It’s challenging to retain one’s sense of dignity while standing in an exam room naked, wrapped only in a crinkly paper hospital gown that doesn’t quite close in the back. It also feels rather undignified to have an esophageal spasm sneak up on me at the dinner table and erupt with a noise something between a belch and a heave. Illness has a way of exposing us–sometimes literally–in profoundly humbling ways.
But what does it mean to possess dignity, or to be dignified (or, conversely, undignified)? To my ear the noun and the adjective have slightly different connotations. I think of “dignity” as an aspect or feature of a person’s character, a personal attribute or identity trait, whereas “dignified” is descriptive of a particular action or behavior–acting in a way generally deemed appropriate to the context or situation. (Thus a person could be possessed of an essential dignity while occasionally behaving in an undignified manner.)
But both words, I think, call up the image of a kind of stoicism or reserve, someone a little outside of it all, above the fray. Dignity is something we attribute to someone who maintains control, keeps calm in even the most trying or tragic of circumstances– the parent who’s lost a child but is able to deliver an eloquent speech, for example, without dissolving into tears. To be undignified, on the other hand, is to be out of control, to react in an outsized manner–the athlete who throws a racket in a fit of pique, the drunk partygoer who turns loud and rude.
But what’s the cost of associating dignity and dignified behavior with a stiff upper lip, repressed emotion, an invulnerable facade? Especially for someone who is robbed of control–perhaps even autonomy–by illness or other circumstances derived not from their own choices? Why should it be undignified to cry if it hurts, to curse at the bloody unfairness of it all? We shouldn’t have to suppress essential elements of what makes us human to feel our own sense of, or be seen as having, dignity.
When I asked hubby Steve how he would define dignity, he answered “recognition of value.” His definition echoes the word’s etymology, which indicates it descends from concepts connected to “worth.”
I will never be comfortable making impolite noises in the company of others. But I know that my inability to control them is not a measure of my worth. And if I cry sometimes, I hope that I am all the more human and none the less dignified for my honesty. Let’s normalize a sense of dignity that embraces the full human, rather than valorizing our ability to partition off our emotions. There is value–and dignity–in all that makes us who we are.
I’m glad to say my hiatus is mostly a result of lots of good things going on, combined with an awareness that I still need to apportion my energy. My June reconstructive surgery went well; I’m overjoyed to have soft-ish implants in place of those bricks they call tissue expanders. My hubby Steve and I had a nice beach week at Emerald Isle, and I returned to work at the beginning of August, where my colleagues have been welcoming and supportive. There’ve been some hard things, too. We lost our sweet dog Imoh suddenly and unexpectedly to kidney failure in July. I have one more minor surgery to go yet, chemo brain is real, and I still have to do some combination of physical therapy, yoga, and/or self-massage daily to address range-of-motion limitations and prevent lymphedema.
Consider: at the last check-up with my medical oncologist, I teared up talking about some trifling symptom—a headache, a knee that kept popping—that had worried me briefly. He nodded, and said “After what you’ve been through, for a while, everything that happens to and with your body, you’ll think— ‘It’s cancer.’ That’s normal.”
The messy truth is that oftentimes people don’t really want to know the messy truth.
But friends and colleagues, especially those I haven’t seen in a while, continue to comment on my hair growth, often with puzzlement or concern. Most know that treatment ended some months ago. There’s an unspoken question under their words: if everything’s okay, shouldn’t I have more hair by now?
Last year around this time, Steve, my father and I visited the first annual Sunflower Festival at Beaver Dam Farm in nearby Fincastle. It was a chemo weekend, but usually after a Friday infusion I’d have a reasonably good Saturday afternoon before the side-effects would hit hard. Sunflowers make me happy, and we had a good, but short, visit. This year Steve and I returned, and though the flowers themselves were a bit droopy due to lack of rain, it was sheer joy to stroll leisurely through the fields of their sunny faces, goofing around, sharing ice cream. Steve and I will celebrate our second wedding anniversary in a few days. For our first anniversary, we squeezed a trip back to the site of our honeymoon in between chemo treatments. I’ll happily supplant a fancier celebration with this year’s simple dinner at a local restaurant, accompanied by cancer-free body and the relative sense of peace in my heart.
The process of bilateral breast reconstruction has a tendency to highlight other asymmetries. The first thing my reconstructive surgeon said to me when he looked at my pre-surgery chest was that my left rib cage sat a little more forward, was a tiny bit more prominent, than my right. I’d never noticed this particular (minor) anomaly, but it’s apparently just as common for there to be asymmetry in the rib cage as in the face. The difference in my bone structure became most noticeable immediately after surgery and during my early tissue expander fills; for a while the right expander lagged behind the left, making me look lopsided. I also discovered I have a pocket of fat on my right upper back, unmatched on the left, which appeared only when I didn’t have breasts to pull the skin forward and keep it flattened out.
I’ve often felt lucky to be in the body I am. Aside from some cranky tonsils, a couple bouts of pneumonia, and one broken bone, I’ve been hale and hearty most of my forty-seven years, and I’ve managed to stay active and maintain a healthy, if not altogether svelte, weight into my middle age without Herculean effort. Excepting the sixth grade, when my legs had a sudden growth spurt separate from the rest of my body that briefly turned me into a sort of hybrid stork-human, my parts are mostly proportional, and my face, while perhaps not symmetrical enough for Hollywood’s standards, is reasonably attractive.
I’m just vain enough to feel relieved that the obvious asymmetries that appeared in my chest and back are slowly evening out as reconstruction progresses. But I’m far more reassured by a different realization. As I walked into the dining room Tuesday night, preparing to sit down to dinner with my hubby, it suddenly occurred to me: I no longer have cancer. Granted, my treatment isn’t quite done–follow-up radiation is the standard-of-care for triple negative diagnoses, even with a complete response to chemo, and reconstruction will take a while longer. But the chemotherapy worked; the surgery confirmed it. No more need I say, I have cancer. Now I can say, I had cancer.
I am more aware than ever of the many gifts in my life. Plentiful food; a warm, safe, spacious home. The love and care of so many people: devoted family who share their time and energy generously, decorating the tree, making meals, running errands, offering a voice of experience. Beloved friends who text encouraging messages, share their skills and favorite books, send beautiful holiday cards and bouquets that brighten up the darker days. And an incredible husband who stands by my side, makes me laugh, and doesn’t blink at changing bandages or fetching yet another Coca-Cola Icee (or even question my weird craving for them).
I’m also aware of gifts I’ve received for so many years without any comprehension they were gifts: the mobility to towel myself dry after a shower, mindlessly, unaware of the many twists and turns my body had to make to accomplish this simple task; the steadiness to reach the sugar where it lives on the highest kitchen shelf without having to ask for help; the stamina to sit at my computer and write for hours at a stretch. The gift of the absence of pain or discomfort. The gift of good health. Gifts I hope to receive again, and fully appreciate hereafter.
We won’t receive the full pathology report from the surgery until early January: we are hoping, based on the post-chemo scans, for good news. Until then, we will continue to celebrate the gift–a precious one– of another Christmas together. And I’ll keep you posted as often as I’m able about my ongoing Adventures in Cancerland.
Still Life, Beyond Cancer 