Fine, Thank You
As I climb back out of the chemo pit I fell into last Tuesday, I am greeted by Christopher Hitchens’ latest brilliant column in Vanity Fair, on Cancer Etiquette. Now, as anyone who has personally encountered The Big C will understand, there is a whole new book of rules that apply to those of us on the ugly side of the fence. And, as Hitch so brilliantly reminds us, the proper response to “How are you?” is NOT a lengthy discussion of your latest symptoms, scan results, and tumor diameters.
Conversely, the asker, when returned with a simple, “Fine, thanks, and you?” should NOT, as happens so frequently, re-state, “Yes, but how ARE you?” There may be things the patient doesn’t want to talk about. Maybe she’s had a long day of explaining to everyone how she’s really doing, and is sick of it. Maybe the news is bad and she doesn’t want to get into it right now. The sharing of bad news is particularly difficult, as the toughest part for me of having Stage IV cancer (and, as Hitch notes, the thing about Stage IV is that there is no Stage V) is having to explain to people what’s really going on inside my body, how dire it is, and watching and dealing with their reactions. Because, frankly, I’m not very comfortable with my own reactions to the situation, and I’m not exactly equipped with the emotional fortitude to comfort you when you hear my news. Hence the “No-Cry” zone I’ve erected around me since 2006; if you lose it, I’m going down, too.
On the flip side, there are those who feel it will be encouraging to share with the patient the story of another person they’ve known, personally or, my favorite, “my sister’s best-friend’s boyfriend’s cousin’s mom” who had the same, or perhaps completely different, cancer as I have, and who took every treatment plus radiation and is now hiking Amazonia/lived thirty years past doctors’ expectations/died a horrible, lengthy and agonizing death in sub-standard hospice care. Whether uplifting or depressing, these stories leave the patient wondering: 1) Is she telling me this story to make me feel better? 2) Is she telling me I’m going to die the same way? And, as Hitch found out, 3) What the hell do I say next? Frankly, we can all do without (see para. 2) having to come up with conversational tidbits to make you feel better about your story/aunt/distant acquaintance and the outcome of their cancer.
You see now why my standard response to the question in question has become, “Upright and conscious.” For those not in the know, my answer is funny, just another frazzled, sleep-deprived mom-on-the-go; for those who are well-versed with my sitch, it’s an honest assessment of my day, at least that part of it that I’m in right now. “Fine, thank you” just leaves too many open ends.
Instead of trying to relate to your friendly neighborhood cancer patient, to make her see how closely you understand what she’s going through (because, unless you’ve been the one holding her hair back for her in front of the throne and massaging her neuropathic feet, you can’t), just ask her if she’d like some company. Bring her a coffee, or take her out for one. Talk about the weather, your kids’ soccer games last week, how annoyed you are by Christmas commercials on November 1. If she wants to talk about cancer, she’ll be more likely to when she knows you’re there for the long haul than just the quick update.
Gee, chemo seems to make me a little bitchy. Aren’t you glad I’m back?
Extended Stay
A very dear (and possibly quite intoxicated) friend emailed me this afternoon with a link to Christopher Hitchens’ beautifully worded essay about his cancer diagnosis, saying it reminded him of my writing. While I am highly flattered, and definitely aspire to that level of proficiency (not to mention professional success), the essay did strike a number of chords.
Hitchens speaks of the discovery of his illness as “…a very gentle and firm deportation, taking me from the country of the well across the stark frontier that marks off the land of malady.” This international one-way trip is the most shocking transition, especially for people (henceforth known as “patients”) who were previously healthy and unencumbered by medical interventions any greater than the occasional Advil. With diagnoses like ovarian cancer, what you think at first will be just a brief visit turns out to be a longer stay, with an extendable visa that might last the rest of your life.
For the past few years, I’ve envisioned myself as I always was: a mom, wife, cook, fashion fiend, friend, sister — exercising, writing, cleaning, driving, living my life — who also happened to have cancer. This summer, however, the paradigm has shifted. Now I feel like I’m a cancer patient who also occasionally writes, walks the dog, folds laundry, and makes dinner. My treatment and attendant side effects have gotten more insistent, more interruptive. I have to have my daily meds, straight from refrigeration or a cooler, at the same time every day. Within three hours, I need to be near indoor plumbing. By mid-afternoon, I need a nap. Water tastes horrible, so I have to bring my own beverages. Comfy shoes. Short walks and a place to sit down. (I’m starting to sound like my grandmother. Who’s 103.) I can no longer be the same person I was in that other country.
A part of me longs for the early stages of my illness again, that optimistic sense of purpose and determination, the adrenaline-charged vigor of the attack. Like a Saturday morning, the future was still hazy but full of potential; the fear of the unknown can be enervating but at least it’s a plan. Hitchens is starting chemo for his esophageal cancer, and I wish him health and strength to get through the journey. I miss the innocence and blind optimism and faith in medicine that carried me through that first summer with cancer. But the wisdom and perspective of the ensuing years I wouldn’t trade for anything.
Okay, maybe a clean CT scan. Or a book deal. Hitchens? Throw me a bone, eh?
Photo credit here.
I'm a two-and-a-half time ovarian cancer survivor who is not only determined to make it to sixty but also to look damn good while getting there. My two boys, husband, and dog are counting on me to get out of bed every day, so I might as well wear something cute and make each one COUNT. I'd love to hear from you about your odyssey - sharing makes it all easier to take. And laugh at.
The Carcinista 
