Post Book Essays Archive

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June 2007 Post Book Essays

"On Grief and Healing" ­ Wednesday, June 20, 2007
"Good Grief, Gracie! An Update on Our Puppy" - Tuesday, June 19, 2007
"On Fathers" - June 17, 2007
"Whassup Since the Book? Part III Emotional and Spiritual Life" - June 15, 2007
"Whassup Since the Book? Part II My Family Life" - June 14, 2007
"Whassup Since the Book? The Physical Side" - Wednesday, June 13, 2007
"'Tis Also Blessed to Receive" - Monday, June 11, 2007


"On Grief and Healing" ­ Wednesday, June 20, 2007

In my extended family, we are blessed by a multitude of styles and cultural backgrounds. We have a few "stiff-upper-lip" types from hardy Northern European stock, mostly English and German. This is my natural emotional adaptation, although I've been cracked open more in recent years. The English part of my family says in my head, "Oh, we don't do strong feelings. Perhaps in the loo, a little boo-hoo with the water running." The German part of my family says in my head, "Ve don't do emotion at all. Vell, maybe rage, but that's it, and only the men."

We also have elements of the family that offer balance to the more reserved among us. My husband Steve and his daughter Laura clearly offer the emotion and outspokenness that often characterize Greek families. Steve was adopted at nearly five years old and doesn't know much about his heritage, except what his father told him, and that included the fact that he was Greek. If you look at him, there's no doubt that he's from that part of the world. You could picture him in one of those rough-knit sweaters and a cap, plying nets as a fisherman in some azure-edged Greek isle. When we saw "My Big Fat Greek Wedding," we all laughed to see how instinctively Greek the interaction in the family often was.

Among this rich treasure of sons, daughters, spouses, in-laws, and outlaws (including an amazing array of amicable former-spouses) is the red-hot chili-pepper portion of the family: Mina, our loving and passionate Puerto Rican. She is the mother of my daughter-in-law, Jennifer, my grandmotherly counterpart in that arm of the Hampton clan.

Mina is an amazing woman. She is energetic and creative. She holds herself to a high level of integrity. She is pure magic with pre-schoolers, whom she taught for years. And, most recently, she was a devoted and capable nurse to her mother, Antonia, who died of breast cancer several weeks ago.

From Thanksgiving or so until her mother's death, Mina tended her mom with tenderness, competence, and utter devotion. She took family medical leave to do this, not hesitating for a moment to step into what, for her, was unquestionably a filial duty and privilege. This was not an easy commitment. She was tied to home for months to manage not only the effects of her mother's treatment but to juggle her mom's diabetes. Hospice was a great support and help, but Mina did the heart of the nursing, day in and day out. To my mind, she deserves a nursing cap and graduate pin. My daughter-in-law Jennifer told her mother in awe and admiration, "Mom, you've set the bar high for me."

When Antonia's death was imminent, Mina really struggled with the full realization and weight of the coming parting from her mother. She was cut ragged by the pain of it, but continued with Antonia's care. When Antonia passed, with Mina by her side, Mina kicked into high gear to arrange a beautiful memorial service, to prepare her mother's body (as we do in our faith), to make sure that family coming in from all over were housed and fed -- all the offices we do when death comes, the tasks that blessedly structure time and occupy our minds in those first days of searing grief. Many of us stay emotionally in that detached place after the funeral, grateful for the distance those acts have given us from the maw of grief.

Mina taught me something powerful at her mother's graveside. We gathered at the cemetery at the end of a long and sweet day of celebrating Antonia's life, during which time Mina had presided with eloquence and serenity.

It was a hot, sunny day. The grass was crunchy under our feet from the recent lack of rain. The grave yawned open and expectant, the red Tennessee soil piled up next to it. Antonia's casket was carried by the men and friends of the family to the edge of the grave. Prayers were once again said. The casket was lowered into the ground. And then a cry cut the air.

