I have given anesthesia for a lot of breast surgery. I don’t think I’ll ever get used to the fog of pain and sorrow surrounding a double mastectomy.

All surgery is invasive in some way. Amputations, in particular, have a horror all their own; the idea that destroying someone – cutting off a body part, violating a coherent whole – should be necessary in order to save a life is almost too horrible to bear. When that kind of mutilation reaches the most private and intimate parts of people’s bodies and lives, the very air around patients and their loved ones can be heavy with unspoken suffering.

As a woman I cannot imagine the grief of such a dramatic physical loss. I remember having bouts of depression when I was recovering from an elbow fracture years ago. Anxiety, too – I was afraid I would lose the ability to use my arm and hand effectively. Certainly that kind of functional loss would have been devastating. But there’s something about mastectomy that makes the loss seem so utterly cruel, the devastation completely personal. Maybe I’m wrong, but I imagine the tears I would shed at having to face a mastectomy would be much more agonized and primal than those I shed worrying about my arm.

I wonder if anyone ever talks about the grief of husbands and partners. I think about that every time I see a patient supported by a spouse or partner who clearly loves her deeply and truly. I still remember the husband of a beautiful young woman who replied, after she said, “I love you” right before we wheeled her into the operating room for her mastectomy, “I am in love with you.” More recently there was another kind, compassionate husband who kissed his wife and said affectionately, “Bye, Babe. Love you,” then looked forlornly at us as we wheeled the bed away from him to take her to the O.R. He looked as if he didn’t know what to do, as if he were about to cry.

In that one moment a thousand thoughts seemed to be emanating from his lost look: There goes the woman I love. I’m so sad for her. I have so many memories of her. The nights we held each other, the children she nursed, the decades of flirting with each other in the kitchen. How can I not feel her pain when it’s my pain too? Is it wrong that I feel it’s my loss too? I love her so much. How could this be happening? I miss her already. I miss what we had. I’m scared of what’s coming. My heart hurts. I just wanna scream and cry. It’s not fair.

I’m guessing, of course. But that’s what his face seemed to say. Some men or women might feel people would criticize them for grieving the loss of their beloved partner’s breasts. I think when there is real love between two people – sexual love, physical love, spiritual love, and committed love that inspires them to work on a lasting relationship every single day – then such grief is completely understandable and natural and inevitable and right. When you love someone body and soul, then Body and Soul are inextricably intertwined in the forging and deepening of the relationship.

A loving partner would be saddened not because he or she thinks breasts are the end-all and be-all of female sexuality, or that a woman’s worth is related to her body parts, but rather because such surgery strikes so visibly and painfully at the heart of a lot of shared stories, intimate moments, mutual devotion, and cherished physicality. Such raw, heavy grief hurts all the more because it is often unspeakable.

One time I was discussing a painful experience with someone, with my husband listening, and while I was describing the regret I felt I started crying a little. I looked up and saw my husband’s face full of love and support for me, his eyes a little wet as he felt in part the pain I was feeling. So often the beauty of compassion between partners is overlooked or forgotten, but when it exists the connection between the two can be felt by everyone in the room.

This is what I see when I meet supportive husbands, boyfriends, and lovers of women who must have mastectomies. I wish I could tell them their profound grief hasn’t gone unnoticed, unwelcome; that the love to which it bears witness matters tremendously and has touched those of us who are taking care of the women they love.

Anesthesioboist T is an anesthesiologist who blogs at Notes of an Anesthesioboist.

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