Tag Archives: cancer

Death by Death

“Thirty years ago my older brother, who was ten years old at the time, was trying to get a report on birds written that he’d had three months to write. It was due the next day. We were out at our family cabin in Bolinas, and he was at the kitchen table close to tears, surrounded by binder paper and pencils and unopened books on birds, immobilized by the hugeness of the task ahead. Then my father sat down beside him, put his arm around my brother’s shoulder, and said, ‘Bird by bird, buddy. Just take it bird by bird.'”  Anne Lamott, “Bird by Bird.”

Book thief quote

I have struggled to write this post for months.  And then, I just decided to take it “bird by bird.”  Still, it has taken me weeks to post it.  No, it still isn’t perfect.  But, in the spirit of being a “good enoughist,”  I pushed the button today.

 A dear friend’s husband died last April from lung cancer (he never smoked); he was 43. This is not supposed to happen and an uneasy chill entered my soul. I felt powerless and incensed:  what is God thinking?  Then, not long after, three dear friends of my husband died in rapid succession, leaving behind a bereaved spouse. As we left the last memorial service, I briefly decided (in a very self-absorbed way) that God might be putting me through “widow” school. I mean, my husband is significantly older than I am and maybe I needed to be ready for the next stage of my life – when he shuffles off this mortal coil.  Who in their right mind thinks this way?  I did manage to recover from this moment of temporary insanity after remembering that not everything that happens is all about me.

I found the unfathomable grief deafening.  And terrifying. I hugged everybody and murmured worthless words that I desperately wished were comforting. But I felt powerless and STUPID. I had no idea how these graceful widows actually felt.  NO CLUE.  I could sense the sorrow, but I could not feel it with them.  I was an outsider – but I really didn’t want to be an insider, despite my clumsy ineptitude.

 For death, as Hamlet notes, is the “undiscover’d country from whose bourn no traveller returns.”  Although, Hamlet cannot possibly be right, as his dead father paid him a visit only a few scenes before he uttered these words.  Of course, Hamlet was not in his right mind.  I relate to Hamlet a lot.

 There was a lot of death last spring and summer.

 And then, the unthinkable happened.  My dear friend Nancy was diagnosed with incurable cancer.  Nancy: the definition of what it means to be alive.  She was whole-hearted, full of zest, passion and love.

And despite the word incurable, I was certain Nancy’s cancer could be cured.  We just needed to find the right remedy, the right doctor, the right hospital.  I researched treatment options for her cancer like a woman possessed and efficiently put together a binder with tabs and places to record symptoms and medicines and tests and infusions and never-ending visits to doctors. I accompanied her to meet with docs to get a second opinion.  I kept very busy looking for solutions.

 Because Nancy could not die.   Who in their right mind thinks this way?

And despite my will for her to live, Nancy, the soul I loved and cherished, began to leave her life here on this earth.  Slowly, steadily, gracefully: on her own terms.  Even though I didn’t want her to leave – not just yet.  Well, I never wanted her to leave.

This is because I still didn’t (and probably still don’t) have a handle on this death being part of life thing.  There is this tenacious piece of my soul that refuses to accept that we cannot be with those we love forever and ever.  I understand that suffering is part of life – but death?  Who in their right mind thinks like this?

 Nancy knew this about me.  So, she kindly and gently helped me understand that she would die.  Despite my “valiant” efforts to help her get cured.  I drove her to chemo whenever I could.  I meditated and prayed daily, imagining her surrounded by healing blue light, as the therapeutic poison dripped into her veins.  When I arrived at her door after being away for three weeks, Nancy no longer could walk on her own and she was breathless even when lying down.  Her energy, which always had seemed boundless, had been stolen from her.  She appeared to be looking off in the distance most of the time and it was difficult for her to talk.  I think part of me knew that Nancy had begun to disembark from this world and she was seeking her way to the next.  But my heart refused to acknowledge it.

So, I was the friend she asked to come to the “end of life” discussion.  I think she knew I needed to hear the devastating news directly.  Frankly, it never dawned on me, as I drove Nancy and her daughter over to the hospital for what I thought was the next round of chemo, that there would be no more life saving efforts.  I saw that Nancy seemed even more depleted and made a note to ask the doctor for a blood transfusion, because I was sure her hemoglobin was too low.  I chatted away like we were going out to lunch.

 With my notebook and pen in hand, sitting next to Nancy in her wheelchair, furiously taking notes as the oncologist, in a detached voice, talked about the failed chemo and continuing tumor growth, I asked, “ok, what’s next?”  But nothing was next.  Well, no cure was next.  And no, there was no need for a blood transfusion.  I was filled with dread and my heart began to hurt, like someone was beating me on the chest.

