When Hard Lilies Cry

By Manal Suleiman Shurafa

When Hard Lilies Cry describes my 26 years journey battling two cancers and preventing two more.

Diagnosed with breast cancer. How do you deal with that? How do you wait for weeks not knowing whether you will live or die? How do you inform your children and raise them while going through treatment? How to cope with your family during chemo and radiotherapy? Can you accept the alteration of your figure after mastectomy? Will your husband leave you? How do you handle your family and friends desire to “help” you through it? What do you do when a family member or friend is diagnosed with cancer? How do you come to terms with it as a person of faith? Why me? Oh God, I don’t deserve this! For a woman of science do you base your vital decisions on science or gut feeling not listening to your doctors’ advice?

This book helped me and will guide you to evaluate ourselves deeply and understand the boundaries of our comfort zone. It will also be an inspiration and a benefit to you, your family, and friends in handling the tensions and complexities of life.

Writing this book made me and now you, more confident and empowered in facing and dealing with hard times or life-threatening situations. It helped me expand my comfort zone and will do for you too. I hope to offer you some guidance to address some of the challenges you are facing and provide comfort as much as possible.

This book helped me and will guide you to evaluate ourselves deeply and understand the boundaries of our comfort zone. It will also be an inspiration and a benefit to you, your family, and friends in handling the tensions and complexities of life. Writing this book made me and now you, more confident and empowered in facing and dealing with hard times or life-threatening situations. It helped me expand my comfort zone and will do for you too. I hope to offer some guidance to address some of the challenges you are facing and provide comfort as much as possible.

• Language: English
• Publisher: Austin Macauley Publishers
• Release date: Jan 5, 2024
• ISBN: 9781685624439

Manal Suleiman Shurafa

Manal Suleiman Shurafa, a Palestinian American, was born in Qatar in 1961 and raised in Libya. She graduated with a bachelor’s degree in pharmacy from the University of Malta. Her work experience as a pharmacist was in Libya and the State of Kuwait. After Iraq invaded Kuwait in 1991, she relocated to England for one year, then to Bucks County, PA. Currently she is an adjunct Arabic instructor. Manal enjoys traveling to experience different cultures. She has traveled to England and most of the Middle East and North Africa. She likes reading and crocheting and loves to spend time with her two boys.

Book preview

When Hard Lilies Cry

This is an honest, candid, emotional account of a truly painful and very challenging experience, that is presented ever so articulately. Nothing in this harrowing tale is fictitious, where a very sensitive young woman went through a trail of agonizing events, and managed to stand her ground, persevere, and prevail.

Yes, Manal had her family’s unequivocal and support (our parents Suleiman and Leila, our sisters Nahed, Nuha, Maha, and Meisoon, and Manal’s baby brother, me!).

Yes, Manal had the support of her own family (her husband Osama and both sons Ayman and Hisham).

Yes, Manal had the support of her in-laws and all her friends.

As much as all this support may have helped, it was exactly that, support. Manal actually did all the heavy lifting: she was the one who, through her strong belief in Allah, gradually found the strength she needed to go through this journey.

I remember when Manal was diagnosed with two different cancers, one after the other, my late father was trying to find the words to encourage her to find her strength. Manal’s response was: I will fight this; I want to see both my sons successfully finish their studies and start their own lives!

Here we are, 27 years later and Manal is going from strength to strength.

Manal’s strength did not stop there. I strongly believe that writing this book meant having to go through these events all over again; having to dredge out all those memories, face them and express them from the heart to all.

Simply put, Manal, you are very brave, and we are very proud.

— Tarek Shurafa

PhD, Civil Engineering

Imperial College, London

This is a sensitive, inspired and eloquent account of a lifetime weaved around a harrowing experience that Manal recounts with brave and vivid narrative. Rare are the people who can live through what she did and, not only survive it mortally and emotionally, but have the strength of character to find the talent to tell the story in such a way as to inspire others who might struggle through major ordeals and still keep their families and lives intact.

Manal is a hero unto herself, her families and her gender.

As a friend, I am happy for her survival, proud of her accomplishment and very impressed with her awakened talent.

This is a book that will inspire women at all levels of life.

— Dr. Hosam Meshal

PhD, International Economic and Investment Relations

Fletcher School of International Law and Diplomacy (A Harvard Joint Program)