Mina gave way fully to her grief. She offered a grief as raw and real as I have ever seen. Frankly, I was a bit taken aback at first. When Mina collapsed under the full weight of her loss, it was an act of total abandon and trust. What it said to me was, "I'm going down into this abyss of pain and sadness and I'm trusting that someone is climbing down here to get me." And they did. She was tended to and loved and comforted by family and friends. No one tried to shut her up. She was consoled as a child is consoled.

Antonia had asked that each of her children turn two spadesful of earth onto her casket. At this point in the day, this was almost impossible for Mina physically and emotionally to do but, believe me, she wasn't going to go back on this promise to her mother. Her brothers stepped up first and that drumbeat of the dry clods of earth hitting the casket was the only sound. Then came Mina's turn. My sweet Jen stepped up next to her mother, holding her up. Jen's feet and dressy sandals sank fully into the soil and, completely unmindful of it, Jennifer helped her mama shovel the dirt and scatter it over Antonia's coffin.

After that, it was as though a collective large sigh was sighed. Mina breathed. We all finally breathed.

As I drove away from the cemetery and as I've recalled this potent scene I had the honor to be part of, I'm struck by how connecting fully to emotion opened the door for real healing for Mina. Steve often says of feelings, "It's pay me now or pay me later." So many of us are taught to sit on our feelings or to hide them, even from ourselves. They're just too messy. Well, Mina's were big and open and honest and, yes, messy.

Shakespeare talks in "Hamlet" about "the bravery of grief" Mina showed us a brave grief, a grief that was a gift to all of us who had the opportunity to love her and shore her up on the day she buried her mother.
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"Good Grief, Gracie! An Update on Our Puppy" - Tuesday, June 19, 2007

I wrote about our new English Springer Spaniel puppy, Gracie, back in March. She was a dear little 12 lb. cuddly, irresistible thing, with velvety soft fur and that delicious puppy breath smell that is to me a combination of newsprint and milk. She had a cute habit of wanting to crawl up behind us on the couch and drape herself around our shoulders, like a little fox stole, laying her cheek next to ours.

Well, it's three months later. We still love her, thank God, because we have ADHD-Dog! She's now 35 lbs. and still wants to get up behind us on the couch to drape her considerably heavier and larger self around us. We're trying to break that habit with serious effort (disregard my smile). She is a beautiful dog, with a wavy black cloak, white leggings, a black and white face with black whiskers on one side and white on the other. She has black blotches on her toes that look like she stepped into paint. She has two little perfect black spots on the back of her throat, completing that Springer dapple, through and through.

She does exhibit the nurse-dog proclivities we had enjoyed with her beloved predecessor, Lizzy. She's very sensitive to our emotional tenor and intuitive about when one of us is not feeling well. She wants to be close. As in very close. As in crawling into our pockets, if she could. These past few weeks, she's had to adjust to a newborn in the household. She's beginning to learn not to become so fretful about the baby's cries.

She has not been the easiest dog to housebreak. She is easily distracted by anything and everything. She notices airplanes overhead, the arrival of a little breath of breeze, a moth fifty feet away, the fact that the neighbors have a new porch light and it is on. All of this can take her from attention from what we are hoping is literally the "business" at hand. We're making headway, with fewer mistakes inside, but this has not been an easy road. She's mastered contrition, but does not always connect it to the event that provoked our displeasure, not matter how we show her. Her mind is already on the next adventure. For a while, we worried that she might think her name was "Dammit, dog!"

She does amuse us daily with her energy and her puppy antics. She continues to be a chewer and nibbler. To her everything is a toy. This morning she had gathered my entire forearm into her mouth as I was trying to read the newspaper. I looked at her sternly and corrected her, "No bite!" She looked me right in the eye, still holding onto me, with her pink tongue savoring my wrist, as though to say, "Who me? I don't know what you're talking about! I wasn't even there!"

