Rule 1: Powerful

As surgeon, you have power over me. I have power over my body, up to a point, after which my body has power over me. Do I wait and see if it will rule me kindly, a benign dictator, or do I pre-empt the battle. Combat zone: my breast. No-one announces the date battle will start. Shall we make plans to invade?

Rule 2: Private

My health is private, yet everyone wants to talk about it. Even Angelina was allowed to do it in private, only talking to the world once she was neatly sewn up, pert and perfect again. Would they feel they had the right to discuss it if I was having an abortion? Yet when I consider having my breasts cut off everyone has a view.

Rule 3: Painful

My pain is my own. If I think about this for long enough, I feel you cut into me, then I wait for my skin to heal, so that you can cut into me again. My skin cringes in anticipation. Your nurse was kind as she explained my options for pain relief. Of course, rather than embrace this particular pain, I could wait, but hope is no longer a viable option.

Rule 4: Performative

I can tell that you love to perform, and I’m grateful. One of us needs to be enthusiastic about this transaction. You explain the risks and benefits, hedged promises rolling off your tongue and over my head, a performance you’ve given many times before. I have forgotten my lines. ‘I de … I dis … I die …’ I stand there, hoping that the curtain will fall.

Rule 5: Political

It’s not just about me, he says. I’m fortunate to live in an age when I have the choice. (That’s when I end up reading Frances Burney.) Many women in many countries would give their … their what, I ask, their left breast? And their right one? In order to be able to choose their fate. The time and date at which battle commences. Ovaries too? Hell, take the lot!

Rule 6: Pissed

I’m pissed. So fucking angry, and who do I shout at? My mother, her mother? Generations of dead women who would have, who have given their lives for what I know. Take it back, I want to scream. I don’t want to know, I don’t want to choose.

Rule 7: Priceless

It comes down to money, doesn’t it? The whole fucking health care system, and because I have a job and insurance I have a choice, a choice that I don’t want. How much do you charge for bilateral prophylactic mastectomy, four nights in a private room, and another stay for reconstruction? How much do you get paid? Do you every wonder if you should have chosen another branch of medicine, another career? Or is it much clearer to you than it is to me, what good you do?