I like the idea of dying of breast cancer. That's the real reason I didn't go to my follow-up appointment. I understand that's distorted. I understand that is not a viable thought. But this is my explanation:
I am not dying right now but I was dying for a long time in the early nineties. I know what I'm saying. It's real to me that I really am going to die of something, and I'm sick of AIDS. I don't want to be sick at all--I just can't imagine not being in a battle, and I want a new one to take over this one.
Breast cancer is a new idea. I'm not dying of it either, or sick of it. I just have a probable fibroadenoma---benign. But the idea that I could die "naturally", of something I didn't acquire...after all this.
It's not that I think my being HIV+ is my fault. I was 18 in 1986 when I got infected. My sin was seeking refuge from a man much older than I was whose past I did not, and don't really know. He died before I could ask. No one really knew what was going on. No one knew anyone who had it, where I lived. It isn't about sin, anyway. But as I knowingly flirt now with the improbable idea of a possible new demise, I do feel like it wouldn't be my fault in a way I don't feel now. The idea is a relief. Breast cancer as redemption. I don't expect anyone to understand that.
And the fantasy that I would fight breast cancer makes me feel like a woman. That's not a fair because some men get breast cancer, too. (I bet their sexual identities are affected the way mine is having AIDS as a straight HIV+ person in an overwhelmingly gay, gender-segregating care community.) But the thought makes me feel feminine,...the post-mammogram sonogram...something growing inside me instead of trying to eat away at me using my genetic identity to replicate its separate, biohazardous self. I would have a wounded sexuality, rather than a deleted one. A pink ribbon.
Breast cancer isn't opportunistic. Rates are not higher in women with HIV than in "normal" women. It would make me feel normal, for real.
And it would be private this time. I would not tell the world without being able to take it back. It would belong to me. I have known about my little kidney-bean shaped tumor for six months without telling anyone. Till now. This writing here is what will make me go back to my breast care center. My doctor is in Uganda. She's not going to remind me.
I am not feeling sorry for myself. These are not excuses--I am going to go back. These are just the realities of my experience. A lot of of-age women don't get mammograms because they don't know breast cancer is preventable, or don't want to think about it. (Many places offer free screenings in October, if money is the reason.) A lot don't go because they don't trust medical care. These are just the versions of my obstacles. I will reschedule my follow-up on Monday. And I hope other of-age women go get checked out, too.
Mayo Clinic breast cancer prevention information