healthmedicinet

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.

I felt perfectly comfortable mocking cancer’s “plucky” attempts to screw with my family. 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 had been complaining that Dad was quickly becoming an “old man.” He was tired, irritable and prone to falling. He was getting lost on the way to places where he had been hundreds of times before. 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, things started out as hopeful. The cancer was operable, and Dad made it through his craniotomy with flying colors. But a few days later, he suffered a seizure, a truly 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, his appetite is now 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 is 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 like to say that we all accept it with the knowledge that no mood is permanent, no bad day is dispositive and no good day is a promise.

But the reality is something else entirely. My mom is sleep-deprived and explosively reactive. When my dad has a good day, the treatment must be working. When my dad has a bad day, death must be imminent. One day she might rage about a doctor’s neglect. The next she may fume that the care is intrusive. Learning that a doctor attended Harvard or fellowed at Columbia is cause for jubilation, which lasts only until that same doctor fails to reply to an email within two hours.

Mostly, my mother is furious — that her husband may be dying, that seemingly overnight he’s gone from husband to dependent and she’s gone from wife to nurse. And I believe that she’s furious also because she has begun to understand that no matter how connected we are to one another, we are ultimately alone in our own heads, and therefore, o one can possibly feel exactly what she is feeling.

Back when I was a teenager, my younger sister used to draw a nightly bath for my mom and listen to her complain about me. Basically, we’re back to that now. Vanessa lives near my parents, whereas I am nearly two hours away. Vanessa has one 8-year-old son and a stay-at-home husband; I have two teenage boys and a husband who’s rarely home during the week. Vanessa is able to visit my parents daily. When she has had to skip work to do so, my mom has reimbursed her for her unpaid leave. Vanessa has grown accustomed to the mood swings and even joins in at times. I am able to visit only once per week, but as a veteran of cancer treatment, I’ve tried to offer my expertise on how to work with the doctors to ensure the best care. To say that it is not appreciated would be a vast understatement.

My mom spends her nights pacing and talking on the phone to my sister. My sister cries a lot and updates her Facebook status with detailed play-by-plays of my dad’s medical issues. My mom updates her Facebook status with loving endorsements of my sister’s updates. I let my feelings out at my shrink’s office and I update my Facebook status with cat memes and discussions of HBO’s Girls.

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 ot 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, my mom is under severe stress, and my sister is absorbing every ounce of it like the “good daughter” that she plays in this. I would like to help in any way that I can. However, I cannot be in New Jersey every day, and cannot suffer in place of my mother.

What I do have to offer is my ability to accept major adversity with genuine equanimity.

Having gone from vibrant at 35 to halfway dead at 36, having had to confront the possibility of leaving my tiny children motherless, having shown up for chemo only to be told to go home because I was too anemic, having had to spend a week in an isolation tank because the chemo destroyed my immune system, having had to accept menopause at 36 — how could I help but cultivate some level of distance between what I experience and how I react to it?

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 that I expect that there will be bad days and good days, in no particular order. It means that I accept that my family is now swept up into a new 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. Therefore, I choose to accept it.

I’d like to say that I would recommend this approach to anyone dealing with adversity. But the truth is, it angers my family, and my unwillingness to engage with them isolates me, even as it protects me. If I could teach my family to create a distance between their experience and how they react to it, I would. They wouldn’t hurt any less. But I know they would not suffer to the extent that they do.

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