experience, guidance, reflection

Beauty, Chemo, Remembering to Be Thankful I Do Not Have Malaria

The Mirror

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Photo by Amine M’Siouri from Pexels

A few years ago, I attended a summer barbeque with a friend- for the sake of the story, we’ll call her April. It was a nice afternoon, and I met several of her friends that I’d never met before. After we left, I mentioned to April how kind they were. When I mentioned one person in particular, April said, “oh, yes, her. I wish you had met her a few years ago. Cancer stole her beauty.” 

I wish I could tell you that this is the point in the story where I told April that was an incredibly cruel thing to say. I wish I could tell you that I stood up for this cancer survivor, this kind woman who chatted with me as we ate pasta salad and shared details about our lives. But I didn’t. I remember that the comment struck me as unfair, but embarrassingly, I didn’t say anything. 

It’s been several years since. April and I are no longer friends, and other details of our friendship are small and widely inconsequential. Those words though – cancer stole her beauty – have continued to ring in my ears, especially in the time since my diagnosis.

When I look in the mirror, I sometimes wonder if someone would say the same about me. Since starting treatment, I’ve noticed I look tired often. I have some new lines around my mouth and eyes when I make certain expressions. I have marks that look like bruises or healed wounds around my feet; my joints are darker and sometimes look bruised or discolored as well. I also have more frequent breakouts, and for a kid who had cystic acne and was on two rounds of Accutane before the age of 16, it plays deeply into my adolescent insecurities. I put on weight from two weeks of Gleevac in December, and it hasn’t gone anywhere as I’ve regained my appetite and I’ve rested more than ever before. I have a noticeable two-inch scar from a deeply misguided surgery and a sizeable growth which raises my chest and extends under my right arm. Maybe it’s because I failed to stand up for the woman with whom I’d eventually share a deeply painful commonality. Maybe it’s because I turned 30 this year. Maybe it’s because these chemicals are truly changing the way my body looks and behaves. But I see someone different in the mirror than I did a year and a half ago. The changes are enough to send me searching for the ways in which I am still me: some days they’re harder to find than the things that have changed.

And underneath it all, a deeper, more complex issue: this cancer started with me. It’s my own cells, my own body, rioting against me. I often wonder if it would be easier to accept a pathogen, to blame an infection, lifestyle choices, even a genetic defect. But this tumor started with nothing else other than me, and ultimately I’m waging a campaign against my own, faulty body.

I’m not writing this to fish for compliments or ask for pity. It’s honestly bigger and more important than all that. Body image, beauty, mortality: these are some complex and entangled issues. I don’t have them figured out and I don’t feel this is the place to try to write a dissertation on them. But I don’t need to tell most of you that to grow up female in America means you absorb countless confusing and damaging messages about beauty and body image. A life-changing diagnosis didn’t do that any favors. Like many other American women, I’m working on sorting and reframe some of those ideas. 

Changing the Conversation

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Photo by Kevin Jesus Horacio on Unsplash

Here’s where my head’s at. We need to change the way we talk about cancer patients, beauty, and their bodies: not just for current patients, but for the sake of those who will someday be diagnosed. When that post-BBQ conversation took place, I could have never anticipated that I’d become a card-carrying member of the Cancer Club just a few short years later. I sometimes wonder if I’d interpret many of my physical changes in my own body as dramatically if I had not internalized hurtful comment. 

I have received countless body-related comments since beginning treatment a year and a half ago, and some of them were unintentionally… well, unkind. When I was on Nexavar last year and constantly nauseous, someone commented, “well, at least you’ll lose a little weight!” As if losing weight is always the ultimate goal for women, or commenting on people’s bodies with unsolicited advice is acceptable. A few months later, I wondered bitterly if this person would say the same thing during an emergency room visit when I was unable to keep down liquids. “Hey,” I would ask her, “am I doing this right?” Food and nutrition during treatment can also be complicated subjects, because food is deeply personal and cancer is deeply painful. When I first announced my diagnosis, someone commented “I’m so sorry. You need to go 100% vegan immediately.” To which I say: let the person on chemo eat what they darn well please. I’ve been a plant-based vegetarian for over 10 years because that works for me. I also ate a Chipwich a day for about a week straight in July, and I have zero regrets, because that worked for me, too. 

There’s another kind of comment that is a bit harder to unpack because it’s well-intentioned, it’s genuinely a compliment, and I’ve said it myself countless times: “you look great!” I appreciate this compliment. I do. The tricky thing is this: it doesn’t always leave room for is the real and present suffering that’s going on just beneath the surface. 

There’s this image we have in our minds when we think of cancer patients: bald, smiling, usually thin. I do not fit that mold. I have, thankfully, kept my hair. I have not lost weight, though I have a reduced appetite and I try to go to the gym to make up for my 23 hours a day of restfulness. Truthfully, I’m really thankful I can skate through most moments in public without looks of pity or confusion. But it doesn’t come without its complications. A cancer patient doesn’t have to “look” any certain way to be a cancer patient. Sure, there are some commonalities – I have yet to see someone my own age on the infusion floor – but with mixed responses to drugs and innovations like Cold Caps, some cancer patients are able to maintain a level of appearance normalcy on a more routine basis.

We know that with everything from mental health to social media, appearances can be deceiving. Mine is no exception. Many of the side effects I’m currently facing can’t be seen or easily measured by others. My fatigue, the way it hurts to swallow, my ocular migraines and occasional vision issues, the pain in my shoulder: you can’t see this stuff. Sometimes it takes all of my energy to shower, and my outside appearance does not match my inner reality at all. So sometimes when I’m told “you look great,” I am just tired, and I want to respond that I would trade feeling normal over looking normal any day of the week. 

