After cancer will I ever be the same?

Dear Cary,
Last year, at the age of 29, I was diagnosed with a rare kind of thyroid cancer. I was halfway through graduate studies and was just about to embark on a year of research as a student, in Central Asia, where I wanted to explore a new region, do some neat environmental work, and enjoy the adventure.

A quick recap: a handful of days before my plane took off from a city in North America to Asia, my dentist casually mentioned that my throat looked unusually large. I’d had a goodbye party and was all set to leave, but decided to follow up with my doctor. The initial test results were inconclusive. I thought hard about some unnerving statistics presented to me (e.g., a 5 percent chance that this could be something scary). Some of my friends advised to just take my trip, saying, Hey, just go and live your life, I’m sure it’s nothing at all. Eventually I opted to cancel my trip  in order to follow it up properly. I’m grateful for that, as it turns out it WAS a scary kind of cancer with a significant mortality risk. There had been no symptoms and the doctors keep saying I dodged a bullet to catch it early enough for successful treatment. Over the last year I’ve marched along, finishing my thesis and the treatment. I know that I’ll need to check in with the doctors every six months for the rest of my life to watch for reoccurrence. But other than that I’m physically in the clear.

I’ve recently returned to the full-time job I had before graduate school. It has health benefits, a decent salary, and demanding work. I go to work every day and stare at the papers. I’m not getting along very well with my new manager and I hear her say that I am not paying attention to the details.

I can’t seem to reconcile the stress of this job with the gravity of all that has happened. Sometimes, when I am alone in my office, I cry. I return home and stare at my boyfriend. We aren’t having a lot of fun these days. I certainly don’t feel a renewed purpose/appreciation for life, as I’ve heard some people can feel after finishing something scary like cancer treatment.  I continue yoga and daily meditation, and have tried counseling, but still feel incredibly fragile. Some other young friends of mine with cancer have passed away recently. I feel some kind of immense responsibility, given my recent reminder that life can be short and luck plays a key role. I want to channel this “lesson” toward good, but I don’t know what or how.

Despite having an incredible network of family and friends and boyfriend, I want nothing more than to leave it all behind and sit quietly on a mountain somewhere. My boyfriend and I have been together for five years and had been talking about marriage and starting a family, but now we just argue every day. There are opportunities to do well in my work organization and contribute lots but I am crumbling in the face of the politics and consecutive deadlines. I just can’t seem to get it together, nor give myself the permission to rest and recover from the shock of the past year. Instead of accepting the offerings of love and stability, I feel angry, empty, and fearful of reoccurrence and regret. I don’t trust myself to make big decisions (e.g., quit my relationship and job) since I’m so obviously reeling.  I’d really appreciate any advice on how to wade through. Thank you.

Survivor

Dear Survivor,

I hadn’t yet finished reading your letter when all the shame and wonder and guilt and majesty and gratitude of being a cancer survivor poured in like light through a hole in the ceiling and the tears came like they haven’t come in a while. I’m coming up on four years since my own cancer surgery. I guess that’s it. Plus your letter just moved me — to anger and to tears.

We know things now, you and I and all the other cancer survivors, and when we meet by chance sometimes that knowing floods in. The crying is a kind of knowledge. And it is a kind of prayer: The body’s prayer, the body’s way of saying Please, I like this life. I’d like to keep going, please. I get it, I might be dead in six months or a year. But please, I’d like a few more years. Thusly the body makes its salty prayers. To whom?  To the earth that gave birth to us? To whatever mystery sustains us? Who cares? We make our prayers.

So listen: You need permission to rest and recover. You absolutely need this. To think that you would be back 100 percent already is ridiculous. Your life has changed. You need time to recover and grow strong and learn how to live conscious of the grave, precious thing life is.

Your boyfriend and your boss don’t understand. The survivor of cancer needs time to grieve and adjust and recover. The survivor is fragile and explosive and can’t go back to life like it was.

A door has closed.

I can hear someone somewhere saying, Well, you know, when one door closes another door opens, and I want to slap that person. Why do people persist in saying that pernicious and ridiculous cliché? When a door closes, a door closes. Another door might open or might not. (Thank you, Sheldon of “The Big Bang Theory,” for pointing that out.)

So yes, you are angry. Hell, yes. You want to survive like a motherfucker and I don’t blame you. Who wouldn’t be angry? Who wouldn’t be reduced to tears at the sudden realization of just how miraculous it all is? So fuck ’em if they don’t understand.

You need your time on the mountain. You need your time in a tent in the woods or on a running stream or up high somewhere. So you need permission. If you won’t give it to yourself, then I will give it to you.

