Elizabeth Edwards has my deepest sympathy. For a cancer patient, bad news from the doctor brings on feelings of horror and metaphysical despair that far surpass a punch in the gut, a slap in the face, a knee in the groin and other facile analogies.
That said, I wonder if I'm the only cancer survivor (squamous cell carcinoma of the nasopharynx as an adolescent) or person widowed by cancer (inflammatory breast cancer) who is utterly burnt out by the cliched responses that invariably arise when any person, public figure or not, has cancer.
Elizabeth Edwards has my deepest sympathy. For a cancer patient, bad news from the doctor brings on feelings of horror and metaphysical despair that far surpass a punch in the gut, a slap in the face, a knee in the groin, earthquakes, tidal waves and other facile analogies.
That said, I wonder if I'm the only cancer survivor (squamous cell carcinoma of the nasopharynx as an adolescent) or person widowed by cancer (inflammatory breast cancer) who has grown tired of homilies reflexively spouted when any person, public figure or not, has cancer.
Not long ago my fiancée and I bought a used love seat. I was home when it was delivered. The guy who brought it into the apartment must have asked one of my housemates about the obvious signs of surgery on my neck, still there thirty years later, because he barraged me with a volley of nosy questions, followed by the pronouncement that I was a "miracle."
My response was a shrug. "Somebody has to win the lottery," I said.
I wish more people could just understand that having cancer is to a large extent a genetic crapshoot, played out at the level of DNA, chromosomes and stem cells. Some patients are lucky. They "roll" a cancer that's easy to treat. Others, sad to say, are doomed before they're diagnosed. Some kinds of breast cancer are highly treatable, but my wife wasn't so lucky. The kind she had was all but certain to kill her within a year. She survived about 14 months.
The odds are against anyone who plays the lottery. That someone will eventually beat the odds and win doesn't signify a miracle. The winner can be a wonderful, plucky Good Samaritan who'll give all the money to charity or a pedophile who'll spend it on child porn and Third World sex tours.
If God had a say in it, nuns would win all the time.
If surviving cancer is not a miracle, then surely the lucky ones must be "an inspiration"! But what do they inspire? Does it inspire others to count their blessings, be glad THEY don't have leukemia, say? Wow, how hard is that to do? How long does that last? Probably till the next time they can't find their car keys. If cancer is so inspiring, why doesn't anyone try to get it on purpose?
Even more depressing are the well-intended platitudes about a cancer patient's "courage" and "bravery." What, I've always wondered, is so courageous about strenuously avoiding death? Isn't that more like procrastination?
We all owe God a death, as Shakespeare's characters were wont to say, but believe me, no one is in a hurry to pay that debt. The will to live resides in the primitive reptilian recesses of the human brain. It's reflexive. It's instinctual, and can't be casually dismissed to avoid even horrific pain, exertion, disfigurement, embarrassment and expense.
The cancer patients who refuse treatment aren't necessarily lazy, wimpy, selfish or unmotivated. The ones who pass on treatment or commit suicide (excluding those who might have some pre-existing mental illness that makes them suicidal) have reached a metaphysical turning point.
The treatment has become more painful and humiliating than the disease. They've done their homework and learned their prognosis is worse than bleak, it's hopeless. They're tired of being lied to by doctors and relatives trying to spare their feelings. They're fed up, ironically, with the guilt that comes with being critically, perhaps terminally ill, trying to maintain the facade of confidence and bravery and fuzzy spirituality. They feel obliged to deny the pain and fear and existential despair, and suddenly it dawns on them that they're doing this just so that others won't feel bad when they visit their bedsides. They're the ones who are stuck full of tubes and vomiting every fifteen minutes, but they have put on a happy face for people who still have hair and can keep a meal down. They're wearing hospital gowns that expose half their private parts, but they feel sorry for a visitor who might be put off by the sight and smell of a used bedpan.
Back to the will to live: When you fawn over the "courage" of someone who has cancer (or AIDS or multiple sclerosis or muscular dystrophy or hepatitis C or a serious disability or amputation or deformity), the message is "Damn, I am so happy that I'm not you. You are screwed, buddy. I don't know why you haven't already killed yourself."
