Date: August 15, 2008
Name: Gila Pfeffer (nee Reinitz)
Age: 34
Height: 5′3″ (OK, 5′2¾″)
Weight: RUDE

Who referred you to see us today? My ob-gyn referred me to this practice specifically, but if you’re asking whose idea it was to have a prophylactic double mastectomy, that’s all me. I’ve been wanting to do this since I first heard about it.

Have you had a psych eval? Yes, I’m fully on board with my choice and frankly would need more of a psych eval if I was prevented from having this surgery. If you think my anxiety levels can’t get any higher, oh yes, the hell they can.

Are you aware of the emotional and psychological impacts of this type of procedure? Yes, I expect to come out the other side of this feeling emotionally whole and validated and psychologically strong, maybe too strong, as though I am invincible. Are you aware of the implications of my not having this procedure?

Do you understand that this procedure is irreversible? I certainly hope so, ma’am.

What is your current bra size? DD

Will you opt for reconstruction? Yes, but less because I care about what my boobs look like and more because of the TRAM Flap reconstruction method, where they take your stomach fat and muscle and repurpose them into breasts. I’ve given birth four times in less than six years. If anyone’s due a free tummy tuck compliments of our expensive health insurance company, it’s me.

What cosmetic result do you hope to achieve in undergoing this procedure? Look, you can replace my breasts with two frozen rib-eye steaks or a pomegranate and one balled-up sock—I don’t care, just get these two ticking time bombs off me.

Please list all operations and hospitalizations: Unless you count the dental implant surgery I had when I was thirteen, I’ve never had any operations, never broken any bones (p’tooh, p’tooh, p’tooh), and overall I’m rather risk-averse. I’m terrified at the thought of undergoing general anesthesia or having my body cut open. I’ve been hospitalized four times, and each time I went home with a new baby.

Last menstrual period: Oh, around three weeks ago, I guess? I’ve got four kids under the age of six; you’re lucky I can remember my own name.

Have you experienced menopause? God, no, I’m only thirty-four.

Were your ovaries removed? No, were yours??

How many pregnancies have you had, and how many live births? Four of each. (Thank God.)

Are you taking any contraceptives at this time? Yes, NuvaRing and it’s the absolute best.

Are you a BRCA gene carrier? What gave it away? Was it the chart of dead relatives in my first intake form? My obsession over having this prophylactic mastectomy? The way I hold my pen?

Anything you’d like to ask the doctor? Well, off the top of my head…Will the anesthesia tube knock my teeth out? What if I wake up in the middle of surgery? What if I die in the middle of the surgery that I’m having to make sure I don’t die?? Will you need to shave any of my body parts? If so, which ones? AND WHO WILL BE DOING THE SHAVING?? I’ve heard that surgeons have a radio station piped into the OR while operating; are you sure this is a good idea? What if they sew me up and forget they left a SURGICAL TOOL in my body, and I set off airport security alarms for the rest of my life and get detained when the TSA lady can’t find any metal on me, even after a pat down, and I miss my flight????

Anything else we should know? I’m terrified. If I try to back out of this, please stop me.

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This is an excerpt from Gila Pfeffer’s new memoir Nearly Departed. You can buy the book here.