She loves her puppy toys and rawhide chewies. Like a toddler, she hates the notion of "opportunity cost," in which she has to let one thing go in order to choose another. She has developed a technique in which she can manage to keep one toy in her mouth and successfully pick up and carry around a second toy. She can even roll a ball while carrying a stuffed animal and then take the ball in her mouth, too. We call her "Circus Dog" when she does that act.

She needs lots of exercise. Springers are very energetic. At least twice a day, she goes into a running frenzy we call her "mad dog" routine. She runs absolutely flat out, as fast as she can, wherever she is. If it's outside, she makes big figure eights, running to the end of her long tether and swinging out on the arc of centrifugal force, with paws barely touching the ground as she makes the turn. If she's inside, she runs from room to room, leaving bunched up oriental rugs and area rugs in her wake, caroming off the sofa and skidding along the hardwood floors.

She was spayed last week. Let me remind you that this is a full abdominal hysterectomy. I remember my own and while I'm tough, I was certainly shuffling around slowly and wincing for days. When we picked Gracie up, the vet rather sheepishly said to us, "Try to keep her quiet for 7 to 10 days." We looked at her in disbelief. "We'll be lucky to do 7 to 10 hours." We took Gracie home, all dopey and subdued from the anesthesia and thought, "Hmmm, just a little IV Telazol every day, maybe" She didn't eat or drink all evening. I was awake at 3 a.m., feeding her Saltines and inducing her to drink so that I could finally give her something for pain. I was certain she must be in agony. Four hours later, she bounded out of her crate and leapt the four feet off the floor, straight onto our bed. So much for a "quiet" recovery period. It's been all downhill from there and, miraculously, she's healing fine.

So, she is our bane and blessing. She is delight and destruction. She is a great companion and a little pain in the neck. We love her. What can we say?

She'll probably put on another 10 to 15 pounds in the next few months. That's a lot of unbridled energy and half-disciplined dog. It's off to puppy school next week for you, Miss Gracie Painty-paws Hampton!

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"On Fathers" - June 17, 2007

Today is Father's Day. I bought the cards, one for Steve, one for his son Chris, and one for each of our two sons-in-law, Rodney and Ron. The Hallmark section I selected from didn't have any sub-section for sons-in-law, so I bought two more "son" cards. It seemed fitting anyway, as these two men who married our daughters are cherished and have a huge role in our lives as husbands and those who raise our grandchildren. They are our other sons.

At our worship service this morning, the theme, obviously, was fathers. Since we do not have clergy in my faith, we all have the opportunity to be readers, sharing the sacred writings each weekend from the holy books of the world's religions. This morning, as we were about two thirds through our worship service, one young woman got up to read the selection assigned to her. She began to weep as she read the words, "The father must always endeavor to educate his son and to acquaint him with the heavenly teachings. He must give advice and exhort him at all times, teach him praiseworthy conduct and character." She returned to her seat next to me and I put my hand on her shoulder. Silent tears continued to slide down her cheeks throughout the rest of the service.

This morning, our choir (in which she sings alto) sang a spiritual invocation that begins, "Here am I, here am I, O Lord, my God." She sang those words and I could see her heart laid bare to God and to the father she doesn't see, who lives out of town and has remarried and is deeply involved with his new family. I could feel her longing across the room. "Here I am, Daddy. Why don't you look at me? Take my hand. Help me."

When we asked for individual prayer requests, as we do each week, for healing, assistance, protection, gratitude and for the departed, a sea of hands raised. Fathers' and grandfathers' names were raised up. There were many prayers of gratitude from those gathered, but also some pleas for forgiveness for the ways in which their fathers had failed them or wounded them.

