Where the hell have I been these past few months? Well, ever since my last episode with radiation of a painful bone tumor in my sacrum, I seem to have misplaced my voice. It could likely be lost among my yarn stash, but if only were it that simple. For not only have I misplaced my voice, but I am afraid to venture out into the world. Instead, I prefer to stay inside my little nest. On some level I must think that if I just stay here everything will stay like it is and I won’t hurt anymore. Hey, it’s not like I don’t have cause.
I’ve been in pain since September 2012, the cause of this direct and indirect pain has been the bone lesions in L4 and my sacrum. Last summer the crisis was all about L4: narcotics, bowel impaction, nerve ablation, radiation. The Letrozole I was taking from May through December caused such fatigue and joint pain. With it I had no quality of life and it made working next to impossible. I finally stopped it in December and though it took a few weeks, on January 27 I woke up with energy. Real energy! FINALLY! I felt like myself again. Exemestane was easier on my body and I was hopeful for the future. And then, two weeks later, BAM! The lesion in my sacrum placed me flat on my back. I had only been back at the office for two days. TWO DAYS!
From lessons learned last summer, the process of diagnosis and treatment was faster and I was down for about seven weeks–as opposed to 15. Radiation didn’t freak me out like it did last year and the nerve ablation was a piece of cake. I experienced some brief depression at the end, just as before. But as excited as I was to return to the office I found–and continue to find–it very hard to move out into the world.
To be sure, I feel wonderful. I am able to walk (in moderation)! In some sense, I feel almost as good as I did before I was diagnosed. I stroll along the streets with a real smile on my face (and in the beginning walked so much that I pulled a groin muscle, but I digress). But apart from my walking success, I feel as if I am sitting on the edge of the chair, just ready to rise up, but all I can do is stay in place. And because I feel as if I’m being tossed around in a dryer at the moment, this might be the most incoherent post I’ve written thus far.
For one thing I have an overwhelming feeling of guilt. So many women with Stage IV cancer are in more peril than I.Young mothers in precarious health. Men and women newly diagnosed. Yet here I am feeling wonderful. How can I have any right to feel so great when so many are still hurting, suffering, and seeing that expiration date speeding toward them at lightening speed? Well, none of this is in my control, of course, and I am not responsible for other people’s lives. However, it is not until you have cancer that your capacity to empathize gets thrown into overdrive. When you are well you feel the pain of others. When you feel your own pain, you want to help others feel better. At least that is how it is with me.
For another, I have been living in the “Scorchy Cocoon” for 18 months. That is 18 months of physical pain and emotional distress. Although I was well read and remained current with news and life, it really was Cancer 24/7: doctor’s visits, scans, tests, shots, and treatments. I felt pain all of the time. Every week I had something medical to do. Facebook became my outlet for sanity and keeping up with my friends and family because I couldn’t really travel anywhere–even in my neighborhood. I haven’t been that self-absorbed since I was thirteen. It was, in a very real sense, a kind of prison.
And now that I have been released from that prison and I don’t quite know what to do with myself.
My Job. Folks have been fine without me. I am so proud of my staff as they kept things moving so well. My previous boss had become vindictive and petty and, I believe, scared of my disease. I was afraid I would lose my job (though in academia you could walk naked through campus holding the standard to the 13th Roman Legion and still be employed). But after he left, senior management made it clear that I was an asset to the organization and they wanted me well and in place. My organization has been so supportive and I am grateful beyond measure. But after such a long break, I just naturally question my knowledge and expertise. I have disappeared from annual and local meetings. What is my worth? Do my colleagues feel that I have worth? Do my colleagues want what I have to offer? Indeed, do I even have anything to offer anymore?
Social Life. I want to be with my friends and enjoy the city. But I am cautious. I cannot plan for weeks in advance for I have no idea if I will be well on that date. Instead I live day to day–which is the hardest thing I have ever done. I can make plans, but my friends must understand that I may have to cancel at the last minute. And if I do that I feel guilty and weak. To date, my social life has consisted of the occasional dinner and logging into Facebook. Sex in the City indeed.
Cancer. I am a master at compartmentalization. With all of the baggage of life, I think I over compartmentalize. Indeed, it wasn’t until I began living with cancer that I realized I had a heightened ability to cloak those compartments in complete and total denial. Not just denial, but a veritable black hole of nothingness. I mean think about it: my entire diagnosis is a story of denial. Today, despite my past ignorance, I am in a good place: the two bone tumors that existed responded very well to radiation; scans are stable and improving; my pain is under control with the occasional flare. On paper, at least, I can live again.
One day I rose with my alarm, showered, dressed, and then just sat on a chair in my living room. I was paralyzed. I sat there for about an hour. I wasn’t in panic. Indeed, I sat there thinking of little more than the weather. And then simply decided I would not go in to the office. I undressed and spent the day as I had for the previous 18 months: in my PJs with cats. Once again I felt safe and secure.
But at the the same time I felt a tremendous sense of remorse and confusion. What the hell was I doing? I want to work. I love what I do. Why would I jeopardize not only my career but my entire life? I am no longer in prison, so why is it so hard to live?
After seeking some counsel, I decided that intellectual engagement may well be the thing that dissolves my fear of leaving my cocoon. That is to say that I need to immerse myself in my work once again and rediscover the real joy I feel in doing it. I went to the office yesterday, as a matter of fact, and I do think that this is the thing that will work for me.
As painful and confusing as my 18 month odyssey was, it was also a time of odd comfort. When I was under the weather, so to speak, friends rallied around me. They told me how much I was loved and how special I am to them. Friends and family really wanted to know about me. Gifts, favors, and treats arrived with love. I surrounded myself with soft blankets and comforting food and drink.
