Sunday, March 19, 2006

Another One from the Archives

During my first go-round with breast cancer, I didn't write anything at all about the experience (unless you count e-mail, in which case I probably wrote a lot). Then, a year or two later, when I had some distance—and perspective—I took a personal-essay writing class, for which I wrote "Words Failed Me" and the piece below.

The class turned out to be a very discouraging experience, which is probably why I've been sitting on these two essays ever since. I also wrote most of a third one, which I would like to revisit—and finish—at some point. It's much funnier than the first two. (A low bar, I know.) If and when I do, you'll see it here.

Meanwhile, I offer up the following as another window into my world (and the strange contraption known as my brain).

No Contest

Whether the currency is SAT scores or mortgage rates, golf handicaps or lost pounds, by our nature we can’t help but compare ourselves to those around us. There are ratings and rankings for everything: sports teams, television programs, book sales, selective colleges, even a website where visitors are asked to rate other people’s photos on a scale of “hot or not.” And in social settings (whether human or animal), it’s fairly easy to pick out the alpha males and queen bees.

I discovered not long ago that this compulsion toward comparison exists even in the world of breast cancer. Since my own diagnosis in 2001 at age thirty-four, I have met dozens of breast-cancer patients and survivors—some through a support group, others through activism efforts, still others through mutual friends, a few by chance. In every case, without fail, these encounters follow the same pattern: after introductions and the usual pleasantries, medical information is exchanged like business cards. But instead of title, company, address, and phone number, it’s cancer stage, surgical procedure, number of positive lymph nodes, and type of treatment. And, as with a business card, those few facts tell you most everything you need to know to quickly size up your new acquaintance. There’s an unspoken pecking order—one based on diagnosis and, by implication, prognosis.

This pecking order was obvious to me the first time I attended a breast-cancer support group. We started by going around the circle, introducing ourselves and giving the medical equivalent of our CVs. At one end of the spectrum was the woman whose breast cancer was diagnosed so early that it was technically Stage 0. At the other were those with metastatic disease (Stage IV), whose cancer might be contained but never cured. These women had the most arduous treatment regimens, punctuated by regular CT scans, bone scans, blood tests for specific cancer markers, and who knows what else. With their unforgiving medical schedules, it was a wonder they were able to attend the support group at all.

I fell somewhere in between, with a Stage II diagnosis and what I have come to call “the deluxe package”—mastectomy, chemotherapy, radiation, and breast reconstruction. With me in the middle were breast-cancer patients of every stripe. For some women, breast cancer was a family trait. They had gotten a preview of their own experience by observing their mother’s, sister’s, grandmother’s, or aunt’s. Others were dealing with a recurrence. These women thought they had defeated cancer, not knowing it would come back like a weed.

Still others had one of the BRCA-1 or BRCA-2 genetic mutations that dramatically raise one’s chances of developing breast and ovarian cancer. Not only did they have to contend with treatment for their current diagnosis, they also had to decide whether to have their ovaries and all remaining breast tissue removed prophylactically. They were walking around with a time bomb in their cells.

Some women had treatment plans very similar to my own but were dealing with some complication or having especially severe side effects. One woman vomited profusely, day after day, despite a slew of anti-emetic drugs. Another was so weak she ended up in the emergency room after fainting in a department store. A third was diagnosed mid-pregnancy, and went through chemo during her last trimester. Every time I saw this trio, I felt lucky, then guilty. Both were reactions to the same thing: the reflexive mental calculation that although we were all in the same basic boat, I was better off. Even just a little. I don’t remember being so aware of my place in the world since high school, when you just knew where you ranked in the social caste system.

While I was busy comparing myself to other women with breast cancer, the rest of the world was comparing me to the healthy young women they knew. Sympathy and pity were offered to me in great quantities, but I couldn’t accept. Hearing about other patients’ tribulations, it was hard not to feel grateful for my lot in the great cancer sweepstakes. Sure, I was diagnosed at an age when most women worry about breastfeeding, not breast cancer, but didn’t that mean that I was stronger and better able to tolerate the rigors of treatment? Wasn’t it a blessing to learn that I had a well-shaped head under all that formerly curly former hair? And hadn’t it been convenient not to have to shave or wax anything all summer long?

To most people, though, my circumstances were nothing short of tragic. I remember vividly the night I bumped into another young woman, a casual acquaintance who had been contending with a degenerative illness for several years. She’d been forced to stop working and spent most days at home, taking heavy doses of pain medication. I hadn’t seen her in several years and was taken aback at the sight of her struggling with two canes to walk a short distance. In that instant, I knew exactly how other people felt when they saw me for the first time without hair: stunned, then incredibly awkward. Should I ignore the obvious change in her health or acknowledge it right away? Conceal my shock or let her see my honest reaction? As she headed my way, I tried desperately to prepare something hopeful and reassuring to say.

I never had the chance. She embraced me and exclaimed, “You poor thing! I heard all about your situation, and I just wanted to say how sorry I am.” I could see the grave concern in her eyes.

My situation?

What about hers?

To my mind, I was in much better shape. Breast cancer was terrible—really terrible—but it was just a temporary setback. I’d finish treatment, my hair would grow back, and I’d get on with my life. This young woman had no expectation of recovery. Yet she felt sorry for me. How could that be?

I realized, much later, how she and I could have such different perceptions of our relative well-being. A diagnosis of cancer is a death threat. Whether you heed the threat or not, whether you survive cancer or die from it, you are forever marked. Some will see it as a mark of courage, others a mark of shame, still others a mark of doom. It is how you see it, and how you wear it, that counts.

I see it as a battle scar, a reminder of human frailty, a reason to hope.

I wear it with dignity, not disgrace.

And I can tell you that it transcends all the pecking orders and comparisons in the world except the one between those who wear it and those who don’t.


Anonymous Christine said...

Can't wait to read more of your thoughts and essays Jody.

Thank you.

March 27, 2006 5:16 PM  

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