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...