any girlfriends she's close enough to confide in about this sort of thing. She has co-workers and employees and contacts, she has acquaintances, but she doesn't have some sort of designated go-to girl for "I'm probably going to get cancer, my genes told me so."
So instead she confides in Harvey. He sits with her for hours that first day, trying to coax words out of her mouth or figure out a way he can help. Trying to think of some way he can fix this.
Jessica tells him about her sister, all the things she was never able to talk about while her sister was sick. She tells him about the gut-wrenching diagnosis. She tells him about sitting in a sterile oncologist's office and knowing, although she could not possibly let herself believe it at the time, that the news was grim the moment he walked through the door.
She always could read people, even when she didn't want to.
Jessica tells Harvey about the first few months, terrifying but ridiculously hopeful months. They researched everything, contacted everyone, tried to find a way. Jessica had known, even tried to accept, that Molly couldn't be cured. But that hadn't stopped them from doing everything in their power to extend her life, make it better somehow.
It had looked like it was working for a while. Molly was doing well. Her oncologist used the word "stable" to describe her scans more than once, and "stable" was better than "progressed" as far as they were concerned. When she passed the one year mark for living with cancer, they almost let themselves dream that she'd be one of the edge cases. She'd be one of those women who, through some combination of sheer will and luck and medicine, lived half a decade or even longer with this disease.
But then Molly wasn't stable at all, the day she started getting double vision and knew what was happening. The day the grim reaper, the traitorous clump of cells lurking in her brain, finally announced itself. Jessica remembers Molly calling her frantically, first thing in the morning. She tells Harvey about how she'd tried to reassure Molly, tell her that it could be anything- it could just be a headache, after all!
But they had both known. It was the sign they had all been holding their breath for, dreading. In a rather ironic way, it was far more terrifying that this should happen than the fact that Molly was going to die either way.
When her oncologist and radiologist agreed that there was no point in even visiting a neurosurgeon, they had known what her fate was. It was pointless to even try. Molly was offered whole brain radiation. It would mean a few more months, maybe a year or two if she was lucky. It would also mean slowly losing her memories, watching her personality change from the drugs, losing her abilities, and dying all the same. She rejected it. The dose of steroids she could tolerate gave her three more months, and then that was that, because at some point medical science will fail every single person alive.
She tells him about her resentment over her sister being diagnosed too late, over there being seemingly no options from the very first day. She tells him about how scared she was of knowing, how scared she is now that she knows.
Jessica tells him about how gut wrenching and drawn out it seemed to watch her sister die, even though Molly lived with her cancer for such a short period of time. How much of a struggle every day was. How much pain she'd never been able to tell him about, because she could never be his burden.
Harvey tries to tell her that she's anything but a burden, but she interrupts him. "I know that now. At the time, though," she says, and he nods. He gets it. "We can never say the important things, can we?" he asks, and she knows it's a rhetorical question.
Jessica's quiet for a minute. "I made a promise to myself. I have to keep it now. Don't let me fail, Harvey."
–
She tells the breast oncologist that she's not ready to die, that she's not ready to toss a coin on the uncertain research surrounding chemotherapy to prevent women with BRCA1 mutations from developing their cancers. She tells him that she's ready to fight.
He tells her that visiting his office is a requirement as part of the clinical genetics program. He tells her that tamoxifen might lower her risk even after surgery, which she knows. In the end, though, he concedes that he himself recommends surgery as the first line of prevention.
"I'll need you to follow up with me six months after your surgery, or in a year, whichever is sooner. We can re-evaluate you at that time, and I'd like to keep following up with you every year or two after that if you choose not to undergo medication based therapy at all."
–
Jessica tells Harvey about the surgeon the week before her appointment over dinner. He swallows visibly, just the once, and then nods sharply at her. "Is there anything you need?"
Jessica steels herself to ask for the one thing she is very much unaccustomed to needing: help. "I'll need someone. Before the surgery and after. I can't think of anyone I'd like to ask except for you, Harvey. But I think I need to go to these appointments myself, see what the surgeons say... I need this to stay my decision."