Is this making sense? It’s a nuanced thing. I’m trying hard to explain the complexities of this without policing how people speak to me. 

So here’s where I stand: Does receiving that compliment bother me? Personally, no. if I look stunning, and you want to say so, hey sure! Tell me! It might brighten my day. But just know it’s complicated, and every patient feels differently about this. The bottom line is that patients usually just want to have their crappy situation acknowledged, and that goes whether they are wearing jeans and just had an expensive blowout or are wearing sweatpants and a wig. You can tell me how you think I look- but be sure to ask me how I feel.

There is one exception to this rule. Please do not, under any circumstances, tell me that my tumor looks bigger or smaller. There are a number of things that can contribute to my tumor appearing a certain way and 0.0% of them are helpful to my psyche. In the past, comments about “it looks bigger!” or “hey! I think it’s smaller!” have sent me into either 1. an anxiety-filled panic or 2. a joyful optimism which has later ended in a crushing reality. So I learned relatively early on to let my radiologist, oncologist, and the UPenn tumor board measure my tumor – no one else.

What’s Working

A few months ago, I started listening to a podcast called This Podcast Will Kill You, which is hosted by two disease ecologists who discuss infectious disease and related topics. While it sounds grim, it’s actually helped me appreciate the way my body is working- which is great since I often think about (ahem, write this whole blog about) things it is doing wrong. Listening to this podcast I’m reminded that the list of things I do not have is staggeringly long! Malaria, encephalitis lethargica, hookworm, zika, measles, scurvy, hanta virus: my body is doing a pretty good job at not contracting things. 

So when I get stuck on how this tumor has turned my life upside down, I remember to thank my parents for getting me vaccinated and my immune system for doing its darndest to keep me healthy. When I feel sorry for myself for getting wrinkles and feeling really old some days, I try to remember that growing older is a privilege. It’s a fate reserved for very few, and I hope I’m one of them. 

Should that be the case, when my desmoid tumor and I turn 100 years old, you can bet your bottom dollar we’ll be riotously celebrating and eating our smash cake while wearing a crown. For me, there’s just no other way.

cupcake

 

experience, reflection, treatment

Three Uncomfortable Truths

Let’s get this out of the way: I had a scan last Thursday. My tumor hasn’t changed significantly. There’s a very tiny measurement of growth. One of my lymph nodes is notably enlarged, which they think is an immune response at this point.

Bottom line: I’m suffering all of these side effects with no real difference in my tumor.

It sucks.

I’ll probably have three more rounds of Doxil, as scheduled. I may be eligible for a clinical trial. A lot is up in the air, as usual. I’ll let you know as I know.

After the phone call, I holed myself up in my apartment. I cried. I told my parents to ask people not to call. I cried some more. I ignored text messages and phone calls, opting to post my disappointing news on Facebook and Instagram to rip the Band-aid off and relay the news as quickly as possible. I watched four straight episodes of Chernobyl, because nothing made sense except for the world being on fire and people looking at each other asking, “how could this have happened?”

In the days since, I struggled to get out of bed. (I’m increasingly grateful I have a dog to hold me accountable.) I’ve noticed a few thoughts circling in my head, and the more I think about them, the more they made sense. They are not nice or comfortable. They are not anything you will find on a greeting card. Maybe they are wisdom, maybe just my own thoughts cloaked in sadness, or bitterness masquerading as knowledge, but nevertheless, they’re hard-won and I believe them to be true, for me, right now.

Three Uncomfortable Truths

1. It is not my job to make anyone comfortable: it is my job to tell the truth.

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Image credit.

I recently read a memoir by Georgia Hardstark and Karen Kilgarif, the hosts of one of my go-to podcasts, My Favorite Murder. There’s a beautiful passage in the book in which Karen describes a picnic she attended. Her mom was diagnosed with Alzheimer’s, and a friend asked her how she was doing. Instead of resorting to sugar-coating the truth or writing off her own experience, as she was accustomed, Karen said a “truer thought hit her.” Here’s what happened next. Read the whole thing. It’s worth it.

“Having a parent with Alzheimer’s is like living inside a horror moving that’s playing out in real time. It’s as horrifying and awful as it is tedious and mundane. It’d be like if you lived in the movie Jaws. You’re happily swimming in the ocean and then everyone starts screaming, ‘Shark!’ You start to panic, but then someone else yells that the shark is twenty miles away, so you calm down a little. But then a third person gets on the bullhorn and says you’re not allowed to get out of the water ever again. So you start panicking and flailing and fighting and yelling for help. You scream about how unfair it is, you having to be out in the ocean with this killer shark alone when all those other people get to be on the beach… You finally start to accept that it’s your fate. But then you start thinking everything that touches you is the shark. You can’t calm down because you can’t stop reacting to things that aren’t there. You grab wildly at anything that looks like a weapon, but every time, it turns out to be seaweed… You get really tired and cry so hard you think your head will burst. And then finally, you gather all your strength and turn and look at the shark. Now it’s 19.8 miles away. It’s the slowest shark in history, but you know it’s coming right for you. And after five years in the water, you start rooting for the [explative] shark.”

