Amy Cohen - Fighting Chance

 

So I, as you now know, have always been a very fearful person. And as a child, I was the little kid who was gripping the stairs in the shallow end with the floaties and the kickboard. And as an adult, I was the person who would see a spot on her leg and think, "Oh, my God. It's cancer," only to realize that it was newsprint from the Sunday Times. [audience chuckles] Yeah. And, I mean, I did not think that I was strong enough for electrolysis, let alone the diagnosis I got when I was 38, when I found out that I had tested positive for the BRCA1 gene mutation, which is often called the breast cancer gene. And I got tested because the women in my family get breast cancer. My mom, my sister, my aunts, my grandmother, they all had it. And when you test positive immediately, like within five seconds, you are assigned an oncologist and they tell you just in case. And I said “It felt like I was taking my first drink and signing up for rehab, you know, just in case.” [chuckle] 

 

And the other weird thing about the test is that they call it a predictive, meaning that it is supposed to predict your chances of getting breast cancer throughout your life, which are said to be as high as 86%. But the weird thing for me was it is sort of hard to understand, is that I felt like I had it. I felt like I had it already. And no one was sort of giving me the legitimacy of saying, like, "We have it already." So, I felt like it was in me. So, I was so anxious all the time. And one of the ways that it manifested was I was constantly giving myself breast exams. So, I would be at dinner with friends, and I would be like, "Oh, yeah. The tandoori chicken sounds really good." [laughter] Yeah. And I was just a wreck. And I started to think, "You really need to do something."

 

And they tell you that you really only have two options. And the options are aggressive monitoring or a prophylactic mastectomy. And so, I started thinking about that. But one of my big fears was, “Am I strong enough for this? Is it going to be okay? Or am I going to explode like a cheap Chinese firecracker? I did not know.” So, the strong one in my family has always been my sister, and never more so than in the year that she had breast cancer. And she is just one of those amazing people who whipped up lemon tarts for a radiologist, and smiled when blood was drawn. And the joke that we had, and it is so true, is that I said I was hoping I could keep up with your exercise schedule when you were on chemo. But clearly, I was wrong.

 

And we always said that it was my mom's legacy of how to deal with breast cancer. You know like you are going to kick cancer's ass. And our mom had breast cancer the first time in 1972, and it was really considered a death sentence by many. And she had a really serious case, and it was a miracle she survived. And she was always so happy to be alive after that she got excited about the littlest things. And she would say, like, "You know DADDY and I went to Morocco and we bought bananas from a toothless woman who was selling them with her feet." And it was like, "Woo, that's so exciting." [chuckle] 

 

And my mom actually had a very, very radical double mastectomy. And in the early 70s, they really gouged you out. So, in profile, she really looked a very delicate letter C. And, I mean, we had no nudity in our household. And I think I always thought that was part of it. And I used to joke that in our house, nudity was the state of existence between the shower and your towel. That’s it. [audience chuckles] Because my mom was always really, really self-conscious. And I always thought it was because of her mastectomies. And so, in addition to worrying about everything else, I really worried that I would hate my body as much as I always thought my mom hated hers. And so, I called my sister and I said, "You know, I'm thinking about getting this operation." And she said, "What took you so long?"

 

And I thought that was particularly amazing because seven years before my sister got breast cancer, she actually had a double mastectomy. And it is very, very rare that anyone gets it. And in fact, the doctor said, "We've only heard about this happening once in Europe." So, we really felt like, "Oh, my God, is this really us?" But it wasn’t. My sister is so incredible that she has been just a model to us all, but she was one of the 3% to 7% who got it. And she was so encouraging of my getting it that I decided to schedule the operation and I could cancel at any time. That was what I kept on saying, "Cancel at any time."

 

So, I started telling people that I was going to have the operation. And the first thing I said is "I can't believe I have to get rid of my breasts," which I actually liked. I mean, I actually liked them, and they are very perky little A-cups, like, people with like, it was sort of like a-- I do not know, like a demitasse cup. I mean, they are tiny. [giggles] And I said, "Why do I have to be getting rid of those? Why cannot I be getting a cellulite ectomy? [audience laughter] That would be good.”

 

But I think part of it too was that I really did not-- I wanted to sort of set the tone for how people were going to deal with me. I did not want any pity. And one of the weird things too is that I was so anxious and so, down. I mean, I was down for so many months when I found out that I was really afraid that if I did not set the tone, people were going to bring me down. So, I was very much like, "This is how we're going to deal with it. Please just respect that." And people were really good. But still I really felt like someone might freak me out and again, I might back out, but I did not.

 

I decided to have the operation at Memorial Sloan Kettering, where they really encourage you to take what’s called a reconstruction seminar, which I said sounded like something from the Civil War. It sounds like a Civil War reenactment, does it not? [audience chuckles] Like a reconstruction seminar with Confederate flags and people in period costume. [audience chuckles] 

 

But in fact, it is a place where you find out about different methods of reconstruction. And there are really two kinds. One is implants, which we all know. Hello, Pamela Anderson. And the second is called TRAM flap surgery, where they take fat from usually your buttocks or your hips and they make them into very natural-looking breasts, but usually have to be a little bit heavier. And so, my plastic surgeon said, "No, no, no. Unless you gain 50 pounds, you're really not a candidate." And I said, "Okay."