Harvey shrugs. "Of course. Whatever you need, you know I'm always here for you."
"Just wait until the surgical menopause hits," Jessica mutters into her food.
–
After her second visit to her breast surgeon, Jessica meets up with the plastic surgeon half of New York recommended to her when she went searching. Jessica spends a few minutes watching Dr. Brandt read her file off a computer screen in the consultation room before they begin.
"So, your surgeon has already sent me over some pretty good information about where you're at right now. My job here today is to talk to you about your reconstruction options and coordinate them with your surgeon. Do you already have an idea of what sort of options are out there?"
Jessica nods. "My primary concern is minimizing recovery time and minimizing my risk. I understand that reconstruction from my own tissue will involve a longer recovery and likely repeat surgeries. I'd like to avoid that if at all possible. I'm not sure if I want reconstruction, but I've been advised to discuss my options with you to help me come to a decision."
"Well, since you're not going to be receiving any cancer treatments after the surgery, there's no reason to delay reconstruction.
First, let me clear up some misconceptions about reconstruction using your own tissue. While it's true that many of these reconstructions require multiple surgeries, it's also quite possible that if things work out we could set you up to have your reconstruction done during your surgery and you'd maybe never need another surgery except for a minor one to restore your nipples ever again. Yes, many patients end up having a lot more surgeries than that, but that's a risk you'll take with any reconstruction.
If you choose to go the route of a skin-sparing mastectomy, we could implant a silicone or saline implant underneath a muscle in your chest to reconstruct both of your breasts that day. Recovery for that should be comparable to or a little bit longer than just the recovery from your gynaecological surgeries if there's no complications.
Although studies with women who already had breast cancer haven't found a significant survival or recurrence difference between women who have a skin sparing mastectomy and those who don't, the risk isn't fully known with women who are having prophylactic mastectomies. You'll need the muscle and skin surrounding your implants re-enforced with alloderm, which is cadaver skin with the cells that lead to rejection removed, which greatly reduces your risk of rejecting it and increases your odds of being able to walk out with a one-step surgery.
If you want nipples reconstructed and areolae tattooed on, that will still mean an additional surgery. There is an option to retain your nipples or nipples and areolae, and that might mean avoiding a second surgery altogether, although retaining your own natural nipples might mean an increased risk of cancer later- we're not sure yet, but the risk seems to be very low if it exists at all.
If you choose not to preserve skin and want a simple mastectomy done, we can place a tissue expander to recreate each of your breasts. Using alloderm can increase how much we'll inject in the tissue expander initially, and speed up recovery, but it's okay if you choose not to use it- that'll just change the course of your recovery. The tissue expanders will need to be refilled here in my office several times over the course of several months and after that, we can go in and replace it with a long lasting silicone or saline implant in a quick surgery. If you want nipple reconstruction, that will also require additional surgery. This option allows you to regain your breasts without leaving any more breast tissue than absolutely necessary, but you'll have to weigh that against the fact that you'll need additional surgery and more clinic visits.
With either of these options, there's a good chance you'll need surgery years down the line because of implant failure, movement, or scar tissue building up and becoming a problem. But that additional surgery might not be until a decade or two from now.
Of course, your final option is to have a simple mastectomy done with no reconstruction and no skin spared. This will leave you with a completely flat chest, no nipples or areolae, and two scars along the site of your mastectomies. Some women choose to just live day to day with a flat chest, some women choose to use an external breast prosthesis which will look quite realistic underneath clothing. Not having a reconstruction can make it easier to detect future breast cancers, which may be an important consideration for you, and it also will likely greatly reduce your odds of ever needing another breast surgery again compared to any surgical reconstruction option. The downside, of course, is that it produces the most radical change to your appearance and it's up to you to decide if the benefits are worth that.
