seeing boobs everywhere

A visit to Philadelphia's Magic Gardens, and a surprise mastectomy and breast reconstruction 101 for you.

Hello friends! This is Ursula Fan Club, where I write on a weekly-ish basis about what I’m writing, reading, and seeing in the world. If you’re interested in speculative fiction, climate, ancestral stuff, textiles, living in a human body, and balancing a creative practice with *everything else*, you’ll probably like it here. Welcome!

This post is a love letter to daylight savings time. Unpopular hot take! But I love “fall back,” which has automatically reset my clock to wake up for writing-o-clock at 5am. I love the baby blue / baby pink infant sunrise out my window as I write this at 6:30am and I love the ghost-story-worthy pitch that will blanket us by 4pm. It’s hibernation season, baby!

Mosaic art in Philadelphia’s Magic Gardens, a sprawling installation by living artist Isaiah Zagar.

Last week was my last week of medical leave and my warm up for re-entry into the pace of my normal routine. I met up with one best friend in Philly for a day trip to the Magic Gardens, and visited another best friend in Virginia for Halloween night with her 6 year-old, where they had over 500 trick-or-treaters-I-kid-you-not. We got our vaccines on Friday night and were an achey puddle of fatigue all day Saturday, but Carla’s kimchi beef stew (which I made earlier that week) brought us new life.

I also scheduled another surgery.

The thing with mastectomies with reconstruction is*, there’s an “easier” way with a short-term payoff but long term maintenance, and a “harder” way with a longer payoff but just about zero long term maintenance. I chose the harder way. Let me explain.

And before you bounce because you don’t think this is relevant to you, remember that about 1 in 10 women get breast cancer, that the rate of breast cancer in younger women is rising, and men can get breast cancer too! The likelihood you will know someone (or unfortunately, several someones) who need this information in the future is, shall we say, probable.

*This is an overly simplistic take, with all the caveats about whether you’re in active cancer treatment, whether you’re a candidate for a specific type of reconstruction, whether your employer allots you medical leave, whether you have reliable childcare while you’re recovering, whether you can afford (financially or otherwise) to undergo multiple surgeries and/or a specific recovery time, etc.

A mastectomy is a procedure to remove all of your breast tissue, and sometimes your nipples, to either remove cancerous cells or avoid their formation in the future. After a mastectomy, and pending their eligibility, a patient can choose from three types of breast reconstruction:

Option 1: Aesthetic flap closure. A patient chooses not to reconstruct a new breast mound. Audre Lorde famously chose this path and wrote about it in her memoir about breast cancer, The Cancer Journals.

Option 2: Implants. I’m not a plastic surgeon but based on what I’ve seen in the survivor and previvor community, I’m pretty sure this is the most popular reconstruction choice, for good reason. Healing is faster than other reconstructions and they can be customized to a patient’s preferred look and feel. Do you want silicone implants or saline? Teardrop shape or round? Do you want to keep your cup size or go up? It’s the short-term payoff choice with long-term maintenance, since they need to be replaced about every 10 years—more of a consideration if you’re a younger person. If I had chosen this route, I was a candidate for “direct-to-implant,” to have my implants inserted during the same procedure as my mastectomy, and I would have likely been “done” with this journey about four weeks after my surgery, back in February 2023. Instead, I chose…

Option 3: Flap reconstruction. When a surgeon takes living tissue from another part of your body—in my case, my abdomen—and constructs new breast mounds from this tissue with cardiovascular microsurgery. Very cool, very Star Trek level medicine! Recovery time is long, and a second (and third) surgery are often needed to adjust scars, add more fat grafting, and achieve the final intended look. After my initial surgery, my initial recovery was two months, but then extended to three months out of work when I had a rare liver disease complication from medication. The upside of this approach is that my tissue is my own. I’m not worried about a foreign object in my body that will need surgeries every 10 years to replace. My breasts are warm, living tissue (not cold “ice packs,” as some folks say about implants) that feel like my breasts. I chose the “harder” way, but I have no regrets.

Following my latest surgery of scar revision, liposuction and fat grafting, some of the fat has reabsorbed into my body (this can be up to 50%). This is common and expected. Another surgery will be short, less than an hour, and source more fat from my bum and hips to layer onto my breasts to help fill in the concavity of my upper chest that still bothers me. It’s scheduled for April. I’m hopeful this one will be the last one, and then my 2.5 year journey of breast surgeries (plus a year of imaging surveillance and biopsies) might actually come to a close.

During the last week of my medical leave, our visit to Philadelphia’s Magic Gardens felt like an unexpected celebration of boobs. They were everywhere. I started taking photos to document as many as I could.

Isaiah Zagar, the artist of over 200 mosaics across Philadelphia, was born in Philadelphia, grew up in Brooklyn, and graduated from Pratt in NYC in the early sixties. He is Jewish and his work echoes the work of other Jewish painters and artists working from a folk tradition, like Marc Chagall, with their own characters, narratives, and mythologies. Zagar frequently features breasts, but he also features bodies, sexual acts, hands, vaginas, dicks, eyes, mouths. Along the walls I found the shards of a Pesach plate, some writing in Hebrew. I wonder if, as a Jew, he has family members who have lost breasts, lost lives because of breast cancer.

What I’m writing

An outline for writing about living with BRCA1 and my mastectomy.

What I’m reading

Ancestor Trouble, Never Whistle at Night, Mourning a Breast, Hagstone.

Three helpful things

Inspired by my bestie who made a version of this for breakfast the morning after Halloween, I cooked a big pot of oatmeal with apples for breakfast for the week. A comforting, warming thing for the ultimate Sunday Scaries. Here’s how I did it:

In a medium-ish pot, combine 2 cups oatmeal, 2 cups water, and 2 cups oat milk with 2 apples, cut up into smallish chunks (this is especially good for mushy apples, old apples, or ones with spots), 1 tsp. salt, 1 tsp. cinnamon, 1/2 tsp. ground ginger, some grated nutmeg, and whatever else sounds good—a handful of golden raisins, some ground flax seed, dried cherries. Bring to a boil, then lower the heat and simmer for a few minutes until cooked through. Serve with maple syrup, some more oat milk, and nuts or peanut butter. Reheat in the microwave or on the stove with a little water to loosen it up. Makes 4-6 servings, enough for the week!

On an unrelated note, my friend Liora Ostroff made some truly channeled and stunning Palestinian liberation art, rooted in Jewish tradition. 25% of proceeds will be donated to Grassroots International Palestine Emergency Fund, which sends 100% of funds to local partners in Palestine. I got my print (and a studio tour) from Liora last week! You can order a print directly from her on Instagram here.

Lastly, if you’re reading any of what I have to say, I’m going to assume you’re a voting kind of person, so I’m not going to beg you to vote and all that.

But if you live in Baltimore, vote against Question H to reduce the size of the City Council, a ballot measure that was funded by David Smith, the conservative chairman of Sinclair Broadcast Group who bought The Baltimore Sun this year, to disastrous effect.

Please also vote against Question F, the question to support the redevelopment of Baltimore’s Inner Harbor, which takes a short-sighted, wholly unsustainable approach to investing in our city’s harbor and shoreline during a time of extreme climate instability. I wrote about shorelines, including Baltimore’s proposed Inner Harbor proposal, here.