From The Feet Up

By Tanya Saad

Tanya Saad's life wasn't perfect but it wasn't far off. Happily occupied with a demanding job, the competitive cycling she loved and the support of her irrepressible family, she wasn't given to introspection. Then the thunderbolt hit. At the age of 30 she discovered she had tested positive for the BRCA1 gene – a gene that meant her chances of developing breast and ovarian cancer young increased exponentially. Worse was to come when one of her beloved younger sisters tested positive too.

A resilient personality, Tanya was used to meeting challenges. Growing up as part of the only Lebanese family in a small NSW country town, then coming out as a gay woman in a conservative culture meant she was used to conflict. But the decisions ahead – should she have her breasts and ovaries removed before disease set in? Should her sister? – would require all her strength and resilience.

From the Feet Up is a dazzling memoir of courage and determination, told with great humour and verve. This book examines what it means to be a woman, shows how to meet adversity with both courage and grace, and offers some revelations along the way. As Tanya says: 'The profound moments in your life are not about getting what you want, they are about discovering who you are.'

• Language: English
• Publisher: HarperCollins Publishers Australia
• Release date: Apr 1, 2014
• ISBN: 9781488710926

Tanya Saad

Tanya Saad is an Ambassador for Australia's Breast Reconstruction Awareness Day, as well as an advocate for a number of organisations targeting breast and ovarian cancer. A strategic policy and communications adviser by profession, this is her first book.

Book preview

PROLOGUE

What did you just say? ‘Sorry, can you hang on a second?’

The pelting rain sounded like a drum roll as it hit the windscreen of my Toyota Rav 4. The wipers swung frantically across the windscreen, curbing the onslaught of water. I leaned forward, attempting to make the most of their valiant effort in pursuit of the expected overpass that was on the way home from work.

I ripped the car to the left and into the breakdown lane before anyone behind me had time to brake. Once under shelter, everything came to a grinding halt and I felt myself instantly relax.

‘Okay, I’m sorry, I’m on my way home from work and it’s pouring with rain. Can you say that again?’

‘I can call you back later?’ Dr Becker, the Head Geneticist at the Hereditary Cancer Clinic, said.

‘No, no. It’s fine,’ I replied, eager to know if what I’d just heard about a cancer gene was correct.

‘Your family has a hereditary gene fault that increases the risk of breast and ovarian cancer,’ Dr Becker repeated. ‘We’ve tested your dad and he’s a carrier of the gene.’

You’re kidding me. ‘Right.’

‘I’m guessing you didn’t know that?’

‘No.’ I couldn’t hide my surprise. My mind quickly rewound back to check I hadn’t missed anything in recent conversations with my parents.

‘I thought so.’ While Dr Becker sounded regretfully matter-of-fact, I couldn’t mistake the familiar tone in her voice that was distinctly Doctor Talk.

‘So …’ I knew I had questions but nothing came to me.

‘Tomorrow’s meeting is so that we can talk to you about the gene and whether you’d like to be tested for it.’

‘Right.’

‘I assume your sisters don’t know either?’

‘No.’ I hadn’t spoken to my sisters all week. I stared straight ahead, unaware the heat in my breath was creating a layer of fog across the windscreen, mindful of only one voice – Dr Becker’s – telling me how she’d take us through everything tomorrow, and then in the blink of an eye her voice was gone.

CHAPTER

1

‘What’s Cess got in his hand?’ Paula said out of the blue. The three of us sat on the kerb, looking down at our feet and breaking up small pebbly pieces of bitumen from our driveway. Vivian and I turned our heads to gaze at Cess walking up the paddock from the shed. We like Cess. Although he’s old – almost 80 – he’s tall and has shining grey hair like Richard Gere from the movie Pretty Woman.

‘I don’t know,’ said Vivian. As he got closer I made out a long wooden object with a seat and wheels. Rising up from the gutter, I started walking down our huge driveway towards the farm gate. Paula’s little footsteps scuffed the bitumen behind me as both my sisters followed in tow.

‘What you got there, Cess?’ I asked as we reached the gate. Paula and Vivian climbed up onto the steel mesh gate, using the chequered patterns as footholds. I was itching with curiosity. A smile appeared on his face. The linked chain chimed as I unhooked it and let it fall against the old weathered timbered post before pushing open the gate. As it swung across the threshold, Paula and Vivian jumped down onto the ground, their feet landing on the milky-brown soil that formed an old trodden track down the paddock. The rest of the paddock had thick green grass long enough to tickle the shins of your legs.

Cess was doing the ‘man pause’ thing. You know: the notable pause between men as they converse with each other. Whether it is in a pub or a business meeting, the rhythm of conversation between men is adagio. Whereas for women, definitely allegro.