If you choose a simple mastectomy with no reconstruction, I can still be in the operating room the day of your surgery. I'll help your breast surgeon ensure that you don't have any extra skin left over, and stitch you up myself to minimize the appearance of your scars. Or you can talk to your own surgeon about doing this, if you feel more comfortable working with them.
And if you later decide you want reconstruction, we can absolutely go back and start the process of reconstruction when you're ready.
They're all valid choices in your situation, and they're all surgeries I think you're a candidate for. Do you have any questions?"
Jessica nods. "I've researched all of this online, of course, so most of what you've said isn't new to me. I read that significant recovery from a simple mastectomy with no reconstruction can take as little as a week or two. How long would it likely take, in your opinion, for me to be back to work? And how long would it take for me to be able to use a prosthetic?"
"Given the fact that you'll be having both your mastectomies and oophorectomy at the same time, I'd guess you'll be fit to work in about two or three weeks. You should be ready to return to work full-time within a month to six weeks. You're young and strong, which matters, but in my experience the patients that get back to work the soonest are the ones that are simply too stubborn to be sick for too long," she says, laughing. "With regards to the prosthetic, you'll be able to wear a fitted vest that's meant to hold your drains immediately after surgery, and you'll be able to put soft fibre filled prosthesis into it as soon as you're up to it. You can continue to use a transitional prosthetic for the rest of the month, and nobody should be able to tell you're using it. After a month or so, the surgery site should be settled down and you can be fit for a proper prosthesis."
Jessica stares just past the doctor at the wall for a minute. "I know this appointment was supposed to open my eyes about my surgical options, but you've opened my eyes as to just how much I don't want additional surgery. I don't want reconstruction."
The doctor smiles. "And that's okay! You don't have to make any final decision now, and you can always change mind. If you do continue with no reconstruction, do you still want me to plan to be there during your surgery to help you get a good cosmetic result?"
"Yes, I would," Jessica says. "I don't want reconstruction, not now and not later. I want it all gone. These breasts are holding me back from living the life I want to live, and I want them gone. I want you to make sure I get that."
"I will," she responds, and that promise means the world to Jessica.
"At least I wont wake up with any surprises on my chest," she thinks to herself.
"I'll contact your breast surgeon's office and start working on setting up a surgery date for all of us as soon as possible. I'm going to refer you back to your surgeon's office for the pre-operative testing. I'd also like you to make a donation of blood before your surgery, as soon as possible, so that we'll have some of your own blood to use if the need for a transfusion arises. And then we'll get you into surgery and get this all taken care of."
"That's it?" Jessica asks.
Her doctor chuckles. "For now, that's it."
–
She breaks the news to Harvey that night, in his living room. Harvey stares at her cleavage, clearly visible in her low cut dress, trying to imagine it gone. Jessica laughs. "Yeah, you wont be seeing any of that any more."
Harvey gives her one of his best soul-penetrating glares. "Jessica, you know that as much as I'm gonna leer, I fully support your decision. This is the right thing to do, and I'll find other things to stare inappropriately at later, okay?"
"The way you talk, Harvey, I'd almost think you liked me," Jessica replies.
Harvey snorts. "Where'd you get that idea?"
–
A few days after going in for some testing and donating her blood, her surgeon's office calls her with the next available date they were able to co-ordinate. The receptionist " so, in just a little over two weeks, on Tuesday," and Jessica isn't sure if she should be happy it's so soon or sad or numb. Instead, she just says the only thing she knows is right: "yes."
–
Harvey makes plans to take off the day of her surgery and the week after it, so he'd be able to drive her home and attend to her needs immediately after the surgery. Mike looks like a deer caught in the headlights when Harvey tells him that him that he'll need to take over Harvey's case-load while he's gone. Jessica's already told everyone who needs to know why she'll be out of work for the next few weeks, and there's nothing like the faint suggestion of 'lady problems' to get a room full of men to not ask any more questions than that.
Jessica decides to attend the breast cancer group her counsellor recommended, not sure if it'll help but sure she needs to try and talk out her feelings and resolve her demons before the surgery. The group gathers in a meeting room at another hospital.