Karen said the mood of the barbeque changed. She was embarrassed that she overshared and brought things down. And then a friend who had his own experience with Alzheimer’s grabbed her by the shoulders and said she was so right, that he felt the exact same way. “After that, I never lied when someone asked me how things were going with my mom. Instead of worrying about the comfort of the person who was asking, I started thinking about whoever might be listening to my answer,” Karen explained.

I love this story for so many reasons. I’ve written before about how being on chemo without progress is like treading water. I have wanted the shark to hurry on up, too. But most importantly, like Karen, I have decided not to waste any more words or time on sugarcoating my experience.

I started this blog to keep people updated on my treatment and to share my experiences in an effort to increase understanding, but more than anything, it is a way for me to shout out into the void and say “hey! Anyone else out there?” And let me tell you, it’s such a relief that a few people have shouted back, “Yes! Here! I am here!” I have met several people, both in person and online, that are also facing this confusing, life-altering diagnosis. That this blog has a wider audience than just desmoid patients or cancer patients is still rather remarkable and surprising to me. So if it has some wider-reaching posts or more enduring wisdom scattered among the treatment updates – awesome. But I’m truly writing for the 5 people that are in the water too, who respond, “oh my gosh, this shark. It’s awful.” And for their sakes, I will not lie or water down my truth, because maybe, on the rare occasion when the stars align, it will be exactly what they need to hear.

2. I do not owe anyone my optimism.

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Image credit.

As I read recently in the Benediction for an amazing woman who the world lost too soon, “[b]lessed are they who can’t fall apart because they have to keep it together for everyone else. Blessed are those who ‘still aren’t over it yet.'”

I’m sorry to tell you that sixteen months post-diagnosis, I’m still not over this whole tumor thing. On Friday, I wasn’t over my results being so disappointing. I’m still not. When your skin is blistering and peeling, your joints ache, ten hours of sleep is insufficient, and it hurts to simply have your elbows touch your bedsheets, it’s really hard to keep your chin up, to expect miracles, to stay positive. These are things that I hope to do, and I expect I will someday, but I do not have the bandwidth for right now, and I think I’m allowed to be furious and rage at the world for a bit.

As a society, we like our cancer patients bald and brave. We like the completed, abridged story: diagnosis, successful treatment, the afterglow.

There is a truthful but uncomfortable article that I came across last year in which the author writes, “I think that as a culture we place unreasonable expectations on the people we love when they’re very sick. We need them to be strong, upbeat, and positive. We need them to be this way for us…  There’s nothing wrong with hope. After all, Emily Dickinson says, ‘hope is the thing with feathers,’ but not at the expense of canceling out all the other complex emotions, including sadness, fear, guilt, and anger. As a culture, we can’t drown this out.”

I am glad to be someone who is perceived as happy and hopeful… but I am no Pollyanna. And I certainly do not want the fact that I have cancer to distill my personality to brave, optimistic, and positive. Maybe I am those things, but if I read that character in a play, I’d call her boring, flat, and unrealistic. Ask anyone in close proximity to me and they’ll confirm: I can be moody and irritable, and bitter and sarcastic. (You know, human.) I do not have the energy to pretend to be something I am not. As I said in uncomfortable truth number one, I’m interested in the truth. If my truth is hopeful some days, then it’s hopeful. If it’s angry others, then it’s angry. Neither of those things is bad, and both of them are true.

3. It does not get easier. 

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Photo by Heather Zabriskie on Unsplash

It just doesn’t. Not after the pathology comes back. Not after telling the news a million times. Not after half a dozen MRIs. Not after starting a blog. Not at all. Sorry.

This is the analogy that makes the most sense to me, shared on a friend’s post on Facebook.

“Imagine you’re going about your day, minding your own business, when someone sneaks up behind you… You feel something press up against the back of your head, as someone whispers in your ear. ‘Sssshhhhh…. don’t turn around. Just listen. I am holding a gun against the back of your head. I’m going to keep it there. I’m going to follow you around like this every day, for the rest of your life. I’m going to press a bit harder, every so often, just to remind you I’m here, but you need to try your best to ignore me, to move on with your life. Act like I’m not here, but don’t you ever forget… one day I may just pull the trigger… or maybe I won’t. Isn’t this going to be a fun game?’ This is what it is like to be diagnosed with cancer. Any stage of cancer. Any kind of cancer. Remission does not change the constant fear. It never truly goes away. It’s always in the back of your mind.”

I can hear you asking: so if it doesn’t get easier, then what?

I don’t honestly know. I’m still working on it. But maybe you learn to celebrate the tiny victories that you can, like getting out of bed, making it through a class at the gym pretty successfully, or not needing a painkiller. You smile. You find professionals who can help you make sense of this mess and hopefully give you tools to cope. You cry. You hope and pray that some of this has a purpose. You try, with every breath, to put one foot in front of the other and remember that despite it all, you are here. And you try to be grateful for it. Maybe some days you’re successful, others not so much. But you try, and it is enough.

experience, reflection, treatment

Buddhism, Chemo, and Me

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I took an Intro to Buddhism class in the spring of my sophomore year of college. Having grown up with enough Catholic education to navigate my way around symbols of saints and the metaphors of resurrection, I decided to immerse myself in a world totally new to me. For the sake of complete disclosure and honest journalism, some of my best friends were also taking it, and it filled a pretty sweet spot in my Tuesday/Thursday schedule along with dance class and dinner. The professor was an adjunct from the city and would cancel classes when his kid got sick – which we noticed always seemed to be on the sunniest, most beautiful days. He would teach while sitting in a chair, told a lot of stories, and seemed to genuinely care what we thought. We did a lot of laughing and listening, and because of this, I remember a good bit of what we were taught.