‘It’s a billycart,’ Cess replied, crossing over into the driveway, raising the mobile-looking object in front of us. I grinned with glee.

‘Wow,’ seven-year-old Paula said.

‘Is that for us, Cess?’ Vivian’s voice shrilled in disbelief, although her voice is always an octave higher than Paula’s and mine.

‘Yes.’ His black gumboots scuffed the broken bitumen as he walked up the driveway alongside our house.

‘Did you make that?’ I asked as we followed him.

‘Yes, I made it using some old timber in the shed.’ He cocked his head back at us, in the direction of our huge galvanised iron shed at the bottom of the first paddock. It’s filled with tractors, farm equipment and bales and bales of hay.

‘Wow,’ I said.

‘Can we have a go?’ Paula’s brown eyes popped eagerly out of her head. She looked about the same height as the billycart.

‘Yes.’ he continued to walk up the driveway where it flattened out. For a tall, burly-looking man, Cess’s voice and stride were completely the opposite – soft, calm and steady.

We live at one end of Victoria Street, the main street in Taree. And our driveway is like an avenue, which comes alongside our house, down to the farm fence and gate to the paddocks, and swings around like a U-turn to follow alongside my grandparents’ house, who live next door. The driveway continues around and up a hill until it meets with the entrance to the main road. It’s like the shape of a scalene triangle, but with round edges and two abutting exit ramps for our respective driveways. What this all means is we have a whole street for ourselves to play.

‘Here we go.’ Cess placed the plain wooden billycart on the ground facing down towards the gate. ‘Who wants to go first?’

‘I will,’ I said. Being eleven I am the eldest after all.

‘Okay, well sit on the seat and put your legs on either side of the shaft. Your legs are your brakes, you see.’

I did as instructed.

‘Now, here’s the rope to steer it.’ He placed the thick rope in my hands.

‘Pull on the left to go left and the right to go right.’ The little wheels at the front of the cart turned from left to right against the old tarmac road as I practised the manoeuvre. It felt easier than steering a horse.

‘That’s the way.’

I glanced up at Cess and caught the excitement on my sisters’ faces, standing behind him.

‘This is gonna be fun,’ I said. I hope.

‘Take your legs off the ground, put them onto the footplate and straighten up the wheels.’ I felt the switch of nervousness turn on as I followed his instructions. ‘Okay, here we go now.’

Cess gave the cart a long push from behind the seat and it took off down the driveway. I could sense Paula and Vivian’s anticipation and delight for the new toy as they ran after me. The cart was surprisingly light, quickly gaining speed as we headed straight for the farm gate. With the U-turn corner in sight, I felt a mix of joy and terror building. I definitely didn’t want to go ahead. As I pulled on the rope to steer the cart into the corner towards my grandparents’ house, I realised my fate. I had to stop and needed to work out how really quickly because there was no way I was going to make it. I lifted my feet off the cart, and leading with my heels gingerly placed them on the ground, waiting for something unexpected to happen. A loud skidding noise coming from the drag of my sneakers against the tar surface deafened all other sounds around me as the cart came to a neat stop next to my grandparents’ house.

‘Okay.’ I smiled, exhaling the deep breath I must have been holding during the entire ride.

Vivian and Paula giggled with delight as they reached my side. Cess joined us, looking satisfied with his little project.

‘Once you girls get the hang of it, you should get some speed up going down the hill in either direction.’ Cess nodded.

‘Can I have a go?’ said ten-year-old Vivian as I climbed out of the cart.

‘Yeah. Come on. We’ll take it back up.’ I handed Vivian the rope.

‘And then it’s my turn,’ insisted Paula, reaching down to grab the back of the cart and her stake in this new toy.

‘Thank you, Cess,’ I said as the two girls turned the cart around to pull it back up the driveway.

‘Yeah. Thank you, Cess!’ Vivian and Paula repeated in unison.

‘Now you get to paint it and give it a name.’ Cess straightened, tilting his chin in the direction of the cart.

‘Really?’ We all exclaimed at the same time. Paula and Vivian stopped momentarily in their tracks.

‘Yep, I have some pink and white paint for you.’

‘We love pink.’ Vivian nodded.

‘Yeah,’ said Paula, smiling from ear to ear. Cess knew that of course, but he didn’t say it.

‘But what’re we gonna call it?’ Vivian piped up. The three of us stared at each other, searching for names. Out of nowhere, it came to me.

‘TVP.’

‘For Tanya, Vivian, Paula,’ Paula expanded without question.

Cess grinned. ‘I’d better go get the paint then.’ He turned and headed back down the driveway towards the paddock.

