A Trek Through Cancer

A Trek Through Cancer
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It's always good when you can be of one mind about something---especially something major like cancer---and my unified attitude about cancer is one of disdain.

When I learned that my thyroid cancer had returned after five years, my first thought was: Dammit, not again. My next thought was that at least the recurrence explained the severe fatigue of the past year. Then, when the ENT surgeons showed me on the scan where "about a billion cells" of cancer, product of malignant cells remaining from the earlier surgery, were now clustered---at the base of the throat and under my left ear, in the lymph nodes---with a new flintiness in my voice I told them they had my permission to "get it all and kill it dead, dead, dead." When family and friends expressed regret about the need for more surgery, I gave them what by then was my considered opinion: "Oh no, bring it on, I hate this cancer thing!" Attitude is all, and I chose disdain.

Because what cancer really wants you to do is collapse in fear---quaking, blank fear, the kind that scatters thought and blasts the self and has you whimpering. As common and almost cliché as cancer has become, just the word "cancer" still has the capacity to, as Emily Dickinson described the snake, strike "zero at the Bone." For me, that dire kind of fear traces back to hushed discussions I overheard between my doctor father and nurse mother. A general practitioner, Dad might diagnose cancer in a patient, then refer him to a specialist. Invariably the report coming back was bad: "Too late, they opened him up and the cancer was everywhere." Then as now, I pictured the cancer as a green slime.

So best to fend off the fear with disdain, I find---not the fiery kind (I don't have the energy to waste and I don't need more wear and tear on my system), but more just a curl of the lip. As for activity when cancer invades, best for me is to write commentary: to loop the thread of logic and le mot juste from sentence to sentence and, while the dogs of fear bark at my heels, to pull that thread tight and upright---it feels like World Cup-type triumph. All hail the saving powers of Reason.

Of course that's bravado, a very necessary bravado. I'd like to think that, had I a more ominous form of cancer---I was told that mine, somehow (very fortunately) not metastasizing to bone or lungs despite having returned for a year, was "serious but not ominous"---I'd sport the same bravado, but then, perhaps not.

Nevertheless, following what the lead surgeon described as a "huge" surgery of six hours, and during a five-day stay in the hospital hooked up to tubes and drains, the enormity of it all came down on me---after all, cancer is up to no good, none, it really is out to get you---and disdain was replaced with gratitude. The tears flowed when my husband told me I'd clung to his hand while still unconscious in the recovery room, and they flowed again when my mother, in a phone call, blurted out, "I didn't realize how much I loved you!" When a huge bouquet from my book group was delivered, I cried at the beauty and friendship of it all, and again when, dressing to leave the hospital, I put on my glasses for the first time and saw the dark, lumpy Frankenstein stitches running from my upper chest to my ear. Tears of a more sober sort came when, going through old cellphone messages, I discovered two from a high-school classmate who's since died (of cancer).

And then the anesthesia wore off and the pain began.... If, on a scale of 1 to 10, Level 10 is the screaming-aloud kind of pain, mine rose to Level 9 and stayed there for six weeks, the result of extended surgical rummaging-around in my chest and neck.

What to say about pain? For starters, it literally takes your breath away, you can't think and can barely converse, and---something I didn't understand before but do exquisitely now---since you can't exercise much less move much, you become wiltingly weak. A vicious cycle; you wonder if you might stroke out. (It's hard to curl your lip in disdain when pain has you bent over, gritting your teeth.) Pain pulls you deep into yourself, too deep. I like to keep my eye on the horizon and on human events, but pain obliterates the horizon and the only human you're interested in is you and how much you hurt. Usually big on commemoration, I forgot friends' birthdays, Mother's Day, even condolences. In a fetal position I kept thinking of Franz Kafka's description of the tight focus that painful illness enforces, one ordained by "his Majesty the Body." It must be said, though: his Majesty's pain is so, so, so boring.

Pain medications can offer relief, but like many people my body doesn't tolerate the most powerful ones like Percocet or Vicodin (they give me monster headaches and nightmares), so I had to make do with Tylenol with codeine. One doesn't want to abuse codeine, however, so after four refills I quit. Silver lining: the codeine enabled masses of sleep, meaning no more sleep deficit. (Actually, best pain relief was tracking the news of Goldman Sachs' mounting legal problems as payback for their double-dealing practices. Such are the healing effects of Schadenfreude.)

With time the pain from the surgical wound subsided, only to allow the underlying pain from nerve damage to the shoulder to emerge. But, fortunately, there's a med (gabapentin), and there's physical therapy, which combined have delivered me to Level 5, where I write from now and where the pain, pardon the doggerel, is more reminding than blinding.

