I’ve been grumpy lately. I’ve been hearing too many stories about women who were breast cancer survivors and then get hit with metastases in the bone, or the liver, or the brain. I fill out a UCSF survey yesterday that reminds me that of 100 women who have lumpectomy plus chemo and radiation, 85 will be cancer free in 10 years. Those are pretty good odds, but they’re not perfect. What happens if you get the short stick, if you’re one of the unlucky 15?
Thinking about such things makes you grumpy. It makes deciding what to cook for dinner an absurd challenge. It makes you snap at your husband when he says he’s going to be home early, and then he isn’t. It makes it difficult to be patient with your kid who is giving you the 18th excuse why she needs to wait five more minutes before practicing her spell-a-thon words. It makes it difficult to forgive your mother for not making a spell-a-thon pledge because, as she reminds your kid, she paid the private school tuition this year. Mild dementia mostly becomes my mother, but there are times when she flashes bits of her old matriarch-who-controls-with-money persona.
Your kid, of course, has no idea what a big deal it is to have her tuition paid when one parent isn’t working. The kid just wants an “atta-girl” for her spelling. Worrying about your own mortality makes it more difficult to remember that your mother has her own problems. She’s been bedridden for years and has way more medical problems than you do: Diabetes, kidney and liver disease, depressed immune system, perhaps 10 surviving teeth, depression, dementia. Mom just got her leg cast off after three months. Her knee hurts because she hasn’t bent it in more than 90 days. She has a bed sore on her heel. She’s lost so much muscle mass in that leg that she’s unlikely to get out of bed ever again. But you’re so grumpy you don’t want to deal with someone else’s grumpiness, someone else’s mortality. You don’t want to be understanding of a dear friend who calls and jokingly asks, “So, are you done with this cancer stuff yet?”
No, I am not done with this cancer stuff yet. And I’m mightily annoyed about it, thank you very much. The back of my left hand is sore from where they’ve placed the chemo IV again and again. My muscles ache. Four months post-surgery, my left breast finally feels almost normal. Next month, they’re going to slice it open again. Then comes radiation. My skin is dry and I have red rings around my eyes again. I feel fat, but I’m not supposed to diet or exercise strenuously right now. I feel tired all the time. I feel like my hair looks crummy and I can’t get a haircut or highlights because it would mess up the clinical trial that is saving my hair in the first place. I can’t have a manicure or pedicure because my immune system is depressed and I probably shouldn’t be having my cuticles cut or my feet soaked in a salon foot bath. I have zero need of a bikini wax, and this has created a new problem: a kind of endless jock itchiness. How’s that for TMI? Oh yes, and the mouth sores are barely at bay and the shoulder pain is mostly gone, but a shadow of it lingers threateningly so I have to have an MRI this evening. I hate MRIs. A week post-infusion, I still have mild stomach upset and nausea in the evenings. I’m bored with being sick and want to work again, but I don’t have any energy to really do that. It’s my birthday and I’ll cry if I want to. I am in full pity-party mode.
And now I’m going to stop. I’ve expressed all these complaints verbally to my husband and to a couple of friends, and now it’s time to put them aside. Do I do this because I think it’s going to save me from cancer? No.
A dear friend from our church in Brooklyn sent me a January 23 New York Times op-ed on Congresswoman Gabrielle Giffords, who seems to be incredibly determined and lucky. It’s amazing that’s she’s out of intensive care a couple of weeks after being shot in the head. But this op-ed makes the point that a positive attitude won’t save your life. The friend who forwarded the piece to me allowed that she has mixed feelings about this message. As the op-ed points out, American culture is in love with the power of positive thinking.
Me? I agree with the op-ed author: A positive attitude alone is not going to save my butt. Biology does not have morals. One of the stories that sent me into a spiral is that a friend of a high school friend is dying of breast cancer: brain, lung and lymph metastases. Last time I checked, Nature was not long on mercy. This dying friend of a friend is described as “one of the bravest people I know.” She is still dying. I know there is some evidence that stress hormones can lead to inflammation, and that can exacerbate just about any disease you care to name. I know there are lots of studies and books about the health benefits of happiness. Yet the Times op-ed cites a Finnish study of 60,000 people followed for 30 years, finding no correlation between personality traits and survival.
My mother is a case study for this. My mother has many good qualities: She was a pioneering feminist, the only woman in her law school class in 1953. As a family law specialist, she fought for the custody rights of what, in the 1970s, were called “non-traditional” parents, i.e. men, same-sex couples, grandparents. She was really bright before the dementia, a whiz at cards and all things strategic. She can be incredibly caring and generous. (See extravagant Xmas presents; kid’s 2010-11 tuition.) But she has a dark side: She can also be controlling, stubborn, paranoid, self-involved, and just down right nasty.
When it comes to her health challenges, Mom has a terrible attitude. She doesn’t listen; she’s checked herself out of the hospital against medical advice more times than I can count. She doesn’t suck it up. She doesn’t work through the pain of physical therapy. Sometimes she refuses to take her meds, or to bathe, or to have her diaper changed. She absolutely does not change her diet or her three-cocktail-a-night drinking habit to accommodate her diabetes or anything else. She sometimes accuses her caregivers, who are truly saintly, of trying to kill her. She usually forgets to say thank you. Dale Carnegie Mom is not.
But my mother is the cat with nine lives. She has almost died again and again. Yet she always pushes back from the brink. Friends are constantly commenting, “Your Mom is still around? That’s amazing!”
The first time I went to the ER with my Mom—it was just after 9/11, right before she started throwing things— one of the docs commented, “It’s always the nice ones who die. The nasty ones keep fighting.”
I’m not sure that’s true. I doubt Nature cares whether Mom and I are naughty or nice. I don’t think Mom survives because she’s cranky. I would guess she’s still here because of good genes; my maternal grandfather lived to be 94. Besides, my imperfect understanding of God does not encompass a judge/accountant who doles out favors for good behavior.
But I think I’ll try being positive and hopeful for the rest of the day. I’m not making this effort because I believe it will save me from a brain metastasis but because I believe like attracts like. Nastiness begets nastiness; as does the opposite. I try to be positive and hopeful. I try to fight because it makes the cancer, and whatever may come in the future, bearable.