Bleeding Heart

Bleeding Heart

I pull back its pink wings,

joined like lungs around an aorta.

Dew puddles in the center chamber,

sits like a crystal ball.

Puss pools, too, on my finger,

teeters atop a mass

the size of a driveway stone.

Cracked open, it bleeds like a river.

I crush the tender-skinned

petals in my palm,

paste the balm on the protrusion

to be biopsied tomorrow.

They say cancer is born of sadness.

Like an eye, the tumor weeps.

 _______________________

REFLECTION

In my third trimester of pregnancy, a small red spot appeared on my right middle finger. It was the size of pen tip at first—tiny. It was raised and bled often. I assumed it was a wart.

Within a month, it grew to be the size of a pencil eraser. The only thing alarming about it was how quickly it had appeared. And, how insistently it bled.

The doctor diagnosed it on sight: a pyogenic granuloma—a small vascular tumor commonly associated with pregnancy. Such masses are the result of hormones over-producing tissue cells around an injury. What was likely a crack on my knuckle had become a lump of too many white blood cells.

Within a week, a dermatologist confirmed the diagnosis via shave biopsy. She used a blade to cut out the extra tissue and a cautery tool to burn it closed. 

“Pyogenic granulomas have a high recurrence rate,” she said. 

“What do you mean?” I asked. My finger throbbed.

“It’s likely to come back.”

“How likely?”

“Odds are about fifty-percent.”

I held my finger and my 38-week pregnant belly and prayed that was the end.

*

But it wasn’t the end. It came back. Three more times. A month after I gave birth to my son, the little red spot re-appeared.  I schlepped the car seat and my three-week-old back to the dermatologist’s office.

“These are pesky things,” she said, holding a canister of liquid nitrogen. “Let’s try freezing it.”

But that didn’t work, either. Six weeks later it reappeared. She excised it again. Cauterized it again.

“If this doesn’t work,” she said, “You’ll need hand surgery.”

At that point, I still viewed the little spot as an inconvenience. I had yelped in pain—the knuckle joint was swollen—and stain-sticked blood out of many shirts by that point, but it didn’t prevent me from doing tasks. The possibility that it was more than a benign annoyance didn’t even enter my consciousness, which was centered around caring for a newborn and my young family. I was so deeply enmeshed in the beginning of the life cycle, that the end of it loomed out of sight.

It was not until puss literally started oozing out of my finger, the tumor now the size of a driveway stone, that I started to get suspicious.  It was shaped like a volcano, the skin layers climbing up and peeling off the small mound. It was red and swollen, the top of it covered with a thick film of oozing white blood cells.

“It looks like an eye,” a friend of mine said over coffee.

I tucked it out of sight because I was embarrassed by how unsightly it had become.

But her comment alarmed me. It was an odd thing to say, that the tumor looked like an eye.

An eye was a live organ.

An eye saw things.

An eye provided clarity.

*

There is a saying that that when you point a finger at someone else, there are four pointing back at you.

Around the time of the eye comment, I was deeply considering my relationship with contempt—more specifically, how MY contemptuousness was influencing my marriage and family.

The context: my husband, kids and I were recovering from Covid and the stress of parenting three small, sick children (while sick myself) with little help or emotional support had pushed my rage to the surface, again. I was furious with my husband for his inability to show up. For what felt like abandoning me at a time I needed help. Underneath that, of course, for all the ways I’ve felt abandoned in my life.

Even when my husband did help—to give our son a bath, for example—I did not appreciate it or allow it to offset my frustration. Long-simmering negative thoughts had created biased lens that I could not set down. In other words, he simply could not win. My resentment—and exhaustion—controlled my attitude and the way I interpreted his actions. I felt filled with scorn and blame.

“When we are so filled with intense negative emotion, it is bound to bubble up,” my therapist said after our Covid experience. “We cannot bottle rage and expect it to stay put.”