Suicide is supposed to be the easy way out. It's not. I admit that I once thought it was, but that was during my naive juvenile years, a period that abruptly ended one night in the cancer ward of Wilford Hall, an Air Force hospital in San Antonio.
I'd been telling myself that if things got too bad, I could jump out the window next to my bed on the ninth floor. One night, I seriously considered it. I'd been subjected to diagnostic tests, including bone marrow biopsies, which are so gruesome that, if Saddam Hussein's doctors had performed them on American prisoners, they'd have been hanged for torture and other crimes against humanity. I was sick from radiation treatment and I could barely sleep at night for listening to the coughing, moaning and crying of grown men and little boys in extremis.
So I thought about suicide, for half a second. Then I had a dark epiphany. I came to the realization that nobody had come back from death to report on the afterlife, if such a thing exists. There were no postcards saying, "Having a lovely time, wish you were here." There were no guarantees that being dead was any kind of release from suffering. In fact, it dawned on me, it was pretty stupid to expect an idyllic afterlife given that the fore-life isn't a trip to Disneyland.
But mostly, it was an understanding that after death, there is nothing. No more drinking, sex or music. No good books to read or movies to watch. It's plain vanity, I realized, to assume my individual consciousness will live on. Life, I decided, would have to be really crappy to be worse than non-existence.
So after that, I could understand why animals chew their legs off to escape from traps. I could understand perfectly well when I read Primo Levi describe how concentration camp prisoners would steal stale bread crumbs from their best friends, or collaborate with the guards just to live a few extra days. I could understand why soldiers run away from the fight, shoot officers who order them out on dangerous missions or deliberately wound themselves in hopes of being sent to a hospital.
Here’s a disturbing aspect of the cancer experience: You want to celebrate when you hear that another patient has just died. It happened to me and to my wife. She had a close friend whom she’d met while both were going through a last-ditch treatment commonly called a bone-marrow transplant. It’s a dreadful, expensive and mostly futile medical ordeal. They bonded. My wife knew the names of the other woman’s kids, husband and cats. They went to lunch together, told each other dirty jokes. When my wife learned that Bobbie had died, she told me, "I felt like having a party." It was a familiar feeling for me. You realize that civilized human beings still believe in a god that demands blood sacrifices. Someone has to die every day, and if it’s someone else God kills, then God’s too busy to kill you. It’s a joyful feeling to the depth of the soul, sometimes followed by a tinge of shame. You want to send healing thoughts or prayers to others who are suffering, but suddenly it hits you: "If they get better, I might get worse." You immediately revise those prayers, substituting "Take them, not me!"
So please, don't tell me I'm a hero. If I'm a hero for surviving, what does that make my wife and decent, but dead, human beings I met at Wilford Hall? Villains? Quitters? Losers? Weaklings?
But doesn't it take strength of character and positive attitude to survive such a horrible illness? I had none, but I survived. I've been clinically depressed most of my life, including for years before I had cancer.
Faith in God? Forget it. I take no pleasure in pointing out that I've seen a lot of cancer patients die after praying, reading the Bible, going to church and witnessing to the rest of us. They died, I didn't. Spirituality is not essential for survival.
Those who grab the limelight to spin inspirational tales about cancer survivorship are doing harm without realizing it, in my opinion. By promoting the myth that cancer survivors are "spiritually whole," confident, heroic exemplars of all that is nice in human nature, they send a message that an average or below-average person doesn't stand a chance. One of them once told me that I brought cancer on myself by being depressed, by having a "negative attitude."
I'm hoping to set the record straight:
You don't have to be special, spiritually enlightened, fearless and high-minded to stick to a course of cancer treatment.
You don't owe it to the world to pretend you're not afraid of dying. Thinking unhappy thoughts will not kill you. You're not required to be anyone's hero, role model or inspiration. You don't need a guru or mentor.
It's OK to scream at your mother or bitch if the nurse is late with your shot of morphine.
You're the one who's sick, and you might be dying and that's probably not your fault. It's OK to feel sorry for yourself, just like you would feel pity for another person in the same situation.
When you know your days are numbered, you might as well be selfish. Those who judge you, as the bodies in Thornton Wilder's cemetery said, just don't understand.