The feeling in the worship hall shifted palpably and powerfully, and a blanket of intimacy and oneness fell over all of us. I looked out over the faces of these beloved friends. I know some of their stories., their heartbreaking stories. Some of the ways in which their fathers failed in their sacred duty are nothing short of horrifying. Others suffered emotional abuse. Some were victims of one of the cruelest things: just a disinterested kind of neglect. There are a fair number who, like so many children after a divorce, are estranged from their own fathers whose lives have turned a corner with a new family, here or in another town. Some of these friends know my own story of my father, who could be a such nasty alcoholic with a hateful tongue, or could be the who woke me in the middle of the night and bundled me up in layers of wool to take me outside to see some magical thing happening in the star-strewn night sky.

I felt like a witness to these lives and to the longing for a father, a loving father, which is surely one of the most fundamental of human emotions. It's the earthly counterpart of our longing for connection with God. This is a longing that is as transparent as the undisguised joy of my granddaughter when her father returns home from work each day, "Daddy!" she greets him with naked delight, running to his open arms. This is a longing as fresh and unfulfilled as the sixty year old longing of a boy who had no voice to protest or protect himself from the most powerful figure in his little life who hurt him irreparably.

I looked out over the faces of my family members, my sons and my husband, brought to me by blood, by legal bond, by destiny, and I felt so blessed by their kindliness and their commitment to their families and to the responsibility to raise their children.

The duty of fathers is holy and solemn. Honor thy father and thy mother is one command. Fathers are also told, "provoke not your children to wrath, but bring them up in the nurture and admonition of the Lord." That takes character and courage.

We closed our worship service this morning with a prayer for the souls of our fathers, for God's grace and forgiveness to them. We also asked help for each of us to live a right life, to walk in the pathway of God's love, a path our fathers might have led us to or might have wanted to lead us to but didn't know how or were themselves too broken to set their own feet on that road. There were tears and talk and embracing as we walked out together to celebrate our fathers this day.

Be a loving father and lift up those who didn't have that person in their life. Honor and encourage fathers.


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"Whassup Since the Book? Part III Emotional and Spiritual Life" - June 15, 2007

Since the completion of Slapped Awake, I'm mostly in a good place emotionally and spiritually. I do have those occasional bolt-upright moments in the night when a fierce fear grabs my heart and my gut, shoving the air right out of me, but I just breathe, breathe, breathe and remind myself that all will be well. I can almost always get back to the calm place. I'm really taking care of myself with my great therapy group for women with advanced breast cancer. I also use Reiki, massage, and do Tai Chi classes. I do the things I love with whatever energy I have to put toward them. I sing in our small choir at my local Baha'i Center. Steve and I still occasionally sing together beyond our living room. I read a lot. Any extra few dollars left over I often put toward supporting other poets by buying their books. I'm the nap connoisseur, enjoying all the permutations of naps. There's the Sunday afternoon nap on the couch, with tennis on the TV and the Sunday paper scattered at my feet. There's the twenty-minute nap before going somewhere, fresh from a shower between the sheets in my lingerie, with the ceiling fan on. There's the facedown serious nap (at least an hour), with the phone off the hook and shoved in the bedside stand's drawer, back in pajamas in the middle of the day. Oh, I could go on and on!

As I continue to face the need for active treatment on a pretty constant basis, I find my fighting spirit up more right now than in several years. I think that having the outlet of my writing and the many gifts that it has brought to me has infused me with extra determination. I have two more book projects in the works: a collection of essays (probably largely drawn from these blogs) and a biography of a businessman I admire who has had an amazing life. I keep looking outward and forward, with an expectation of a future.

I think that contentment is truly the theme of my life right now. In my faith tradition, our sacred writings talk about "contentment with whatever God's will has decreed." I've pondered that most of my life. Not just acceptance, but contentment. That may sound like some high-flown, impossible spiritual notion, but I'm actually experiencing it many, many days. It's wonderful.

I've tried to teach my children and grandchildren that life is not about pursuing happiness, despite what the Declaration of Independence says in this country in which we are so privileged to live. Happiness is not some goal unto itself, to my mind, but contentment perhaps is. I believe passionately that everyone has a right to the pursuit of contentment. Let's face it: life is just plain hard. We could help ourselves and each other by getting accustomed to that reality. We would treat each other a lot more tenderly if we remembered that everybody we meet has their own wounds. We don't know what others are facing. The world might be a lot different if we could give each other the benefit of the doubt.

