Project goes past the pink to the heart of women’s health


I am writing this in October, the official month of all things pink. You know, the color of breast cancer awareness. And store shelves were completely pinked out well before October, as if buying pink merchandise is the only answer to the problem.

If we’re being honest here, do we really know how much buying the pink lanyards spouting slogans like “I Love Boobies!” and “Save the Ta-tas!” — largely favored by male teens, it seems — does to support breast cancer research?

Do those pink water bottles marked down to $1.29 by the end of the month truly help the cause? Or do they just add a rosy glow to the landfill situation? Does feeling like we’re doing something make us all feel better? It’s not called “pinkwashing” for nothing.

One Walla Walla medical provider sees breast cancer from past the pink. Niki Flemmer is a family nurse practitioner who spends her days working with surgeons. Raised and educated in the Valley, she thinks a lot about women’s health.

So much so that Niki founded “The We Belong Project” with the goal of improving health care for sexual minority women. She puts guidance, articles and resources for women and for health care providers on the project’s blog of the same name.

Recently Niki wrote and posted this. Once you read it, you’ll see why women here and everywhere have shared it via social media, email and word-of-mouth.

Hello, Dear One,

Today is the day. I am a member of the surgical team who will take care of you — the team that will remove your breast to treat the cancer that has tried to make a home in your body. We all have our role today, and the world would see yours to be the “patient.” I see it as something more: a powerful gift to us.

Because you remind us why we do what we do.

Today will feel sterile and scary. And I am sorry for that.

I wish there were a better way. Today we will ask you to take all your clothes off and put in their place a gown. Women before you have worn it. Women after you will wear it. Be sure to ask for warm blankets, because we always have plenty. We will ask of you your blood type, your medical history, your allergies. We will ask you to lie down in a bed that’s foreign to you. We will have to poke you so that we can start an IV.

You will meet many nurses, doctors, and hospital employees. We will write down important things for you to know. Your surgeon will see you soon. He will have to mark the breast we are having to remove today.

We will take you into the Operating Room — a room only few have seen. There will be bright lights, lots of metal, instruments that you’ve never seen, and we will be dressed in gowns, gloves, and masks. Over our masks, we hope you can see our eyes reassuring you as you go off to sleep.

Today is the day you will have to say goodbye to a part of your body, a part of yourself.

Your breast has felt the warmth of a lover’s caress, has fed your child with life-sustaining milk and connection. You have many memories stored in your breast, stories none of us today know about. Somehow I wish I knew them.

And yet. Here we are. We must do our rituals. We must scrub our arms and hands with alcohol so that we can fight off infection before we start. We don our gowns, our gloves, our masks. We must drape your body in blue.

You are exposed. And unconscious. And it must be difficult to trust. I honor you, Dear One.

My job is to help your surgeon take away the cancer. I get a bird’s-eye view of the process. The surgery begins and I feel your warm skin through my gloves. I wonder what stories you already have and the ones that are yet to come.

We carefully remove your breast. It never gets easy to see or to do. You must know this. It never feels natural, it never feels cavalier. It feels sacred to me. Every. Single. Time.

I look down and see your pectoralis major — the big muscle behind your breast. A source of strength. It is beautiful and shiny. Sometimes it contracts a little bit while we work. Sometimes the muscle is bright red and young. Sometimes the muscle is faded a little. But it is always strong. I like to gently touch it with my fingers. Because I feel your strength there.

We must send your breast away now. It officially leaves your body. I always feel an ache in my gut in that moment. There is no way for you to fully prepare for this day, Dear One.

I like to think that your body is already healing, as we close the incision we had to make.

Sewing your skin back together feels like I’m helping a little. But I know it’s actually all you doing the work. Even as you sleep, Dear One.

We will put a bandage on your incision. We will wake you up. We will tell you everything went well. But the road is just beginning for you.

I saw you today. You are beautiful. You are strong.

Thank you for entrusting me and my colleagues with your most intimate moments. I am honored to be a witness to this phase of your life.

Because now the healing begins. Now the grief is in full force. Now your breast is gone and in its place is a memory.

I watch you as you wake up. And I want to make it all go away. I can’t. Today your body underwent a transformation. And today our team took care of your body. I hope we took care of your heart, too.

There is nothing we can say or do to make it go away. But please know that I care. We care. Behind our masks and gowns are heavy hearts and sometimes tears.

Yours are a gift today. Because you remind us of human resilience. You remind us of strength. You remind us of trust.

I saw you today.

You are beautiful. You are strong.

I will not forget.

— Niki, your Nurse Practitioner First Assistant on the Surgical Team

She needed to write this, Niki told me. No matter how compassionate a surgical team is, routine takes over. As it must, of course, you don’t want your surgeon sobbing in anguish while you’re on the table. This, though, was a chance to get back in touch with what they do and why they do it, she said.

“It’s sacred work. I wanted to convey that to patients and other health care providers. This really does matter and it really is a loss.”

You’re reading this in November, when the pink has long been replaced by the red and green of Christmas. Yet the pinkwashing is important as part of advocating for breast cancer victims, Niki added.

“But sometimes it can be caught in the abstract for the people who see it and work with it. Talking about the reality is necessary, too.”

As for me, should I ever need this kind of care, I hope I get a Niki to go with it.

Sheila Hagar can be reached at 509-526-8322 or


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