As the tears roll down my face I just have to say that you have been through hell and you might be fragile for a while and that’s OK. Cancer changes a person.

Maybe you’re here for a reason. Maybe that’s what this means. I don’t mean that in a superficial way but maybe there’s something you were supposed to do. I wonder if when you heard the diagnosis something flashed through your mind. That moment is a kind of whiteboard, a litmus test: Whatever is most present, big and pressing in your life will show in that moment.

I haven’t read the last paragraph of your letter yet. I’m still crying and writing but let me see about your last paragraph. There’s probably something there.

OK, you want to channel this “lesson” toward good but aren’t sure how. Well, environmental work is important. We came from this planet and we owe it our lives. So maybe your life belongs to this planet and what this is telling you is that your environmental work is your life’s work. How can that not be true? So if there are barriers, which there always are, then you set about overcoming them.

As to the career: Listen, it might not all make sense to you but it does to me. You are studying the environment because you fucking care about it. There is a big problem with the environment. And it is our fault, we humans, how stupid we have been, how we live, and more generally how we minimize what is harm, what is a wound, what is destruction. It’s all connected. After injury and loss comes grief that cannot be outsourced or cut like a line item from the budget but as a culture, we don’t see that. Or if we do, we don’t act on it with compassion. And that is all connected: Our refusal to make time to grieve and repair injury is connected to our inability to see how our behavior injures the environment and to take the time and spend the money necessary to repair it.

Compassion and sentience of life: These things are connected.

To do good for the planet you can start by doing good for yourself. You are a child of the planet and you must care for yourself before you care for the planet. Treat your own wounds. See them as real. Be reverent before them. Recognize that it’s all connected: Your thyroid cancer, the planet, the failure of those around you to respond to the gravity of what you went through: It’s all connected. A cultural critique rises naturally from this: Our economy of endless growth, our unrealistic expectations, our minimizing of your emotion, your illness, your grief, your own hesitation to do what is natural, your own inner conflict: These are all connected.

You say, “I just can’t seem to get it together, nor give myself the permission to rest and recover from the shock of the past year.”

OK, well, if you won’t give yourself permission to recover from the last year, then I will. Permission is hereby given.

You need to mourn and grieve and take as long as you need. You are a new person. This new person is not all full of bright cheer and gratitude and consciousness of life’s preciousness. This new person is also fierce and angry. You will need time to let this new person in.

This mountain you speak of:What does that mean? Does that mean solitude? Does it mean perspective? Does it mean connection to the earth, to something powerful and eternal?

You don’t need to quit your job and your relationship. But you need some time off. And you need help. About a year after my surgery I became deeply, clinically depressed. It was awful. I needed serious help. I got it. It took a year or so to come out of it.

So, yep, while reading your letter I’m crying and I’m still crying. What’s that about? Fragility and beauty of life? Guess so. My own cancer? Guess so. Dec. 17 it’ll be four years since I went into UCSF for surgery for a sacral chordoma and Dr. Christopher Ames and his remarkable posse of skilled, dedicated, brilliant surgeons, doctors and scientists turned their terrible and precise knives and saws upon me. And then turned me back out into the world a week later to hobble about and adjust.

Am I incredibly grateful to be alive? Yes. Do I feel tenderness toward you, whom I don’t know, who have just given me your story? Yes. Do I feel that same thing for the many millions of people who go through this? Yes. But why is it so intense right now?

I dunno. It just is. Trust me, it just is.

I went through hell. I survived. My friend Lori in Seattle went through hell but she survived. You went through hell. You survived.

But we’re not the same. None of us are. Don’t expect us to be.

If I could say one thing, that would be it: Afterwards, we’re not the same. Don’t expect us to be.

Readers: Just a reminder. Feel free to share this column via the social media buttons above. Many people are helped and encouraged by this column, so know that in sharing it you are doing a good thing.  Thanks! Happy Holidays!–cary t.

[author] [author_image timthumb=’on’]https://carytennis.com/wp-content/uploads/2013/11/withdogsoncouch.jpg[/author_image] [author_info]Cary Tennis, shown here with his wife Norma and their two standard poodles, wrote the “Since You Asked” advice column for Salon.com from 2001 to 2013. He now continues the column twice a week, on Tuesdays and Thursdays, at www.carytennis.com. He also gives writing workshops using the Amherst Writers and Artists method, as well as producing getaways and retreats around the world, and also finds time to write his own fiction, poetry and songs. [/author_info] [/author]