Everywhere’s a Metaphor

You know how when you buy a new car, suddenly that make and model starts showing up on every street you drive, every lot where you park? You’d never noticed it before you owned said car yourself, but suddenly it’s everywhere?

When you get diagnosed with cancer, the same thing happens. Instantly, it seems, every magazine you pick up has an ad for a new cancer drug, or a story of someone’s battle with cancer, or both. Every novel you read features a character with a mother or brother or friend who struggles with the disease (often used as shorthand for explaining the character’s current problems, especially if the mother’s/brother’s/friend’s cancer resulted in death). Watch any TV series long enough, and there will be a cancer mention, if not a full-on plot-line. Turn on NPR, and it comes up in that day’s interview.

Was I just not paying attention before now? Sometimes I wonder. I’ve lost count of the number of people I’ve met who reveal, once they hear I have breast cancer, that they are survivors: the technician who administered my pre-chemo EKG, a nurse practitioner I saw for an unrelated issue, my massage therapist. Friends have told me about mothers, aunts, sisters, co-workers who’ve traveled this path. It’s not that cancer had never entered my personal sphere: my sister-in-law is a six-year breast cancer survivor, and my husband, though his journey took place long before we met, is twenty-nine years cancer-free. But now I see it everywhere. Now it feels epidemic.

And with it come the metaphors.

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Professional hazard: when you’re a writerly type, and you’re trying to make sense of the weird detour your life has taken, the metaphors are dogged. You’re in the early stages of diagnosis and testing, and you drive to the beach. The weather is gorgeous for a few miles, then suddenly the gray gathers ahead, and your road leads straight into dark, threatening clouds. Rain pummels the car with such force you slow to a crawl. It lets up, a breather. You keep driving, round another bend, the storm crashes again. Just when it seems you’ll have to pull off the road to breathe without fear, the road bends westward, and the sky ahead shines clear and blue. You even catch a glimpse of a rainbow before it shimmers away. A bank of black clouds still hovers to the left. Will the rain follow you? Will the road turn directly into its path again?

You walk a mountain path through a nearby park. The first 100 yards of the trail are open, exposed to the blazing sun. It’s hot and uncomfortable until you reach the wooded portion of the trail that winds through the trees, where the dappled shade and a light breeze keeps the heat in check. It’s an out-and-back route, so you’ll trace those same 100 yards at the end of your walk. They weren’t fun at the beginning, and you know they’ll be even harder once you’re tired and spent and sweaty from the rest of your walk. But the only way home is back through.

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According to F. Scott Fitzgerald, “The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.” Chemotherapy, I think, is a first-rate test of a first-rate intelligence—and it’s a tough one, physically and psychologically. Embracing chemo means embracing toxic chemicals and nasty side effects that feel a lot like “harm,” even as you understand they’re doing “good” by helping you defeat the threat of the cancer.

Though the comparison feels more cliché than metaphor, chemo, for me, has been a roller coaster. Most breast cancer patients who have chemotherapy are on an every 2-week or 3-week cycle. As a two-weeker, I have one good week and one tough week. To concretize: imagine you’re going to be hit by a truck and catch the flu at the same time. For a week, you have intense body aches, nerve flare-ups, fatigue, nausea or other digestive issues, headaches, some fever. The worst passes after four to five days, followed by a couple days of lingering, less intense symptoms. You feel better, maybe almost normal, for a week. Then you willingly throw yourself in front of the truck again, because the truck is going to save your life.

I’ve been lucky, all things considered. My treatments have consisted of two sets of drugs, the first four a combination of Cytoxan and Adriamycin, and the second four rounds of Taxol. The first were the hardest, in part I think because of the ripple effect of adding drug-upon-drug to control side effects. In addition to the two chemo drugs in my drip, there was a steroid and two anti-nausea medications. I was also given a drug to boost my white-blood-cell count the day after chemo. Add Claritin to counter the bone pain brought on by the white-blood-cell booster, two at-home nausea meds should I need them, and laxative because all the anti-nausea meds cause constipation. I was already taking Ativan to sleep at night and Tylenol for discomfort. We’re talking twelve drugs going into a body that until a few weeks before hadn’t been processing anything more complicated than ibuprofen and the occasional Tums. Thankfully, I didn’t need all that was on offer—nausea wasn’t a major issue for me; I’ve only thrown up twice since I was eighteen. For what it’s worth, I did spend those eight weeks belching like a seventh grader. This phenomenon was not caught on camera.

