to others, and to give and receive a hug.
Chapter 9
Karen: Accepting and Aspiring
At the end of the Friday evening lecture and throughout the weekend Rob shares stories, like this one, about his experience as an oncologist and support group leader.
In Love, Medicine and Miracles, Dr. Bernie Siegel, the famous surgeon and support group advocate, describes the personality traits of his “exceptional cancer patients”. Bernie noted that those people who did much better than expected were able to accept their diagnosis and find a deep sense of peace in their lives despite the outward challenges. Decades later, an increasing body of scientific literature supports Bernie’s theory. Compiled medical reports of people undergoing spontaneous remissions of their cancers, and other “remarkable survivors”, seem to support the power of acceptance.
But what does ‘acceptance’ really mean? Can we fully accept the distress that comes with a cancer diagnosis and still strive to heal?
Acceptance doesn’t mean resignation. It is not an excuse to give up, or a passivity to let others make our decisions, or a wish that God would do everything for us. We still need to be proactive in our medical care and wise about how we spend our energy. Neither is acceptance meant to mask the emotional turmoil caused by a cancer diagnosis. Cancer can be the most trying experience of our lives.
Acceptance means looking directly at reality with mindful attention: “This is what is happening to me. This is how I feel.” We gain greater clarity of the situation when we accept what is happening. With our feet firmly planted on the foundation of what is true right now, we can choose our next step more wisely. Conversely, not accepting or seeing the simple truth as our starting point is like walking in a fog so thick we can’t see our feet.
My friend Karen is someone who tapped into the power of acceptance at a remarkably early phase of her breast cancer diagnosis. I was very close to Karen in medical school before she went on to become a nationally-respected anaesthetist, a wife, and a mother to two young children. We lost touch for a while, but over the last few years we began to exchange Christmas letters giving humorous updates on the lives of our young families.
A couple of years ago, when she had just turned forty, I received an email from Karen asking me to call her. I assumed that someone in her family had a cancer diagnosis, and she wanted some advice. As it turned out, Karen had found a lump in her breast and a suspicious mass in her armpit. Within days, a biopsy revealed locally advanced breast cancer.
Fortunately it had not obviously spread to other parts of her body.
When I heard this news, tears welled up in my eyes. She had called me for advice about how to draw upon the body-mind-spirit connection as a complement to conventional care but, in those first moments when my voice began to break, it was Karen who consoled me just as she had many of her family and friends in the few short days since her diagnosis.
I was impressed with her matter-of-fact approach. When her friends would say to her, “I know you’re going to beat this”, she would respond with a gracious “Thank you” and then add that no one knows what is going to happen in the future. She knew exactly what was going on, was getting excellent care, and in her wisdom, she seemed comfortable with the uncertainty of what was to come.
Tired of explaining her philosophy to her many family members and friends, Karen sent out the following email to all her supporters:
“First of all, I want to thank you from the bottom of my heart for your expressions of concern and support. It means so much. Secondly, I want to reassure you that I am doing well—my spirits are good, my attitude positive. If you are interested in knowing more about where I am at, and where I have been, then read on. It may be a little bit raw, and a lot personal, so feel free to skip it if you’re feeling squeamish.
…In finding a lump in my breast, then a mittful of lumps in my axilla during an idle moment sitting at my desk, I went from “life as I knew it” to the realization that I had an advanced stage breast cancer in less than 30 seconds. The next day, lying in the radiology suite for a series of core biopsies, with my three-year-old daughter in tow, I had the very real sense that this was happening to someone else. I saw two of the technicians exchange a look—that scrunched-mouth grimace of pity, a facial expression that says “What a sad case.” I wanted to scream out “No, you don’t understand. This is me. I’m a doctor. I’m a healthy person!”
But the ensuing week brought many discoveries, some painful, some wonderful. I have come to the belief that a large part of the shock of an experience like this comes from being forced to face one’s mortality so clearly. Does any of us REALLY believe that we are going to die? Are we able to think about it and picture the seasons continuing to turn long after we are just dust? For some of us, I think, it is a hard place to go, and living our lives day to day demands that we tuck away that hard truth in order that we function in the quotidian.
But once I managed to accept that the reality of MY mortality had always been there, I could accept that nothing fundamental in my life had really changed with this diagnosis. I am still the same “me”. My life has not changed drastically or dramatically. I am still here. I was not hit by a bus. My loved ones are still around me. Unbelievably, I can honestly say that I am as ‘happy’ now as I was five weeks ago. I am, even in this moment, missing a body part or two, hair about to fall out, completely and utterly whole. To be sure, I have different worries than before, and my time will be spent in ways that I had not anticipated. There is a large question mark about my health and my future. But again, I would argue that it was always there for me, as for all of us. It has now just struck me square in the face. Even the knowledge that the cancer had actually been there for five years or longer (EEK!) allows me to see the last few weeks, and the year ahead, as the first steps towards, rather than a plunge from, true wellness.
Few things in life are all good or all bad. One would think that winning twenty million dollars would bring unmitigated joy, but when one follows those “lucky” individuals five years down the road, it is clear that misery predominates. While I would erase my diagnosis in a minute if given the chance, I also recognize that it has brought me many gifts. My friends, family, and colleagues now express their love for me without hesitation. I feel a bit like Sally Field during her awful Oscar acceptance speech: “You like me! You really like me!” Regardless, it makes me feel surrounded with love in a way that I have never experienced before. All of the experiences of life have become more profound, more intense, more cherished. I have been able to give myself permission to focus exclusively on myself and my family, with nary a tinge of guilt.
Of course, it is not a bed of roses… While I really feel very little in the way of fear for myself, I am constantly thinking about my children. There is no positive spin to put on the scenario of two small children losing their mother. That part is so painful for me to contemplate that I cannot go there very often, nor for very long. But it does make me ensure that I give them the best of me that I can right now, that I love them with all the intensity that I feel. It also steels my resolve to fight this disease with everything I can. I will accept any treatment that shaves even a fraction of a percentage point off my chance of recurrence, and God forbid, if recurrence comes, any treatment that will give me a single extra day. I am planning and working towards living until they have to send me to a nursing home at age 95 and I can make them feel guilty for not visiting me often enough.
To this point, I have lived what I would describe as a ‘charmed’ life. No major hardships, many blessings. Sometimes we can lead ourselves to believe that we are totally in control of the path we are on, and that we are entitled to continue along that path as we wish. It is a rude awakening for someone like me to discover that I was connected to the
