The Magazine of The Evangelical Lutheran Church in America


Preparation for surgery to remove a breast

Originally this rite was set up in a blank book journal. Each reading was put on a page by itself to encourage silence for meditation as part of the ritual. Empty pages remained for pictures and for later journal writing.

Order of Service

Silent Meditations
Sharing Reflections on the Meditations (as appropriate)
Naming the Loss
Mary & others, if present
Song: Rocka My Soul
Prayers for the Surgery and for Healing
Words of Reassurance
Closing Songs:
How Firm a Foundation
There is a Balm in Gilead
Some Thoughts Before You Begin...
Who? When? Where?

As I think about saying goodbye to your breast, it seems you might want to be in a place where you could comfortably sit bare breasted, or at least with a loose fitting blouse, open some at the front. I imagine that answers the "Where?": At home when your child is in someone else's care or soundly asleep.

Such a setting would also mean that you would either be alone or with the closest of friends. It's my sense that it really would be better if someone could be with you, to lead you through, a pastor or spiritual friend. Who could best assist you? Who might also help you to sing? It's possible just to read the words of the songs, without singing, but music has special power and singing would add to the experience. It's also my sense that this ritual would be appropriate for your husband's participation, for he's got a loss in your loss, too, and also needs support. It seems that this ritual could be something that might work for both of you together, but only you will be able to answer that. His needs also might be quite different from yours right now. It will probably help you in the course of the ritual, if you use it, to think ahead about how you can most be yourself and feel safe enough to enter into it fully.

Give yourself enough time not to rush. The meditations are meant for slow pondering before moving on to the next one. The experience might well take a couple of hours.

Silent Meditations

For use alone, each one followed by silence. With others, each may read them, silently or aloud. Leave time for meditation following each reading. If others are present, there may be time for the sharing of insights after all of the pieces, if that seems right.


And you grew up and became tall
and arrived at full maidenhood;
your breasts were formed,
and your hair had grown;
yet you were naked and bare.
Ezekial 16:7


[My surgeon] told me some women preferred a mastectomy. Weeks of radiation would then be avoided, along with side effects. I'd just get it over in one fell swoop.

Sure. Just get your breast cut off and it's all over. Permit me to doubt. I'm rather attached to my breasts — downright fond of them. They're part of my identity as a woman and an important part of my sexual pleasure.
Cathy Hitchcock
Breast Cancer. By Steve Austin and Cathy Hitchcock. Rocklin, CA: Prima
Publishing, 1994. Page 57.


Joseph is a fruitful bough,
a fruitful bough by a spring
his branches run over the wall.
The archers fiercely attacked him,
shot at him, and harassed him sorely;
yet his vow remained unmoved,
his arms were made agile
by the hands of the Mighty One of Jacob
(by the name of the Shepherd,
the Rock of Israel),
by the God of your father who will help you,
by God Almighty who will bless you
with blessings of heaven above,
blessings of the deep that couches beneath,
blessings of the breasts and of the womb.
Genesis 49:22-25


I was told by two doctors, one female and one male, that I would have to have breast surgery, and that there was a 60 to 80 percent chance that the tumor was malignant. Between the telling and the actual surgery, there was a three-week period of the agony of an involuntary reorganization of my entire life....

... within those three weeks, I was forced to look upon myself and my living with a harsh and urgent clarity that has left me still shaken but much stronger.

Audre Lorde
"The Transformation of Silence into Language and Action." In Sister Outsider. By Audre Lourd. Trumansburg, NY: The crossing Press, 1984. Page 40.


Jesus, Savior, pilot me
Over life's tempestuous sea;
Unknown waves before me roll,
Hiding rock and treach'rous shoal;
Chart and compass come from thee.
Jesus, Savior, pilot me.
As a mother stills her child,
Thou canst hush the ocean wild;
Boist'rous waves obey thy will
When thou say'st to them: "Be still."
Wondrous sov'reign of the sea,
Jesus, Savior, pilot me.
When at last I near the shore,
And the fearful breakers roar
Twixt me and the peaceful rest,
Then, while leaning on thy breast,
May I hear thee say to me:
"Fear not, I will pilot thee."
Edward Hopper, LBW 334


How fair and pleasant you are,
O loved one, delectable in delights!
You are stately as a palm tree,
and your breasts are like its clusters.
I will climb the palm tree
and lay hold of its branches.
Oh, may your breasts be like clusters of the vine,
and the scent of your breath like apples,
and your kisses like the best wine
that goes down smoothly,
gliding over lips and teeth.
Song of Solomon 7:6-9


Making love. Nursing a baby. Holding a child. Hugging a friend. Standing in a bathing suit at the pool. It's my life with others that I have such trouble imagining if I were to be without one breast.


And when [the doctor] touched the area, I felt my flatness.
Judy Hart


Every loss is a death.


