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Does Cancer Ever Win?
Does Cancer Ever Win?
Yesterday, yet again I read an obituary of friend’s sister who wrote the most commonly used sentence about death caused by cancer, ” she (her sister) finally lost her battle to cancer”.
I have a problem with that sentence, a big problem. This sentence implies that cancer has won. If that were true, her cancer, as an entity, would be alive, thriving and sustaining, but is not!
So if this were to be appraised it as a win or lose situation, at the most it is a draw, a situation where both parties played each other well, matched each other equally and there was no result. A game where both parties ran out of play time, both spent and exhausted. For someone to win, the victor has to be able to live to enjoy the success, to celebrate the battle, to count the loot.
Here no one loses. For those who survive the assault by cancer, they can be perhaps called winners of the moment but those that die at hands of cancer by no means are defeated.
Right from the time of diagnosis to the last breath that a person takes in their morphine induced stupor, the cancer survivor is the winner. Their will to survive trumps the growth of rogue cells at every angle, every corner. Their spirit is mightier than rapidly multiplying DNA. The body fights back with an army of little white blood cells that are jumping out of the bone marrow in throngs. The body’s immune system creates barriers and hurdles to stop the march of belligerent cells that are the traitors from within.
How can anyone say that a survivor was defeated when they have looked at death in the eye and said I am not afraid of you? How can anyone say that a survivor lost when they endured the hardships of the treatments of a dreadful disease? When they submitted and conquered the cut, burn and poison regimen? How can anyone say that a survivor did not emerge victorious when they gave this fight every ounce of their being?
Death is inevitable, we all know that. We all will die someday. For some it will be quick and sudden , for others prolonged and painful. How can a person’s life, that is full of achievement and accomplishments, of love and warmth , of thoughts and affection, of compassion and giving be ever considered a loss? Just because it ended ? Just because the survivor stopped breathing, it’s a lost battle? No, it’s not. The cancer did not live either. It is gone as well , as is its source of replenishment and growth.
So if I die due to the challenges of my disease, please let the obituary read, ” She emerged victorious in her battle with cancer and as of today is no longer alive and neither is her cancer.” Thank You!
Of Forgetting and Remembering
In the last month, I have had three episode of unexplained swelling of my mouth and lips, usually triggered by a fruit. My conclusion was that it must be an allergy so I dutifully set up an appointment with my immunologist.
My immunologist is a bright, rather matter of fact and keep-to-business type of young woman. She is however very compassionate and I witnessed it when she sat all day in the ICU as I got Adriamycin after the allergic reaction to it 3 weeks before. Although she doesn’t hug or call me “sweetie”, she nurtures me with all her professional competence.
When I had met her the first time, she declared “Look, you’re a doctor and weird things happen to doctors so get used to it.” It didn’t feel comforting at that time, but it was the truth. One episode of full body hives and 3 bouts of swollen mouth and lips, I am convinced of her theory of misfortunes of physician patients.
Today however she looked pale. A ghastliness that couldn’t be explained by just having been on call over night or stressors of every day life. She lost her train of thought, walked out, and came back to check if she had missed something. I reminded her of what she forgotten to answer. She then said “I am sorry I have had a death in my family over the weekend.”
As the conversation unfolded, she sat down in the chair fully embracing the seat, not the “I am out of here” descent on the edge of the swivel chair. She started to share, “My sister-in-law died in a car accident. She was only 43.” My heart sank. Someone obviously close to her heart had died and she was here at work, passionately giving to others when she herself feels broken.
Yes, that is what doctors are made of. This passion isn’t fed by the pay check that so many complain about or the recognition or appreciation – it is the internal obligation to help set things right for others, to relieve their suffering , a sense of a greater responsibility, a greater purpose. She talked and I talked.
She was grieving and my whole last year has been a prolonged journey of grief. We had a moment, a moment where I was listening and she was talking.
We talked about the unfairness of life, of the two kids that her sister-in-law has who are 5 and 2 and her brother who is feeling completely lost. I shared how I had thought about what my husband and kids will do without me. We talked about Anne Frank and Victor Frankl, and about surviving.
She saw me, I have gotten through last year, her eyes were scanning me and my existence and at least momentary victory over cancer ….some thing to validate her belief that she, and her brother, and his kids will get through this. She then stood up wished me luck, and moved on to the next patient.
The karmic cycle had made one complete loop.
It seemed that she that she found what she had forgotten.
I came home and hugged my kids and I remembered, I am here, I am blessed. Somewhere, a family is grieving the loss of a mom.
Happy Birthday to Me!
