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CHAPTER 1
Sienna
March
The paper sheet crinkles as I lie back on the exam table per the doctor's instructions. I stare at the fluorescent lights in the ceiling and imagine that the long breaths I am taking will pull calm over my fear like a tarpaulin over the back of Daddy's pickup.
It will be okay.
I wish someone else were saying those words to me. Holding my hand. Kissing my forehead.
"Sienna is a pretty name," Dr. Sheffield says in a coffee-shop-conversation tone. She's in her late forties, I think. I wonder if she has kids.
"Thank you."
"Wasn't there a Seinfeld episode about a girl named Sienna?" Dr. Sheffield pulls back the right side of the paper gown I put on five minutes ago — opening in front, per the nurse's instruction.
"Yeah."
"Lift your right arm, please."
I raise my arm, bending at the elbow. The doctor begins the breast exam while the nurse stands like a centurion in the corner of the room. To ensure propriety, I assume. I think it would be more appropriate to have fewer people looking at my half-naked self.
"Wasn't the episode about George dating a crayon?" the doctor continues.
"Yeah." Tyson and I had found the episode a few years ago after yet one more person had brought up the reference to my name. People a generation ahead of me. Dr. Sheffield fits that category just like this topic fits well into the small-talk paradigm.
"So, Sienna is a color?"
"Yeah."
"Reddish brown?"
"Yeah." Dad says it's the color of sunset in autumn, when sunlight has depth and shadows are solid. Tyson compares it to the red dirt in Hawaii, where we honeymooned a million years ago.
Dr. Sheffield's movements become slower, focusing on the upper part of my right breast and confirming that the lump isn't some macabre figment of my imagination after all.
I begin anxiously reciting the poem I memorized in the fourth grade. I need to distract myself.
Who has seen the wind? Neither I nor you. But when the leaves hang trembling, The wind is passing through.
The poem always makes me think of the line of poplar trees separating the backyard from the ranch. When the wind blows, the leaves sound like a river and shimmer like thin sheets of metal. Wind is invisible, but you know it's there because of what it does.
"That's the lump?"
I nod.
"Tender?"
"A little."
"Hmm. Let me check the other side. Put your left arm over your head."
I do as I'm told, then close my eyes and picture the shimmery leaves of the poplar trees again. I recite the poem a second time and try to add other images to center myself on the far side of the swirling panic. Acres of ranch land, tight against the horizon. Tyson with his shirt off throwing bales of hay onto the trailer. I can see the memories but can't get lost in them the way I so desperately want to.
The doctor finishes examining my left breast and pulls the paper gown over that half of my chest. She goes back to the right side and moves more slowly for a second exam.
"Your mother had breast cancer?"
Inhale.
"Yeah."
"When?"
I do the math in my head, though I shouldn't need to.
Exhale.
"Twenty-three years ago, I guess. I was two when she died." The paperwork I had filled out in the waiting area had asked about my family medical history but not whether my mother's breast cancer had led to her death. I think that's an important oversight. I imagine my mother — a woman I don't remember, though pictures prove that I look like her — lying on a table just like this one twenty-three years ago. There is only one family photo of us, taken in the hospital on the day I was born — Dad grinning bigger than I've ever seen and Mom's freckled face flushed and sweaty. Dad calls the freckles I inherited from Mom "Cinnamon Sprinkles." Not a little smattering on my nose but rather head-to-toe coverage that gets darker when I spend time in the sun, though the parts of me that have never seen the sun are freckled too.
"Any other direct relatives with breast cancer? Aunt? Cousin? Grandmother?"
"I don't think so."
The doctor raises an eyebrow, and I answer the unasked question. "I don't know my mom's side of the family.
"They're in Canada," I continue, reapplying the effort it takes to stay in this moment. "My mom was an only child." So was Dad. So am I. I've been so sure that I would be the one to usher in a generation that would fill all six seats around a standard kitchen table. After two years of trying to start that fantasy-league family the old-fashioned way, Tyson and I went to a specialist and found ourselves in the seventh circle of modern baby-making hell. Pokes and prods turned into drillings and scrapings. Thirty-thousand dollars and multiple procedures later, we had nine viable embryos and fresh hope I find embarrassing to think about now. The first round implanted three embryos, all of which failed. Tyson wanted to take a break. At first he said it was so that my chemistries could stabilize, but then admitted that he'd started exploring some career options that wouldn't be feasible if having a baby were our first priority, which it had been for three years by then. It broke something in me. What if all our efforts had been a waste? Of time. Of money. Of marriage. Of all that stupid hope. I had been trying to recover from the fallout of all of that when Dad got sick. Now what? If this is cancer ... what then?
"Do you know what stage your mom's cancer was when she was diagnosed?" the doctor asks, drawing me back to this moment.
"No."
"Was it a single tumor or multiple?"
"I don't know." Why don't I know?
"I'm sorry for all these sensitive questions." She is still palpating, pressing from angles I did not know existed. It hurts. Has she found a second lump?
