Don't Judge a Book By It's Cover

My name is Rivka and I was diagnosed with SCC of the tongue at age 29, and a scan revealed metastasis to my right lung about a year later. I have endured chemo, immunotherapy, and radiation to my head and neck area, and then my lung. But the thing that has affected my life the most is a sub-total glossectomy removing 70 percent of my tongue, and a neck dissection removing lymph nodes. I have a "faux-tongue" constructed out of tissue taken from my thigh, and I am still working on my speech and eating skills. I love cats, reading, baking, nature, and trying out different art projects with varying levels of success. I have my ups and downs, and try to be truthful about my cancer experience. No toxic positivity here!


At age 29, while I was working as an English teacher in Argentina, I found out that I had a cancerous tumor in my tongue. Though I am originally from the United States, my parents moved to Israel several years ago. I flew there three weeks after my diagnosis to live with them during treatment. The first treatment (of many) that I endured was chemotherapy, which can affect the reproductive system by damaging egg quality. As I would like to have kids someday, I decided to have eggs retrieved and frozen before chemo as a fertility preservation measure.


I grew up as an Ultra-Orthodox Hasidic Jew, though I have since stopped leading a religious lifestyle. Girls and boys in the Orthodox community are kept strictly separate, and all physical touch is prohibited until marriage. Unlike my religious counterparts who mostly got married in their early 20s, I was nearing 30 and unmarried.


On a warm autumn day, my mother and aunt and I sat rigidly in a row in front of a fertility doctor’s imposing desk. My mother and aunt are visibly religious; they wear long-sleeved shirts that cover their collarbones, long skirts, stockings and wigs. I no longer follow the rules of modest attire, but that day I happened to be wearing a reasonably modest dress. In Israel, where attire is a key signifier of level of religious observance, sect, place of residence, and marital status, my dress and uncovered hair placed me in the category of “single, religious girl” to the casual observer.


The doctor went through all the preliminaries: the schedule of daily shots that I would self-inject in my belly for two weeks, the blood tests and ultrasounds every couple of days, and the egg retrieval surgery once my ovaries were hopefully brimming with egg-containing follicles.


The doctor then wanted to do an ultrasound just to see what he was working with. He said, “We usually do a transvaginal ultrasound, but in your case, we can do an external abdominal ultrasound.” (For the uninitiated: a transvaginal ultrasound involves inserting an ultrasound wand into the vagina and moving it around to view the reproductive system).


I was confused about his emphasis on “in your case,” when I was perfectly fine with a transvaginal ultrasound, especially since it shows a clearer picture.


“Why would you do an external ultrasound on me?” I asked. I could tell I was supposed to be reading between the lines, but all I saw was blank space.

There was a pregnant pause (no pun intended). The doctor cleared his throat and gave me a significant look. “Er, a transvaginal ultrasound can result in a broken hymen.”


I started to laugh, jarring the uncomfortable silence that followed his proclamation. It wasn’t out of discomfort; I had just put the pieces together and was genuinely amused by his assumption. The doctor waited, confusion evident on his face. My mother and aunt sat in stony silence, facial expressions fixed. This just made me laugh harder.


When I was still giggling a few long seconds later, no explanation forthcoming, my aunt leaned over and peevishly hissed in my ear, “Tell him about your IUD.” (At an earlier appointment with a different doctor, my mother and aunt had learned that my uterus proudly and scandalously houses an intrauterine device).


Me: “Um, I have an IUD.” The doctor’s confused expression deepened.


My aunt hissed disapprovingly: “Tell him why you have an IUD.”


Me: “It’s for birth control.”


Comprehension finally dawned on the doctor’s face, and after regaining his composure, he asked if I’d ever been pregnant. My aunt started as though she’d been shocked and let out a gasp. My anticlimactic “no” ended the discussion, and I was led to the ultrasound room. I had a transvaginal ultrasound after all, and this incident was shut in a vault, never to be mentioned by my mother or aunt ever again.


I would have avoided this slightly embarrassing scene had I been wearing jeans or a sleeveless top that day. But I am not at all upset that my coincidental clothing choice that morning resulted in this priceless story that makes me laugh whenever I retell it.


I hope that the doctor learned a valuable lesson that day: don’t judge a book by its cover, even if it covers the collarbones.

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