July 15th is the day that I heard the words that pushed me from a life of carefree existence to a lifetime of spiritual liberation. “I am sorry, it’s cancer” are the words that were uttered from the other side of the line. A phone call that I had been dreading all weekend. My lymph node biopsy was done on a Friday leaving me about 60 plus hours to contemplate what life held in store for me.
I had read almost all medical articles that I could find online on causes of lympadenopathy ( swollen lymph nodes) in the axilla (arm pit) and the physician part of me had concluded with some audacity that the primary resided in breast.
Normally weekends feel short and are over in the blink of an eye but that weekend lasted a life time. I had already “seen” my funeral, my mastectomy, chemotherapy treatments, the sickness, all of it. No movie was entertaining enough that weekend, no company was distracting enough. I was walking towards the edge of the cliff and I knew it.
I wish I could have been as optimistic as my internist who was “rooting” for a phyllodes tumor. After diagnosis, I did go back to her office and told her ” I am here to get my phyllodes”, she hugged me and teared up.(Phyllodes tumors are usually benign)
My mind was constructing and deconstructing scenarios all weekend, my hope wasn’t that it not be cancer (a lttile too much confidence in my knowledge and diagnostic abilities) but perhaps the least sinister and early stage kind. It isn’t easy when you know that a swollen lymph node if caused by breast cancer is already stage 2. I hated having that knowledge. I wanted to be someone who could have been blindly hopeful thinking that swollen lymph node came from a nail infection and “the doctors” just wanted to be sure its nothing. I wanted to be someone who didn’t know what having cancer meant in terms of the gruesome treatments, I wanted to be someone who didn’t know that if her biopsy samples sank in the container, they are likely to be cancerous.( which they did).
Yes on July 15th, I was told, that your life will be interrupted for a whole year to make room for being a ” patient”. And that from that day on, you will just have to believe that you will be OK. That you will look for good ‘omens’ to reassure you, that you will lean on faith more, that you will feel helpless at the loss of control, that you will accept cancer and survivor ship as a part of your life, that you will go through an “experience” that will bring awareness to you.
That you will now have to live your entire life is tied to the word “cancer” with strings , strong transparent strings like the ones that hang the puppets, you cant see them but they are there, part of every movement, every gesture, every turn.
Yes July 15th, your life will start in a different way. A rebirth to a life of awareness that wasn’t there before. An awareness of the darkness that comes with truly realizing how alone a human being is, and what it means to be born alone and die alone. An awareness that you are willingly going to get cut , poisoned and burned because you do love life that much. An awareness of how each moment of life carries value. An awareness that good things come at a cost. And awareness of the strength that resides within you, the kind of strength that bubbles to the surface only when the pressure is intense and there is only one outlet outwards, flowing out like hot molten lava burning everything in its path, only to bring vitality after cooling down.
Yes July 15th is my other birthday, its start of my new life. A life, much like any life any where, to be celebrated, appreciated and be thankful for. A life where I have more faith, more belief, more love but less control, less expectation, less frustration and a whole lot of peace!
Happy Birthday to me and I sure hope to have many more and if I do , I certainly promise they will be celebrated !
Here and Now
I was pretend traveling on FB when a friend of mine asked me “so where are you?” .My reply was “in the moment!!”. That is exactly where life needs to be, in the moment in the present, free of the past and liberated from the future. Just here, just right now. The goal is to appreciate the moment you are currently living in without shadows from the past or apprehensions from the future. When this happens, I breathe easy, I smile more, I laugh a lot.
Cancer leaves a person with fear of the future. I was discussing this with a patient recently who noted that someone he loves may die. My response to him was, that is true for all of us. We all may and will die. It really isn’t new information. If the present is lived well, it helps the future be the future and not become the present.
When I had had the biopsy on a Friday last year, I remember the exact moment when this thought crossed my mind….”If its cancer, what will I change about the rest of my life?”. At that point, content as I was, I said “nothing really’. One year later, I still think, no major changes except for staying grounded in the present.
One of my friends said to me during treatment, “Tragedies need not be rehearsed” that is exactly true. Every thing has a time, I have no desire to live that sooner than I need to. As far as I am concerned, its over, I have my life back and I am in the moment!
Dye another day…..no, not another day
Who would have thought that after a year of grueling cancer treatments, the step that would feel like THE conclusion to the process would be some hair dye in a bottle. Yesterday I said bye to cancer hair. I woke up and decided this is the day to end it.
End what? In my mind, an official end to the cancer tenure in my life. I was finished with treatments but it hadn’t felt like the end until now.
I am amazed at the power this has had. I feel well again, I feel “undiseased”, I feel “normal”. I was unaware of how much I couldn’t stand the gray.May because it whispered “cancer cancer cancer” as I looked in the mirror. May be it reminded my of the time when my life had lost color. May be it was familial.