The concepts of impermanence and suffering are at the core of Buddhism. I suppose they are in many other religious, ashes to ashes and all that, but the Buddhists hold this as their central tenant and arguably discuss it more than anyone else. The Buddha taught that we are trapped in this thing called samsara, an endless cycle of birth, suffering, death, and rebirth, broken only by reaching nirvana and obtaining enlightenment. (This led us to joke as our laptops acted up that they were attempting to escape samsara.)

Consequently, the Buddhists have a lot of labels around suffering. There are many different types, but my favorite is hands down the Suffering of a Fine Meal. A delicious dinner, the Buddhists would argue, is a form of suffering – because it’s in our human nature to miss what we had. We don’t just think, “wow, what a great meal!” but, “wow, what a great meal! Man, that was just SO good. I wish my portion were larger. I wouldn’t have been able to finish it, but taking some of this home would have been great. Think we can come back here again?” Way back before foodie culture, the Buddhists knew we’d be taking photos of our food to proudly post on Instragram.

I’m learning a lot about impermanence these days. The infusion cycle is different for everyone, and while there are general patterns, nothing can be certain. Here’s the general pattern: on infusion day, you get steroids in addition to your prescribed poison, and you feel kind of great. They hang out in my system for a few days, giving you a little boost of fake energy. During these days, I try to make the most of it and do some cleaning, socializing, and gym going. I see a previously unprecedented number of Broadway musicals. I feel guilty for being out of work and miss my students. During that time, I often think that this chemo thing really isn’t so bad and maybe I can be like those people on 60 Minutes who train for marathons during treatment. Lather, rinse, repeat. It’s a heavenly meal.

About a week later, I’m brutally humbled as the wall of fatigue hits. As though little weights are attached to all of my limbs, it is a struggle to put my feet on the floor next to bed or ignore the siren song of the couch and Netflix. In the coming days, I’ll also possibly enjoy a metal taste in my mouth, painful mouth sores, peeling and burning hands, itchiness, a rash, and increased tumor pain. Before I know it, my thoughts have become patterned in the opposite way. I think that I will never have energy again and wonder if I will ever get to do anything I love, like travel or dance or wake up to watch the sunrise, ever again. Ah, that meal, remember how delicious it was?

Sound dramatic? Fair enough, but I think it’s universal and part of this human nature business of not believing in impermanence. A comedian named Jim Jefferies accidentally gave him and his son food poisoning. In the throws of his son’s illness, he described the pattern of thinking as, “well, this is me now. This is how things are from now on.” I would venture to guess that most of us have had that very thought in a similar situation, whether four or forty four. Think back to the last time you had a stomach virus. Not a quick one and done job, but a real rocking, bring the blanket in and sleep on the bathmat trip. Hard to believe it would pass then, right? (And if you have gracefully edged around this with a level head and a wisdom beyond your years, and you think I am just catastrophizing, remember that not too long ago, I bounced from doctor to doctor and was told I was making a big deal out of nothing, only to be told it’s a sarcoma… So bear with me; I’m fighting my own experience here.)

Eventually though, that “this is my life now” feeling does pass. I’ll start to feel almost normal. A few days before my next infusion, the combination of renewed energy or anxious anticipation will lead me to do insane things, like re-pot houseplants at midnight. (So, not quite normal, but you get the picture.) It’s absolutely bittersweet because I want to enjoy the normalcy, but I know the next part of the story. I know I’ll feel terrible again soon. It’s really stinking hard to be present, and live in the moment, to live, laugh, and love, or whatever the other wall art in Homegoods is preaching these days.

An Explanation

“Do I contradict myself? Very well, then I contradict myself, I am large, I contain multitudes.” — Walt Whitman

In trying to create a context for my experience, this “chemo samsara” really helps me understand myself. It is why I feel some days that I have been called to be an advocate for patients with a rare diagnosis, but others, I don’t want to talk about how I’m feeling. It’s why I am itching to write a blog post on some days, and others I opt to numb out with another season of Parks and Rec. It’s the reason why I wear a “Straight Outta Chemo” shirt at the gym and also why I can’t motivate myself to go. It’s why, despite years of saying I fell out of love with New York, I take the train in so I can be just another face in the crowd.

It’s why many days I want people to text me and so I don’t feel forgotten, and other days, I want to be forgotten completely. It’s why silence is scary and why, despite having practiced and taught both yoga and meditation, I drown myself in podcasts to listen to anything other than the sound of my own thoughts echoing in my head. It’s why, on the days where I feel like complete crap, I hate being called brave, even though it is a huge compliment and a perfectly wonderful thing to say to someone. But I don’t want to be brave. I would rather be a coward and have my old life back. Like a child screaming from the back of my throat, “please, I’ll be good, I promise!” I am clawing at the leg of something bigger than me, begging for that thing I just had in my hands moments before.

This round of chemo, while in many ways made more tolerable by being out on disability from work, is infinitely harder because I don’t have work to distract me. I’m living in a house of mirrors, where every moment is a stern invitation to look at myself. In all this physical mess, I’m also being challenged to answer that great, question of, “who am I?” Like a second adolescence, it’s changing every single day, perhaps exactly as it was before, only now I have nothing to distract me from this business of discovering who I am.

