
It’s amazing the things we don’t know.
Like the fact that a hippo’s jaw can open wide enough to fit a whole sports car inside. That’s something I did not know. Or that cobwebs have antifungal powers – who knew?
Or that the average doctor spends approximately 40,000 hours training to meet the infinitesimal needs of the human body and still it’s not enough.
Let me explain.
Doctors are wonderful– doctors have cared for me through the years and given me excellent advice.
Go to the gynecologist? I’m there!
Panini press my breasts into the mammogram machine? Wouldn’t miss it! No one wants breast cancer.
Get that bloodwork done? Sure!. How many vials?
But it turns out that in all that time and with all those physicians no one ever thought to ask me about my ethnic heritage and how that might play as decisive a role in my health as say the more routine “Do you drink? Do you smoke? Have you ever used recreational drugs?”
It came up over coffee – the way it does when you are talking with a friend. That my grandmother had breast cancer.
Except my friend is a genetic counselor which makes our conversations a little different…
“Are you Ashkenazi?” she asked, fiddling in the fridge, digging around the contents.
The question took me aback.
“I am –”
“Tell me you’ve been screened,” she said, suddenly much more serious.
Screened for what? I thought.
“Oh my Goodness,” she said. “You don’t know, do you?”
Here is what I did know: In the year 1941, my paternal grandmother, Laura Hirschel, crossed the ocean from Czechoslovakia to escape the Holocaust. She carried a small leather suitcase, unthinkable loss and a lot of hopes and dreams across that ocean. To her credit, most of those dreams came true such that when she left us, some seventy years later, she passed to us her strength, her moral fiber and her beautiful penchant for philanthropy.
But she may have passed something else as well – something Ashkenazi Jewish woman are at a 10 fold higher risk for having – and that is the BRCA gene mutation. I did not know that. I also did not know that women who carry the BRCA gene have a likelihood of 45% to 85% for developing breast cancer in their lifetime, along with a 10% to 46% chance of ovarian cancer.
No wonder that by the age of forty, my grandmother had undergone a double mastectomy. As a little girl, I remember asking my dad why grandma’s breasts looked like lumpy pudding sacks. "And they aren't even the same size," I complained.
“They are falsies” he explained. “She had cancer…”
And all this time, I though her getting breast cancer at forty was entirely happenstance.
Like I thought a yearly mammogram was the only available diagnostic screening tool for breast cancer prevention and that all women carried the same risk, regardless of ethnic background.
“I trusted my doctor,” I said to my friend. And then, finally, “Who else is there to trust?"
And here is the answer – the answer that every woman needs to get straight right now.
A GENETIC COUNSELOR. That is who else we can trust…
And I didn’t know it.
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Within the week, I will get genetic testing done.
I will swab my cheek and send off a sample and hope the results don’t confirm what is more likely to be true of me than other women.
But if it is, I would rather know early. I have a loving husband and two amazing children; I have work that I treasure and a life that I adore. Should it come down to it, if the clouds are going to gather,I I would feel blessed to have the opportunity to outrun the storm before it touches down in my body.
Because it is amazing the things we don't know –
And in the presence of a loving genetic counselor, the things we can.
--- Jess Ippolito
High school teacher
Pennsylvania
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