When Hard Lilies Cry is more than a biography which is brilliantly told. It is a terrific and an inexorably sad, wise story, which is an elegant book to read and is healing for everyone. Its echoing style is deeply moving and takes your breath away. The author is the main character. The story started around mid-July 1996. The parents’ role has been carving her hard personality to see that everything happens for a reason of Allah’s divine decree. Dr. Anis Al-Qasem, (father-in-law) was behind planting in the author’s mind and heart the seed of writing this book. The authors words go as: I am forever grateful to my brother, Dr. Tarek Shurafa, for strengthening that spark for watering and nurturing that seed to blossom, and for translating a big part of this book, the part that I wrote in my mother tongue, Arabic. He patiently listened to how I really felt during those difficult times, and not once did he criticize me for reacting and behaving the way I did. Also, my deepest thanks go to my sister, Dr. Nahed Shurafa, for being there for me every step of the way. My family and I always will rely on her for honest medical advice. I am eternally grateful to my sister Meisoon for coming to be by my side as soon as she knew I had a crisis. My brother-in-law, Hani Al-Qasem, besides many things, was the second to read and edit my book as English is not my mother tongue. Marital bliss with Osama was indescribable and after our marriage we became best friends. You have only one precious tear to claim as yours. It is an element of strength because it is the only thing that can keep you going for everyone else’s sake, including those who criticize you for using it. I hope to share part of my heart and soul which will inspire all the wonderful lilies to open their hearts and share their braveries.

— Dr. Nuha Suleiman Alshurafa

Professor of Linguistics

Manal, a guide of unwavering honesty and compassion, extends her hand to accompany you on a transformative voyage. It is a journey that you must undertake, for although we face the challenges of our lives alone, it is crucial to recognize that we are not alone in treading this path. But perhaps the most formidable task of all is confronting yourself when times are hard. Learning and unlearning. Discovering all the characters within your own self. Striving to shield both ourselves and our cherished ones, all the while yearning for honesty and openness, sometimes resorting to veiling our true selves behind a mask, only to feel disheartened when others do the same. The purpose of this remarkable book transcends that of offering hope or inspiration; it seeks, above all, to reclaim the essence of our shared humanity. It unfolds as a raw, unfiltered testimony—a vivid chronicle that bares all, unafraid of vulnerability and unyielding in its honesty. It is the journey of a beautiful soul, seeking the beauty of life once more in spite of cancer. In spite of pain. In spite of fear. Manal dares to find solace and meaning once more.

— Fadwa Al Qasem

Bilingual author and mixed media artist

About the Author

Manal Suleiman Shurafa, a Palestinian American, was born in Qatar in 1961 and raised in Libya. She graduated with a bachelor’s degree in pharmacy from the University of Malta. Her work experience as a pharmacist was in Libya and the State of Kuwait. After Iraq invaded Kuwait in 1991, she relocated to England for one year, then to Bucks County, PA. Currently she is an adjunct Arabic instructor. Manal enjoys traveling to experience different cultures. She has traveled to England and most of the Middle East and North Africa. She likes reading and crocheting and loves to spend time with her two boys.

Dedication

My book, my story is dedicated to all the wonderful, soft, and delicate, yet very hard lilies.

With your wisdom, you know when you can be soft lilies and when you have to be hard ones.

You are lily soft to bend to the challenges of life and yet lily hard to stand up and face them.

You are lily soft to feel the pain from a little hurt, yet so lily hard to endure that pain.

You are lily hard to bear the pain of childbirth, yet lily soft to embrace and comfort your child.

You are lily soft to get hurt by the rejection from your children, yet lily hard to endure that pain and yet again lily soft to love them unconditionally. I wonder if loving your children unconditionally is being a hard lily or a soft one.

You are lily hard to take care of your family in sickness and fatigue without complaining when everyone has given up, yet lily soft to listen to everyone’s problems and to sympathize with them and feel their pain as if it were your own and yet again lily hard to endure that pain.

You are lily hard to fight and sacrifice for your husband, yet lily soft to be hurt by even his smallest and silliest mistakes, yet again lily hard to forgive his most hurtful ones and fight and sacrifice for him again.

Your hardness comes from your softness and your strength from your weakness, and you wisely use all these contradictory values, which are surprisingly compatible, yet totally different from each other, at the right time for everyone’s benefit but yours.

You have only one small, yet precious tear to claim as yours and only yours. You don’t need a reason to use it, so don’t hesitate to shed a drop whenever you need to because, even though it is so minute and misinterpreted by many as a sign of weakness, it is an element of strength because it is the only thing that can keep you going for everyone else’s sake, including those who criticize you for using it.

I would like to thank with all my heart the wonderful mysterious muse who inspired me to write this dedication.

I hope to share my story. Sharing a part of my heart and soul, a part of who I am, will inspire all the wonderful lilies to open their hearts and share their braveries.

Copyright Information ©

Manal Suleiman Shurafa 2024

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other non-commercial uses permitted by copyright law. For permission requests, write to the publisher.

Any person who commits any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

All of the events in this memoir are true to the best of author’s memory. The views expressed in this memoir are solely those of the author.

Ordering Information

Quantity sales: Special discounts are available on quantity purchases by corporations, associations, and others. For details, contact the publisher at the address below.