I’m still figuring it out, but here’s what I’ve got so far: contradictory multitudes. I am complex and straightforward, defeated and resilient. I am hopeful and discouraged, angry and I am grateful. I am healthy and sick, grief and laughter. I am no longer and I am in spite of. And on the days when nothing else makes sense, I take a page from the poet’s book.

“I took a deep breath and listened to the old brag of my heart. I am, I am, I am.” — Sylvia Plath

reflection

Cancer-versary: My First Year, in Self-Portraits

January 31, 2018

I didn’t know it when I took the photo, but my life was about to be turned upside down.

I sat waiting in the office of a Thoracic Surgeon with the University of Pennsylvania, number six in the line of doctors I’d seen about the swelling near my collarbone. I had grown restless and annoyed as I waited. He was late, and I was already reeling from the radiologist’s recent assessment: a hematoma, caused by my surgery three months prior.

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The photo I sent to my mom as we waited in the office where I’d be told a short time later I had cancer. “Un-selfie,” January 31, 2018.

I took a very ridiculous, very unflattering selfie, (the one seen above), as I have done more than several times. In an effort to break up the silence and my own irritation, I sent it across the room to my mom, who had insisted on attending. A few friends offered to come in her place, but being the World’s Best Mom, she felt better being there, just in case.

Over an hour passed. Finally, the doctor came in with a nurse practitioner, shook my hand, and started to speak. Not particularly quickly. Nothing different in his tone than as if he were explaining how something worked in a piece of machinery; say, a car. But he had a lot to say. He explained that as I waited for the past hour, he had been trying to reach a radiologist he trusted to look at my scans. The radiologist didn’t feel it was a hematoma at all.

And then he used the word sarcoma.

He kept talking. No one moved or made any sounds, as though we were listening to a discussion about someone else’s life. I stopped him. “You said sarcoma. Are you telling me I have cancer?”

I don’t remember his response.

The room didn’t spin. The floor didn’t tilt, my legs didn’t give out from under me. Everything was unnaturally cold and still. I excused myself and rushed to find a bathroom, where I let out a wail that was more animal than human. There were no tears, which felt fair. How could there be enough tears to match the scale of the news I’d just received?

A few moments later, I let myself back into the room. There was a lot of talking. My mom was asking questions, writing down notes, furiously springing into action. There was a folder passed to her with handouts and phone numbers of places to call. The words biopsy, MRI, and catscan were used. Not knowing what else to do, I made a joke about having a team now. My mom drove me back to my parent’s house.

I don’t quite remember the rest.

I know that at some point, I sent texts to a few friends. I told my boss the news and that I wouldn’t be in for the rest of the week. In the coming days, I collected medical records from various doctors. I went to the Perelman Center for the first time and had an MRI, a catscan, and a core needle biopsy done.

I waited. Days passed.

I went to the movies and saw The Greatest Showman. I watched the previews and wondered if I would be alive when the advertised movies opened. I slept when I could, ate when I could. Monday came. I went back to work, because I didn’t know what else to do. I told my coworkers all at once, in a meeting, because it was easier than facing whispered speculation or fearful yet compassionate glances in the hallways.

One memory stands out from the rest of the rest, crystal clear in its detail. It was late, and I stepped outside to bring my dog out. It was cold, but quiet and calm – so much so that even the frosted tufts of my breath seemed too garish for the evening’s simple beauty. The moon was bright. I remember looking up and thinking, if this is it for me, I could be okay with that. I was loved by the most wonderful friends and family anyone could ask for. My profession fulfilled me personally, professionally, artistically, and spiritually. I enjoyed too many adventures to name: singing with a jazz band, training with a circus, walking 500 miles from France to Spain. I loved and had been loved. I certainly want to stick around, but if I had no say in the matter, I held the knowledge that I had done the most with the time I have.  Peace- quiet and small yet strong- settled somewhere within me.

More days passed. Valentine’s Day came and went. And on February 15, I finally got a call with my diagnosis: fibromatosis, desmoid-type. A google search said it wasn’t cancer. I called my thoracic surgeon and my nurse. They kindly replied that while google might say that, it very much acted the same way and needed to be treated as such. 

The rest is a blur.

January 31, 2019

It’s been a year: 525,600 minutes, for any Rent fans who may be reading this. Those movies I saw in previews have long ago opened and closed. I’m still here.

There have been times where I have felt forgotten, that I cannot convince people to take me seriously, or that I have every reason in the world to despair. At other times I have felt guilty, that others have it worse, or that I am making a big deal out of nothing. My life has never been harder. It’s also never been filled with so many reasons to hope.

I’ve been shown the kind of immense generosity, kindness, and compassion that pops up in occasional news articles about goodness in the midst of tragedy- the type I’d read about and believed in but never experienced firsthand. I received cards, messages, kind words from people I have never met. In eight months of fundraising, you’ve donated over $23,000 for the Desmoid Tumor Research Foundation.

When I last wrote, it was with the news that I was trying another oral chemotherapy called Gleevac. Unfortunately, it did not work out as I was unable to tolerate the side effects. I put on ten pounds in two weeks. My face was so swollen in the mornings my eyes could barely open. My joints and muscles ached and my pain skyrocketed. The day after Christmas, I was taken off of it, fearing that the treatment could have actually made my tumor grow. Fortunately, once off of the drug, my pain improved. Better still, a scan done two weeks ago showed that my tumor did not grow. It remains “mostly stable” with “small amounts growth.”

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Mornings on Gleevac, December 2018.