When she's invited to talk, Jessica tells them about her sister, about finding out her own fate, about her surgeries. She tells them about her anxieties over the upcoming surgeries, about the fact that it all feels like it's moving too fast and she barely feels like she can hold on.
"So why don't you wait? To schedule the surgeries, I mean. Why don't you wait and think about it?" she asks.
Jessica shrugs. "Because I know that it'll still be the right choice a month or a year from now, except then it might be too late. I can't spend the rest of my life worrying if today's the day, and if I put off the surgery that's what I'll be doing until one day it is the day and that'll be the day I've lost some of my power against this disease," she says with a shrug.
"I don't want the surgery. I don't want to face the person I'm going to be after it, or think about how I'm going to look like when it's done. I don't want to be cut open with nothing left behind," Jessica continues, pausing to try to think of the next words to say, the right ones to convey her thoughts.
"But I know that it's the right thing to do. I know that it'll still be the right thing to do later, except then it might not be my choice to make, and I'm having a much harder time living with the idea of that than the idea of surgery. I can view the surgeons taking away parts of me as losing myself, but they're not taking -me-, only the parts that are going to kill me if they stay in. As much as it makes my skin crawl to think that I'll be out a reproductive system and my breasts in just a few days, the idea of living with these parts inside my body for even a moment longer is far worse. It's still my choice now, and I need to take it. That doesn't stop it from being the hardest thing I've ever done."
–
The day of her surgery, Jessica wakes up at four after having barely fallen asleep at midnight to get ready. She showers again quickly, rinsing out her hair and drying it off with a towel before pulling it back into a bun. She double checks that her bag is fully packed, making sure she has a spare set of clothes to come home in after her surgery, her post-surgical camisole and breast forms, and her laptop, cell phone, and chargers to work with while she's still in the hospital.
Harvey wakes up just after four thirty to make it over to her house on time, packing his own computer to entertain him during the surgery and while she's in recovery and he can't visit. When he'd asked if he should be there for her after her surgery, Jessica had chucked at the thought. "I'm going to be coming off anaesthetic and I have a head full of secrets. Do you think the two things are compatible?"
Harvey had chuckled at that.
He arrives at her doorstep just past past six, ringing the doorbell and waiting in the hallway. Jessica hears the bell just as she's rolling her suitcase up to the door. She pauses in front of the mirror in her hallway, taking one last look at the woman she's no longer going to be in just a few short hours.
She reminds herself that she's going to be something better.
They walk out of the building and out to Ray's waiting car without exchanging so much as a word. As they drive, Ray doesn't ask a thing or say a word as they try to brace themselves for the day.
–
The hospital is already full and bustling when they arrive to check into Surgery. Other groups of patients and family huddle around the waiting room, every last person there for a cancer related surgery. Some faces look anxious, some faces look nervous, many of the faces just look like theirs... scared and a little bit numb with disbelief.
Today's the day, and even though they've all been seeing it coming for weeks or months or years, it somehow seems so much more real at this very moment in the waiting room surrounded by green chairs and scared, tired faces already worn down from a day that's barely even begun.
Jessica signs her name in, producing an ID and receiving her wrist-band in exchange. Harvey hovers over her, helping her secure the band around her wrist, running a finger along it like it's a prized possession or at least one he's a little bit afraid of, and he's not sure what the difference is.
Then they wait a lot longer, because nothing can go as scheduled, or at the very least, the schedules they give you are never the schedules they internally keep. More tired looking patients, more fear, more family members crying.
Finally a nurse calls them over to a private room, giving Jessica a gown to change into and telling her that the surgeon will be in to get the markings for surgery drawn soon.
Harvey turns around to face a wall while Jessica changes into the thin hospital gown, regardless of knowing that it's going to be coming off in a few moments all the same. Jessica sits upright on the examination table, legs dangling off the sides.
Her breast surgeon comes in just a short while later, checking her chart and comparing the name on it against the name on her wrist-band and re-reading the notes to be safe. Harvey takes a seat next to the examination table.