However, as I improved, many of those things naturally fell to the wayside with the expectation that it was now time to move on with my life. But after such a long time in crisis, I am now left raw and vulnerable. I need to relearn my limits, build my confidence, and live with some modicum of comfort with my disease. This transition from intense illness to wellness is a potentially fragile time for some of us–and we may not even be aware of it until it is upon us.
Intellectual engagement may be my path to easing the uncertainty of my future. Only time will tell. But I cannot possibly be the only person to experience this paralyzing fear of wellness. I just can’t be.
Physicians are focused on their specialty, fair enough, but they might do well to consider the emotional state of their patients as they transition from acute crisis to wellness (as well as wellness to illness). It may be a time of jubilation and excitement. But those feelings are expected to some degree, are they not? I know I told everyone how excited I was to return to my life. And I was. But under it all I was afraid and, even more so, embarrassed to admit that to anyone–even to myself.
I am confident that I will emerge from this mentally healthy and engaged. But like most things I have learned as a result of this cancer experience, transitioning from protracted illness to wellness is a delicate shift. And I don’t think it is on anyone’s radar. When faced with a challenge like this we need to be kind to ourselves first and foremost. Listen to that inner force–if it doesn’t feel right, then it isn’t. Our physicians need to be aware of this as well and ask their patients about how they feel about this transition and if they need help moving through it. Otherwise we may well find ourselves moving from one prison to another. Not only will that continue to cause mental distress, but that will not aid our physical condition.
No one deserves to live in a prison of uncertainty and fear. Least of all anyone who has been hit with cancer, regardless of type or stage. Ain’t nobody got time for that!
The Sarcastic Boob 
The Breastless Nude
Recently I went on quite a tear when it was revealed that Kohl’s and Komen had co-opted METAvivor’s intellectual property for an ad campaign. It really rakes my last nerve when people do this; rather than call up an original idea–which I’m sure their advertising departments could have done–they chose to take an idea already copyrighted and trademarked. And what bothered me most was that the campaign, which had no mention of Stage IV breast cancer, was built on the backs of Stage IV women and men via METAvivor. But now there’s something else that’s got my pantyhose in a bunch.
I came across a project by photographer Charise Isis called Grace. Isis, inspired by Hellenic sculpture, has assembled a collection of photographs of women who have had mastectomies as an “exploration into the grace of their humanity.”
Yawn.
People start taking photographs of women with mastectomy scars and suddenly it’s pushing the aesthetic envelope. It begs the audience to empathize and then hold these women in high esteem because they have a disease, have gone through treatment, and survived. It must be noted that women and men with breast cancer are no braver, stronger, or aesthetically pleasing than anyone else who goes through the experience of cancer. Then why the imagery?
Women–particularly their breasts–have been objectified for centuries. Now we witness the objectification of mastectomy scars. Indeed, Isis emphasized that sculptures of antiquity, despite their amputations and scars, survived and are “valued as objects of beauty within our culture.” Is the corollary, then, to value women as “objects of beauty” in society? Do mastectomy and further surgery scars become “objects” of beauty and bravery in breast cancer culture?
This project also perpetuates the iconic mythology of breast cancer–that to conquer breast cancer one must be strong and brave. It is the responsibility of the woman to defeat her disease and become a survivor. If she doesn’t survive? Well, she didn’t try hard enough.
Of course, in Grace they’ve all had cancer. We should not be surprised that women living with metastatic disease are absent from yet another pithy piece on breast cancer survivors. The ugly scars hold no interest if they are on a woman who has metastatic disease. Breast cancer isn’t about death. It is about pink ribbons, endurance, and survivorship.
I am not particularly moved by this project. The images try very hard, but they seem forced and largely uninspired. And although some may find inspiration in its images, my view is that as a body of work it objectifies the surgery, the scars, the physical detritus of breast cancer. Although I have only just heard of it, the project has been traveling the United States for the past two years “showcasing the brave subjects who bared their bodies for the camera, in the name of survivor solidarity.” (Source.)
Bullshit.
I am an enthusiastic supporter of David Jay’s SCAR Project. And it is largely because of the foundation on which the project has been constructed: “The SCAR Project is an exercise in awareness, hope, reflection and healing. The mission is three-fold: raise public consciousness of early onset breast cancer, raise funds for breast cancer research/outreach programs and help young survivors see their scars, faces, figures and experiences through a new, honest and ultimately empowering lens.” Jay also includes men among his subjects.
The women who pose for the SCAR Project are not representing some existential depiction of disease. They are there to show the pain, the disfigurement, the life changing hell that this is breast cancer. Indeed, as the project proclaims: breast cancer is not a pink ribbon.
I think that it is time to rip to shreds the idea that breast cancer is a rite of passage for women. We need to acknowledge that despite the pink camouflage, those of us with breast cancer withstand the barrage of treatments most other cancer patients undergo: oral drugs/chemotherapy, IV chemotherapy, radiation, and surgery because we have a disease that can kill.
We must stop romanticizing this deadly disease through ideas of bravery and survival skill. Breast cancer patients are no braver, stronger, or aesthetically pleasing than anyone else who must experience this dreadful disease. And remember that many with metastatic disease have no outward signs that they have breast cancer.
And we need to stop putting women on pedestals, for as soon as a woman stands there she loses her identity. She is reduced to her being identified with her body parts or how she appears to the senses. She becomes a scar, an implant, a loss.
I am much more than that. We are much more than that. It is time that we demanded nothing less.