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would say.ā€

Nancy also had other things to consider. She told her doctors she had a busy schedule over the next weeks, including a charity dinner in Chicago at which she was to accept a $100,000 donation to the Nancy Reagan Drug Abuse Foundation that she was getting off the ground. After that, there was an event in New Hampshire for the Foster Grandparents program. Her physicians assured her there would be no problem with a short delay, so they scheduled her surgery for October 17.

On the flight to Chicago, Nancy told her press secretary, Elaine Crispen, and her assistant, Jane Erkenbeck, what was going on. As they all cried, the three of them agreed to keep it secret until right before she went into the hospital. Nancy spent that night in the Drake Hotel, looking over the same view of Lake Michigan that she had seen so often from her childhood apartment. She wished for her parents. But Loyal had been dead for five years, and Edie no longer knew who she was.

The evening before the surgery, Nancy checked into the hospital and watched the gripping televised rescue of Jessica McClure, a little girl who had been trapped in a well in Midland, Texas. The first lady awoke at six thirty the next morning, an hour before the operation was scheduled, to find that the Washington area was shrouded in fog. That meant Ronnie and her brother, Dick, who had come down from Philadelphia, could not take a helicopter. Ronnie became frantic and demanded a car, which got him there just in time to give Nancy a kiss before they put her under.

The operation took fifty minutes. When her doctors came out of the operating room, they told Ronnie that the seven-millimeter tumor was indeed malignant. The president collapsed into a chair, dropped his head, and wept. Hutton wasnā€™t sure what to do. It occurred to him that in this moment, Ronnie needed to be in the hands of a woman. Hutton found Paula Trivette, a nurse he knew the Reagans loved, and asked her to go into the room where Ronnie was. As she put her arm around the presidentā€™s shoulder, Ronnie felt that he had been visited by an angel. Trivetteā€™s quiet words, he wrote later, ā€œlifted me from the pit I was in and kept me out of it.ā€

The initial White House announcement, issued while Nancy was still in surgery, described the first ladyā€™s tumor as a ā€œnoninvasive intraductal adenocarcinoma of approximately seven millimeters in size.ā€ Her decision to undergo a modified radical mastectomy for a small cancer that had not spread, rather than lumpectomy, which involved removing only the tumor and a small amount of surrounding tissue, was the subject of no small amount of second-guessing. Rose Kushner, the executive director of the Breast Cancer Advisory Center, a group that counseled women, told the New York Times that Nancy ā€œset us back ten years.ā€ Kushner added: ā€œIā€™m not recommending that anyone do it her way.ā€ Nancy, justifiably, resented the carping about what for her had been an intensely personal decision.

The first lady also opted against breast reconstructive surgery. But she worried what her husband would think when he saw how she had been disfigured. ā€œI still havenā€™t shown Ronnieā€”me,ā€ Nancy wrote in her diary a week after the mastectomy. ā€œEven though he says it doesnā€™t make any difference, and I believe him, I somehow canā€™t bring myself to do it yet. Iā€™ll know when the time is right.ā€ In that same diary entry, she noted that she had received ā€œthe dearest letterā€ from Ronā€™s wife, Doria: ā€œIt was full of love and concern, and Iā€™ll save it forever. I couldnā€™t help wishing it had come from my own daughter.ā€

Nancy became a prominent public advocate for women to get routine mammograms and a private source of comfort to others in her situation. When Los Angeles Times reporter Betty Cuniberti was diagnosed with breast cancer at the age of thirty-six in 1988, a letter arrived from Nancy on the very day that doctors were explaining to Cuniberti the procedures for her own operation. ā€œBelieve me, no one knows better than I how you feel right now (although youā€™ll probably find a lot of people you know have had it done and you didnā€™t knowā€”at least, I did),ā€ Nancy wrote. ā€œWhen they use the word ā€˜malignantā€™ or ā€˜cancer,ā€™ your heart stops, really stops.ā€¦ After itā€™s over, youā€™ll find, I think, it really isnā€™t so bad.ā€

But her cancer diagnosis would shortly be followed by another blow. Nine days after her mastectomy, Nancy was on the phone with her son, Ron, when the bedroom door opened, and her husband walked in. ā€œHoney,ā€ Ronnie told her, ā€œEdie is now with Loyal.ā€ Though it had been a long time since Edie had been able to talk to her, Nancy felt sad and guilty that she had not been there for her motherā€™s end as she had for her fatherā€™s. She arranged quickly to get to Phoenix. When she and Ronnie walked into the mortuary the following day, Nancy was taken aback to see her mother lying in her robe, her gold beads, and the little red mittens that Edie in her final years wore summer and winter. As Nancy began to sob, Ronnie took her in his arms and tried to absorb her grief. The most powerful man in the world felt helpless. He had never seen his wife in such pain.

Nancy took the mittens as a keepsake and then told her mother one last time how much she loved her, how grateful she was for the woman whose drive and example had made so much possible for her daughter. No doubt the pain and emptiness of Nancyā€™s early years without Edie stirred again as she faced the fact that this time, her motherā€™s absence would be permanent. In one last nod to the life story that Edie had written for herself, the obituaries cited her age as ninety-one, which was eight years

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