* * *

‘Paula, Vivian and Tanya! The bus is going to be here in five minutes. Hurry up,’ Mum yelled from the kitchen. The weekly ritual had begun. ‘If you miss the bus, you’ll have to walk to school. I’m not going to take you.’ That was one of the biggest threats you could ever get from my mum. She isn’t a very stern lady.

‘Come on, girls.’ I ran down the corridor from my bedroom.

‘Did you make your bed?’ Mum glanced up at me as soon I appeared. She stood behind the kitchen bench, packing the lunch-boxes, blue for me, red for Vivian and pink for Paula.

‘Yes.’

‘Did you brush your teeth?’ Mum’s petite features remained unchanged.

‘Yes, Mum.’

‘Okay. Here’s your lunch, Mum.’ Mum shifted the lunchbox a little way towards me. Her expressions were suitably small and succinct. It was the intonation of her voice that marked her temperament. I wonder if I’ll actually get to eat it today.

‘Thanks, Mum,’ I replied. I still don’t get that. My mum, Mon, short for Mounira, calls me ‘Mum’. Actually, she does it to all of us girls. It’s an Arab thing, a term of endearment and somehow, it worked.

I picked up my lunchbox packed with a Lebanese roll, fresh fruit and some cheese and crackers, and put it in my schoolbag. I heard Paula and Vivian coming down the hallway from their bedroom. The hallway came to a stop like a T-junction with a full-length mirror throwing your reflection right back at you. The living room and kitchen led to the left, and the front door entrance to the right. Either way, you weren’t going to get out of the house without seeing yourself.

‘Bye, Mum.’ Paula sounded jovial as always. I turned to see her poking her head around the entrance to the kitchen. As usual, her dark-brown frizzy hair was pulled back in a ponytail. Vivian stood in front of the mirror, busy tidying up her hair with her backpack wedged in between her legs. Our chequered school tunics hung like a piece of loose cloth, similar to the play clothes Fräulein Maria made from the drapes in her room for the von Trapp children in the Sound of Music.

‘Wait a minute. Come and take your lunch before you go, thank you,’ Mum replied.

‘Okay.’ Paula and I crossed paths as she headed for the bench.

I heard the bus beep. At least we didn’t have to wait at the bus stop with the Meyer kids.

‘Let’s go.’ I quickened my pace, dashing past Vivian to open the front door. I stepped down onto the front porch and turned around to see Paula scooting behind me but no Vivian. ‘Hurry up, Vivian,’ I called out before letting the door go.

‘Coming,’ Vivian called out, indicating she wasn’t far behind. I glanced up to notice the school bus now was parked out the front of our house on the nature strip. That’s the beauty of country towns like Taree, the bus driver knows where you live. And he isn’t on the kind of schedule that means if he waits for you, he’s late for the rest of the day. But it was pretty embarrassing. My eyes cast down to the footpath leading to the edge of our property and didn’t come up until I found the steps of the bus.

When the bell rang for lunch, I watched my classmates making their way to their bags on the rack outside our door. I waited for everyone else before getting up to get my own. Before heading out, I pulled out my ham-and-cheese salad Lebanese roll. I stopped halfway down the stairs of the old gable roof school building to get a look at what groups had already formed. My chances were slim. In Year 6, girl groups were well established and very little changed after that. I sat down at the nearest seat to the building and began eating my roll.

The quadrangle is huge. To my right is our music room and then a gap between the weatherboard buildings to the grass gully and primary playground where, no doubt, Paula would be right now. My eyes scanned around the quadrangle until I found Vivian sitting with her best friends eating their lunch.

I finished my roll and sat watching the groups interacting with one another, careful not to make eye contact with anyone in particular. A group of boys from my class had started playing handball halfway down the quadrangle. They weren’t the coolest guys in my year, so it wasn’t completely out of the question. Plus, I don’t care about the girls anymore. I got up and weaved my way down to where they were playing. Careful not to get in the way of their game, I approached the more reasonable of the two group leaders.

‘Brett, can I play?’ I kept my voice low and my head somewhere between Brett and the game. The point finished and he looked up at me for a second before he spoke.

‘Go hang out with the girls, wog,’ co-leader Paul said quickly.

‘Please, I wanna play.’ I looked at both of them. ‘Five minutes,’ I pleaded, despite feeling very stupid for bothering.

‘What you got for lunch?’ asked Paul. I knew he wasn’t hungry, he just needed to substantiate why he would let me play with them in front of his peers.

‘Nothing. But I’ll give you a dollar to play until the end of lunch.’ I fished it out of my tunic pocket and stuck out my hand. It was the tuck-shop money Mum gave us for the week. Paula and Vivian always got plenty of lollies anyway.

‘Let her play. Lunch is almost over anyway,’ Brett conceded. I waited.