Publisher’s Cataloging-in-Publication data

Shurafa, Manal Suleiman

When Hard Lilies Cry

ISBN 9781685624422 (Paperback)

ISBN 9781685624439 (ePub e-book)

Library of Congress Control Number: 2023906981

www.austinmacauley.com/us

First Published 2024

Austin Macauley Publishers LLC

40 Wall Street, 33rd Floor, Suite 3302

New York, NY 10005

USA

[e-mail]

[phone]

Acknowledgment

I will always be grateful to Allah for giving me so much and for being there for me no matter what. I praise and give thanks to Allah for my parents who raised me to be such a hard lily. Although my father left us to a better place, I still feel that they both are still here for me, to take care of me and treat me like a soft and delicate lily, although I am an adult. It is difficult to express how grateful I am to my parents who carved my personality and raised me to be an independent, stubborn, and a tough fighter. I am grateful for their endless support and presence, not only during my illnesses but also throughout my life.

My parents taught me that everything happens for a reason, and we have to learn to have the insight to discern the reason before we react to our fate and Allah’s divine decree. I may never know the reason for why difficult things happen, but my parents taught me to have faith in Allah, knowing that He has my path planned out for me and buried within that path are certain incidents that I must go through, that are a part of my journey, a journey that is connected with my life’s purpose, but which I have yet to discover.

My parents also taught me that along our journey of life, we learn from our own experiences and teach those lessons to others, just as I learned from my parents’ experiences. Through their actions, they taught me that life is not about falling down, but about benefiting and learning from the falls, about learning to stand up stronger, tougher, and wiser, and look at such falls as blessings in disguise.

I am also grateful to my father-in-law, Dr. Anis Al-Qasem, for striking and emitting the spark and planting in my mind and heart the seed of writing this book.

I am forever grateful to my brother, Dr. Tarek Shurafa, for strengthening and feeding that spark for watering and nurturing that seed to blossom, and for translating a big part of this book, the part that I wrote in my mother tongue, Arabic. I would also like to acknowledge the way Tarek always stood by me, as a strong beacon of love and affection. He patiently listened to how I really felt during those trying times, and not once did he criticize me for reacting and behaving the way I did or even comment or give his opinion or try to force his recommendations on me.

I praise Allah for giving me my friends who have always been by my side during the good times as well as those times of blessings in disguise.

My deepest thanks go to my sister Dr. Nahed Shurafa for being there for me every step of the way. My family and I have and always will rely on her for honest medical advice. Like Tarek, I thank Nahed for listening to me when I am down and not commenting, giving me the right to be myself and to express what is in my heart.

I am eternally grateful to my sister, Meisoon, for coming to be by my side as soon as she knew I had a crisis. With my parents, she was always with me during all my operations. In much the same way as with Meisoon, I thank my husband’s aunt, Faiqa, for being there for him when he needed a friend.

Thank you, my friend, Margaret, Peggy for being the first to read this book and for giving me your honest opinion and feedback. And honest and sincere you were. Peggy really pushed and inspired me to get out in the open, to face events, and not to fear certain details that I kept running and hiding from. Such inspired action not only motivated me in making this book a personal success, but also had a big role to play in my psychological recovery. Her commitment to my well-being was relentless. She not only threw a gigantic stone in the stagnant pool of my past, my very being, but also stirred that murky pool to awaken and arouse all the dark remnants that settled at the bottom until they were cleared out, released from my system.

My brother-in-law, Hani Al-Qasem was the second to read my book, after Peggy. I would like to thank him for editing and proofreading some of the book, as English is not my mother tongue. Hani not only stirred my pool as Peggy did, but he also blasted and turned that pool upside down and awakened all the remnants I buried and conveniently forgot existed. He raised them to the surface of that already scarred pool so they could look me in the eye as his way of forcing me to get them out in the open, to face and defeat them. I was petrified of what my past might resurrect from the bottomless pit of that pool. He awakened everything that I thought did not exist anymore. And once awakened, there was no putting them back to slumber. Hani then securely concealed the surface of the pool, so I could not reopen it and bury any remnants that might occur in the future.

His way was to force me to face and defeat all remaining troubling thoughts and emotions. He not only pushed me beyond my comfort zone, but he extended its boundaries to such a degree that it seemed to me that he destroyed that zone and erased its existence. I do not know how many times I expressed to Hani how strongly I hated what he did to my pool, but as I went on writing, I realized that Hani continued what Peggy had started; he helped me get out into the open even more, so I could see the fearful events that I did not realize still existed at the bottom of that pool.

My deepest thanks go to my out-of-this-world editor, Joan Levinson. I learned a lot from her, and her wise suggestions had a big role in making this book a success.

Lastly and mostly, all my heartfelt gratitude and appreciation go to my husband, Osama Al-Qasem, for being the person he is and for having such a big heart, for being so tolerant and patient during my whole illness and weaknesses, and for steadfastly standing by my side, even during my worst moments, when I know most husbands would have given up.