As for the idea of happiness and the pervasive belief that it's a destination, I think we need to understand that happiness comes and happiness goes, like crests of a wave in a sea full of peaks and troughs. We have to learn to ride it all out. We even have to acknowledge the sometimes life includes becalmed days in the doldrums when nothing seems to be happening except drifting in place. So row!

I looked up the origins of the word contentment and see that it has its roots in the Latin for "to contain." Perhaps the secret is to be able to contain what has happened to us. When I can do that, I don't feel struggle or anxiety. When I don't feel struggle or anxiety, I can look outside myself and notice beauty and love and generosity and kindliness. When I do that, sometimes I feel deeply happy, but that happiness has its foundation in contentment. When the happiness ebbs, the contentment is still there.

I can hold all that has happened in my life in both hands and just sit with it and let it be enough.

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"Whassup Since the Book? Part II My Family Life" - June 14, 2007

Since those of you who read Slapped Awake stepped fully into my life and now know me and my family, I wanted to finish answering yesterday's question: "So, what's happened in your life since you finished the book?"

I find that for me and for so many of us who are dealing with cancer long-term, it's easy to answer the question first (and sometimes exclusively and reflexively) in terms of disease status and current treatments. But, what's the point of all this if it isn't to have a life and for something redeeming to emerge from the suffering and difficulty? So, here's what's been happening to me with the family since the last pages of Slapped Awake.

First of all, my motto is "Don't postpone." If there's something I want to do or somebody I want to see or a place I have a chance to go, I'm on my way, now! We've done some wonderful travel since I finished the book, back twice to our beloved Gulf Shores, Alabama and on one big trip to Salt Spring Island, British Columbia. We needed to hurry up and use frequent flier miles we racked up going back and forth to San Antonio for my clinical trial. We thought, "What's the farthest flung place from Chattanooga in the continental US that we can go for free?" Seattle! Then our dear friends, Kim and Julian, who have a house across the border in BC, encouraged us to go there. Salt Spring is part of the Southern Gulf Islands, the Canadian counterpart of our San Juan Islands. Two lovely ferry rides from Seattle and you disembark on Salt Spring, a sleepy little island in terms of pace, but a rich island in artists and artisans. It also has the most spectacular temperate geographic beauty I've ever seen. Our friends offered us their house for as long as we could stay, and we really relaxed and recuperated without any schedules to follow. We marked time by when the ferries passed and left our watches in our suitcases. I'm posting a photo of me kicking back, overlooking Fulford Harbour.

Steve and I are strong as a couple, weathering the changes that aging is beginning to bring to both of us and savoring what sometimes feels like stolen time, given the poor prognosis I was facing just two years and a half years ago. He continues to be my best friend and chief supporter. One happy and unexpected side benefit of the book has been hearing readers say how they came to know and love him through the story of my own journey. We're looking toward our tenth wedding anniversary in February of 2008.

During this time, I've also really tried to connect with family. My brother and sister-in-law made a long overdue trip from Maryland to see us. It was the most time I had spent just with him since I was 18 and he was 13. Last spring, I drove four hours to meet my half-sister and her family in Asheville, North Carolina. It turned out to be my last visit with my brother-in-law, who passed suddenly two weeks ago. Recently, after 30 years, I had a happy reunion in Virginia with most of my first cousins from my mother's side. I find that these ties are dearer and dearer to me as I age. Cancer ramps up the sweetness and urgency even more.