‘Here.’ Paul reached out to take the money from my hand. ‘Let’s go.’

Now play good. But not too good. I quickly joined the game, trying

not to smile too much at my little victory.

On the way home that afternoon, the little bit of hope I’d received from playing with the boys made me sad. As the bus neared our stop, I turned to look for Vivian and Paula further down the bus. Both of them appeared to be saying goodbye to their friends. It was so different for them. I figured it was because I was the eldest, which made me the first of our family, including the extended family of Saads, to start school in the last decade and bless everyone with our presence.

Our grandparents’ house is the last house on the street, making ours the second last. Once the bus left the stop, the three of us crossed the wide road to our driveway. Our grandparents built their beige brick double-storey house when I was born. It wasn’t just a double-storey house. It was a mansion compared to the rest of the houses on our street, whereas the front of our dark-brown brick house was single-storey and blended into the mix of brick and fibro English cottages a little better. As we walked down the driveway, I looked for my grandmother’s silhouette in the dim light of the bottom left window of the mansion. It had become second nature.

‘Mum’s not home again,’ stated Paula. I looked across to the closed garage door at the end of our house, before returning my attention to the mansion. I found my grandma’s silhouette as she raised her hand to wave, and I waved back.

‘Oh well. We get to have ice-cream,’ said Vivian, smiling across at Paula.

‘Yum! And snakes,’ Paula added, declaring her favourite treat. Vivian broke into a run to get to the side door first. I watched Paula initially sprint after her, before quickly conceding defeat within a couple of strides.

Click, pist. I smiled at the sound I had become accustomed to since I was two: the lock being released and the seal of the glass door broken meant one thing – my grandparents’ house was open for business and my life was content.

I stepped onto the side verandah as my sisters disappeared inside. I walked through the open door to see everything as it should be. The billiard table that belonged to my dad, the television blaring with some afternoon soap into the living room, where two three-seater caramel-coloured leather couches were dutifully occupied by none other than my grandfather, Jiddo, and my grandmother, Teta, otherwise known as Baheeg, aka Bill, and Mary Saad. These are two of the few Lebanese words us girls knew and used every day of our lives. I glanced at Jiddo on the three-seater and Teta sitting in her usual spot, facing me. She was leaning over the side of the couch, no doubt to put her latest Mills and Boon book out of sight.

‘Hi.’

‘Oi,’ exclaimed Jiddo, jolting his small slender frame to sit up.

‘Hi,’ replied Teta.

I dropped my bag by the billiard table and walked over to give Teta a kiss. Jiddo stuck out his hand to give me a shake as I passed by him. It wasn’t like the old-fashioned shake, where you could be at risk of straining your wrist if you didn’t adjust quickly enough. It was a strong hold and simple handshake congruent with a no-nonsense kind of fellow and a man of few words. Mind you, even with his hearing aids, when he does speak it’s almost always a couple of decibels higher than the rest of us.

As I bent over to give Teta a kiss on her cheek, I couldn’t help but reach out to touch her upper left arm and give it a gentle flap. It was so soft. Her expression flashed from one of affection to annoyance and back to affection once I had let go. I smiled with satisfaction. It was one of her trademarks, along with her flappy arms, her blow-dried medium-brown hair that orbited around her milky-white face and the sundresses and the Betta scuffs she wore every day. Jiddo’s gruff voice, tanned skin that always seemed to be prickly along with his white moustache and bone- or grey-coloured business shirts and pants were also trademarks. The only common ground between the two of them was their height and their respective reading glasses. Teta was more than my grandmother, she was my best friend. I’ve never had a lot of kids to play with and given I was the first-born grandchild in a decade and a girl at that, we spent a lot of time together. I like to think we are similar in nature, but in truth, I just want to be like her. I love both her toughness and gentleness and she teaches me to be fair and kind.

‘Can we have a pleasure bar please, Tet?’ asked Paula.

‘After you have your Saos.’ Teta rose from the couch.

‘Okay. And then we can have a pleasure bar,’ reconfirmed Paula. Teta didn’t reply. I hopped up onto one of the dark-brown vinyl bar stools tucked under the mustard yellow L-shaped kitchen bench. I watched as Teta pulled out the regular ingredients for our afternoon tea: margarine, vegemite, tomato and cheese and the Saos. Vivian sat on one of the stools next to me.

‘Where’s Mum, Tet?’

‘In my pocket,’ Teta answered, all calm and casual.

As soon as we devoured our biscuits, Paula dashed down into the laundry to the large freezer housing the pleasure bars.

‘Can you bring me an ice-cream square, Paula?’ I called after her. ‘Do you want one, Tet?’ I asked, watching her eat a Sao with a lather of margarine that could be mistaken for a slice of cheese.