Introduction

I never thought that one day I would display any of my subjective experiences and feelings for everyone to read. When I started this book, I wanted to write about my battle with cancer, yet, at the same time, divulge as little as possible about my personal and private life. I convinced myself that I wrote this book so cancer survivors could benefit from my experience, but as I went on writing, I realized that nothing could be further from the truth. And to date, I still do not know what that truth is. As I continued to write, I opened many doors in my life, doors that I had previously closed and conveniently forgotten ever existed and, as a result, I realized that cancer was not the hardest trauma that I had survived and that there are other extraordinary events that unfolded that I dealt with, events and tribulations that made me who I am today.

One day, while writing this book, it hit me—surviving cancer was not what made me the hard lily that I am now but going through the challenges of my daily life made me a strong, brave, and stubborn warrior, and that was what gave me the strength to face, defeat, and survive cancer. It was then that I turned the book in a different direction. I realized that every hard lily has at least one story of bravery in her life and by writing this book, I wanted to encourage all the wonderful lilies out there to share their stories, to learn from my experience as I will learn from theirs. Yet, I still do not feel that this is the primary reason behind writing this book.

I skipped many events that toughened me and enabled me to outlive cancer and much more because I not only did not want to display my own privacy more than I had to, but I also wanted to respect and protect the privacy of my family and friends. I also realized that each one of my stories of bravery deserves to be told in a book of its own, so many books that I may or may not write.

I realized that men are like cacti—they are hard on the outside, yet very soft and tender on the inside. They bravely and, with no complaints, take all that life throws at them. Although they remain strong, life tends to always leave deep grooves within their hearts and, like us hard lilies, these cacti have the right to expel their tears. They do not need a reason to do so. This does not disfigure their image as brave warriors and tough fighters.

The Easy Way Is Never the Right Way

For three years, I could neither face my true emotions nor my faithful feelings. For three long years, I blocked my feelings and was very hesitant to write. I felt unable to express what I was going through in the hope that one day it would all go away, thinking that pretending everything was fine would really make it fine and the pain would somehow vanish. Maybe it was easier to ignore my anger and frustration and the immense pressure I was under by keeping it all inside. Sadly, however, the problem was growing, and I was paying a heavy price just to maintain my personal respect within my own privacy.

Ever since I can remember, I always preferred to keep my private issues very private, no matter what. That was possible, but only up to a certain point, beyond which the pain deep inside me grew and spread, totally out of control. I eventually recognized that I had to make a choice—either I write my book and display my private life for all to read or I continue to suppress my emotions deep inside of me and bear the consequences of not opening up should my emotions explode—but when they did explode, they would do so only after they first painfully and excruciatingly implode. In the end, I opted to write so that everything would be out in the open, so I may finally find and enjoy the inner peace for which I have been yearning for so long.

I tried to treat my wound the easy way by covering it and pretending that it was not there, hoping that it would go away, but when I realized that it was growing out of control, I decided to open it, clean it, and treat it the harder right way so it would heal forever. For me to enjoy the inner peace that I felt committed to achieving, I decided to face the pain. For me to do so, I first had to face myself, face my buried unresolved issues of my past so I could happily live in my present and optimistically embrace my future. It was not until I began to write that I became aware of the scope and magnitude of the rage that was ever-increasing within me.

Anger, fury, depression, and rivers of tears were my only forms of expression for a long time, and it was to such amplitude that I was dazed and astonished. How could I build, nurture, and hold onto so much ferocity? Wow! Ferocity. Me? Yes, that practically summarizes me.

I never realized until that moment what I had been enduring to protect my privacy. I never realized that keeping my personal pains to myself, so I would not burden any of my family members or friends, was so costly and that it would leave me with such pain, like a monster growing out of control and getting stronger and stronger, waiting for the right moment, a moment of unawareness and, when least expected, would force its way out and destroy me and my family. And the scariest thing about it all was that I, the one who has enormous love for my family, am the same one who was nourishing and cultivating that monster. I thought I was protecting them from all that pain by bravely concealing it all in my heart, but instead, I was hurting each one of them by shutting them out.

To my horror, I discovered that Osama and my two boys were aware of the emotional turmoil I was living in. To save them from joining and dwelling in my harrowing experience, I turned the focus of my ferocious energy to emotion-blocking tactics. This was by no means a clever tactical choice because I knew that the more I postponed facing myself and my situation and the more I suppressed my anger, fury, and depression, the harder the repercussions would be on Osama, the boys, and myself.

In time, I turned to writing as a more effective way to release the burdens and heavy emotional baggage that had mounted within me all these years. Thankfully, having now written this book, it has become clear to me that writing is a potent healer. Now I can gratefully say that I embrace life with a stronger, tougher attitude, full of acceptance and self-assurance. This calamity made me tougher and stronger, it purified my heart, and it made me see clearly beyond myself.

Writing this book was a journey that deserves a book by itself, a book that I may or may not write.

My journey has opened many doors, each with a different experience behind it. It sobers me that each reader will perceive a different purpose and each reader is right. As for me, I realize that I wrote this journey with all these purposes in mind.

