11/29/2012 08:58 am ET Updated Jan 29, 2013

Young Diagnosis, Grown-Up Conversation

"I hate this part." I looked up at my boyfriend James. I could see only his eyes above the surgical mask. A second-year med student, he knew to maintain the sterile field that surrounded me.

The bandages that dressed the scar tissue that held the tubes that guided the chemotherapy and the antibiotics and the other chemicals straight to my heart needed to be changed weekly. At this point James was just as much my caregiver as he was my boyfriend.

Until I got cancer again at age 24, James and I had been long distance for almost two years, anchored on his end in Chicago and on mine in Washington, DC. But we were from the same small Minnesota town, surrounded by a sea of smaller towns, sausage-makers and silos.

When we started dating I assured him that cancer was five years in my past, something I only thought about during my annual MRI that proved my tumor was still dead. But cancer survivors know the threat is always still there.

And then I made that phone call that I pledged I wouldn't have to.

"James, I have to move home," I stammered. "I need a bone marrow transplant. My doctor says that's the only cure." The very chemotherapy and radiation that had saved my life seven years ago had now sunk its toxins so deep in my bone marrow that my blood became cancerous, too.

"Promise me you won't worry too much," I cried, knowing myself there was good reason to worry. After almost two years of dissecting each sentence of his medical textbooks, it was hard for James not to dissect mine. What would cancer do to us? Could we survive it? Did we want to? With that, our relationship required a resoluteness it hadn't before.

The conversation was similar to another I'd had as a senior in high school. My doctors told me a pediatric bone cancer was invading the sinus in the middle of my head. "Pediatric" sounding odd paired with a disease that ages you so quickly. I told my boyfriend at the time that it was okay to break up with me. "Even if you wanted to break up with me for normal 17 year-old reasons, I know you would feel guilty. No one wants to be labeled 'that guy who broke up with the bald cancer girl.' Really. It'll be easier if we just break up now."

A week later after my first round of chemo, my red hair still clinging to its roots, he pulled a handwritten note from his pocket. He had drawn doodles in the margins to lighten the delivery. He muted the TV in his parents' basement and cried when he read it to me, letting the note dictate where the grown-up situation had forced him. No amount of balding chemo could take away his hardy feelings, he told me.

I barely survived that cancer, but our relationship survived well into college.

We broke up later for normal reasons, but I felt guilty. Was I a bad person to break up with the guy who stayed in with his sickly girlfriend while all the other guys were out drinking their first Bud Lights and sneaking in after curfew? Did I owe him in-sickness-and-in-health loyalty?

Later, I enjoyed the anonymity of dating, allowing myself to leave out major life details for the sake of simplicity. As soon as you introduce a cancerous past, questions of the future automatically surface. "You had cancer? Really? How long has it been since you've been sick? Whoa. Are you supposed to get sick again? Look, I'm not asking for anything serious." And they walk away. Surely there are other less complicated girls out there.

A cancerous past demands honesty to those you love and those you want to love. Sometimes it insists uncomfortable candor with yourself too about what a cancerous future would look like. But too many grown-up conversations were never good for anyone.

Jenna writes regularly on her blog The Redhead Report.

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