 As the doctor left the room to get the papers to “release Nancy to hospice care,” I just kept writing furiously, vowing to stay in my head, ignore my breaking heart and silently prayed for a medical miracle despite this damned, seemingly indifferent doctor.  Nancy’s daughter had been softly crying and quietly apologized.  The room was so quiet, except for the sound of my pen scratching senselessly across the pages of my notebook. And then, Nancy said, “Allison, don’t apologize.  Your crying is perfectly normal.  Of course you’re upset.  I’m the weird one. I’m so detached.”

And with that, despite my heartache, I laughed – as did Nancy – as we had laughed together so many times before when sharing the sorrows and joys of our lives. Allison’s tears were soon mixed with laughter (Nancy’s laugh was one of the most infectious on the planet). I said, “Thanks for sharing that.  I am so glad you noticed your detachment. I thought it was just me.”

It was at that moment, I got it.  She was getting ready to depart – and looking towards her next life, in “the undiscover’d country.”  How like Nancy to help me see what I did not want to see.

For years, Nancy and I had talked as only good friends do as we “fast-walked” the Chicago lakefront path, often meeting before dawn to fit the walk into our hectic schedules.  But now, Nancy embarked on a journey that only she could take, with her family and friends at her side, but yet, alone, all by herself.

 I hated that she was alone.

 Nancy was the friend in the past 10 years that often helped me whenever I felt most alone.  She listened, supported and laughed, no matter what. Despite my relocation 1300 miles away, we i-chatted most days.  Often, she greeted me as soon as I opened my laptop in the morning.

I hated that Nancy was leaving.

Like Mary Magdalene, who clung to the earthly Jesus, I wanted to hold onto Nancy.  She knew this about me.  And even as she suffered through the final stages of cancer, she tried to help me let her go.  Slowly and lovingly.

I last saw Nancy and hugged her a few days before Christmas.  She died 3 weeks later.  On her terms.  And I grieve.  Every day.

 I realized at Nancy’s memorial service how much trouble I was having letting her go, despite her work to help me in my stubborn quest to keep her immortal. I fled the service quickly, consumed by grief, and I continue to struggle with the swiftness of her death (barely 6 months after diagnosis).  I watched cancer, that evil beast of a disease, ravage her body, once the epitome of strength and endurance. My yoga teacher, my shiatsu specialist, the woman who did 100 things a day could no longer sit up for more than a few minutes without being out of breath. But cancer never took away her wisdom, her beauty, her sense of humor, her love, her kindness, her empathy.  So selfishly, I wanted her to stay.  Despite her suffering.  Some friend.  Who in their right mind thinks this way?

 I know I must help clear the path for Nancy’s spirit to “move on” – these are the instructions I remember from the memorial service.  And I panic every once in awhile that I am hurting her by not clearing the path properly.  I’m not experienced in this death business.  Honestly?  I hate leaving places once I am having a good time.  Nancy and I used to joke and laugh about this difference between us – we would be out at a gathering or watching our boys play baseball together, and I would linger at the end, hugging everyone goodbye (sometimes twice).  And I would look to hug Nancy goodbye and she was long gone…she always said she knew when it was time to leave and that drawn-out goodbyes were not her style.  Clearly.

A dear friend, and widow, who despite her own grief, has gently reminded me that the souls that leave earth still visit us.  And though I sometimes claim to be an unbeliever in the spirit life (like Hamlet), most of me believes that we are watched over by those that have gone before us.  And so, every morning at my workout, when I clasp my hands together in a yoga pose and gaze over my left shoulder, I say softly, “good morning, Nancy.”  And sometimes her laugh enters my ears and I see her briefly smiling before me, surrounded by blue, healing light.

 And every day, I work to sweep the path for her, always wondering if I will get any better at this, death by death.

nancy  Continue reading

The Silver Lining: An Insightful & Supportive Guide to Breast Cancer, By Hollye Jacobs, RN, MS, MSW

Silver LIning Cover

“Cancer.” Loathsome and foul.  Relentless. The treatment is brutal.  My most immediate experiences with Cancer have been as an outsider: daughter, sister, friend of patient.  Over the years, I’ve read everything I could get my hands on about breast, colon and liver cancers*, stumbling through complex medical jargon.

And I searched high and low for something resembling a handbook that addressed, in “people-speak,” a patient’s day-to-day realities of dealing with “Cancer.”  My search has ended, thanks to Hollye Jacobs, an RN, licensed clinical social worker and  palliative care provider, who was diagnosed with Breast Cancer at the age of 39.  Hollye has published an insightful, compassionate, practical, graceful, honest, and humorous guide to dealing with breast cancer titled:  The Silver Lining.

The book is drawn, in part, from Hollye’s blog,  The Silver Pen which, like her book, looks to serve as a guide and inspiration to “navigating the realities of cancer.” The chapters center around Jacobs’ own life journey with cancer (she writes a heartfelt explanation of why she does not personally view cancer as a battle) and each includes a memoir portion, a section on “practical matters” (key clinical details about managing the patient experience), and some silver linings.

hollye jacobs 2 holly jacobs

Hollye’s narrative is accompanied by beautiful, uplifting and elegant photographs taken by her friend and gifted professional photographer, Elizabeth Messina, whose words in the introduction resonated with me:

“The day that Hollye told me that she had breast cancer, I felt haunted with helplessness. I wanted to hug her, to bring her flowers.  I wanted to do something, but nothing seemed quite right.  I did not want to burden her with my fear and sadness.  I also knew that I could not eliminate the intensity of the path that lay in front of her.”