*

My anger was, quite literally, erupting through my skin. Someone even pointed out that it was on my middle finger: the “fuck you finger,” as she put it. My body had manifested my internal environment. And it had the energy of urgency, petulance, doggedness. Despite any intervention, it kept coming back.

I imagine my anger, this fury embodied in a small blood-filled tumor, to be like a small, scared child sitting in a classroom. At first, she raises her hand: I am here. Then, after being ignored, she stands on her chair: I AM HERE. After the teacher shushes her, she stands on the desk and yells: I AM STILL HERE! Then, after three attempts to communicate, the girl jumps off the desk and starts cry: I TOLD YOU I WAS HERE BUT YOU DIDN’T LISTEN, she screams.

It was not until my tumor wept, quite literally started weeping pus, that I began to listen. To really hear that my body cannot sustain the intensity of experience within it.

I booked an appointment with a more experienced dermatologist, at a bigger hospital.  

“This is very concerning,” she said at my consult. She examined the granuloma under a bright white light. “It’s behaving abnormally. I am concerned there is something else going on.”

“Something else?” I asked. 

“We need to rule out melanoma.” She prepared a punch kit to biopsy, again.

My face went white. “Okay.”

She took three samples from the mass and stitched it shut. “We will call you right away if it’s cancer.”

*

My mother was diagnosed with cancer when she was 44, just six years older than I am now. It all started with a lump—a mass of ticked-off cells. 

Even before her cancer diagnosis, her own anger simmered below the surface. As a child, she had learned to keep it there because her father’s temper was sharp as a razor—cutting, shaming, mean. She learned to push her own frustration away in service to someone else’s. The result was denial and inexpression: a vibrating inner core with a mask of fine-ness.

I remember feeling like she might be hot to touch when I was young. I knew not to ask for things when she was shuffling around the kitchen with her eyes cast down. She rarely exploded, just quietly boiled, denied, boiled, denied.

Occasionally, she would blow. “God DAMN IT,” I remember her yelling once. I was six, maybe. I had convinced my brother to cut a hole in the screen door that she had just replaced. It scared me, the intensity of it, and confirmed something to which I had been vigilant: underneath her passionate, happy façade, there was a deep well of rage.

The rage erupted from her body after she found out my father was gay. She was 42, with two young children, and was blind-sided. She loved him, but, I imagine, felt gravely disappointed, betrayed and hurt. Abandoned. Her expectations of a perfect family unit, unlike that of her childhood, had been shattered. And so, her anger found its lightening rod.

Two years later she found a mass in her left breast.

Over her ten years of cancer treatment, her anger—at least toward my father—became characteristic of contempt. Her simmering started to boil—became sharper and more aggressive. Under her breath, or sarcastically, she would call him a “downer,” a “hum bug” or a “fun killer.” I would cringe when she did this, but deep down I understand her urge to blame.

I, too, blamed my father: for, in essence, being who he was.

*

I’ve read that cancer is born of sadness. And, as my therapist says, anger is almost always born of hurt. And fear.

The day after my biopsy, I laid on the grass in my front yard. With my back against the earth, I wept. Tears slid down my cheeks and onto the wet earth. My mother had been dead for sixteen years.

Like a bank of fog, my mortality surrounded me. What-if’s paraded through my mind and the thought of–the mere peripheral gesture toward–leaving my children behind was enough to make me stand straight up and howl. I could not even sit with the idea. I was terrified that my undealt-with-stuff, my lens of anger-turned-contempt would make my body revolt—would be responsible for leaving my own children motherless.

Next to me, the bleeding-heart flowers were in bloom. Like a parade of tiny soldiers, they hung from a delicate green branch.

I plucked one from its stem and held it in my hand. Its petals were so delicate, so thin, so – fragile. Mortal, in a way. Within a month, the little hearts would fall to the ground, become part of the soil, exist only as memories.

I crushed the little heart in my hands, rubbed it over my tumor.