"Do you know how long after diagnosis your mother passed away?"
Finally, a question I have an answer for. "About six months." I have outlived Mom by two years now. I am supposed to live a long, productive life to make up for her not having had the chance. I had already been failing on my course when I found the lump.
The centurion nurse holding my chart clears her throat. "Her dad is under fifty and has had prostate cancer," she says.
Her sentence should be followed by an exclamation point. Both of my parents have had cancer! One of them is dead.
I am drowning, flailing my arms in hopes of finding something to stop my descent when Dr. Sheffield asks, "When was that, Sienna?" The calm of her voice becomes the steadiness that I am looking for. I grab tight, dig my nails in, and pull myself up to where there is air to fill my lungs again.
Who has seen the wind?
Inhale.
Neither I nor you.
Exhale.
"Last fall. They caught it early, and Dad agreed to aggressive treatment. He's doing pretty good." Pretty good, but not well. Not really. I can't think about that right now if I want to hold myself together.
Dr. Sheffield nods. "Did you notice in your self-exam that the lump moves?"
"Yeah." Google said that was a bad sign.
"It's small."
"Yeah." Google said that was a good sign.
The doctor pulls the right side of the drape closed, sits down on her rolling stool, and puts out her hand for the chart. Paper charts — so twenty-first-century Wyoming.
"You can sit up, Sienna."
I sit up and pull the paper gown closed across my chest, trying not to feel violated. Not by the doctor — this is her job — by the lump.
Dr. Sheffield looks up from the chart, her expression sympathetic. "Thursday is your birthday?"
I shrug. I've been dreading my twenty-fifth birthday since before I found the lump. The day will end with one of the letters Mom wrote to me on her deathbed. They were a way for her to remain a part of the life of the daughter she would never see grown. I used to revel in those letters that started with "Dearest Sienna." I'd also used the advice within them the way a ship captain might map his course by the stars. According to the pattern of previous letters, this one will be full of advice about motherhood and enjoying the journey and treating my marriage as the most important relationship I'll ever have. This is not how my life is supposed to go, I wail in my mind with plaintive regret, frustration, and embarrassment wrapped into a ball of silent words. The keening rolls through my mind like a thunderstorm across the prairie.
Deep breath.
Hold it together.
I have the whole drive back home to fall apart.
"You've never had a mammogram," Dr. Sheffield says as she sets the chart aside.
"No." I've thought that I'm not old enough for mammograms. But I'm not a woman of average risk, am I? Why hadn't I taken that more seriously?
The doctor opens a drawer, removes a pad of paper, and starts writing. "My nurse is going to call the woman's center here in Cheyenne. If we're lucky there'll be a cancellation today. We'll need the mammogram and ultrasound before you come back here for a biopsy. Can you do all that today?"
I want to say no, I'm not ready. "Yeah."
The doctor tears off the paper and gives it to the nurse, a look passing between them before Dr. Sheffield's attention settles on me again. Her expression softens.
"This is all very routine." Dr. Sheffield smiles. "If you didn't live such a distance away, we wouldn't be moving so fast."
I appreciate her empty comfort the way a blind man might hold a sentimental photograph and force a polite smile to show acceptance of the offering. I begin to shake on the inside. This is real. It's happening. I imagine that after my mom was diagnosed, she held me and Dad and cried. Who will I hold? Who will I even tell? My family can't take this.
"The results won't be available for a few days. I don't suppose you'll be staying in Cheyenne that long, though."
"I have to head back tonight." Dad thinks I came to Cheyenne to pick up a riding saddle I want to fix up. I found the saddle listed for a reasonable price last week and convinced the buyer to hold it until today if I Venmoed him an extra twenty dollars. The saddle has a hand-tooled border and wooden stirrups but is in need of new straps and stitching. Dad agreed to pay for the saddle as my birthday gift, and I arranged pickup around this appointment. I'm going to have to think of an excuse for why I'll be hours late getting home. I don't need another saddle or another leather project as much as the ranch needs the four hundred dollars. But Dad bought the saddle because he loves me. Because he wants me to be happy. Because family is everything and I am the last branch of our family tree, barren and stark against a winter sky.
There is a tapping at the exam room door, and it opens a few inches. I can't hear what's said from the other side, but Dr. Sheffield nods in response. The door shuts again, and the doctor faces me. "We're in luck. The radiology department can see you in forty-five minutes. We'll text you with the time you can come back this afternoon for the biopsy as soon as we figure out where to fit you in. Does that work?"
My stomach begins to hurt. I hadn't expected things to be quite so efficient. "That works," I say in my big-girl voice. I want to appear confident, strong, and ... I can't think of another word to describe the woman I have tried to be for years. I'm not that woman. Maybe I never was. Maybe I never will be.