‘No thank you.’

I got up and made my way into the kitchen as Paula handed me the vanilla ice-cream.

I turned to find that Teta had already pulled out the milk arrowroot biscuits for me. It was her invention after all. Smooth vanilla ice-cream sandwiched with the caramel flavour of milk arrowroot biscuits. It was our speciality now. I carried my plate out of the kitchen to sit on the stool. We weren’t really allowed in the kitchen, especially when Teta or Mum were cooking. They’re both great cooks. They use their hands and their heads to cook, which means no meal will ever taste the same as any other person’s. Every single person’s hands add a scent to a meal, you see. The only time a book containing handwritten recipes emerges on the kitchen bench is for something special and rarely cooked. So to learn, I have to watch, over and over again from across the kitchen bench. I don’t mind given I get to be a taster, which of course is my favourite bit.

A loud crunching noise sounded outside. Although it was familiar, we all looked out the window. It was our family car driving over the broken bitumen in the driveway.

‘Mum’s home,’ Paula announced, seemingly pleased.

‘She’s late,’ Teta stated matter-of-factly as she headed for the couch. Mum was always late getting home with the groceries after work or coffee with friends, whereas Teta was always on time. Apart from the cooking, they were very different people. Mum loves to entertain. She has dinner parties all the time and is a social butterfly, whereas Teta is quiet and a bit of a hermit. She does get a twinkle in her eye when the family comes together for a meal, though. Mum is often the one who starts off the dancing, while Teta will sit and clap away encouraging others to be jovial.

‘Thanks, Tet,’ Paula called out, as she picked up her bag by the door. No doubt she was headed for the billycart. We hadn’t stopped playing with it since Cess had painted it. Teta looked ambivalent and remained silent as she leaned over the side of the couch for her book.

‘Yeah, thanks, Tet,’ Vivian followed suit. ‘Woo.’ She lunged at the melting ice-cream, catching it in her mouth just in time before it headed for the floor. ‘That was close,’ she joked, as she disappeared out the door to go home.

CHAPTER

2

I stepped outside the Qantas arrivals terminal and inhaled the warm air of Sydney. In October Canberra was still very cold. The smell of fumes and rubber immediately filled my cavities, confirming my arrival in the big smoke. As planes flew in and out, taxis zoomed by on the ground.

Beep. Beeeeep. Beep. Beeep. I spotted the black car. Vivian and Paula were usually fashionably late but not today.

Beeep. Beeeep. I couldn’t help but smile. It was a moment of chaos amidst the general order of life and made the simple task of being picked up special. I watched as nearby passengers looked yonder, wondering what the spectacle was. It was quite a commotion my sisters were making and you could get a fine if the police saw you. But then I was sure Paula would manage to talk them out of it. The beeping continued until there was absolutely no question who the car was picking up. It was one of the Lebanese traits of my sisters and had become a tradition since I’d moved to Canberra twelve years ago. It also extended to a host of other occasions, and yet it still embarrassed me and they both knew it. Actually, I’m convinced Paula does it in an attempt to shake my conservative nature, which Canberra has nurtured, before I hop into her car. I have to admit it works, or maybe I just return to being part of the wild three girls who grew up with curls. Like so many others, in 2000 I had moved to Canberra and planned to move back to Sydney a year or two later, but I always found a reason to stay.

Vivian and Paula’s faces beamed through the windscreen in front of me. I laughed and shook my head at them as I reached for the door.

‘Hi.’ Both girls excitedly turned their heads towards me.

‘Hi.’ I gave each one an enthusiastic kiss. I’d been looking forward to catching up with my sisters.

Mum and Dad had told us that the cancer clinic was doing some research on our family and ‘it’s our turn to do the tests’. I love Arabs. When they try not to make you worry, they end up making you worry. Paula said Dad mentioned some gene was in our family, but that was it. We’d never heard of the BRCA gene until we discovered it existed in our family.

‘How are you, sis? We missed you,’ Vivian shrilled.

‘I’m good.’

‘You look great,’ Paula said. I sat back in the seat, relieved I’d picked the right outfit.

‘So do you guys.’ They were both wearing dresses, but it was like a complete flip. Vivian was wearing the colour and glamour and Paula the classic lighter style, although both were equally fashion conscious and happened to be able to wear clothing that normally doesn’t fit the general population. I prefer to think of myself as my own trendsetter. Take a bit of this and a bit of that and make it my own. Sometimes it worked and sometimes it didn’t. Today it worked. Vivian’s hair was gelled back so tight it was hard to see where her head ended and her hair started. She’d almost always leave a white gel mark on the back of any seat she sat in and today looked to be no different. Paula’s long curly hair was free, wild and full of volume, making it hard to find her face at different angles. Her makeup was eccentric and deliberately accentuated her high cheekbones and big brown eyes, whereas Vivian’s skin was smooth and discreet, complementing her baby face.