I’m at a crossroads with treatment once more. While stability is in many ways good news, it’s not shrinkage. My tumor is still close to my brachial plexus. It’s taken my pectoralis major, my clavicle, and two of my ribs and pushed a lot more out of the way, rendering my shoulder area unable to operate as a healthy person’s shoulder would. My pain has increased. In order to finally shrink this tumor, now the size of a grapefruit, it’s looking like aggressive treatment will be necessary. I haven’t made any decisions yet. I’m taking time to meet with more doctors and make the decision that’s best for me, my health, and my life. I do not have any updates yet.

What I do have is the thing I once feared most I would lose: time.

Here, Now. 

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Self-portrait, December 2018.

I’m calling today my Cancer-versary. I’m not quite sure what one does to celebrate a Cancer-versary, so I’m making it up as I go. I bought myself flowers and took the day off of work, my first personal day this year. I spent the morning snuggling with my dog; I think I’ll read and make cupcakes later.

With the chaos of the past several weeks and an indeterminate plan for the future, I didn’t really know how I’d feel leading up to today. Now that it’s arrived, I mostly feel what I did that night I stepped outside under the bright, beautiful moon: I’m thankful.

Thankful for my mom and dad, who have shown me the true meaning of unconditional love, and who would (and have) done anything possible to make my life easier.

Thankful for my family, especially my brother and sister, who take the time to check in on me during their full lives and have been there every step of the way wanting to know how they can help.

Thankful for my friends, who, when it’s hard to know what to say, let the silence sit between us without judgment, and who provide a steady stream of photos, memes, and stories to keep me laughing.

Thankful for my coworkers, who offer their unflinching support and always say yes to any of my requests for help.

Thankful for my students, who give me reasons to smile no matter how I’m feeling and whose innocence, empathy, and love remind me what’s truly important.

Thankful for my medical team and the Desmoid Tumor community, who have embraced me and guided me through this terrifying maze with a voice of resilience.

I’m thankful for being here and for having so many reasons to fight.

With all its sham, drudgery, and broken dreams, it is still a beautiful world.”  – Desiderata

experience, reflection

To Build (and Re-Build) a Home

I’ve been living with my diagnosis for just over four months now, and I’m continually surprised at how my experience of the news has evolved. I recognize within myself the changing landscape of emotions day to day, minute by minute. Now that I’m not purely on survival mode, this diagnosis has settled into the fabric of my identity. It’s not who I am, but it’s certainly a large part of my human experience.

Being diagnosed with cancer didn’t just change my relationship with myself, it changed my relationships. The way I interact with my coworkers, family, and friends has shifted in ways both subtle and dramatic.

If you’ll allow me, I’d like to explain what I mean using the analogy of a house fire. I chose this because it’s ostensibly imaginable and involves a lot of help. (Well, okay, the other reason being I’ve been watching a lot of This Is Us recently. ) It’s not a perfect analogy, but it communicates my point well enough.

Catching Fire

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When a house catches fire, hopefully someone alerts the authorities early enough and firefighters show up. My uncle was a volunteer firefighter, and I have fond memories of hanging out with him in the firehouse when I was younger. Here’s what I know: firefighters are unfathomably brave. They walk into blistering heat knowing their hat might melt to their scalp and they may leave needing medical care of their own. Without firefighters, buildings would burn right to the ground and leave so many without a place to call home.

Eventually, when their job is done, the firefighters leave. After an appraisal, some guidance, and lots of complicated insurance steps I don’t understand, contractors and workers come in to help re-build the house. Anyone who has ever had remodeling or construction work completed can tell you: it takes a long time. Deadlines are set and then pushed back. Calendars are changed. Plywood frames seem to stand bare in the cold, unchanging and without progress. But construction workers are undeterred. They’re hardworking, show up day after day regardless of the working conditions, and stick it out so that someday, somebody can move back in.

There’s another group, too. It contains a wide range of people who aren’t as apparent at first. As the house is burning, there are some who aren’t quite sure what to do in an emergency, or they don’t think it right to intervene, since it appears everything is being taken care of. Maybe some people feel it’s best to stay out of the way and say some prayers that everyone gets out safely and or that rebuilding goes according to plan. Fires are pretty terrifying, so it’s understandable it strikes a chord of fear in some and they don’t want to get too close. Or maybe one of the pipes just burst in a neighboring home, and that person needs to get on it before their basement floods and their possessions are lost. And I’m fairly certain there are some people who are just staring at the moment, still shocked at the fire happening just down the block, on their very own street.

The Afterglow

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Image courtesy of deviantart (psychonoir)

In case you haven’t caught on by now… I’m the house. And the homeowner. (I warned you this wasn’t a perfect analogy.)

When I was diagnosed, I was astonished at the number of people who rushed to help through their words, gestures, and thoughts. I received flowers, cards, text messages, and food. People offered me excursions to distract me from my circumstance, a place to stay in the city, their beautiful stories, their platelets: you name it, I received the offer. It was absolutely critical so soon after my diagnosis. If I didn’t have this outpouring of support during the first few days, I probably would have melted down completely. I’m so lucky to have these first-responders in my life.

In the weeks since, I’ve received less of the “emergency” response and moved into the builder experience. There’s not as many daily offers of help now that the smoke has died down, but a committed group shows up to check in and make sure things are on track. They’re the ones sending a text once a week, just to say hi. They’re the ones messaging me funny memes. Let it be known: these people are just as important the firefighters. They recognize that I’m not in a dire circumstance, but they can see that I’m currently down to the studs, and at times, in need of an extra pair of hands. I’m so lucky to have these foundation-layers in my life.