Chapter 1

Cancer Has No Home Here

My story started around mid-July 1996 on a warm day with a sunny and clear sky, with a cool breeze, the kind of breeze I always appreciated on such a warm day.

I have always defeated whatever challenges life threw at me with laughter so that whoever saw me would think that I had no worries or that I was so naïve that I was not aware of or was not mature enough to assess the seriousness of those challenges. Yet no one ever cared to look beyond my skin-deep laughter to see what actually did reside there. In fact, I never cared if anyone ever did.

My motto was and still is that I cannot change whatever challenges I face, so why stress over them when I know that that stress would only cloud my thinking and judgment and make it even harder for me to face and work through those challenges. Being calm makes me see the picture more clearly, so I can come up with the best solutions possible.

My parents’ love and support had always assisted me in overcoming any obstacles and challenges that I faced. Marital bliss with Osama was indescribable. After our marriage, Osama and I became best friends, not just a husband and wife. Of course, we had arguments, but not one night did we go to sleep before clearing the air.

We used to take the kids every weekend to parks and indoor play places, where they played while Osama and I chatted over a cup of coffee about whatever came to our minds, not necessarily life’s challenges or obstacles, much like two old friends would. Nothing was ever a competition between us, and there was no my duty, your duty motto. We happily took care of the housework and helped the kids with their homework, sharing the responsibilities without argument.

Osama did all that he could to please me, and I joyfully did the same. We only competed to see who could make the other one happier and be as understanding as possible; we both did it from the heart, for the good of the entire family.

It was not easy when we were first married because, even though we both share the same heritage, we came from different backgrounds. Osama was raised in England with Western values, and I was raised in Qatar and Libya with Middle Eastern values. We understood, accepted, and respected our differences. We both believed that the best way to protect one’s partner was to let them in on any challenge one faced. No obstacle we faced was ever difficult to solve because we both tried to simplify any problem and we looked at life as a journey of happiness and enjoyment and, together, we made it just that. Our journey expanded as our delight with our two sons, Ayman and Hisham, was incredible, almost inexpressible.

Ayman is my elder son and Hisham the younger. I felt that each one was my first born as I loved them just the same. I never gave Ayman the feeling that he was superior to his brother because he was my first born, and I never gave Hisham the impression that he was the spoiled baby because he was the younger. I taught them both how to love, protect, and respect each other and their differences. I taught each one to not only respect but also to accept his brother’s space and privacy and, even when they were young, I included them in our family life where we shared our obstacles and challenges, asked for and respected their opinions so as to boost their self-confidence and self-respect. I taught them to think for themselves and to make their own decisions, form their own opinions, and dare to be different from everyone else. I taught each one to be his own man.

Although in my life, much like everyone else’s, I was not free from the usual daily challenges, every night when I put my head on my pillow ready to sleep, I would give thanks to Allah for the blessed life I was living in the hope that nothing would spoil it, that the song and dance of life would remain the same or even get better.

Chapter 2

Don’t Tell Me What to Do

Then one day, the song changed to a different beat. While taking my morning shower, I suddenly thought of my gynecologist and felt a strange compulsion to apply what she taught me, to check my breasts. I listened to the unexpected impulse of the beat of my heart and I carefully examined my breasts exactly as I had been shown. My left breast seemed healthy, as I thought it would be. I went on to examine my right breast. As I casually, yet carefully, moved my hand I suddenly felt a knot the size of an apricot stone. Although it was not too large, it still spurred me to rinse my hair swiftly of the shampoo, climb out of the shower, slip on my bathrobe, and pick up the phone. I called my doctor’s office, explained my findings and we scheduled an appointment.

After I wrote the appointment in my calendar that I hung next to the phone. I strolled to my room to get dressed. As I took off my bathrobe in front of my mirror and looked at my naked figure, I remembered that my mother always said that I have the most beautiful shape among her five daughters and as I remembered that I heard my voice say to take my mind off that knot and what it could be. I couldn’t agree more.

I am five feet five inches tall and at that time weighed one hundred and ten pounds. I had a narrow waist and white skin. As I was gliding my firm arms into the sleeves of my t-shirt, I remember thinking that this cannot be anything serious. It is nothing. Yes, that’s right. Simply nothing.

I repeated the word nothing several times as if to convince myself. It was just a silly little apricot stone-sized lump, that’s all, and as my thoughts took a scary pessimistic turn, I decided to relax, to shake my head to extract it from my mind. I slipped my slim legs into my blue jeans and looked at my small triangular face with my father’s hazelnut eyes and black curly hair. I started straightening my curly hair when I was twelve years old and for a mysterious reason, as hard as I tried, I could never get it to grow longer than two inches beyond my shoulders. My father still had some of that curly black hair around the back of his head, always kept short, never long enough to curl.

