Recently I was chatting online with a friend who has a rather different cancer course than mine, and faces even deeper challenges than I do. We were talking about the emotional context of cancer, how it inflected her primary relationship and had played a key role in the destruction of mine, and how difficult it could be to find support for the fear, desperation and depression that can grip one.
I mentioned that I had rather disturbed my therapist with a recent comment that it would almost be a relief if I received a terminal diagnosis, because at least then I would know what was going to happen and plan accordingly. My friend almost burst out through the chat window, explaining she’d had the very same thought, and wondered if she was just nuts.
As I said to my therapist at the time, no, of course I don’t want a terminal diagnosis. I want to live on in health, very badly do I want that. But what both my friend and I are reacting to in having such thoughts is the profound uncertainty and complete loss of control that cancer brings into our lives.
This is so hard to talk about. That comment about a terminal diagnosis would seriously freak out my friend’s partner if she made it aloud. It would seriously freak out my family if I just dropped it in conversation. The people around me so desperately need me to get better, to be well, to stop living under daily threat. For me to confess such a despairing thought is a direct challenge to what their heads and hearts need.
But the despair is real. The risk is real. The reality is huge.
Often when I talk about this, I am reminded by whomever I’m talking to that we are all mortal, that we could get hit by a bus at any time.
Ok. Listen carefully to me, people.
Fuck that noise.
It does not help, and it’s specious besides.
I am 47 years old. According to the Social Security Administration, the odds of a generic 47 year old American dying within one year, of any causes, are 0.4208%. Slightly less than one in 200. (Assuming I’m reading the table correctly.) They don’t get significantly stronger over the next few years of middle-aged life.
My personal odds of dying within the next five years are 70%. That’s seven out of ten odds.
Take your proverbial bus and shove it. That’s not a meaningful comparison, and it sure as hell doesn’t make me feel any better when someone trots it out. The overwhelming majority of people don’t wake up thinking that at least if they got hit by a bus their life would have some certainty and some closure. They don’t have any reason to.
When you live with cancer, especially an aggressive (in my friend’s case) or persistently recurrent (in my case) cancer, you walk with death on your shoulder every minute of every hour of every day of your life. Every time I look at my daughter, I wonder how much of her life I will get to be a part of. Every time I talk to my parents, I wonder how they’ll survive my funeral if I should die before them.
Is it any wonder we have these odd ideas about dying?
Cancer produces some strange emotional terrain. It produces some strange thoughts, that we can feel guilty, or even crazy, for thinking at all. It opens deep wells of loss and regret that will never be filled, even if we survive.
If you know someone with cancer, one of the best things you can do is make it safe for them to think and say these things. Don’t deny it, don’t talk them out of it, don’t tell them it will be fine. For frick’s sake, don’t tell them that any of us could be hit by a bus tomorrow. Just accept their words with love and friendship and an absence of judgment. Because these are ideas and thoughts that if swallowed up can consume a person from within, until they feel like a hollow shell of desperation.
Some journeys you never come back from. But sometimes the people around you can help you on your way.