I’ve felt this way – with my mom, sister, dad, and my dear friend, Nancy – after they were diagnosed with Cancer and during their treatment and recovery.  You do what you know how to do to help them, and it never ever seems quite right. Messina offered to take photographs to help Jacobs record the journey. The photos were initially intended as a personal gift of love.  The two of them only began to envision the book a year after Hollye’s diagnosis.  An inspiring collaboration of healing and friendship.

silverliningphoto

Jacobs’ guide in the early pages of the book of  what to do when facing a cancer diagnosis is invaluable, in my own experience, as there is a mental fog that envelops patients and families during these initial weeks.  She offers  a primer on medical tests and types of breast cancer/staging,  a list of coping mechanisms for needle phobias, questions to ask during tests and questions to ask at the time of diagnosis. And that’s just Chapter 1.

The subsequent chapters cover:

  1. communicating with children about your cancer diagnosis,
  2. navigating the surgical experience (Jacobs had a double mastectomy),
  3. and the unique experiences of chemotherapy and radiation.

Her humor is ever present (the chemotherapy chapter is titled “Chemo Sobby”) and she doesn’t sugarcoat the side effects of treatment, reporting that she had all listed side effects except seizures, with details on vomiting, pernicious diarrhea, mouth sores, and constipation.  Jacobs offers practical advice as to how to deal with these and other treatment side effects and, in her eternal optimism, views them as a “silver lining” as she is able to write about her experience with them and offer guidance to others as to how to navigate them.  Her chapter on the emotional impact of cancer treatment is also a must-read for cancer patients and families.

The final chapters of The Silver Lining include a list of comprehensive resources and address the ebb and flow of recovery once treatment ends and what life after cancer looks like. I think Jacobs’ focus on her marriage and working her way back to intimacy with her HOTY (Husband of the Year) make for compelling  and inspiring reading.

I love the “Lifelines” set in the margins of each chapter in The Silver Lining. These brief notes offer worthwhile, thoughtful and practical advice or encouragement:

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Many of these “Lifelines,” and much of Jacobs’ practical advice about chemo and radiation, could be applicable to other forms of cancer as well, despite the books focus on breast cancer.

I follow Hollye’s blog and I was thrilled to win an advanced copy of the book from the publisher (Atria Books) in a giveaway on Goodreads.  But, honestly?  Before reading it, I was pretty skeptical about the “silver linings” bit.  I’ve witnessed Cancer from a variety of angles and I struggled with the idea that there are any silver linings to be found in the living with  all that comes with it.  Here are some of Jacobs’ personal silver linings:

  • seeing a hummingbird outside her window when she was wretchedly ill from chemotherapy
  • vile tasting medicine managed pain
  • feeling isolated from the world helped her tap into her “inner resources”

To me, these “silver linings” made sense – they  gave Jacobs a focal point (and some days she had to look really hard to find the silver lining) and helped her endure a painful, rotten Herculean journey. Jacobs is no Pollyanna – she is emphatic in stating that CANCER IS NOT A GIFT.  But she writes that she had two choices about how to handle her diagnosis:  from a place of fear or a place of optimism.  I admire her courage and her resilience.

This is a practical and hopeful book for anyone with breast cancer, especially those in the initial stages of diagnosis, undergoing treatment or in the early days of post-treatment. There isn’t much specific information for those faced with a recurrence of breast cancer (and I pray Jacobs never has to walk that path), but I do think there is a great deal of supportive material in the book for patients who experience recurrence, especially in her chapter on “Sustenance & Soulfulness,” which describes nutritional and complementary therapies to help with cancer treatment.

The-Silver-Lining-Maureen-Abood-1024x768My personal “silver lining” or “lifeline” in the book was the section for friends and family, Being With, where Jacobs compassionately sets forth the “practical ways TO BE:

  •  PRESENT
  • PATIENT
  • CALM
  • A GOOD LISTENER
  • HONEST & COMMUNICATIVE
  • NORMAL
  • PERSISTENT….and
  • DON’T TAKE THINGS PERSONALLY!  

No, not all of us are wired to look for “silver linings” in hard times and individual personalities have to find their own coping mechanisms for dealing with Cancer. Nonetheless, even for those with different approaches, The Silver Lining offers practical, insightful “lifelines” for people impacted by Cancer.

silver lining door

*A great book that discusses Cancer  from a medical/scientific/historical perspective is The Emperor of all Maladies: A Biography of Cancer, by Siddhartha Mukherjee.  Accessible to the non-scientist, it lays out how society has dealt with Cancer through the ages.  Fascinating read.

 -Karen  DSC02405