As I finished dressing, I looked at my reflection to check my hair and, as I did, my mother came to mind. I thought of her blue eyes and straight brown hair. Actually, I was never sure about the color of my mother’s eyes and I may never be sure, for whenever she wears blue clothing or she is at the seashore under the blue sky, I see blue eyes; yet whenever she wears green or is in a park surrounded by green nature, I see them as green. People say I look more like my mother, maybe because I inherited her white skin. She is a couple of inches shorter than I am and was as skinny when she was my age, but, after having six children, she put on more weight. I can never see the resemblance between any two people, so I trusted other people’s judgment even when they say that Ayman looks like me though with his father’s dark-brown eyes, and Hisham looks like his dad though with my hazelnut eyes. I always smile to myself when people say that they both have my black straight hair because only a few people realize that my hair is curly and straightened.

I looked away from the mirror after I pulled my hair into a ponytail and went on with my daily schedule as if nothing had happened. I tried as best as I could to avoid thinking about that knot, as it started to possess me and occupy my mind. I fought and won, at times, kicking the thought out of my attention. Other times, it won and the apricot knot flooded and saturated my mind. I fluctuated between winning and losing until the day of the doctor’s appointment.

Thinking back now, I realized how clueless I was when I took for granted that cancer does not happen to me, to us, to any of us, and would never hit close to home, let alone my home—me. I did not feel any urgency to go to my appointment as it never occurred to me that it might be malignant. The appointment was simply a way to set my mind at ease, to quiet the nagging, scary, and pessimistic voice in my head, the one that kept reminding me of what if? Yet, at the same time, I would automatically counter act that voice with, Hang on a sec, cancer happens to other people. To which it immediately counter-counteracts, Really? Are you sure about that?

I went at the appointed time to the doctor’s office. On my way there, the song Girls Just Wanna Have Fun was playing on the radio. Holding my hands tightly on the steering wheel, feeling happy and chirpy, and to take my mind off that scary knot, I sang the entire song with Cyndi Lauper. I gently drove into the doctor’s parking lot and as I did so, I reached out and switched off the radio, but that song kept echoing in my head. I had one last glance into the rearview mirror and climbed my way out of the car. I locked it and headed toward the entrance, informed reception of my appointment and was asked to take a seat.

I sat down slowly as I looked around, noticing that there was no one else in the waiting room. I looked at the pile of magazines and did not even see what the titles were. I just stared at the pile, thinking of what the doctor might tell me while the tune Girls Just Wanna Have Fun still played in my mind. After fifteen minutes, my name was called and I made my way to the examining room, not knowing that what awaited me would change my destiny.

The nurse casually followed me to the examining room, handed me a small blue gown, and said, Take off your top and bra and put on this gown. She then quietly left the room so I could do as instructed in private.

I stood silently in the examining room. Here goes nothing, I whispered to myself as I unhurriedly took off my top and bra. As I put on the gown, I started thinking that when the appointment was over and the knot was identified as an abscess, the doctor would simply give me antibiotics, or at the most would open it and squeeze some puss out and send me on my merry way home, and that would be the end of it. Or at worst, he would tell me it was fibroma.

After all, remember, cancer does not happen at the young age of thirty-five and most certainly does not happen to me. My thoughts were interrupted as the door opened and Doctor Smith slowly walked into the room. It seemed that he had not a care in the world. I sat down on the examining chair, and he stood firmly next to me. After a short pause, he looked down at me and quietly said, Good morning.

I looked up at his face and greeted him back, Good morning.

He looked directly at me and asked, What brought you to see me today?

I gently opened the blue gown and showed him the knot. Well, I hesitated, I found a knot in my right breast while having a shower the other day. It’s probably nothing, but I thought I’d better have it checked out.

Doctor Smith pulled up a chair and sat down next to me. He stretched his arm to the knot and said, Let me have a look.

I noticed how carefully he examined the knot, tilting his head from side to side, not making a sound, and how slowly and gently he touched and estimated its size. At one point I thought he had a change of personality. He’s usually calm and makes so little out of everything, and nothing is serious enough for him to take any action. I always wanted to go to a different doctor, but Osama kept asking me to give him another chance. The most he ever did was to prescribe an antibiotic one day, and even then he would not do that until after my first appointment as he wanted my immune system to strengthen and fight before he gave me the antibiotic. When it did not and only after I kept getting sicker and my temperature kept getting higher and higher, did he then decide to take action—and that was on the third appointment when I went to address the same issue. What a miracle! He finally gave me that antibiotic after my temperature reached 104. That day came back to me as he was delicately and tenderly examining that knot. I thought he must have started to take his patients more seriously as I noticed how he vigilantly studied the knot.

Every time I see him, he tries so hard to give me the impression that there was nothing wrong with me and I pretend that there is. On that occasion, he was very calm and patient, I thought he had a change of character. The doctor had a good look, a really good look. He felt the knot, stroked and gently squeezed it to ascertain its size. He then asked a series of questions—how long has it been there, when did I first see it, was it painful or did it get bigger since the first time I discovered it?

