Today is:
- Ash Wednesday
- My 45th birthday
- Two days since getting the call from the breast oncologist’s office to say that the lab results of the MRI biopsy of my left breast were benign
Remember that you are dust.
Ash Wednesday has perplexed me since I was a kid. I appreciate the solemnity, the congruence of saving a few of the palm fronds from the previous year’s Palm Sunday to burn into ash, and, as a younger person, the knowing nod of the “in group” cred of showing up to work or school with a powdery smear on your forehead.
I liked the ritual of it, even as a Presbyterian – walking up the church aisle to the awaiting pastor, silently shuffling in a somber line of adults and some kids, I would present my forehead for a sign of the cross – the only one of the year for my Protestant body. “Remember that you are dust, and to dust you shall return.” Turn, walk to the side aisle, go on with your day and contemplate your mortality.
I supposed these other folks must need to be reminded that people die. That they will die. That all their striving will come to nothing and eventually they will be ash heaps? I didn’t need the reminder. My impending death, and the death of everyone I love, was the buzzing static drone of my subconscious at all times. It still is.
I woke up on this sleet-slicked morning as a healthy 45 year old. I have the mammogram, ultrasound, two MRIs, a biopsy, and even a fresh set of dental records to prove it. Since November, that clean bill of health was more like an iron-welded question mark teetering on its ball point in the corner of my brain.
“You sound calm,” my friend said to me on the phone a couple of weeks ago when I called to see if she could drive me to my biopsy.
“I am calm!” I assured her. “I’ve been training my whole life for this! Four decades of mentally rehearsing Worst Case Scenarios comes in the clutch!”
“I don’t like that for you.”
“Honestly, Anticipatory Dread is my comfort zone. I spent *literally* decades steeping in it. It made me who I am. I’m in the zone here.” And it was true. I, a person will barely-managed anxiety, felt calm about something that, objectively, was not a low-stress scenario. It was remarkable.
I spotted an annoying rash across my torso in November, which became itchy, weeping welts, which became chronic hives, and gray leakage from my nipple, which resulted in a gradual escalation of testing that revealed, of all things, engorged milk ducts and “suspicious activity” in my left breast. The initial MRI concluded that a biopsy was in order.
At each appointment, a doctor assured me that it was either an allergic reaction (Urgent Care and Allergist), an angry flare of eczema or a symptom of that unfortunate catch-all perimenopause (dermatologist), Paget’s disease, which is a cancer of the nipple itself (OBGYN), or maybe, none of these or all of these or some other kind of cancer or breast disease (breast oncologist and radiologist).
It has been a wild, and wildly annoying, three months. Blood tests, allergy scratch tests, steroid shots in my butt, antihistamines, antibiotics, a mammogram, ultrasound, two MRIs, a biopsy. A shoebox full of prescription creams and treatments. All of my personal care products and carefully curated skin care regimen had to be chucked to appease the rage of the hot splotchy sunburn of my raw skin.
Now that I have the biopsy results, I still don’t have a diagnosis beyond “probably a dermatological condition related to perimenopause”, but the medical experts are satisfied that it is nothing malignant. Scary, gross, itchy, annoying, and expensive, but not malignant.
The breast oncologist was confident from the beginning that even if they found cancer, it would be localized and treatable. “Whatever this is, we’re getting on top of it early” she assured me. Miraculously, I believed her.
Throughout this ordeal, people I love have reached out with funny texts and meme-packed DMs and urgent speakerphone calls while driving to school pick up. “Are you OK? How are you handling everything? How’s your anxiety?”
It’s good to be known.
I wasn’t worried. Not because I was optimistic, mind you. Maybe because I know my body, and it wasn’t telling me this was the end. It was telling me there is some weird shit going on in there, and I felt a peaceful hum when one doctor gently suggested it was most likely the beginning of the maddening and murky symptoms of perimenopause, when my body begins its downshift out of its Reproduction Era and into an era of (so far, in my experience) Giving Zero Craps about the trappings that used to form social norms of my identity.
Oh, and physically, perimenopause is like some kind of bizarro-world repeat of puberty, apparently. Who wants to play “Will I Get My Period This Month, and if so, Will It Last 3 days or 13?”? Acne! New soft curves out of nowhere! Crying all the time! Poor Sleep! Caring about everything intensely and caring not at all about anything!

Speaking of puberty, I was in the thick of that mess in the early 90s. I was obsessed with Dead Poets Society. So obsessed that I wore out our VHS tape and my mom refused to buy a new one, for fear that the nightmarish ending was resonating a bit too hard with my impressionable first wisps of teenage depression.
I wasn’t focused on the shock and horror of Neal’s death. Dreamy, preppy nerd boys reciting poetry in a cave? Yes please. I bought my own Sharpie marker and scrawled CARPE DIEM on every surface at my disposal. School folders, my shoes, handmade posters for my wall. I even got a t-shirt with the phrase printed in block letters across the chest.
Seize the day, boys. Make your lives extraordinary.
I did not want to take even one single day for granted. I wanted to make my life extraordinary, too. I didn’t appreciate the through-thread of grief in that movie until I was much older.
The questions I had then still tumble through my head in quiet moments. What makes an extraordinary life? What happens if you just live an ordinary one?
So now that I have spilled my personal midlife crisis all over you, what’s next?
Months have given way to years of “What’s Next?” in my life. Maybe in yours, too. This year feels like a year I need to make more space for change. Years of survival mode haven’t produce the best fruit.
I’m waist-deep in some program evaluations and risk assessments in my work life, which have given me a lot of food for thought for my personal life. Am I using my resources effectively? Do I have any blind spots that expose me or my family to unnecessary risks? Are my activities furthering the mission? Am I experiencing mission creep? What needs to be cut to get closer to my vision for myself? For my family? For the part I have to play in my community? This is how my brain works.
My birthday has always felt like my personal New Year’s Day, so this year I’m going to be thinking about Spaciousness and Change and a whole lot of letting go of the “meh” to make that space for that change. And recent events have inspired me to make this year the year I start taking a little bit gentler care of this midlife body of mine, on purpose. And enjoying her more, without shame or judgement. Learning to love her and work with her and listen to her, rather than the clang and the clatter, is the work in front of me this year.