“This is serious,” the breast surgeon said, walking into the room.

It was cancer, and I had a choice of lumpectomy (removal of the tumor and surrounding tissue) followed by radiation, or a full mastectomy (removal of my entire breast). For early detection, which this was —”The process is working the way it’s supposed to,” she said — the approaches gave equal results.

That was an easy decision. “Lumpectomy with radiation,” I said confidently.

That was almost a word-for-word repeat of a phone conversation we’d had the week before, which she didn’t seem to remember. Then we moved to new information.

Some surgeons automatically ordered MRIs; she sometimes did but didn’t feel it was necessary in my case — but I could choose to have one. “I want an MRI,” I said. “I have anxiety, and I don’t want to wonder and worry.”

She said an MRI was very likely to find something else they’d want to investigate. “I have anxiety. I want an MRI,” I repeated. She said she’d order one. That was Tuesday.

On Friday, I called the office to follow up; they called back and said the order had been placed. The imaging department called and scheduled me for the following Friday.

The day of the MRI, the tech said she wanted me to change and then make sure I fit in the machine before she did my IV.

A breast MRI is done face-down, with your body several inches above where normally your back would be. I’m large. When the tech slid me into the machine, it was snug — the machine so tight around me I couldn’t take a deep breath.

“Nope,” I said, and she slid me out.

“Call your surgeon’s office and tell them you didn’t fit and you need an open MRI,” she said. “There’s one in Foxboro.” I told the surgeon’s office I hadn’t fit in the MRI and said phone wasn’t ideal; the patient portal was a better way of reaching me. My husband and I left the hospital and headed to BJ’s to pick up an order. My phone rang on the way. “I bet it’s the surgeon’s office,” I said and let it go to voicemail.

“The doctor doesn’t usually work Thursdays and Fridays,” the voicemail said when we listened, “and she doesn’t have your information in front of her, but she didn’t think you needed an MRI, and she’ll still do the surgery if you want. She prefers to not use the portal, but I’ll send you this message there, too.”

Three strikes

Strike one: My pathology results came in on a Wednesday. On Friday, my friend encouraged me to reach out and ask to speak with a person before the weekend — my surgeon appointment to review results was the following Tuesday. I messaged the surgeon in the portal and then messaged my PCP. Soon my phone rang.

“This is Dr. Surgeon,” she said. “I don’t usually work on Thursdays and Fridays, and I don’t have your information in front of me, but I was able to pull up enough on my phone.” It was serious, she said; I had cancer, and I could choose between lumpectomy and radiation, or mastectomy. The process was working as it was supposed to; this was early detection, and they’d take care of it while it was relatively simple.

I was so relieved that I wouldn’t need chemo that I ignored what felt like criticism that I was contacting her on a day off.

Strike two: telling me on Tuesday that she’d order an MRI and not ordering it until I called on Friday.

Strike three: dismissing my twice-stated preference to have an MRI.

I panicked, froze, and shut down — my usual. While my husband went into BJ’s, I waited in the car, my mind spinning. I remembered seeing a Dana Farber office in Foxboro, a few towns over; I went on their website and self referred, then messaged my PCP in the portal.

Dana Farber called a few hours later. By the end of the afternoon, I had completed a phone intake and had appointments with a breast surgeon and oncologist; the oncologist specializes in my kind of breast cancer: invasive lobular carcinoma. My appointments were about four weeks out.