Thoughts on Cancer

My chances of survival are exactly the same as everyone else's--that is, 0%. I'm always struck by how we know this fact but are able to simply not believe it. The only other time death has been a big deal to me was after Lucy died, and I remember then realizing that my attraction to death was the result of severe psychological injury, and that to some degree I could measure my recovery by how quickly and completely I regained my irrational denial of my own death.

My chances of dying sooner rather than later have gone up. I will have a better notion after the surgery. Will it be 30 more years, a more or less normal lifespan and what I would expect if cancer were not involved? Will it be six months, three years, ten years, dealing with cancer and its horrendous treatment throughout whatever time is left?

I remember some years ago thinking about some of the more degrading and painful deaths possible, and idly considering methods of suicide if I found myself on the road to such a death. "I'd have to do it while I still had enough autonomy to manage it," "it would have to be an 'accident' and undiscoverable," "it would have to be quick," etc. I have discovered that I am not up to suicide. I don't really want to "fight" cancer (as in "after a long and courageous battle with cancer, _______ passed with her family beside her"), but I also don't want to hurry it up. I'll go out like a passive resister being arrested by the authorities while practicing civil disobedience--no flailing or yelling or violence, but no helping it along either. I'll be a dead weight (ha!) I'm interested in observing the process--witnessing it.

Amy caught me reading the obituaries. "Why are you doing that?" she said suspiciously, as if an interest in death made it more likely. Before, I morbidly read the obituaries looking for evidence of young suicides, particularly gay suicides. Now I look for "lingering illness," "courageous fight," etc. To add to this morbidity, nearly everyone I tell (not many yet--the opportunity doesn't come up in casual conversation, oddly enough) relates their personal cancer stories back to me. "My sister had cancer..." "When my mother-in-law died of cancer..." and so forth. Usually they stop just after giving the gruesome details, with a somewhat sheepish look. It is similar to the time after Lucy died, in which I found myself comforting and reassuring all my loving acquaintances as they didn't know what to say and said it. It was exhausting then. I'm not to that point yet, but I am a little more panicky than after Lucy's death, simply because by the time I realized her death it was already over, while mine is in the future--uncertain, but on the horizon.

People also don't know what do say or how to deal with it, and I feel a tiny bit avoided. That's OK too. In some ways my analogy to the passive resister is inaccurate. I have an obligation to be here for the people I love for as long as I can, and to help them deal with my death as well as they are able.

Despite my habitual stance of proactive pessimism, the diagnosis was a surprise to me. (That was a surprise to me too). But I found that I could finish my patient appointments of the day, tell my family calmly, and proceed with my life. It feels like denial, but it's more just practicality. I remember when Dave was burned, how grateful I was to all the medical personnel (at least after we got him to the burn unit) for their cheerful, practical, matter-of-fact competence. I'm sort of treating myself that way.

I'm sure I'll have hysterics at some point--in fact I had an argument with my Cylon gynecologist about stopping the aspirin two weeks before the operation. "If I have a ministroke before August 9th, I'll let you know!" I said. "All right!" she said. "You're not going to have a stroke. But take your aspirin if it will make you feel better. Just let me know ahead of time." So I recognize this as a function of anxiety--I have cancer, I'm facing major surgery, I've never had a blood clot, but I pick this issue to obsess about rather than any other? (And I still think they--the medical community--have no clue what anticardiolipin antibodies mean or how they originate--but the aspirin anxiety is probably irrational).

Another issue--perhaps not so irrational--I've had the same symptoms for at least the last two visits to the gynecologist's office. Last time I even had an "inconclusive" biopsy and ultrasound, but no one suggested further exploration or treatment. Certainly no one mentioned cancer. I'm sure I misheard or misunderstood, but my take-home message from the last two visits was "lose weight, and then we'll talk." What was the difference this time? I wonder if it has something to do with the fact that I never saw the same practitioner twice--Cylon gynecologist, then physician's assistant, then nurse practitioner, then another nurse practitioner. My Cylon gynecologist can't even remember that I saw her first.

On the other hand, I really can't afford to consider "what ifs." After Lucy died, it was no use thinking, "if only I went to the doctor 24 hours earlier." No one has total control over all the chances of life, and pining over or being angry over lost possibilities would cost me too much.