The third group is tough to describe at times because it’s less of a vocal and visible role. (I myself am not sure who’s entirely in it.) It could be that someone doesn’t feel it’s their place to reach out, or they’re more comfortable stepping back and sending some good thoughts my way. For many, there’s a good chance I haven’t heard that someone I’m otherwise close to is experiencing recent hardship or emotional trauma, and by all means, I WANT you to take care of yourself so you can be all that the world needs you to be. Just as I am lucky to have the firefighters and the contractors, I’m lucky to have the quiet support from people who want the best for me: I swear they are knitting and re-knitting the invisible wings I reach for and strap on my back on the hardest of days.

Truth Telling

What pains me most to admit is that there are people in my life who I expected to show up, and they haven’t. I don’t know why they aren’t able to be around (at least not yet). It’s embarrassing to admit because the number of these individuals pales in comparison to those in the other categories. But to omit this fact from an honest recording of my cancer experience would mean I’m not telling my full truth.

It doesn’t in any way detract from the volume of love, support, and good thoughts I’ve received from others. It’s just as though I expected someone to help me with a task, then something happened and they couldn’t make it, and I never got word. “Well, okay,” I think, and I try to make peace with it and not to take it personally. Because here’s the thing: despite them not being there when I expected them to arrive, I’m lucky to have them, too. Each of them had a role to play in my life in some way. I wouldn’t be who I am without their influence. Besides, who’s to say they won’t show up later?

I try to operate on the hypothesis that everyone is doing the best they can. It may sound spiritually enlightened… but it’s also just an easier way of getting through life without dramatizing too much. I believe deeply that it’s best to leave room for grace and generosity. I fully support giving people the benefit of the doubt. And regardless of whether or not they’re around now, no one is more worthy of that generosity then the incredible people who are part of my life.

A Housewarming: All Are Welcome

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I’ll take any excuse I can to share a Fixer Upper dining room photo.

Here’s what I want you to know: very, very few people can be both a first responder and a foundation-layer, and that’s the way it is supposed to be. Your true, authentic response, whatever it may be, is perfect, valid, and absolutely necessary. There is no need to change who you are or how you respond.

Stop trying to be a builder if you’re a first responder: if you didn’t send me that text that first week after I was diagnosed, I may have not gotten through my first week of living with cancer.

Don’t guilt yourself because you weren’t a first responder and you’re here to build: your support now, in the quieter moments, is so, so needed.

And I promise you, it’s okay to sit this one out, my friend: you may need to be an observer in my experience so you can be the first responder or builder in someone else’s life. Go. I’ve got this. And they need you.

There are very few individuals who have the emotional bandwidth and stamina to show up day after day after day for my needs. I myself get exhausted with my own drama at times. I consider myself inordinately blessed to have more firefighter/builders than I can count on one hand, and I hold them close and try to tell them every day just how much I love them and appreciate them.

There’s a great passage in Elizabeth Gilbert’s book Eat, Pray, Love where Elizabeth describes the difference between her sister and herself through a short anecdote, which I’ll attempt to capture accurately here for you. When her family received the news that another family experienced a tragedy, Elizabeth’s first thought was “my goodness, that family needs such grace right now.” Her own sister responded,”that family needs casseroles,”

Whoever you are, no matter what you bring to the table (grace, casserole, or company), thank you for being part of my journey. I’m lucky to have you here.

reflection

Living Out Ultreia

A Memory

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Savoring guava juice and a peach at a stop along the Camino.

Once upon a time, when I thought the lump by my collarbone was a lipoma, I walked 500 miles from France to Spain.

I have to be honest with you, most days I forget it happened. That speaks so much to the human condition, doesn’t it? You accomplish a dream, you finally get the material object you want, you finally end up in that happy relationship that you want – and its meaning slips away. You begin to wonder what’s next.

For several years, that 500 mile journey called the Camino de Santiago was my dream. Then I did it, my life radically a few months later, and now it seems like a part of another person’s life. It was not even a year ago when I set off from St. Jean Pied-de-Port with one of my dearest friends and embarked on over a month of walking. There are days when I do not recognize that strong, healthy woman smiling, sunburnt and dust-covered in those photos. It was hard, but despite being only partially aware at the time, I was experiencing the vibrant fullness of being human.

I read recently that the experiences of our elders, our generations past, live in our DNA. Isn’t that wild? Somewhere, encoded in the basic scientific cells that make up our bodies, live the heartache, the loss, the beauty, and the striving of our ancestors. It puts in mind another amazing phenomenon: when individuals with Alzheimer’s and dementia are played music from their past, and suddenly, though this person may not have even spoken coherently in years, lyrics start to ascend from lips to the heavens.

We know, deep down, who we are. The world will try to tell us otherwise, but if we try hard enough, we can remember.

Forgetting

I’m fairly certain social media is a black hole that launches us into forgetfulness. It’s a vortex that pulls you through and flips you inside out until you forget what time it is as you look at pictures of better meals than the ones you make, someone better looking than you are, adventures that are better than those you’ve had. It’s not all bad: Instagram and Facebook have been a lifeline for me in the wake of my diagnosis. I’ve made “friends” with desmoid patients from all over the world, despite never having met a one in person. But the negative force of the vortex is strong.

