Day 0. You hear that a lot once you get into the world of cancer medicine. You have to learn the jargon, like chemo, CAT scan, anuploidy, GCSF, etc. It's a real vocabulary builder. Day 0 usually means the day of chemo administration, which always seemed strange to me. Why not start with one? But then a lot of this doesn't necessarily make sense.

For me, Day 0 was the day the doctor came into the waiting room with a big smile on his face following what was supposed to be a routine lump removal and said (still smiling): "Well Mr. Catchpole, it's CANCER. I'm sorry. I've checked her in, we need to do a mastectomy."

As long as I live I'll never forget that moment; it still seems like only a minute ago. All the things you hear about really do happen: time slows down, your surroundings shrink away down a tunnel, and your mind races with a hundred questions like Why?, What does this mean?, What should I do?, and WHY IS THIS IDIOT STILL SMILING AT ME?.

Of course, Day 0 was really some time long before this Day 0. Day 0 for Jackie was the day one of her cells divided incorrectly and it's DNA got all messed up. Researchers say this happens fairly regularly to people, perhaps many times a day. But on this particular Day 0, for some reason Jackie's immune system broke down and didn't clean up the problem. So this poor confused cell that didn't understand its role as a valued member of a complex organism escaped destruction, and it grew and divided and grew and divided and grew. Or, maybe something happened a long time ago to this cell, and it sat dormant like a time bomb until just the right set of circumstances caused it to explode. I don't know, and neither does the medical and scientific community. Remember that. They JUST DON'T KNOW. In fact, the scientific community recently came up with a theory that the widespread use of DDT in the late 1950's and 1960's may have set off the dormant time bomb, which could explain why there has been such a large increase lately in cancer occurrence. Other researchers disagree.

This was really the day of discovery, and it preceded Day 0 by several weeks. At 32, Jackie was considered too young for regular mammograms and she had no family history of cancer. BUT on one fateful night, in the middle of our major house remodeling project (which we had started because we wanted another child and needed the room) she said, "I found a lump and I'm scared." I felt it, but I had felt other lumps and I honestly couldn't tell if it was different. What scared the hell out of me was her absolute certainty that it was cancer. Of course, I did the usual comforting thing and down-played it all. "Don't worry ... what makes you think it's cancer ... your brother had a lump and it was just a cyst ... remember when the doctor told ME I had cancer and it was just an old scar? ... " Well, maybe that wasn't such a good idea.

You're better off assuming it's cancer and feeling tremendous relief if it's not than to endure the sinking feeling of falling down an endless mine shaft if it is. When Jackie went to her gynecologist to get the lump checked out HE DID THE SAME THING. "This is no big deal, some benign lump, why don't I just aspirate it."

Well, another thing you hear out of doctors is "Those tumor cells sure look angry." You may think this is merely personifying tumors. IT'S NOT. Cancer cells can get angry, just like a swarm of killer bees, but they can be even more deadly.

That's what the doctor did. He jabbed a needle into it 10 or 12 times. It got angry. Actually, if you don't like the application of emotion to tumor cells, look at this way -- the worst thing you can do with cancer cells is start the metastasizing process (spreading to other parts of the body). To stop this, the body tries to encapsulate the tumor in order to contain it. I wonder what 10 or 12 needle holes in this makeshift shield did to this defensive mechanism?

Doctors are not the infallible gods we often imagine them to be. They're not all Marcus Welby's, or even Joel Fleishmans. They make mistakes. You'll see many more in the days after Day 0.

Be prepared for FEAR. For everyone involved. Just before her biopsy Jackie got very scared, almost panicky. It was in the middle of a regular kind of evening, and it hit her and she said she was leaving I guess she was going to run away from it all. I don't know if I did the right thing, but after a lot of arguing and talking, I finally convinced her to stay at home. I don't think she would have really run away for long. I don't know if the right thing to do would have been to let her go and get it out of her system, or if I did the right thing in confronting the fear and having it out right then. I guess you just have to do some of these things based on what works for you, and even then you don't always get it right.

It would be easy to blame the doctor for making Jackie's tumor angry, but that wouldn't be right. He said cyst, he said benign, and that's what we wanted to hear. We hadn't learned Rules 1, 2, 3, or 4 yet. With the words benign and don't worry still ringing in our ears, we simply had to find a surgeon. After all, we didn't want to take a chance -- let's get a biopsy. This leads to the grounds for choosing a surgeon -- someone I know knew someone who saw him once. Look, he's close to home, and after all, it's only a routine little biopsy. What a ridiculous criterion for selecting a doctor who may hold your life in his hands. If only we had known the rules.