The 100th Percentile | By Nancy Zafris

As it happened, breast cancer arrived during the season of my son’s college entrance exams. ACT stats dogged me everywhere. When an oncologist — female — walked into my examining room, this startling sight was preceded by the ghost of a girl with a death grip on a pencil, scratching in an answer sheet beside the slouching boys. My new doctor was Indian, beautiful, and wearing high heels. Her smile was as brilliant as I imagined her college boards had been. She dragged over a chair and placed a writing pad over our touching knees. Had a test score catapulted her to the top — rather, had a single question on the test done it?  Just one bar graph, just one it’s apostrophe S could topple a future, this according to fretting high school superstars who poured their hearts out on the college blog I read — clandestinely, so that my son might never know the suffering that resided there (omg a 33! I am so fucked!). If they scored a 34 on the ACT (out of a perfect 36), they were anxious for another shot. If they got a 35, they were but one point away. No matter that 33 through 36 were all rooted in the 99^th percentile, three, four, five times they would retake the test in order to achieve perfection. They told each other, I just read in another thread that a 36 improves admissions chances by around 100% compared to a 35. (Around 100 percent of what?  This, I had learned from cancer stats, is the question to ask.)

On some of the breast cancer blogs, similar number panic was happening. One patient wrote she had decided upon chemotherapy because the 3% boost it promised would raise her to 92%, almost the Ivy Leagues of survival rates. Who could legitimately tell her, Forget the chemo, an 89 is good enough, when a 89 was a B in my son’s AP class while a 90 was an A, that one point the difference in a whole letter grade, that letter grade the difference in a cumulative average, that slipping average responsible for two dropped spots in class rank, a plummet from the top 3%, a farewell to merit scholarships. For God’s sake, get the 92! Do whatever it takes to avoid an 89 and the irreparable damage a B will do to your life.

On the notepad the oncologist drew pictures and went through the confusing arithmetic of breast cancer. I was way ahead of her. I’d been playing the numbers for weeks, both for cancer and college. I knew everything but my final oncotype score — oncotype being another new exciting integer in the world of pink. I was one of the kids counting down to the midnight posting of ACT scores (7 minutes! I don’t think I can wait, I’m going to die, I’m so nervous). I hated to lose this gifted and kind woman as my doctor, but staying with her meant anti-hormone therapy with all its side effects. For a moment I almost wished I didn’t understand that the 60% effectiveness she touted didn’t mean overall, it meant 60% of my risk, 60% of, for example, a 16% chance of recurrence  — by any accounting, a far lesser number. Was a 6 percent or 10 percent or 12 percent worth further treatment? Was a B so deadly? Did I really need an A? And what about the 6 percent risk I had of dying from some other cause in the next five years? Chance me! pleaded students after their not-quite-perfect midnight scores were posted. Chance me, please. Do I still have a chance?

*

NER Digital is a creative writing series for the web. Nancy Zafris is the series editor of the Flannery O’Connor award for short fiction. A new collection of her short stories, The Home Jar, will be published by Switchgrass Books in spring 2013.