Woody Allen once said that the most beautiful words in the English language are not "I love you" but "It's benign." I'm not sure I agree, but then, I have had only limited experience gazing into the eyes of a doctor and hoping for those two words that every neurotic longs to hear.
The one time it came up, the doctor's words were far from beautiful. "It's cancer," he said of the lump I had found in my right breast while showering one sunny August morning in 2002. I was 36. Although the cancer was aggressive, and my two years of treatment make the trials of Odysseus seem like a playground tussle, I am still alive nearly 11 years later.
My dad heard his "ugly" words 15 years ago, when at age 55 he was diagnosed with prostate cancer. He survived. Eight years ago, the words were uttered again. This time, it was an aggressive form of lung cancer that was inoperable and had already spread to his lymph nodes. Miraculously, my dad responded to treatment, and the cancer remained in remission for eight years. But you've seen enough horror films to know what happens next: Bad guy is down, his body riddled with bullets. He's gotta be dead. But wait, is he... is he moving? Is? He? Still? Alive?
During the fall, my mom expressed her concern to me that my dad seemed to be getting lost on the way to places where he had been hundreds of times before. He was also tired and irritable. Then one day in February, he woke up unable to swallow. By the end of that day, we learned that the ugliest words in the English language may very well be: "Your cancer is back -- this time it's in your brain."
Nevertheless, the cancer was operable, and Dad made it through his craniotomy with flying colors. But a few days later, he suffered a seizure, an ominous sign of the cancer's murderous intent. And with the seizure came a change in my father. He was no longer who he had been before.
Once a voracious eater, now his appetite is poor. He sleeps most of the time. When he's awake, he sometimes doesn't know where he is. After reading an article about Thailand, he believed that he had just returned from vacationing there. He was briefly obsessed with buying a new car even though he can no longer drive. He can barely walk. At times, he's hostile ("someone needs to kick you right in the gut"). At times he acts like a young child (pulling the covers up over his head to signal that it's time for me to leave).
I'd love to say that with 15 years of experience fighting cancer, my family approaches my father's illness with equanimity. I'd love to say that we've come together like a well-oiled machine, steadfastly supporting one another as we face this ordeal.
Unfortunately, the reality is something else entirely.
My mom is sleep-deprived and highly reactive. When my dad has a good day, the treatment must be working. A bad day means that death must be imminent. On a Tuesday, my mom may fume over a doctor's neglect, despite that on Monday she was seething over what she felt was intrusive care. Learning that a doctor attended Harvard is cause for jubilation, until the doctor takes too long to respond to an email. Mostly, my mother seems furious -- and with good reason -- seemingly overnight her husband has become her charge, and how can anyone begin to know the pain she is feeling?
To my younger sister's credit, I believe that she has come as close as anyone can in helping my mom feel less alone in her anguish. Although my sister has a high-level job 45 miles from her house, her house is a mere five miles from my parents' -- and my sister has been physically present for my mom nearly daily since this ordeal began. That physical presence has been an invaluable source of comfort to my mom. I know this just clearly as I know that my own relative lack of physical presence has been a source of anger.
Why can't I be there, they have asked me, given that I don't work outside the home (which is solely their opinion, by the way)? The short answer is that I live nearly two hours away from my parents, I have two teenage boys who play on sports teams, no carpool prospects (not for not trying) and a husband who's rarely home during the week. The inevitable follow-up question is: Why not hire a car service to drive my kids around?
That I feel obligated to answer such boundaries-breaking questions is disconcerting to me. But here goes: My boys suffered terribly as a result of my cancer. I honestly believe that they have largely recovered from their abandonment wounds. But I also believe that the wounds left scars. I can't erase the pain of the past, and I can't alter the course of the future. But I candecide that at this time, while my father is sick but still in treatment and not without hope, I am not comfortable dumping my boys several times a week over an indefinite period.