I felt that he was asking all sorts of questions but was not waiting for my answers. He moved on from one question to the next as if it was a matter of duty with no interest in my wellbeing. We weren’t having a conversation; it seemed as if he was reciting something he memorized. Although he made me feel that I made up the knot story and there was nothing inside my breast, I still answered all his questions carefully and with great detail.

I started right from the beginning, from when and how my gynecologist showed me how to examine myself and ending with my phone call to his office. And after all that, I felt that he did not hear a word I said. He just heard how well he asked all the questions, feeling somewhat proud of himself for knowing that he recited what he learned to ask in medical school in such cases, making sure he did not leave any out, much like a student taking his final exam. He kept talking to himself as if he were studying the night before his exam, and I was talking to myself about what I went through those last few days. Two people talking, and two people listening only to what they themselves were saying.

Yet I went on and answered all his questions, hoping that he would really start to take his patients, or at least me, more seriously. Once all the questions had been answered, he slowly, calmly, and with a calm tone said, My dear, do not worry about this knot. It’s nothing. Just keep an eye on it. If it grows larger, come back and see me.

At that time, with a sigh of disappointment, I thought to myself, Well, I thought he changed and was taking me seriously.

Although the intention behind the appointment was to reassure myself that the knot was nothing serious, and despite the doctor’s reassuring opinion, for some reason that day I experienced an unexplainable gut feeling compelling me to request a surgical biopsy. This feeling forced my mouth open. Fine, but I would like to have a surgical biopsy to make sure what type of cells are in there. I was so mad at him, yet I controlled my temper and continued in a very calm tone, I would prefer it if you would take it out and put it under the microscope.

I knew it was not superstition or a false notion for I had experienced such feelings in the past and they had always been right. My intuitive feeling was so strong on that occasion that I decided to listen to it and act accordingly. I decided to follow my heart and not my doctor’s advice.

There’s nothing to worry about, Mrs. Shurafa, Doctor Smith replied, a biopsy is not necessary.

No, I need to have one. I need to put my mind at ease, I insisted.

Doctor Smith still did not see a reason for me to worry or perhaps, like many doctors, he wanted to kiss up to the insurance company and not charge them the cost of the biopsy. I really do not see any reason why you want to do this.

This strengthened my insistence to have further tests, and after I made my unrelenting persistence clear to him, I replied, I can go to another doctor and ask him for his referral to pursue this matter further.

He relented and wrote an order for me to have a mammogram. Maybe he hoped that if the mammogram was negative, it would weaken my persistence.

To erase that hope from his mind, as I was leaving the office swinging my purse over my shoulder I said, You know that whatever the outcome of the mammogram is, I still want to have a surgical biopsy. I did not wait for his reaction, and I left the office.

Somehow, at a certain point, during our to-and-fro debate, I felt that Doctor Smith was right, that there was no need for further tests, but my intuition kicked in again and my stubbornness got the best of me and decided to surface. I did not want my doctor to tell me what I should or should not do. That had to be my decision and he had to abide by it. My stubbornness must be heard and must be adhered to; that was another reason why I went against his opinion. I left Doctor Smith’s office with the tune Girls just wanna have fun still playing in my head.

Well, when I think of it now, I do not know if I used my stubbornness to rationalize following my intuitive feeling or if I followed my intuitive and unfounded feeling to rationalize my stubbornness, or maybe it was a little bit of both. My perseverance paid off. I managed to get a mammogram appointment the next day and only because I insisted on it. I remember a few years after this incident I said to Osama over a cup of coffee one day, I hated Doctor Smith because it took so much effort to convince him to investigate my knot and take me seriously. I really hated him for being this calm. Then I paused and before Osama had a chance to respond, I continued, Well, had he taken my knot seriously and suggested a mammogram, I would not have listened, so I think had it not been for his attitude that struck my stubbornness, I would not have pursued this matter any further. And I’m actually grateful for that.

So, you like your doctor, yet you hate him for the same reason? Osama replied.

Well, now that you put it this way, it does sound confusing. And yes.

He quickly replied, sarcastically, Living with you, honey, is like a rollercoaster. Never a dull moment. No one can ever predict what you will think and why you think the thoughts that you do, let alone how you think.

Osama was feeding me bait as he always has since the day we got married. I decided to bite. Aren’t you grateful that because of me there is not a dull moment in your life? Without me, your life would be predictable and terribly boring, which is why I always put you through what you call a rollercoaster for your own amusement.

He just laughed and hugged me. You are never lost for words. You always know what to say and when to say it.

I smiled sheepishly, stood back, and said with simulated innocence, What? I’m doing it for you.

Osama laughed, stepped forward, and gave me another hug, this time tighter than the first, and whispered romantically into my ear, Well, I am so grateful to you, honey, thinking of me like that all the time.

I gently pulled away from him, lifted my head slightly and said, with my right hand on my heart and with a little bow, You’re most welcome. Anytime.

