Three words increased Grace’s isolation tenfold: ‘It’s your decision.’ The oncologist laid out all the facts and what could be done, but never what should be done. He began by explaining why she was high-risk and talking percentages that in that moment made no sense. Lenny took notes and nodded along; she just sat there as the consultant explained what was involved in an MRI. A needle! She heard him say that a dye would be injected into her arm and the rest was a blur. He recommended mammograms and MRIs twice a year to keep on top of things. Counselling was a must, especially if she was considering risk-reducing surgery. He talked at length about what was involved in a double mastectomy including various reconstruction options which all sounded barbaric and painful. Then he moved on to a bilateral salpingo-oophorectomy. Grace felt dazed. She found it hard to focus on anything but how heavy the air felt, but Lenny was on it.

‘Oophorectomy – can you spell that?’

The consultant spelled out the word as Lenny wrote it in big letters.

‘Now what is that?’ he asked.

‘It’s the removal of a woman’s ovaries and fallopian tubes.’

‘But Rabbit had breast cancer – the only place she didn’t have cancer was in her ovaries.’

‘Rabbit?’

‘My sister,’ Grace heard herself say. ‘In the end it was everywhere.’

‘Grace’s gene means that she is considered high-risk for both breast and ovarian cancer.’

‘So you want to cut her breasts off and take her ovaries?’ Lenny said.

‘No, I don’t want to do that.’ Then came those three words. ‘It’s your decision,’ he said, looking to Grace.

‘But do you recommend that?’ Lenny asked.

‘All I can do is tell you what’s available – it’s your decision,’ he repeated.

‘I’m asking for your opinion.’

‘Everyone’s different. This is a choice. Some choose to have the operation, some prefer to increase their breast checks and rely on monitoring. It’s your decision,’ he said again, looking at Grace.

The psychotherapist, the consultant, the consultant’s nurse, the radiologist, the counsellor, the surgeon they went to for a second opinion, even the girl on the helpline . . . Every single person within the system told her the gene could kill her, but when it came to deciding on risk-reducing surgery they all uttered those three same words. She wanted someone – anyone at all – just to tell her to do it. Have the surgery. Save your life. They didn’t. ‘It’s your decision.’

‘If it was necessary it wouldn’t be up to you,’ Lenny said. ‘There would be no decision to make.’

She researched everything, spent hours online looking at protocols from country to country. Tick-tock. It’s your decision. Tick-tock . . .