After the news that my tumor had not grown, I was shocked at how quickly I fell into that pit of jealousy. Comparison is the thief of joy, and I was bereft of any excitement in less than 24 hours. I sat bitterly staring at this tiny phone screen, watching as friends and peers and people I’ve lost touch with share that they were cast in shows, starting families, or doing ordinary things like going on a run. These people had done nothing to offend; they were simply living their lives. Still, I found myself filling with resentment and seething with jealousy.

I’m aware I project a pretty positive attitude in public. It’s no less real or valid or “me,” but it’s only half the story. I am grieving in some way every single day. Some days, it’s the flinching recognition that my yoga mat is collecting dust in a corner. Others, my restless thoughts spin inside my head. How did I pull the short straw? Why do I need to focus on just living when others are thriving? My life was once that easy too. What the hell did I do to end up here?

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A self-portrait: two weeks after being told it was a sarcoma, two days prior to my official diagnosis.

Remembering

One day before our final walk to Santiago, I was sick – really, really sick. Other pilgrims walking the Camino had been walking in and out of the room until well after midnight, and when they finally slept, it was a symphony of snoring. I had oily spinach and eggs the night before, poor fuel for a vegetarian completing a day of waking in August heat. A fever was brewing that would rage on well into the next day. I was determined to get into Santiago, even if it meant crawling on my hands and knees, but I seriously doubted that I had the strength to do it.

There’s a rush of pilgrims, or as they’re called in Spanish, peregrinos, who join the Camino only for the last 100 km. While everyone has a right to their own Camino experience, those of us who had already been walking for four weeks could get annoyed at these “tour-ogrinos” pretty quickly. Many of these latecomers were inclined towards drinking heavily, talking loudly, treating this religious pilgrimage as a holiday.

Around 10 AM, my walking partner and I stopped at a bar to get a Coke and hopefully a tortilla, a hearty Spanish frittata, to fuel the rest of our day. The bar was crowded, and judging by the cleanliness of most of their boots, they hadn’t been on the trail for long. I was feeling awful and the expression on my face warned anyone within several yards to stay far, far away. So naturally, one man who had just ordered a round of shots for himself and his friends came up to us at our table. He lunged his head forward, alcohol and smoke on his breath. He smiled and piled on the bravado, announcing, “You see, my friends and I, we will smoke and drink all day, and we will still get to Santiago before you!”

When I spoke, it was without pause, with a voice I did not recognize. It was thunderous in tone, yet restrained. This was the voice of a fierce warrior, one who pulled no punches and took no prisoners. This was the voice of someone who had nothing to prove. I stared him down, my nausea and fear cast aside, and responded unwaveringly.

“Yes, you may. But I walked here from France.

I can’t remember what his reaction was. I believe it was something akin to a half-sneer, half-smile, perhaps a smug chuckle as he sauntered back to get his drink. It doesn’t matter what his reaction was. What mattered was that I found this new, steady voice that I didn’t know I had within me.

I arrived in Santiago two days later.

A Reckoning

This recollection surfaced at just the right time, as I was neck deep in my present-day social media binge. I stumbled upon the honest reflection of a fellow peregrina who had arrived in Santiago on a Camino facebook group. The post was translated from German courtesy of an auto-translator, but the words ring true in any language.

I don’t know how many steps I’ve gone physically, mentally and psychologically on my way. However, in the last few years I have learned so incredibly much about me, living, incredible, wonderful, sad and fulfilling stories and experiences, which fills me with deep gratitude.

The Camino never ends in Santiago – the actual journey takes place to a large part in the interior and begins afterwards. My truth, my experience. Don’t believe me a word, feel it, take something for you and leave the rest. Trust yourself and the way. It’s all there. Always.

To all the people who have supported me for the last few years, all camino angels and also all the ass angels who have often made me mad. Thank you, because through these experiences I grow. And I’m here for that. I don’t cry tears of grief.
I shine. I’m happy. I am.

— @wild_one_walking

It took reading this post to remind myself that it’s all there. Always.

I am no longer in Spain. Hell, I am not able to lift a full Brita pitcher without two hands and take off a tshirt without getting caught in it, let alone audition for shows or run a 5k or walk across a country. Most days I make myself a smoothie and then drive in traffic, trying to get to work on time. I give my students as much heart as I can muster, then come home to walk my dog, make dinner, do dishes, and maybe watch Netflix. It’s not the existence I am accustomed to or one I’m particularly proud of.

But I am still here. And though I forget the significance of that very fact as I trudge through this new normal, after a while a voice inside fiercely whispers the truth. The words cut through the anger, fear, rage, bitterness welling up and spilling over: I walked here from France. I walked here from Spain. I walked here after being told it’s a soft tissue sarcoma, from a conversation about taking out bones and muscles and tissue and sinews, and from a discussion of how I would be stitched up and pieced back together like a jigsaw puzzle. I walked here on chemo. I am walking through hell and some days I feel transcendent, one of those spiritual firewalkers, and others the embers burn my feet so badly I cannot imagine going forward one more step.

And yet, here I am. Isn’t that something.

The word “ultreia” is seen often on the Camino. It’s an old, old word, mentioned in the 12th century Pilgrim’s guide called the Codex Calixtinus. It’s something pilgrims would say to one another in greeting, meaning “keep going” or “beyond,” encouragement to head onwards to Santiago, or perhaps, further.

When I said this word on the Camino, my eyes were on Santiago. Now, my destination is unclear, a blurry spot on the horizon or even somewhere past. But I must keep going and go beyond. It will not be easy. I am bruised and battered and broken. I can’t do the things I once took for granted. But here I am, continuing onward and beyond.

Ultreia.

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