We held each other for a while. I enjoyed this close embrace and I know he did, too. It was during this quiet moment that I understood Osama’s intention; he was trying to take my mind off the test results and perhaps his mind, too, for all I knew. It was at that moment, while melting in the warmth of his embrace that I decided not to talk about it anymore until the day I would go to get the results.

I was actually not worried about the results for it never crossed my mind, not even for a split second, that my own life was going to become one of the world’s longest and ugliest rollercoasters and, worse yet, one that I would never be able to get off no matter how hard I tried.

A week later, the results came back. They were negative. I did not tell anyone, not even Osama. Well, I did, but not immediately because I did not want anyone to pressure me and convince me that there was no need for a surgical biopsy. Even though the results were negative, and part of me was happy, yet an even bigger part was begging me to beware. It was firing up my persistence, giving me more fuel, more drive to insist on a surgical biopsy. The waving flags were big and plentiful. They could not be ignored.

I still remember that call from Doctor Smith’s secretary. Ms. Shurafa, I have the results of your mammogram; they came back negative.

I also remember my immediate reply. I would like to see Doctor Smith. When can you give me an appointment, please?

Can you come tomorrow at three in the afternoon? she asked.

Yes, I’ll be there. Thank you."

As soon as I hung up the phone, I started to prepare in my mind what I was going to say, how I was going to attack and fight with him to show him how much I wanted a surgical biopsy, because I knew that he would try to convince me otherwise. As I sat in the examining room and I saw Doctor Smith coming, I did not even give him a chance to say good morning. I am going through with the surgical biopsy even though the result was negative.

Doctor Smith said patiently, The insurance company will not cover a biopsy unless you have another mammogram, until we see the result of the second one.

I stubbornly said, Fine. But I will still insist on a biopsy no matter what the outcome is. I went home and complained to Osama, Can you believe they are making me have another mammogram?

Osama knew how persistent I was about having this biopsy. He calmly replied, Okay. Do the second mammogram and then have a biopsy.

I looked at him and said, What a waste of time! I looked down.

I know, but if it is the protocol, you cannot do anything about that.

I quickly accepted that Osama was right, so I decided to abide by the rules. I did that second mammogram in the same place with the same person, who looked at me as if I was a lunatic. I just tolerated her looks and said nothing because I did not feel like fighting with her or anyone else. I just wanted the mammogram to be over with and the result to come out so I could go ahead with the next procedure. Three days later, I received another phone call from the secretary to tell me the good news. I took that opportunity to make another appointment. I went to see Doctor Smith again with the intention of having a biopsy. I took a deep breath as he entered the examining room where I was waiting. I was the first one to talk and I said with a strong, stern tone, I know the second results are negative, but if you do not give me a referral for a biopsy right this minute, I will leave your office and call the insurance company right away to give me another doctor’s name to go to.

Ignoring my seriousness, he said, I told you it was nothing. Now we have two negative mammogram tests so there is no reason to try to convince the insurance company that a biopsy is necessary.

I was furious. I felt my brain explode. I yelled back at him, And I told you that I insist. I am adamant to have a surgical biopsy even if the results were negative. You hear me? I paused for a second to take a deep breath, then I continued with a lower tone, You let me take care of the insurance company. If they give you any trouble, I’ll take them to court.

Seeing the expression on his face, I knew that he got my message. I really wanted to ask, what’s in it for you, doctor? But I thought that I had offended him enough with the last sentence, so I was satisfied with him giving in to me and sending me to a surgeon colleague of his. I wanted to be surer than sure, and there is nothing more accurate than a surgical biopsy.

I finally left the examining room, leaving the echoes of my mind still reverberating against the walls. On my way out, the secretary handed me a note with the surgeon’s name, phone number, and address. I took the note with an automatic lifeless movement, without saying anything. I did not even thank her and I left the office. Just before I closed the door behind me, I heard her saying, I will send the referral to Doctor Robert to make sure that he receives it before you make your appointment. I victoriously closed the door. I still was beside myself, although she was helping me, but I was so angry, I was sure if I answered her, I would have said something inappropriate, so I kept my mouth tightly shut.

Chapter 3

Facing My Worst Fear

As soon as I returned home, I called the surgeon’s office. My name is Manal Shurafa and I…

My introduction was interrupted as the secretary quickly said, I know who you are, Ms. Shurafa. Doctor Smith just spoke with Doctor Robert about your situation.

I took a quiet deep breath and asked in a relaxed tone, So what’s the plan?

She said, "I have to wait until we receive the referral; then I’ll call you with the appointment time for the procedure.

I did not reply for a moment and then said, Oh, so no pre-operative visit?

No need. Doctor Smith fully explained your situation to Doctor Robert. He is aware of your case. When I put the phone down, I smiled to myself and heard my voice say, Well, it pays to be strong and hard on people, even on my cool and smooth doctor.

The next day, Doctor Robert’s secretary called