‘We missed you,’ Vivian reiterated.

‘I missed you guys.’

‘How was your flight?’ Paula said in anticipation, as she feistily navigated the myriad taxis departing the airport.

‘It was actually pretty smooth, which was good.’ I grinned. Paula and I weren’t the biggest fans of flying, we liked our feet on the ground. There was also the motion sickness and the fact that some stranger held our lives in their hands that played a factor, too.

‘So, fun times ahead.’ The sarcasm in Paula’s voice was unmistakable. You could always rely on her to talk about the elephant in the room. Vivian and I said nothing. ‘Trust our family to have a cancer gene.’

‘What happens if we have it?’ Vivian turned and looked innocently at us.

‘Who knows? We’ll probably die from it. I don’t want to know.’ Paula flicked her head away to re-engage with the traffic.

‘That’s what they’re going to explain to us today, Viv.’ The truth was none of us was any the wiser about this cancer gene that ran through our family and today’s meeting with the Hereditary Cancer Clinic would give us all the answers.

‘I still think we both have it.’ Paula’s eyes pointed at me in the rear-vision mirror.

‘Yeah, me too.’

‘Why not me?’ Vivian sat up, offended we had left her out.

‘You can’t even cope with a muscle tear, Viv,’ Paula protested. ‘I really hope you don’t have it.’

Vivian turned and faced the front. Paula was right and Vivian knew it. She had an unusually high level of anxiousness around the unknown and most recently around health issues, minor health issues that each of us had helped her curb from one month to the next. After all, what were families for?

‘Anyway, it doesn’t mean we have cancer, does it?’ Vivian said. If there had to be a blonde in our three musketeers, Vivian was it. Well, she really had honey-brown hair, which is the closest natural colour to blonde you will find in the Arab world.

‘No,’ Paula said. ‘I’m pleased we’re doing this together.’ Paula sounded relieved.

‘Yeah.’ I turned to look out the window, catching the sunlight before we entered the car park of the hospital. Vivian and Paula used the mirror in the lift to smooth over their outfits and hair before making our way to the clinic. We were miraculously on time for our appointment and the receptionist led us through two closed glass doors and told us to sit down and Dr Becker would come and get us.

‘Holy fuck, I hope we don’t have this gene,’ Paula whispered. The three of us sat side by side in the waiting area, looking at the potential pathway of our life. The chairs faced inwards in the large rectangle-shaped room and were full of women with cancer either just about to start or finish up their chemotherapy or radiation treatment in the adjoining rooms. Most of them had catheters implanted in their arms, were without any hair, pale with dark circles under their eyes but resolved to living beyond cancer. I felt sad and anxious, and was certain my sisters would be feeling the same.

‘Why are we sitting here?’ I scorned under my breath at Dr Becker’s receptionist for making us wait in here. I felt like an inappropriate audience that these women didn’t need. Plus, we didn’t belong here. We didn’t have cancer yet.

‘Tanya, Vivian and Paula.’ We all turned and stood to face the woman who had informed us of our predicament yesterday.

‘TVP, that’s us,’ Paula joked. The hearty Dr Becker looked up at Paula and laughed. ‘Elizabeth Becker, but you can call me Elizabeth,’ she said, smiling from ear to ear. Dr Becker ushered us into one of the meeting rooms and introduced us to her colleague, who was a genetic counsellor.

‘Did the three of you drive here together?’

‘Yes,’ Paula said.

‘Did you come up today or last night, Tanya?’

‘Today. The girls picked me up from the airport.’

‘Right.’ Dr Becker’s mouth lay ajar, listening to our every word. She didn’t look like a doctor per se. The kindness in her voice and eagerness to connect straight off the bat made her feel like our Mother Hen. Her casual flat shoes, thin-rimmed glasses, makeup-less face and all-round dishevelled look typified the scientist in her and convinced me she was about to come up with the drug to offset this gene fault.

In a nutshell, Dr Becker explained that our family had a hereditary cancer gene fault called BRCA 1, and because our father was a carrier, we each had a 50 per cent chance of also carrying the gene fault, which would give us a spectacular chance of getting breast and/ or ovarian cancer. The very sympathetic genetic counsellor sitting next to her looked like we were about to die, but the only thing she was killing right now was our feverish intent to know more of this family secret.