When I typed the last words of Slapped Awake, I had six grandchildren. As of last Wednesday, June 6, I now have nine. Jen and Chris have had two more precious little boys, and my daughter, Hollin, gave birth last week to a new daughter, Lindi Faith. The children and grandchildren are the "clocks" in the family for me, as I watch their own lives unfold. When I held little Lindi for the first time last week, I was just overwhelmed by all the possibility that is embodied in a newborn. As I held her and looked over at her proud big sister, Naomi (who turned four on that very day), and as I think of my oldest granddaughter, Jesse (nearly 17), I pray that these girls, whom I love to distraction, won't ever have to worry about breast cancer.

I pray that this disease will soon have passed into the annals of medical history, like smallpox.

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"Whassup Since the Book? The Physical Side" - Wednesday, June 13, 2007

One of the pleasures of sharing my own journey through my writing is that I hear from readers. Sometimes this journey feels lonely, but then I get emails and letters from folks who tell me their own stories or respond to mine. It's like I'm trudging up some impossible hill, believing that I'm alone, but then I look over my shoulder and see battalions behind me, moving up quickly to walk with me. I'm so grateful.

One reader encouraged me by saying that these blog entries are like a continuation of the book. If that's so, I'd also be curious as a reader to know what came next. "So, what's happening now?" is a frequent question I get from readers.

Since finishing the book, I've been on several chemo agents for recurrences. At this point in my illness, I haven't had a full remission for several years. I'm very happy with partial remissions. We're able to push the cancer back, even if we can't completely eliminate it. For one thing, it gives me a brief break from treatment. For another, it's reassuring to know that we're still able to corral it and it's not yet stampeding over me.

Since I finished the book, I've had recurrences or progression of the cancer in my liver, my chest wall, and in lymph nodes under the breastbone. The liver lesions (three at last count) are not large and my liver function tests are still normal. They have slowly grown in size but, as a doctor recently told me, my tumor "bulk" overall is comparatively small. Good news, since my 'junk in the trunk' load has sure gone up!

To the smorgasbord of drugs I've been on over the course of this little adventure we've added Faslodex and Navelbine, which I took for about three months last spring and early summer. Nearly all my response to chemo now is a mixed bag, obliterating tumors in some areas and producing no response in others. I now have sub-groups of tumors with different characteristics. The Navelbine kicked my patootie, and when I was feeling down-in-the-bed lousy about 25 days out of 30, I told my doctor that this quality of life tradeoff wasn't acceptable and we needed to do something else. For the record and so that any of you who are facing Navelbine are not scared off, I have a good friend who took it for a year, with good results. She tolerated it so well, I remember asking her in the chemo room one day when she and her husband were leaving on a trip to Paris. "Tonight!" she answered happily, as the nurse hung her IV Navelbine. Response and side effects are so highly individual.

We played a waiting game for a while when I was off the Navelbine, giving me some time to regain physical strength and to have a life for a few months. My doctor watched my tumor markers and my physical symptoms and, when I began needing narcotics for chest wall pain and my tumor markers were at a level of concern in late 2006, I started back on Xeloda.

Xeloda had worked for me before, but had just blasted me. I was nervous going back on it, waiting for the torrent of side effects I had experienced before, but the doctor put me back on at half the dose I had taken last time. We watched my side effects, especially the "hand-foot syndrome" that is often part of Xeloda and produces fiery red hands and feet and sometimes blistering and peeling. When I began to get the redness and peeling, we backed the dose down a little. I've got some leeway myself to move it up or down by 500 mg. according to my side effects. I love this doctor! You have to give good old Dr. J. some real credit for respecting my own experience, too, and collaborating with me so fully on this. We keep in close touch about this, obviously, and he's seeing me regularly.

We're trying to add Tykerb, the drug I was on in San Antonio in a Phase I clinical trial back in 2004. The studies show it really helps Xeloda work better. Getting it has been a challenge, especially now that I'm on Medicare (because of being on disability). Believe me, that's a whole other blog, an op-ed piece, a blistering letter to my elected officials, and a communiqué with the National Breast Cancer Coalition Don't get me started!