 

So, we went to this reconstruction seminar and we saw lots of before and after photos and I was in a room with like about 70 women, all of whom had breast cancer. And I did not tell them why I was there. And I got to ask my question, which was, "Do people ever get implants and then decide to get the TRAM flap surgery?" And they said, "No, no, no, that never happens." And so, afterwards, I was standing by the buffet table, and this woman came up to me and she was wearing the kind of really kooky glasses that German avant-garde architects wear, you know, like Elton John, and something bad is going to happen. And she said, "I was talking to my husband, I heard your question about not having enough fat. And I said, 'Look at her. She's got plenty of fat. Plenty.'" [audience laughter] And I just-- I had just gone through this terrible breakup where I gained 15 pounds and I was eating a Danish at the time, [audience chuckles] so it really did not help. And just the words were ringing like, "Plenty of fat. Plenty." [audience laughter] 

 

And so, I told that story so many times afterwards. And I think one of the reasons I told it is because the truth was so overwhelming for me, which was being in that room with all those women who had breast cancer, I felt lucky. I felt really lucky. And before that, I thought, like, "Who has put in the decision to remove a part of their body? What kind of decision is that?" And then I thought, "Oh, my God, that's a decision that so many of those women wish they had had." And in that room, we had seen so many scary before and after photos, and the after photos were just terrifying. And a lot of these women asked questions and trembling voices, as did I. And that was really the moment where I realized I was not going to turn back. I was absolutely, positively going to go forward with this operation because I was lucky. I really had an opportunity that they did not have.

 

So, we get a little closer to my operation. And I was all misplaced anxiety, never-- I never said like, "I'm excited, I'm terrified about the operation." I would say, like, “Because my parents, my whole family was trying to get me to date.” And I was like, "I am not going to try JDate." I was just hysterical. [audience laughter] Like, that was my big thing. “No. Because I am having this operation and I do not have to.” [laughter] And then the other fear I had is because I had never had surgery, was that I was going to OD on anesthesia. [audience chuckles] That was really--. And that I was going to be the person on 20/20 with the feeding tube like in the assisted living facility in New Jersey. Terrified. Terrified. I had a mosh pit in my chest. I was so anxious about that.

 

And then the day of my surgery arrived, and I was calm. I was really at peace. It was pretty amazing because now you guys know how crazy I am. [audience chuckles] And it was just incredible. And I got to the hospital and I felt really proud of myself. And I remember also wearing my little gown and my little paper booties and shuffling into the operating room and feeling like Sean Penn in Dead Man Walking. And [giggles] then I got into the operating room and the nurse said, "Wow, you don't look 40." And I said, "Well, now I don't need any anesthesia." [audience laughter] And then that was it.

 

And then the next day, I woke up, and it was time to see my new breasts. And I thought, "Oh, my God, is it going to be Pamela Anderson? Is it going to be Anderson Cooper? What am I expecting here?" [audience laughter] "Yeah, who knows?" And actually, I had skin expanders placed under my chest wall, and then they are filled with a little bit of saline. So, I remember being in the hospital room, and my gown was opened, and I slowly looked down, and I said, "Well, that's not traumatic. That's what they look like before," because they are tiny, which was perfect.

 

Then they sort of put more saline in you as weeks go by. And at this point, I realized something incredibly important about myself, which is “I love having bigger boobs. I love it. [laughter] I love it. So, it is the greatest thing that has ever happened. So, [giggles] my plastic surgeon said, "At some point, we really need to decide what size you want to be." And I said, [audience laughter] "Yes, God's here." I said, "Vulgar." [audience laughter] And he said, "Yes.” Because also, it was like the first time my postman remembered my name. I was like, 'I'm loving this.'" And he said, "No, no, no. I'm serious, Amy, what size do you want to be in?" And I said, "Seriously, I want you to think, like, Playboy Mansion, Hollywood Wife, [audience laughter] Carnival. Carnival." Literally, as I was going under, I swear to God, this is true. I was saying, like, "As big as you can? As big as you can?" [audience laughter] 

 

Yeah, yeah. [audience laughter] So that was-- yeah. So, then now, as we know-- so, [laughter] So, when I never could-- yeah and actually, my dad and I had this really cute moment at Starbucks one day because he said-- because I was loving the boobs. And he said, "It's going to be a big year. Aim big, big, big." [audience laughter] And I said, "D, lightful." [audience laughter] We thought that was hilarious. It was our little bit of double mastectomy humor.

 

So I think what I never could have realized in a million years is that I would consider this-- I am almost done, Maz, I swear, is that I would consider this to be really one of the best things that has ever happened to me. I mean, I really-- I really feel that it has changed my life, and I have begun to talk to a lot of women who have had the surgery or are having the surgery. And one of the Times Memorial called me up and they said, "We don't even know how to ask you this." And I said, "I know what you're going to ask." And they said, "What?" And I said, "She wants to see them." And they said, "Yes. Is that okay?" And I said, "Sure. Whatever."

 

So I met her in the locker room of Equinox, and I was like ooh, [audience laughter] which I have done so many times since. And she looked at me, and I knew what she wanted to do. And I said, "You want to touch them?" And she said, "Yeah, can I?" [audience laughter] And I said, "Sure." And so, I went to second base with this stranger in my gym locker room, [cheers and applause] as I have done so many times since. Yes. Trust me. And I think actually, the most incredible thing I have realized through this whole thing is that I thought so much about my mom and my sister and I sharing the BRCA1 gene, but I have realized that we share another gene, and that is the gene that tells you not to pity yourself and to deal with things in your own way, which, in my case meant saying, "It only took me 40 years to become a blonde with big boobs. Great." [audience laughter] 

 

And I so underestimated myself, thinking that I would crack. And I saw these incredibly strong women deal with breast cancer, and I never realized until I had my own episode how much it had influenced me and how much stronger I was than I ever gave myself credit for. And now my sister is perfectly healthy, and she is in the room, and yay. [applause] I know. I love you. And my mom fought valiantly against the brain tumor that ultimately took her life. And I thought about how in addition to the BRCA1 gene mutation, we share another gene, and that is the resilience gene, and that is the gene that I hope will define me and everything I do for the rest of my life. And for that, I could not feel more fortunate.