Judy Hart shares a journal entry that reveals how a focussing technique helped get her through a terrible time with panic and terror. She started by going to a comfortable spot, a porch overlooking geraniums and out onto the ocean. She sat with an empty chair beside her and invited her terror to sit beside her.

Can you invite your loss of your breast to sit beside you? To sit with the loss fully, not avoiding it, not laying it aside?

Some of her thoughts:

Just now I've stopped writing and allowed my tears to flow, tears of sadness, loss, inexorableness. All I've built hasn't been enough to prevent this from happening.... I couldn't prevent this....

How are you now, my terror? I reach my hand out to you. You seem to have put your feet up on the railing, and together we can stare out over the sand to the sea and wonder about something that is larger and more spiritual than what I have felt negatively engulfing me. We will cope as we are already coping because we don't have to encompass everything at once -- just whatever is going on now. And we can feel the love we have for ourselves and others and the love others have for us.

Judy Hart
[Love, Judy: Letters of Hope and Healing for Women with Breast Cancer.
By Hart. Berkeley, CA: Conari Press, 1993. Pages 34, 25-28]

Naming the Loss

Mary speaks aloud, naming the losses she is feeling. People close to Mary feel a sense of loss, too, though theirs is of a different character. Any others present who want to share may name their losses as they choose.

Song: Rocka My Soul (Traditional Spiritual)


Rocka my soul in the bosom of Abraham
Rocka my soul in the bosom of Abraham
Rocka my soul in the bosom of Abraham
Oh, rocka my soul.
So high, can't go over it
So low, can't go under it
So wide, can't go 'round it
Got to go through the door: Refrain

Prayers for the Surgery and for Healing

For all who feel the need for healing, of body, mind and spirit: Christ, in your mercy: HEAR OUR PRAYER.
For Mary, in these days of preparation and waiting: Christ, in your mercy: HEAR OUR PRAYER.
For other loved ones, especially (NAMES), that you, O LORD, may bring healing and ease the pain: Christ, in your mercy: HEAR OUR PRAYER. For Chris and Matthew, and for all who wait and fear and touch and hope: Christ, in your mercy: HEAR OUR PRAYER. For those who have traveled this path before; for those who stand beside and listen: Bless we the LORD: THANKS BE TO GOD. For nurses and doctors, that their skill and compassion may bring healing to Mary: Christ, in your mercy: HEAR OUR PRAYER.

For these and all that you see that we need:

[Silence, or other petitions...]

Into your hands, O LORD, we commend all for whom we pray, trusting in your mercy through Jesus Christ, our Savior. Amen.

Words of Reassurance

[If alone, read silently or aloud. If others are present, they may take turns reading the words aloud.]

God is our refuge and strength,
a very present help in trouble.
Therefore we will not fear
though the earth should change,
though the mountains shake
in the heart of the sea;
though its waters roar and foam,
though the mountains tremble
with its tumult.
There is a river whose streams
make glad the city of God
the holy habitation of the Most High.
God is in the midst of her,
she shall not be moved;
God will help her right early.
The nations rage, the kingdoms totter;
God utters God's voice,
the earth melts.
The LORD of hosts is with us;
the God of Jacob is our refuge.
Psalm 46:1-7

Without breasts
a woman's heart
rounds and
softens her body
bears her milk.
Elana Klugman*
From the poem "Without" by Elan Klugman.
The New Our Bodies, Ourselves. New York: Simon and Schuster, Inc., 1992. Page 626.

Rejoice with Jerusalem, and be glad for her, all you who love her;
rejoice with her in joy, all you who mourn over her -
that you may nurse and be satisfied from her consoling breast;
that you may drink deeply with delight from her glorious bosom.
Isaiah 66:10-11

I will accompany myself in this voyage into the unknown.
I will remember the life-saving reasons for this.
I will honor all that I am.
Judy Hart*
Ibid. p. 36; from Hart's affirmations used in preparation for looking at her flat chest for the first time.

So we do not lose heart. Though our outer nature is wasting away, our inner nature is being renewed every day.

For we know that if the earthly tent we live in is destroyed, we have a building from God, a house not made with hands, eternal in the heavens
II Corinthians 4:16; 5:1

Closing Songs:

How Firm a Foundation (LBW 507)
There is a Balm in Gilead (Traditional Spiritual)

There is a Balm in Gilead (Traditional Spiritual)


There is a Balm in Gilead
to make the wounded whole,
There is a balm in Gilead,
to heal the sin-sick soul.
Sometimes I feel discouraged,
And think my work's in vain,
But then the Holy Spirit
Revives my soul again: Refrain: Refrain [Originally written in July, 1995.]

The following attribution should accompany any use, in part or in whole, of this ritual:

Reverend Janet S. Peterman, St. Michael Lutheran Church, Philadelphia (Germantown), Pa.

Reverend Janet S. Peterman, St. Michael Lutheran Church, Philadelphia (Germantown), Pa.

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