The doctor puts the chart on the counter and rests her hands in her lap as she looks at me with a compassionate expression. Her bobbed brown hair is perfectly coiffed as though it's popped out of a Jell-O mold each morning. She doesn't look old enough to be one of those women who goes to the beauty shop once a week to have her hair set, but maybe she's older than she looks — yet young enough to appreciate Seinfeld and wear Dansko clogs. Or maybe she spends an hour on her hair every morning. Maybe one day I'll have a high-maintenance bob like that and stop putting my hair into a ponytail all the time. Maybe I'll be bald in a few months. Maybe I'll be dead. I swallow the bile that rises in my throat.
"I'm glad you came in, Sienna. So many women wait too long, especially when they're young. If this lump is cancerous — and I'm not saying that it is — you caught it early, and that can make all the difference." She cocks her head to the side, looking more thoughtful; sympathetic. "Are you okay?"
I look down at the textured paper drape covering my thighs so that I can hide my thoughts. No, I am not okay. I haven't been okay for a long time, and this certainly doesn't push me over the mountain range that separates me from everyone else. People who make a plan for their lives, follow it, and look back with self-assurance of a job well done. "Yeah."
"A few final questions," Dr. Sheffield says when I don't offer anything else. She picks up my chart again and glances over the paperwork.
"Your insurance is through a Tyson K. Richardson."
I pick at the drape.
"Sienna?"
"He's my husband."
"Does he know about this?"
We don't really have that kind of relationship anymore, but out loud I give the same excuse I've given everyone else these last months. "He's working in London right now." Like coming to Cheyenne for a saddle, it's true. But like this appointment I've hidden from everyone, it's not all the truth.
She waits a few seconds until she realizes I'm not offering up anything else. "But you put down Mark Chadwick as your emergency contact — that's your dad? You live with him in Lusk, right?"
I nod.
"Does he know you're here?"
I want to say that I'm not a child and I don't need my dad to hold my hand for a lady doctor appointment. Instead I shake my head. And wish Dad were here and that he were holding my hand.
"You and your family have been through a lot, and I'm guessing that makes it hard to talk to loved ones about difficult news, but this is a really heavy burden for you to carry alone, Sienna. Don't keep it in."
"I won't," I say.
You'd think that without much experience being dishonest in my life, telling these lies would be hard. I tell myself they're coming easy because they are kind lies. Necessary ones. Protective.
The doctor leaves. I shed the paper drape and start putting my clothes back on while I wonder who I'm really protecting. Them or me?
CHAPTER 2
Mark
October 1993
Mark turned off the alarm on the clock radio within a nanosecond of the newest Celine Dion song blaring from the speaker on top — they loved her up here. He missed his Alan Jackson, truth be told, but when in Rome. ... He rubbed a hand over his eyes and looked over to make sure the alarm hadn't woken Mae.
Dolly's Donuts had to be hot and ready by six in the morning Monday through Saturday, which meant the donut fryers clocked in at three a.m. He really needed to get to bed earlier, but that thought only emphasized why he continually stayed up too late. Despite the pride he'd taken in turning off the alarm before it woke her, he rolled onto his side and slid up against her smooth back, closing his eyes and loving how perfectly their bodies fit together. He nuzzled her neck, and she snuggled backward into him, a mewing kitten-like sound escaping those perfect lips. He was suddenly very awake.
"I've got to get to work," he whispered into her ear, hoping she'd convince him that he could stay in bed another ten minutes.
"Mmmmm." She didn't turn around to face him.
What he wouldn't give to stay just like this all day. Even if all they did was lie nestled together, warm in their bed: enough world for just the two of them. After another minute, he accepted the inevitable, kissed her neck, and began to pull toward his side of the bed — it would be freezing when he stepped out from under the covers. Their tiny apartment was heated by a single radiator in the living room, which meant the bedroom was left to the influence of a very cold fall. Mae rolled over to face him before he moved away, lifting her hand to trail her finger down his forehead and over the bridge of his nose. When she rested her finger on his lips, he kissed it and could just make out her responding smile in the dark. Her hair looked like mist floating around her head in the minimal light cast by the streetlight outside. "You 'ave to go?" she asked.
The accented words rolled off her tongue. "You know I do. It's a good job."
After blowing out his knee on the rodeo circuit when he was nineteen, Mark had convinced Mom that it would be worthwhile for him to get a degree in agricultural management. If generational ranching families like theirs wanted to make it into the new millennium, it wasn't enough to just know how to raise and sell cattle. The University of Wyoming, in Laramie, was close enough for him to work the ranch on weekends and come home for summers. When his final year at U of W came into view, he met with a counselor about study-abroad programs. The rest of his life was going to be spent on the ranch, and before that happened he wanted to live somewhere else. It was the only part of the world outside his home state he was ever likely to see. Mom eventually agreed to a two-semester program offered in Ontario — at least he wouldn't have to cross any oceans or learn a different language.
(Continues…)
Excerpted from "Whatever It Takes"
by .
Copyright © 2019 Josi S. Kilpack.
Excerpted by permission of KENSINGTON PUBLISHING CORP..
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