"I see that your gynaecological surgeon changed your scheduling from a laparoscopic salpingo-oophorectomy to a total vaginal hysterectomy? Whys that?" he asks.
"We discussed it, and given the fact that retaining my uterus puts me at a disadvantage when choosing future chemotherapy medications, it seems prudent to remove it while I'm having surgery all the same. And having no cervix would effectively end my need for high-risk screenings, while likely having no practical difference to me than if I'd just had my ovaries and fallopian tubes removed."
"I have to say, not many of my patients take the "while you're down there..." approach," the doctor jokes.
"I want this to be the only time in my life that I have surgery because of cancer. This isn't a guarantee, I know that, but I'm willing to sacrifice a little to increase my chances of that being true. The total hysterectomy hardly seems like a loss at all, given that the oophorectomy I've already signed up for is the most life-changing procedure by a far." Jessica replies.
"That's perfectly reasonable. Now, I'll need you to drop your gown down so I can get a view of your chest to get the markings on," he replies.
Jessica reaches back to untie the gown, shrugging it down to pool around her waist. The doctor sets to work, markers leaving clear and smooth lines across her flesh. Harvey stares in fascination as he works, knowing that if the man can concentrate so much on something so simple as taking a marker to human skin, he would love to see his work with a razor-sharp scalpel. He only realizes that's a morbid thought after he's thought it, because this is Jessica's skin being cut into, being dug out, taken away.
When he's done, he grabs a hand mirror off the counter and lets Jessica approve his handiwork. Jessica stares at the marks in the mirror for a while, knowing that they're where she's going to be disfigured soon. Where parts of her will be torn away.
"Only the bad ones", she reminds herself. Only the bad ones. They need to be taken away. She has to act now, no matter how jarring the marked lines look on her skin, no matter how scared she is of the future and all hat it holds, no matter how scared she is of how things will be in an hour or two or five when she wakes up and she's without eight organs and without... so many of the parts of her femininity. Just gone.
Jessica tries to imagine that, tries to wrap her head around it, although she knows full well that she's not going to be able to appreciate the full extent of her emotional reactions to this whole surgery until it's over and done with, until she's awake and alive and very much different.
Instead of letting herself continue down that road, Jessica tells herself to think about all the good things. The markings look great, perfectly even, perfectly gone. There will be nothing left after all this is said and done, and that's one of the most comforting thoughts she can possibly have at this time.
"None of these diseased parts will stay in me any longer," she thinks to herself.
–
She's called back to get her IV inserted and to get anaesthesia started all but half an hour later. Harvey can't be there for that part, so he offers her a hug and a whispered "you'll do great" before she walks through the double doors and into the great sterile light.
–
The anaesthetic feels cold, and then Jessica feels nothing at all.
–
Harvey leaves the briefcase with his laptop in it, and Jessica's suitcase, abandoned underneath the chair where he should be sitting were he not anxiously pacing around the new waiting room he'd been led to.
He drinks half warm hospital coffee and forces himself to have breakfast, knowing that he's no use to Jessica if he's too tired to function.
–
Five and a half hours later, they're finally done and Jessica's been in recovery long enough that the doctor feels confident about her having visitors.
Jessica looks frighteningly pale in her bed, with tubes coming out from underneath the blanket covering her and an IV and oxygen sensor on her left hand. Her hair's a damp mess, and Harvey can see the bumps of the bandages underneath her hospital gown.
This isn't the first time he's seen someone sick, but this is the first time he's seen her sick. He's pretty sure this is the first time he's seen her truly fragile.
But then she opens her eyes, looking at him, and Harvey knows that it's going to be okay. They can get through this. He can get through this.
–
There's plenty of doctors and nurses keeping the both of them awake and grumpy after Jessica gets moved into her room. It seems like every time Jessica's down for a nap, one of her surgeons is there to do a follow up, or a nurse is there to take vitals yet again.