So, how do I feel? My physical energy is kind of low, a by-product of long-term chemo and also not getting enough exercise, I'm sure. I currently need the addition of Tykerb or another whole chemo regimen because I continue to have chest wall pain, a string of positive lymph nodes cooking under the breastbone and, oh, yeah, that liver thing. I'm taking Lyrica to help manage the zingy, burning nerve pain in my chest wall. Do you remember as kids giving each other what, in politically incorrect times, we called "Indian rope burns"? You grasp another person's wrist in both your hands and twist the skin in opposite directions, dropping him to his knees with a searing pain. That's the kind of pain I'm having. It scintillates all along the nerves, sending off little bottle rockets of pain. The Lyrica is helping a whole lot. Thank goodness, there's also Percoset when I need it occasionally.

Last month, I went to Atlanta for a consultation with a radiation oncologist who uses a "cyberknife" to deliver radiation to hard-to-get-at places, hoping that perhaps he could use this technology on the nodes in my chest. I really appreciated the time he spent with us. Since he's in such a specialized area of radiation oncology, I went in wondering if the old maxim about carpenters would apply: when you're a carpenter wielding a hammer, everything starts to look like a nail. He was the exact opposite. He really looked at me, not just at my films and PET/ CT results. He said that since I had been irradiated twice before and the skin on my chest is basically shot, he would worry about skin side effects if he used the cyberknife to treat the positive lymph nodes. He said, "You're relatively strong right now and, given the stage of your disease, you've got a pretty decent quality of life, from what you've described. If I treated the lymph nodes, you might end up with some radiation burns on your chest. Your blood supply is poor to that area now and you might need skin grafts or at least burn care for a while. If that happened, you'd have to stop your chemo. Your liver is the biggest threat to your life. You need chemo for that. If you had to stop chemo, I might have cured the lymph nodes but killed the patient." That sounded logical to us. Cross cyberknife off the list for now.

So, here I am, doing what we do: trying to stay strong, dealing with the challenges of ongoing treatment, fighting the insurance wars, and creating a life. Not too bad a tradeoff, given that things looked really grim two and a half years ago. Stay vertical! Stay hopeful!

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"'Tis Also Blessed to Receive" - Monday, June 11, 2007

One of our family members has just been diagnosed with non-Hodgkin's lymphoma. Speaking with her recently brought back all the memories of those days after hearing the words, "You have cancer." What I heard from her, what I experienced, and what I've heard from hundreds of other cancer patients over the past 13 years reinforced my belief that there are some universal truths to be discovered in the common experience of shock, disbelief, and fear, and particularly in how we cope with one aspect of the fear.

I think the fear after diagnosis is multi-layered. First and most obvious is the fear of death. This is not necessarily contradictory to a belief in a life beyond this one. Getting from here to death is often the issue, not what's on the other side of that threshold. For so many of us, the response includes, "Wait! Wait! I've got so much more to do here!"

Another aspect of the fear of death is fear of pain and the physical aspects of escalating illness. For many of us, especially if we are diagnosed with cancer at a comparatively young age, contemplating the physical decline of our bodies is not something we've yet encountered as a normal developmental issue related to aging.

Perhaps one of the toughest aspects of fear when confronted with a cancer diagnosis is the fear of dependency, which ultimately comes down to having to receive care. And you will need care. You will need it when you become weakened from treatment and are tired beyond description. You will need it when you are distracted and consumed by the demands of the medicalization of your life. You will need it when you are anxious or depressed as you grieve for the life you had up to the nanosecond before the doctor uttered the words that changed your life.

Being cared for requires many things that may not be in our repertoire, at least not as adults. If we didn't have the experience of being lovingly and adequately cared for as children, then receiving care during serious illness poses an even bigger challenge and opportunity for real change and growth. Being cared for requires submission and trust. It requires dredging out a channel that allows us to receive that care. Ultimately, it requires reframing the act of receiving as part of a mutual relationship that isn't just about us but includes a partnership with those offering the care or caring acts.