What if, I kept asking myself: what if this were cancer? What would I do differently immediately? What would I change?

What is my finger telling me?

In his book The Body Keeps the Score, Dr. Bessel van der Kolk writes, “Once you start approaching your body with curiosity rather than fear, everything shifts.”

*

In the week I waited on pathology results, a mentor of mine suggested that I ask my finger itself: what are you here to tell me? So each day I wrote the answers in my journal.

It occurred to me during one of these writing sessions that the actual tumor, covered with a Band-Aid, was the exact point where my pen hit my hand—the exact point of mean-making on my body.

The questions unfurled: how were the stories I was writing, telling myself, hurting me? How was the narrator in my mind creating such a negative bias, that my body was in constant survival mode, convinced of its need to drain energy protecting itself? Perhaps the eruption at the touch point of being a storyteller – my right hand, middle finger—was making clear that the way we tell the story affects the body.

That the stories themselves can be toxic.

Shifting the story, then, might make my body respond differently.

I began to reflect on the anger I held toward my husband based on our bout with Covid—a case study of the larger dynamic. What was another story, one beyond the track that I kept replaying in my mind? 

Such an exercise requires a new narrator: one who is not stuck in resentment. The victimized narrator can write the story of a husband who didn’t show up for her during Covid—abandoned her. But there is another truth, another way to see the same story. A detached, hovering-above-the-trauma-response narrator—the one who has the power to shift her perceptions—might pen this story: her husband was just being himself, taking care of himself, and these actions activated his wife’s deep abandonment wound.

The gay husband was just being himself and it activated his wife’s deep unprocessed anger from her childhood.

So how, I asked my finger, could I become the second narrator, the one who gives the benefit of the doubt?

To take on this perspective, I needed to find ways to befriend the anger coming through my finger—the anger signaling my need to take care of myself. To stop telling the wrong story.

To stop pointing the finger.

Continually, the messages from this exercise returned to this: “You cannot sustain the anger or contempt.”

It never said, or else.

It didn’t need to.

*

In his book A Year to Live, Steven Levine talks about the consciousness of the dying—how when we get to the end of our lives, there are common themes that arise, such as taking more time to do what fulfills us, to forgive. He argues that we don’t need to be given a terminal diagnosis to harness this energy, to assume this consciousness. As an exercise, he encourages readers to live a year like it was your last.

One morning, when I was writing, I let myself imagine what this would be like—to receive a terminal diagnosis. My gut told me that the tumor on my finger was not malignant, but I returned to my question, what would I do differently?

Immediately, a short list came to me—from planting more flowers in my backyard so I could be surrounded by more beauty, to hiring more help with my children so I could write more regularly, to taking monthly retreats to the ocean, to not worrying so much, to taking serotonin, to letting go of my contempt toward my husband.

*

Seven days after the biopsy, on the 16th anniversary of my mother’s death (to the day), I got the pathology report:

BENIGN pyogenic granuloma.

I rejoiced at this, of course—that I did not actually have to receive a cancer diagnosis to hear the messages my body was giving me. That a near miss might be enough for me to wake up to the effects that my internal environment was having on my body and the ripples it was likely causing to those around me.

Maybe this experience could be enough.

So, with a bandage still around my middle finger, I went to the local nursery. I walked through the rows of petunias, peonies, pansies, marigolds, snapdragons, roses, begonias, hanging plants, annuals, perennials, and I stopped at the bleeding hearts.

They were so very fragile, fleeting, delicate.

I handed my credit card to the cashier.

“What’s wrong with your finger?” she asked, pointing to the bandage.

“It’s a wake-up call,” I said, half-laughing.

“A what?”

I shook my head. Smiled. “Never mind.”

When I got home, I put on a gardening glove, dug a deep hole, and planted the bleeding heart for my mother. For myself. For my body speaking up. For the warning and reminder that life is too precious to assume we have the time, or the vitality, to allow the rage to live within us. 

Because unchecked, it will erupt.