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Taxol, for most, is more easily tolerated and requires fewer maintenance drugs, though I am in the 20% of patients (yay!) who experience fairly pronounced bone and muscle pain, and the cumulative fatigue that’s been promised is setting in. But on the whole I’ve done well. I’ve hydrated like crazy, brought yoga and massage on board to help, stayed in communication with my doctors so adjustments could be made, and (knock on wood) had no major allergic reactions. The worst event was a single scary blood pressure crash one evening after the first treatment.

The being yanked back and forth has been, perhaps, the toughest piece. The days I’m out and about, dressed, seeing friends, playing with hats: those are the good days. I seize them joyfully because I can (and because after a week parked on the sofa binge-watching The Mindy Project, I am restless and bored and eager to interface with actual people). It’s necessary to find and relish the joy, to resist succumbing to the undertow of I feel good now, but I know I’m going to feel bad again. The upside of knowing: I can plan around it. The downside: the pressure of trying to cram in everything I need and want to do, especially with increasing limitations. At first, I was fully functional during my “good” weeks. Then I started limiting myself to no more than 2 outside-the-house commitments or errands per day, then one, and I’m rapidly heading toward an every-other-day energy conservation model.

In truth, all of life moves this way, back and forth between the strong days and the hard ones. In a way, having some measure of predictability is a rare gift. In our everyday lives, none of us knows when such shifts will occur, when we will turn into the path of the storm, when the trail will grow hot and steep, when or if the rainbow might reappear.

My current shifts are dramatic and clearly delineated, but the biggest change is in my own awareness. These shifts have always been. They will always be. I can neither anticipate nor thwart them, and trying to do so just makes more wasted energy. The best, the only, place for me, for any of us to rest is here, now, in this intricate present.

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Heads Up! #2: A Hat with History

∼ Beautiful, quirky vintage hats make me happy. The “Heads Up!” series is a reminder to keep my (currently bald) head up, to pay attention to the good in the world, and to encourage myself and others facing a tough road that it’s possible to find the fun in even the most challenging circumstances. ∼

The red hat featured here belonged to my mother Margaret, who purchased it at a milliner’s shop in Albuquerque, New Mexico, when she was a teenager. The shallow crown and wide brim suggest it is what’s known as a “cartwheel” hat. She wore this red blocked beauty, trimmed with a bow, to church (along with white gloves, as that was the fashion for young ladies then) during her high school years.

I am wearing it to celebrate being three-quarters of the way through my chemotherapy treatments. Hooray!

Heads up!

 Photographer: Steve Prisley

Still Life, Still Celebrating: Special Anniversary Edition

njm_3015-001One year ago last Monday, Steve and I stood atop the Rooftop of the Center in the Square surrounded by family and friends and said “I do.” It was a cloudy, almost blustery day, but the rain held off, and we had a beautiful ceremony with our beloved mountains as backdrop, and a wonderful evening with dancing, cupcakes, heartfelt toasts that made us laugh and cry, and so much love and joy I thought I might burst.

I’ve often heard people say the first year of marriage is the hardest. There have been some adjustments to be made as Steve and I settled in to our new home (“Do you really want to hang that pink and yellow painting in the living room?” “Can you please close the hamper to keep the dirty clothes smell inside?”) Slowly we found our way to shared spaces that make us both smile, and we discovered new “together” routines that we love, honor and cherish.

My cancer diagnosis added some unexpected complications to that “first year is the hardest” admonition. I don’t think when we said our vows that either of us realized just how soon, and how dramatically, we’d be practicing the “in sickness and in health” portion of our pledge to one another.

imageBack when Steve and I celebrated our one-year dating anniversary, we had traveled to Seattle for a conference that same week. While touring around Pike Place Market, we hit upon the idea to honor our milestone by purchasing a piece of artwork jointly. We had already discerned that our tastes in art didn’t always converge–Steve preferred the representational, while I looked first for color, pattern, and mood–and though we weren’t yet engaged, we knew we were heading toward a future together. At the market we found a Scott Alberts woodcut of Mount Rainier with a cobalt blue sky. Steve liked the wood, I liked the color, and we both liked the mountain, which was recognizable but not straight realism. Sold!