I glanced to my right and left to get a look at my sisters’ faces as Dr Becker opened a booklet to explain our predicament. Vivian’s eyes looked pensive, while Paula looked tolerant but wishing to be elsewhere. The doctor flicked to a double page that illustrated electronic seating charts to show the rarity of breast and ovarian cancer that is caused by faulty cancer protection genes BRCA 1 and BRCA 2. This kind of special identity reminded me of my primary school photos and being the odd one out.

Dr Becker turned the page to two graphs, one for breast cancer and the other for ovarian cancer.

‘In general, the older in age women are, the higher the chance of developing the respective cancer, particularly breast cancer.’ Dr Becker highlighted a black line representing all women. However, my eyes were glued to the two thick lines that rose sharply on each graph.

‘The two thicker lines show the lifetime risk for developing breast and ovarian cancer if you have the BRCA 1 and 2 gene.’

‘Which one are we?’ Paula put her finger on both lines and waited.

‘This one.’ Dr Becker pointed to what was clearly the worse of the two. Double worse, in fact.

‘Number One,’ Paula said in an Arabic accent, holding her finger up at me. I smiled facetiously back at her.

‘So.’ Dr Becker shifted forward to regain our attention before she continued. ‘Women in your family with the BRCA 1 gene fault are at the top end of the range, which means their lifetime risk of developing breast cancer is up to 80 per cent and 55 per cent for ovarian cancer.’

‘Why are we up the top?’ Paula asked the obvious question.

‘Because, of the women in your family that do carry the BRCA 1 gene fault, it’s been quite active.’ Dr Becker’s eyes froze on us.

‘They’ve got cancer?’ I attempted to clarify what she meant.

‘Yes.’ Dr Becker’s chin dropped with regret. ‘And also because your family has an early-onset group of breast cancer cases occurring under 35, as early as 21 years old in fact, and ovarian cancer cases occurring under 40 years.’

‘So, if we have the gene, are we gonna die from this?’ Paula looked desperate to contain the doom and gloom.

‘Inheriting the BRCA 1 gene doesn’t mean you have breast or ovarian cancer or that you are certain to develop it. At the moment, if you did have the gene fault, your risk would be very low and not very different to the rest of the population.’

‘So what happens if we do have the gene?’ I asked.

‘If you decided to do the testing and we find you carry the gene fault, we would get your screening started, particularly your breast screening. It’s difficult to screen for ovaries, but there are good preventative measures like removing your ovaries that we can consider as you get older. There are also a number of clinical drug trials going on at the moment which will hopefully mean we can minimise the risk in the next five to ten years.’

Dr Becker went on to talk about the range of things, including maintaining a healthy, balanced diet, being physically active and not smoking, to reduce the overall risk. She also highlighted how important is was to regularly examine our breasts for any breast changes, something I know I hadn’t ever done.

‘We’d like to have a chat with each of you separately before you make your decision as to whether or not you each want to be tested.’ Dr Becker sat up.

‘We don’t hide anything from one another. Knowledge is power and we all want to do the test,’ Paula said on a rare serious note.

‘I understand you’re a close family, but we still need to talk it through with each of you before you each decide to go ahead,’ Dr Becker spoke plainly. As far as I was concerned there was nothing to talk about, I wanted this to be over already.

‘If all three of you do decide to do the test, each of you has a 50 per cent chance you won’t have the gene.’ Dr Becker flipped the coin. ‘So there’s a chance none of you will have the gene.’

I turned to look at Paula and she stared back at me. I knew exactly what she was thinking. I turned back to face Dr Becker before I spoke.

‘Paula and I have the gene,’ I announced, waving my finger at 25-year-old Paula and myself. ‘And Vivian doesn’t,’ I added, pointing my thumb to 28-year-old Vivian sitting on my left.

‘What makes you say that? Is that because you think you are more like your dad?’ Dr Becker smiled, cocking her head to one side. I got the feeling she liked our sure-fire personalities, but there was no hiding her scepticism. It went hand in hand with her ever-inconclusive world of science.

‘We just know, it’s the gypsy in us.’ I shrugged. ‘Paula and I have the gene and Vivian doesn’t,’ I reiterated in earnest, knowing my justification was mystical and carried no scientific weight. But it was the truth.

‘Okay. Well, you could be right. Each of you is at a different stage in your life. It’s important that we make sure each of you considers your choices and how the test could affect you as well as how it might affect your partners and family.’ Dr Becker attempted to provide some emotional insight into the journey ahead of us. ‘If one or two of you does have the gene and one of you doesn’t have the gene, it can be hard on the family to deal with. Naturally, your dad being the carrier might feel guilty if he passes on the gene.’ Given our parents didn’t tell us about the gene, I was willing to bet they were feeling pretty guilty already, especially Dad.