My grandmother who has passed away now, used to have her hair dyed way into her 90s. It was a routine to go to grandmas every two to three weeks to help dye her hair. As I got older, I became the assistant to my mom in the process. She had long beautiful hair and I enjoyed combing it very much especially as she got older and could no longer sit up, so she would lie there and I would comb her hair spreading it out as I pleased. It was a wonderful connection between 3 women and 3 generations. My mom has always kept her hair short but she also is militant about keeping up with the color. So it was but natural for me to have lots of ambivalence about the gray hair received as a parting gift from the cancer treatment.
It seems that some memories had gotten woven into the silver that I no longer wanted to reflect on, braided in were the glimpses of nausea, fatigue and melancholy and this silver needed to be tarnished so it was no longer vividly potrayed times that were painful, times that were sad, times that were challenging.
I wanted to join in with the mainstream women. Women that get hair cuts and go to the salon and chit chat with the hair dresser, not the chemo nurse. As the stylist was combing my hair, he asked “Am I hurting you?”, an innocent question but nonetheless a trigger to flooding thoughts of IVs being put in mixed in with the question “Am I hurting you?”. I smiled at him and said, “Absolutely not! “.
I had never imagined that dying my hair would be such an emotional celebration and would feel like such a triumphant ending, as if I have prevailed over cancer. I will admit that I was a little startled when I looked at myself with the dark brown hair I used to have, I hurriedly looked away and then I looked again. This time I saw my self, just my self . That is all I wanted to see, no more no less.
Going Back
A year has passed since I had a normal mammogram and a normal ultrasound. It was time to go back last week.
A few weeks ago I had received a generic letter explaining to me the importance of mammography screening and how I needed to make an appointment to get one! Yeah right, the medical betrayal of sorts ,the false security that a normal mammogram have given to my surgeon and I, that test. The test that for lucky ones leads to early diagnosis and treatment, the test that can diagnose stage 0 or 1 cancers.
I thus grudgingly returned to the breast center. What I was unaware of was how much of a disturbing process it was going to be.
I have treated many patients with Post Traumatic Stress Disorder, very aware of how places, things even scents can trigger memories, memories that the mind tries to suppress but instead they flood with overwhelming intensity. Being a psychiatrist did not render me immune to such processes my self, whether I understood it theoretically didn’t affect didnt matter.
I was calm until I changed into the gown, put my stuff in the locker. This time as I hung up a bra that was a mastectomy bra with a prosthesis.I slammed the locker shut but it didnt do much to the gates that were starting to open.
Then I sat in the waiting room. As I sat and waited, a wave of emotion started to rise, a scalding mix of anger and melancholia , at odds with each other, the kind of emotions that ball up in your throat to the point that the windpipe can no longer freely move and the air struggles to go in and out.
The kind of emotions that get the whole body riled up in mutiny, with muscles being tense and the stomach in knots. A “why” slowly tried to rise in my mind which my rational brain promptly suppressed.
This last year, nothing in this room has changed, the chairs are in the same spots, the carpet looks the same, the walls and paint, exactly how I remembered and then I thought of this year as I experienced it and nothing seemed the same.
I was suddenly face to face with how life has moved on and is still the same for many and will continue to be.
The technician peeked her head calling my name. This one looked like a sub, for I had not seen her before.Excruciatingly matter of fact and dry and her demeanor matched the feel of the room just right …cold and distant. And then “squeeze time” arrived.
My only breast, squashed between two plates like a specimen on a slide, literally. My mind flashed a picture of my deceased breast after the biopsy and the mammogram squeeze that led to bleeding from the biopsy site.I saw blood spread underneath the acrylic plate.
I so wanted this to be over. I don’t want any more mammograms please,I wanted to scream, I just wanna go home.
The technician disappeared to review the images with the radiologist as was taking shallow breaths. She reappeared still stoic, we need some additional views.
Now I really wanted to just leave. I wanted to tell her, “Listen I have seen the worst, I have gone through the worst, it wouldn’t be fair if you saw more”
Some more squeezes later, I was let go. My heart refused to respond to any zen thoughts my mind threw towards it and it remained defiant. I was not ready to hear another sentence starting with “I am so sorry”, I have done that.This cant be happening.
.As I then proceeded to see my breast surgeon my anxiety spiked.He presented with smile and told me that “it was nothing”.
I am not sure if I did feel relieved . Is every thing really normal? That is what he said “last time” but was it… My throat was dry, my mind felt drained.
But what is the other choice? This is my fate as long as I live, monitoring and scanning, missed beats and shaky hands. It comes with the package. Fear is the side served with cancer, and periodically you get seconds even when you are full. I just hope I am done with the main course …for good.