The traditional first wedding anniversary gift is paper, so Steve had the wonderful idea that we should reprise our joint-artwork purchase: instead of each buying separate gifts, we could look for a watercolor or painting on paper that we both liked during our brief celebratory visit to Asheville, where we’d shared several special moments, including the day when Steve met my dad, and our honeymoon.

imageAs we wandered around some of the downtown shops and galleries, we kept our eyes open. Nothing much grabbed us until we saw a beautiful Jane Voorhees giclee print of a watercolor. The colors were rich and vibrant, the scene impressionistic rather than realistic, yet the painting clearly captured a Blue Ridge mountain landscape. When we picked it up and read its title, “these healing mountains,” it seemed meant for us.

Our first anniversary looked pretty different than what I would have described, if you’d asked me to project a vision of it back on our wedding day (especially the hairdo I’d be sporting…). Still, I was able to stroll through a city filled with good memories, enjoy delicious food, and let the beauty of the mountains sooth me, all with my husband, my love, right by my side.

It is enough.

This Brave New World

Getting a cancer diagnosis is a disorienting experience. It’s as if you’re sitting curled up on the sofa, reading the newest Jennifer Weiner, empathizing with the protagonist as she navigates the everyday joys and foibles of new love and family life, and you turn the page to find yourself suddenly thrust into the middle of a dystopian sci-fi novel. The characters are mostly the same, outside a few additions wearing white coats or colorful scrubs. But the rest of the world has changed. Surrealistic and strange elements—barium smoothies, giant machines, unpronounceable chemicals—appear frequently. The tone, previously light peppered with poignancy, now shifts between darkly serious and comically absurd, every page weighted with philosophical subtext probing what is the meaning of life?

You want more than anything to flip the pages back, to return to the other story. But you can’t.

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The weekend immediately following my Friday biopsy, a lone gunman entered Pulse, a gay nightclub in Orlando, Florida, and shot and killed 49 people and wounded 53 others. That Tuesday, the day after my diagnosis, a toddler was snatched by an alligator in the shallows of a Disney resort lagoon while his parents stood steps away. As I read accounts from those in the club who’d lost loved ones in the shooting, as I imagined the horror and pain of the parents who lost their son, I wondered: how do people who have experienced such suffering, such sudden and horrifying trauma, stand it? How do they go on?

I am slowly discovering: you just do.

I’m not equating anyone’s tragedy with my breast cancer diagnosis; another lesson I’m quickly learning is how individual the process of navigating any form of grief or loss is. And yet all of us who experience a sudden trauma (and many, if not most, of us will) must face that same question, and need to find an answer.

I go on because there aren’t many alternatives. Some who are ravaged by grief take their own lives, but that’s exactly what I don’t want: I don’t want to die yet. That’s exactly why a cancer diagnosis is scary and soul-shifting: the aura of death that hovers around the word. I don’t want to die yet because there are still so many things I want to do. And that eliminates another alternative: curling up and hiding. It’s tempting, and I did lay low in the early days, when we were waiting on more information before we shared the news. It was easier to avoid people than to lie when they asked “How are you?”

But I’ve since felt spurred to action. To reprioritize. To kiss my husband Steve more often. To work actively on a book project. To tell my friends and family as often as I can how grateful I am for their care. Even when it feels like this giant looming thing has pressed the pause button on my life, I am still a newlywed, a wife, a daughter, a friend. I still have stepsons, a dog, cats I love; trails I want to hike, words I wish to write. Uncertainty will be foregrounded in my life for a while, but it’s better, necessary, to keep moving forward. If I found myself in any other threatening landscape—a snowstorm, a swamp—I wouldn’t stop and stand still; that would be uncomfortable, painful, dangerous. I keep moving because hunkering down and staying put won’t make things easier, only harder. I keep moving because whatever hope there is lies somewhere ahead.

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Getting a cancer diagnosis is a disorienting experience. You wake up one morning, head to an appointment for a routine procedure you’ve had done maybe 10 or 15 times—already assured of your good health from a test the week before—and then: an image on a screen, a doctor’s pause, and you know the world you knew is no longer. The story is rewritten in an instant. Perhaps it is a bit like standing on the edge of a peaceful lagoon where an alligator you never imagined could exist appears and snatches away your heart. You wonder: What could I have done differently? Is it my fault? Why me? How can this happen? Yet you know these are pointless questions. The thing has already happened. The world has already changed.

And so you go on. Put one foot in front of the other, and go.