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Act 5

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My best friend -- and finest journalist I've ever known -- Sean Holton determinedly took a break from brain cancer yesterday to post this response to Facebook well-wishers:

"Thanks to all who have left so many encouraging messages of support on my wall during the past couple of weeks. Your support has meant the world to me as I shrivel up in a state of near nothingness each afternoon watching cooking shows and storing my bodily waste in pickle jars and waiting for these damn Mormons to finish my blood transfusion so I can watch Ice Station Zebra one more time -- (with apologies to Howard Hughes)."

While he wrote, I told him I know it's sad but you're making me laugh. And that's exactly why we love him. It was more than two years ago, in his first month of this epic battle, he wrote the following piece for his blog. It's as though he was preparing us all those many months ago:

by Sean Holton
Same Time Tomorrow
(How Sean Holton Learned To Stop Worrying And Just Have Brain Cancer Instead)

August 24, 2009

I've been thinking lately about why the idea of the individual case of terminal cancer commands such enduring dramatic interest in our society. There are plenty of other life-ending cards people are dealt that are just as horrible and way more tragic in the end. People can be struck dead in a random instant in all kinds of ways -- by lightning, in a car or airplane crash, in a shooting or fire, in an accidental fall from a great height. There are other incurable diseases that are equally or more debilitating over the long haul - those who suffer from multiple sclerosis and amyotrophic lateral sclerosis come right to mind. People have heart attacks and die on the sidewalk all the time. They get hit by buses. Or they suffer from mental illnesses that lead to suicide or fatal substance abuse. Or they waste away with Alzheimer's disease. And let's not even get ourselves started on the tragedy of the individual deaths that pour forth from wars, genocides and natural disasters.

Right now, I'd rather be dealing with my terminal but potentially manageable brain cancer than to be in any of the situations I just listed. In that twisted sense, I feel lucky.

So what is it about terminal cancer, then, that seems to set it apart and get people so wound up, so personally invested, time after time? How is it that there is this ready-made narrative that people seem to know by heart and are able to latch onto so instinctively?

I think it's because people naturally respond to drama, and lots of cancer cases have all the classic elements that make for the best drama. At the core of the cancer drama is that it is viewed paradoxically as "incurable" but at the same time is known to be "beatable." There is sadness, yet it is mixed with hope. From that essential conflict, you can just cue up the basic, five-act narrative structure that has been a bankable formula for packing cinema multiplexes and theater houses since Shakespeare made it so popular in Elizabethan England, and going back even further than that to when it was perfected by the ancient Greeks.

Act One unfolds by introducing us to both the too-young-to-die protagonist and the evil villain that is the devastating diagnosis. Then Act Two carries things forward by bringing in more complexity and texture, more medical details, the rallying of doctors, family and friends, the wearing of yellow bracelets and bandanas or the shaving of heads in solidarity. In Act Three, we get the marshalling of all available scientific resources to confront the dark force as we approach the climax of the uphill battle against all odds to "beat" the "unbeatable" disease. But dramatic tension is preserved because the final outcome is still unknown (this is crucial).

Acts Four and Five take us through either the heroic recovery of the protagonist or his tragic death and the resulting fallout from either outcome. And either ending does make for a good story in a strictly dramaturgical sense. So that's that.

Now let's look at the other examples I mentioned of how death commonly expresses itself in individual human stories and consider how they fail on the level of sustainable drama:

1. Sudden accidental death of any kind. Failing: The play is over before it can begin.

2. Wasting incurable, diseases of all sorts. Failing: The outcome is known from the start, there's not a lot of action to follow and the movie runs too long.

3. Mental illness, substance abuse and suicide. Failing: Too dark. People don't like talking about it, and they just turn away. Nobody's going to buy tickets for that.

4. Alzheimer's and old age: See #2 and #3.

5. Wars and natural disasters. Failing: These make good action movies, but individual human lives are mere props here. (See Joe Stalin: "An individual death is a tragedy. A million deaths is a statistic.")

I don't go into all of this to be blithe about the nature of my specific illness, nor to minimize the real human pain that cancer doles out to its individual victims and their loved ones. But all of those other manifestations of individual death and disability I mentioned deal out equally intense human pain at all of the very same levels.

I saw a slice of this myself when I was coming out of my fog in the intensive care unit after the surgery to remove my tumor. Whole families would file past my door and down the hall, wide-eyed and wondering what they would find when they stepped past a curtain into their loved-one's room -- a loved one who most likely had suffered a sudden, unexpected heart attack or been mortally wounded in a common accident or shooting. And often I would see those families going back the other direction a few minutes later in tears, adults and kids devastated and crying, holding up each other for support as they walked away. Chances are, I thought, there is to be no further drama in those sad stories. The outcomes have already been written. No one will be shaving their heads in solidarity with those people. They'll just be going to a funeral in the next day or two and scattering some ashes or shoveling dirt on a grave.

People ask me how I can remain so positive and upbeat about my situation in the face of such uncertainty. Part of the reason is that I don't see my cancer diagnosis as a drama. I don't conceive of it as an uphill battle against all odds to beat something that is unbeatable. As a 49-year-old man who already has experienced a lot to be grateful for and who has no immediate dependents, I'm not really interested in that kind of story right now anyway.

Right now I see my diagnosis as something else entirely. It is a gift that will give me the opportunity to learn more than I thought I would ever know about the mysterious line between life and death.

In the meantime, it will teach me to love the people I love even more, and to hold them more closely than ever. It will bring me incredible amounts of life-giving strength from the support of friends, past acquaintances and even total strangers. Many people don't ever get that chance. They either just live, or they just die, and they never get to see what's in between. But my diagnosis puts the idea of death in slow motion. It lets me pick up death in my hand and turn it over again and again to study it in its every small detail. I can hold it up to the sunlight each precious day that I remain alive and see it illuminated from any angle I choose.

It is as if Death has softly perched itself on my shoulder in the form of a wild and rare bird. In this form it will neither kill me immediately nor has it yet chosen to kill me slowly and inevitably - as it routinely does to so many people in its so many other, more fearsome forms. Instead, it will allow me to hold it for a while and to look it calmly in the eye. It may even talk to me. After that, of course, the Death Bird may decide to burrow itself into my head and build another nest to lay a second egg-shaped tumor in my brain -- and so kill me in that fashion. Or it may just fly away from me as unexpectedly as it landed, never to visit again until the time comes for it to return to me years or even decades from now; not as a bird, but in another of its myriad forms.

I hope the bird does fly away one day, and I think there is a pretty good chance it might. I guess then I will be able to say I have "beaten" cancer. But I will not gloat, because I will not have beaten Death. No one ever does.

More of Sean's writings:

Sean Holton spent 25 years as an award-winning newspaper journalist. His widely-recognized work as a reporter, writer and editor focused on land development, public policy, politics and governmental issues, including nine years as a Washington DC correspondent and bureau chief for the Orlando Sentinel, and as Associate Managing Editor based in Orlando. Sean holds a master's degree in Journalism from Northwestern University and a bachelor's degree in English and Political Science from Rockhurst University.