Jessica's breast surgeon tells her she can eat whenever she's ready, and Jessica isn't feeling nausea from the anaesthesia. So when dinner rolls around, Harvey has Jessica sipping chicken broth and all but force feeds her a cup of orange jello.
Harvey can't bring himself to get any work done that first night, because he can't imagine a thing he'd rather think of or be doing than being attentive and by her side. He jokes with her, changes the TV channels for her, calls the nurse when she declares she needs to use the bathroom and wants the catheter out yesterday, and when she finally gets rest, he watches her sleep until sleep claims him.
–
Jessica's ready to kill by the second day. She spends a few hours on her laptop and phone, commanding her ship even though she cannot be with it. Harvey tries to reason with her, tries to tell her to relax, but she's not hearing any of it.
They watch Jeopardy and Wheel of Fortune, and Jessica calls out the answers she knows like she's not just recovering from major surgery.
–
That night, her plastic surgeon checks in with her again and offers to show her what her chest looks like during a bandage change.
Jessica holds Harvey's hand for support when she stands in front of her mirror and drops her gown to reveal the stitched and taped wounds that run across her chest, the drainage tubes hanging off the sides. She doesn't cry.
Later, in the hallway, he does.
–
The next morning, her gynaecological surgeon comes in just before she's cleared to be discharged. Jessica's already in a button up shirt and soft pants, bag repacked and expectant to leave.
She carries a folder in her hands almost reverently, and there's an odd twist to her voice when she speaks. "I've never said this to a patient, so I'll ask you to excuse me if I can't find the right words," she says, eyes still fixed to the chart. A smile develops on her face. "We got the results back from pathology on your hysterectomy. We discovered a tumour in your right fallopian tube. It was malignant. We caught it in stage 0. You wont require any treatment beyond the surgery you already had," she continues.
"We probably wouldn't have caught this in your ultrasounds until it was far more advanced, and by then I'd be delivering far different news to you. If you hadn't had this surgery, it likely wouldn't have been a matter of if this cancer progressed, it would be a matter of when it killed you. But you're cured, cleared, and there's absolutely no reason to believe you will ever require treatment for this cancer ever again. I don't know what drove you to have this surgery when you did, but I do know that it probably saved your life," she finishes.
Jessica processes for a minute. "I... had cancer."
"Yes."
"And I didn't know it, but I had it taken out of me."
"Yes. This happens in five percent or more of these types of surgeries, we discover a cancer that imaging didn't see and take it out. Rarely are we so lucky to discover a cancer so early, to be able to give you as good news as I'm able to give you now: there's no reason to believe you wont have a long, healthy life without tubal cancer ahead of you. No chemotherapy, no radiation."
Harvey listens quietly, and in the privacy of his own mind, thanks whatever gods may exist that this happened now.
–
Jessica winces at every bump on the ride home. Ray drives slowly, carefully, but she's still clearly not loving the trip as they get back to her apartment. Ray keeps looking back through the rear-view mirror to check on her, but ultimately he's helpless: New York traffic will be New York traffic no matter how precious the ride in your back seat is.
–
The drains stop filling up with fluid two days later, and Jessica's breast surgeon removes them at the follow-up appointment. Harvey helps her switch out the tank top meant to hold surgical drains in its pockets for a soft front-clasping bra with her breast forms already in it. She curses as he works, but refuses to go about without her bra on.
"With my luck, the moment I walk out of this door we're going to run into someone we know and I'll be the special edition of the rumour mill," Jessica mutters.
Harvey sighs. "So what if people know?"
"Would you want everyone to know if you'd had your balls cut off, even for a good reason?" Jessica fires back.
"Good point."
They get her out of the doctor's office more or less in one piece.
–
By the following Tuesday, Jessica's going insane at home. Harvey had returned to work the day prior, Mike having called him dozens of times in desperation over the course of the week. With each call, Jessica grew more panicked.
The rational part of her knows that the office will be fine without her for a while. But the part of her that made this, the part of her that can't stand the idea of failure, knows that one wrong turn can set off a catastrophe.