My mom resents this, as do my sister and her husband, who just so happen to have structured their lives so that one of them (my sister's husband) is always home and available for their 8-year-old son. Their disapproval of my choices is registered both publicly and privately. But it's not only my parenting choices that are under attack. During the three weeks (a total of 12 performances) when I stage-managed an off-off-Broadway play, the accusatory question shifted briefly to, "Why is this job more important than your dad?" When I hosted a fundraiser for the play (which I had committed to doing well before my dad became sick), I was publicly shamed for having "fiddled while Rome burned." When I was recently down with a cold, I was accused of being happy to have been quarantined from visiting. When I created a fundraising page for the charity for whom I am keynote speaking in April, I was accused of spending all day on Facebook instead of visiting my dad. When I posted professional headshots taken well before my dad became sick (in connection with the same charity), I was accused of spending all day taking photos of myself.
Over and over again, and in all manner of contradictory fashion, I am accused of not caring.
It's not that I don't care. I care deeply. If caring were measured in the damage done to one's fingernails, no one would question me. I have bitten my fingernails until nothing is left except cuticles, and then I've bitten my cuticles. I am pained by the notion that the man who taught me to think like a lawyer and took me shopping for my prom dress might be gone soon, and that in a sense, he already is. And I am pained by the unavoidable connection between my father's illness and my own frailty.
Two years after my double mastectomy, my surgeon congratulated me for surviving past the point where "most women have a recurrence." At three years, I got the same exact speech. At seven and 10 years, I heard it again. Huh. I've tried to avoid thinking about what that might mean. Then last year my oncologist mentioned that breast cancer can recur even 20 years later. Still, I tried not to think about it.
But when my dad's lung cancer spread to his brain after eight years, how could I not think about it? There it was, springing up like some sinister jack-in-the-box at the most inopportune of times -- when I am alone in the car on my way to see Dad, or when I'm sitting in the chair beside his bed, hoping he doesn't get irritated with me for talking too fast.
Yoga, once my primary form of exercise, is now fraught with issues because it is deeply connected for me with cancer survival. I began yoga while I was in treatment, and I always believed it helped make me well. But now I'm skeptical. How dare I imagine that yoga could possibly matter when actual medical science didn't matter for my dad?
But this isn't about me. The fact is that my dad is gravely ill, and we as a family are not handling it well. I am not willing to compromise my parenting values at this time. I cannot take away my mother's suffering by suffering on her behalf, and I can't take away anyone's suffering by absorbing their verbal attacks. But still, I want to offer my support in any way I can. And what I do have to offer is a what I have learned about accepting major adversity with equanimity. Cultivating equanimity does not mean denying feelings. It means making choices about how to react to those feelings.
Having gone from vibrant at 35 to halfway dead at 36, having shown up for chemo only to be told to go home because I was too anemic, having just gotten used to wearing my wig when my eyelashes and eyebrows suddenly fell out, having celebrated my last day of chemo only to be checked into an isolation tank because the chemo had destroyed my immune system -- how could I help but cultivate some level of distance between experience and reaction?
I didn't choose to cultivate equanimity. It chose me. My experience has taught me that nothing is permanent. Change is inevitable; sometimes it brings pleasure, sometimes pain. While you can't avoid pain, you can choose to suffer less.
Choosing to suffer less does not equal choosing to not care. It means expecting both bad days and good days, in no particular order. It means accepting a new and truly awful normal. I don't have to like it. But failing to accept it is tantamount to trying to control an unstoppable force. It is doomed to fail, and you will get crushed in the process.
I'd like to say that I would recommend this approach to anyone dealing with adversity. But the truth is, in some cases -- in my case -- it seems to alienate those who are still riding the roller coaster. My unwillingness (or inability) to stomach the curves and drops isolates me from my family, even as it protects me. If I could teach my family to cultivate some level of distance between their experience and how they react to it, I would. They wouldn't hurt any less. But I truly believe that there would be far less suffering.
For more by Lauren Cahn, click here.
For more on emotional wellness, click here.