‘So what is Dad’s risk?’ Paula sat up as though she’d had a moment of clarity despite the uncertainty of our future. I immediately felt guilty having had no thought to what this might mean for our dad. After all, he was the only one we knew for certain had a faulty copy of the BRCA 1 cancer protection gene.

‘Men like your dad, who have inherited a faulty BRCA 1 or 2 gene may have a slightly increased chance of developing prostate and breast cancer and certain other types of cancer than the general population. But we don’t know for sure yet,’ Dr Becker concluded.

Paula was the first to speak after we headed out of the clinic. ‘We need to leave Mum and Dad out of this, otherwise they’ll stress out.’

‘Yes.’ I nodded, looking up at Paula. I looked across at Vivian as we walked side by side towards the lift. Her brown eyes were glazed over, like she was still trying to make sense of it all. She had been pretty quiet during the meeting and left the talking to us. ‘All we have to say is that we’re going to do the test and we’ll wait and see. Don’t make a big deal about it, if they ask,’ I outlined.

‘Man, our family has shitty genes,’ Paula said in exhalation and struck the lift button to the car park like she was retaliating at a piece of furniture for stubbing her toe.

‘Yeah,’ Vivian acknowledged. ‘I wonder who the 21-year-old girl was?’ Vivian sprang to life at the prospect of gossip.

‘I don’t know.’ I really thought we’d met most of our cousins already.

‘See her face when we told her we had it?’ Paula said, looking amused.

‘Yeah, she doesn’t believe us,’ I chuffed, shaking my head. This gene was starting to look like a curse and I didn’t want to believe us either.

CHAPTER

3

My dad, Michel aka Mick, and his siblings own shoe stores. Jiddo and Teta opened the first one in 1953, having already opened a milk-bar café and a wholesale fruit-and-vegetable business in the late ’30s. It’s no wonder Dad and Jiddo are so good on the land. As well as the cows, we had the biggest fruit-and-vegetable garden around. Watermelons, mangos, cucumbers, figs, avocados–you name it, we grow it. The garden stretches from the top of the driveway where it meets the main road, down the side and around the back of Teta and Jiddo’s house, finishing at the fence to the first paddock.

Apart from breakfast, we don’t see our dad much every day unless we go to the shoe store to visit him. But then he would just put us to work. I’ve been serving customers on my own since last year.

Reviews for From The Feet Up

[shelleyraec · Rating: 3 out of 5 stars]

At the age of 30, Tanya Saad tested positive for BRCA1, a hereditary gene that greatly increases the risk of its carrier developing aggressive breast and/or ovarian cancer, forcing her to make difficult choices in order to preserve her health. From the Feet Up is the story of Tanya’s journey from childhood to a woman facing up to an uncertain future.The eldest of three girls, Tanya was born and raised in the small New South Wales country town of Taree by her immigrant Lebanese parents, next door to her fraternal grandparents. Athletic and talented, Tanya, and her sisters, were involved in competitive swimming with Olympian dreams and Eisteddfods (playing piano) in between working at the family’s shoe store chain and helping out on their grandparent’s small cattle and fruit & vegetable farm. The most significant childhood event for Tanya was a three month holiday to Lebanon taken just months after the end of the Lebanese Civil War in 1990 to visit relatives. Bullied in part because of her heritage during primary school, high school provided some relief but Tanya gratefully escaped the region after graduation, returning only for family occasions and holidays.Tanya’s memories of her childhood experiences weave in and out of her adult narrative. In the period before her diagnosis, Tanya was living in Canberra enjoying a high pressure career in politics while developing a competitive edge in road cycling. She maintained close ties to her parents and her two sisters, Vivian and Paula, now living in Sydney, and undertook the genetic testing as part of Hereditary Cancer project after it was discovered her father was a carrier of the faulty gene, their family history having revealed several generations of women who died of breast or ovarian cancer, some only in their early twenties. Both Tanya and Paula were found to have inherited the BRCA1 gene.With strength, grace and courage Tanya shares her thoughts and emotions as she wrestles with the hand fate has dealt her. Still single and childless, the preventative options for sufferers of the BRCA1 gene including a bilateral mastectomy and a complete, or partial salpingo-oophorectomy (the removal of the ovaries and fallopian tubes), could permanently affect Tanya’s chances of pregnancy, but decrease her risk of developing cancer by as much as 90%. Tanya must weigh the risks and benefits and make a decision about her future.From The Feet Up is a poignant, articulate and ultimately uplifting memoir sure to give hope to women facing a similarly confronting diagnosis and raise awareness of the risks associated with the BRCA1 gene.* I should disclose that Tanya’s family home, as described in her memoir, is just around the corner from where I live. We have never met though, I’m not a ‘local’, only having lived in the town for a decade, but I have shopped at the family’s shoe store in town.