She tells herself to wait just a little longer, and barely makes it to the next Monday.
–
Jessica gets a few curious looks as she comes back to the office that day, Harvey with her like a protective watchdog. "I'm fine," she reassures him. "All my doctors said I could try going back part time. If you disagree with them, maybe we can dig up some funding to send you to medical school?"
"Which means I'll be dragging you out of here by the hair if I see you here in three hours, Jessica. You need to go home and get your rest," Harvey replies, but he can't keep the amusement out of his concern. This would be just like Jessica, and he knew it was coming. He reminds himself that Jessica's a grown woman, that she's been through more than enough to know how to take care of herself.
Donna corners her in her office just before she leaves for home during lunch hour. "I wish you'd have told me," she says.
"Told you what?" Jessica asks, feigning concern to evaluate what Donna knows- or at least what she thinks she knows.
"Oh, don't play dumb with me. I see the way you're holding yourself, walking, and wincing. Bet if I hugged you right now I could confirm a theory?" Donna asks, amusement in her eyes.
Jessica stares. "How'd you know?"
"Had mine done three years ago, I'm pretty sure I had the exact same expression of horror on my face every time I lifted my arms," Donna replies nonchalantly.
"But Harvey didn't..." Jessica replies, uncertain.
Donna cuts her off. "Harvey didn't know. Remember when I convinced him to let my parents stay in his condo? My parents were in town hovering over me because of the surgery. It didn't seem relevant."
"And you..." Jessica gestures to her chest.
"Pack more silicone than a barbie doll," Donna replies, giggling.
Jessica shrugs in disbelief. "This has been one hell of a month... and you just made it stranger."
"I don't know your reasons, Jessica, but I do know that you did the right thing. If you ever need a friend," Donna says.
"Maybe one day," Jessica replies, not sure if she's ready to say all the words again.
"Whenever. Don't tell Harvey I told you any of this, though," Donna adds.
"Why?" Jessica asks with confusion.
"Because I don't want it to be what he thinks about when he sees me. Not yet, maybe never," Donna replies.
Jessica doesn't understand completely, but she does understand, so she nods in agreement.
Donna leaves.
–
Two weeks later, her plastic surgeon tells her that her skin is settled enough to get fitted for prosthetics. Her gynaecological surgeon has already cleared her to return to work if she takes it slowly, and her breast surgeon already gave her the all clear after removing her stitches and seeing how nicely she'd healed up.
The front of the store looks just like a regular bra shop, except all the styles are far more modest than she'd have bought in a past life. Jessica knows this is because the bras need to cover the entire prosthesis.
The prosthetics are in the back room, and her fitter, Marlin, guides her there. Jessica strips down to a tank top and her trousers, and Marlin measures various points about her chest to attempt to determine what sizes to start with.
"What bra size were you?" she asks.
"30DD," Jessica replies as the woman carries on with her measurements.
"And what size do you wish to be?"
"Wish to be?"
Marlin chuckles. "Of course. Within reason, you're free to choose another size. I can bring out a few varieties in your pre-surgery size to get an idea of what you'd like?"
"Thanks."
Two hours later, Jessica leaves with a fabric-backed silicone form, a lightweight silicone form, a swimming form, and an adhesive form, figuring she might as well try them all to see what she likes. The worker had told her the fabric-backed silicone form could be used with some of her regular bras, which was definitely an advantage, but Jessica bought half a dozen mastectomy bras all the same.
She models the different forms in the mirror at home, under her shirts and dresses and suits, marvelling at how similar in shape and size she was able to get them to her own natural breasts.
As she stands only feet from her mirror, the only difference she can see in the mirror when she thinks back to the woman she was before the surgery is that this version is more confident, more alive. This version will not be killed by inaction.
And everything isn't all better, but it's a start, and Jessica feels like she's finally truly recovering, finally becoming whole again. She'll have a long, long time to figure the rest out.
–
Jessica is 37 years old when she gets her second chance.