For me, one of the wonderful gifts of cancer has been that gift of learning to receive. As a woman, I know that whatever my natural inclination and personality may or may not be, I've been acculturated to be a caretaker. It's what women do. Part of that, of course, is normal biological destiny. We care for our infants and children. But this role still extends into all aspects of how I'm socialized. Sometimes I feel resentful about what I can define for myself in moments of self-absorption as the burden of caregiving. Most of the time, however, the ways in which women offer acts of caring spontaneously (particularly to each other) makes me proud and happy to be a woman. It's part of our ability to connect with others rapidly, without the burden of macho posturing that men seem to have to carry. I'll give you two examples. This is not a scientific sampling, obviously, but it may ring true in your experience, too.

When we married, my husband needed an internist. He was 54 years old, and I don't think he'd had a physical since his sophomore year of college. For convenience sake and because I have a lot of confidence in her, I recommended that he see my own internist, a woman about my age. After his first trip to see her, I asked him how it went, especially seeing a female doctor who did a complete physical on him, including the prostate exam that was indicated at his age. He told me something that went approximately like this: "I'm kind of amazed at what I realized. First of all, I liked her. I felt comfortable. She listened to me. She talked to me. She answered my questions. And as I was getting dressed and ready to leave, I realized what had been missing. I hadn't felt like I needed to jockey for position in this new relationship in order to feel safe. Then I realized that posturing was for me a reflexive kind of guy thing."

Now the next example. If you are a woman, picture yourself in any airport restroom. You're traveling alone, but you are acutely aware of the mothers around you who are traveling alone with small children. They are herding them, trying to manage luggage, strollers, crying, hand-washing, nose-wiping, keeping an eye on their purses, making sure one of the kids doesn't bolt for the door, making sure one of the kids doesn't flush the passports. I'll bet that at the very least you are vigilant to see if that mom needs some help. I'll bet that at least one woman doesn't hesitate to reach out. I'll bet that woman is often you. It's just part of caring for each other. We know how to do this and even how to receive it if it's not just about us.
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So, now you have cancer. The spotlight is on you. It's all about you, at least for roughly a year between the time of diagnosis, when you finish your adjuvant therapies, and when you begin to recover some strength and start to integrate the process you've been through into the fabric of your life. What's going to get you through this year is submitting to what you have to do and receiving help and care from others. Man! This is a brick wall for many of us! I had to shuck off a whole lot of baloney about what I believed about myself in order to accept the help fully. I had to let go of, "I'm not worth it. I'm too much trouble. I'll be beholden and therefore vulnerable if I accept this help. I should be able to do this for myself; I'm just not strong enough, tough enough, good enough, smart enough, courageous enough (you fill in the blank from your own messages)...to deserve this kindness."

What I want to invite you to do is to lean into this time of dependency. Let the little acts of kindness pile up on your doorstep and see that the world doesn't end since you accepted them and, yes, that the world goes on without your trying to run it. Accept the massages, the casseroles, the offers to shop for you, the offers to drive for you, the offers to come to chemo with you, the offers to watch your kids. Let someone clean your house, even if you fear that the dust bunnies will ambush them or the ring in the toilet might become a public scandal. Even accept material help if you need it.

I think that you're going to find a couple of powerful truths. First, you've given those who love you a way to be of help when they feel helpless to change what has happened to you. Service to others, offered lovingly and willingly, is the highest act to which we can be called as human beings. You are giving the gift of this path of service to those who care for you and about you. Second, you're going to yield to the truth of what's happened to you. You're on the path to getting better, but right now, you're sick. That's just the plain, bald truth of it. When you get to that place, it's very liberating, and a lot of emotional and spiritual energy gets freed up to use toward your healing. You will have submitted in the literal sense. You will have bent low. You will experience the blessing of receiving and allowing yourself to feel the full power of so many people who love you.

And ultimately, what could possibly be more healing than that?

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