Happily, after three months, my trek through cancer---"through" being the key word---has resulted in a clean bill of health. Following a one-two process---first, imbibing radioactive iodine (a surreal experience requiring an overnight in the hospital's isolation unit), then a full-body scan---the radiologist announced: "There's no sign of the cancer, you are clean." Since I'm still in pain, the good news didn't immediately impinge, but it did my husband: When I called him with the news, he was driving and had to pull over, to cry, which got me going. (Note to self: Send another thank-you note to my meticulous surgeons.) Of course the cancer may recur yet again, and in a more aggressive form, as all my doctors underscore, including my endocrinologist who flagged this recurrence. Technically, the trek never really is over, but I choose to think of another bout with disdain and bravado, not fear.

Now, to assessment: Cancer takes a toll, what's the toll after this particularly rugged round, what's been added to my life's kit-bag? For one, I now have infinite compassion for anyone who lives with chronic pain---it can be personality-altering---and I can understand how pain relief drugs might be abused: you just want the pain to, please God, stop. For another, I have even more admiration for modern medicine than before. My father used to exclaim about the advances he'd seen in his 40 years of practice, and they continue: the imaging technology that made my cancer visible, and the surgical techniques made possible by that technology, were in his day only experimental. I'm one very grateful beneficiary.

More personally, being the recipient of a super-abundance of get-well cards, emails, and bouquets, I can attest to their power to uplift the spirit and assuage pain, especially those that went into detail in their messages about how much they cared for me. An old friend who called while I was deep in the Valley of Pain gave me one of my few laughs when she asked, "Haven't heard from you in a while, how's that famous fighting spirit?" Another friend, knowing I was in pain, sent the perfect card: "You are not alone," it said---perfect, because pain is so isolating. Another friend, a classicist, usefully suggested the meditations of the stoic Marcus Aurelius; and another termed my trek "existential." Closer to home, no sister enjoyed more brotherly love than I from my two brothers; one, a nurse, made it his project to coach me out from behind the pain curve. Our best friend called weekly, to check the status of his "girlfriend." And then there's my husband's endless dedication....

Physically, cancer takes a visible toll, thyroid cancer in its own way. I used to be pretty, with porcelain complexion; I used to be slim; I used to be dynamic and active---all that is gone, at least for now. I've also acquired a prominent widow's hump in my back, from all the hunkering against pain. I've enough vanity to care, but I sense full-bore self-pity would be, well, killing. I'll work to get it all back; deep down, though, I salute my surgeons' priorities: life first, then function, then aesthetics. More than aesthetics, in my weakened state I find myself fantasizing about getting strong again---getting back to the gym and the body-sculpture class and speed-walking, taking up water aerobics, biking. With my bum shoulder I am denied my special pleasure, playing the piano, at which I used to be quite good. (How good? Once upon a time I could play 22 of the 24 Chopin preludes.) Right now I'd have to lift the arm to the keyboard; maybe with work it will come back.

Importantly, though, I remain unchanged in my life's purpose as a writer, as a moral artist. Many survivors of serious illness create a bucket list---life-changes they must make, relationships they must mend, trips they must take. Fortunately, all my core relationships I have put in order, and the one major trip we've yet to take---to the ancient amphitheatres of Greece and Turkey---we're now planning. But life-change, no. For twenty years I have been making the moral-ethical point, in plays, essays, and op-eds, working as my husband puts it "at altitude," an endeavor which, in an age tainted more brass than gold, has been heavy going. But now, it's not hard to make the case that America's present low state---some call it decline---is due precisely because the moral-ethical line has been blurred all across the culture: in finance, in business, in politics, even in religion (the Catholic church's sex abuse scandals), with little moral counterforce mounted by the arts and humanities. Talk about a call to arms! I'm heading back to the barricades with an even greater sense of urgency.

But, I'll be going back with one big change: no more frying of my body's grid. When, to take the latest inciting example, Abu Ghraib broke in 2004, revealing the awful fact of America's descent to torture, I was engulfed in shame and revulsion, and I stayed there for several years, burning, inveighing in print against this evil, my body electrified. Well, no more. Cancer occurs when cells go crazy, when they multiply abnormally. From here on out I'm taking exquisite care of my cells' health---which doesn't mean, however, any less passion. Just as one can write with feeling from the memory of old love, one can write from the memory of old moral fire. And if I must live with pain, I am determined it will not hinder my output, nor distort it: Not for me the example of Karl Marx who wrote Das Kapital in the British Museum, declaring "The world will pay for my carbuncles."

Nor does becoming a more watchful steward of my health mean any less urgency. Having come through this second, exceedingly painful battle with cancer, I now know---I now feel, in my bones---that there is a finite frame to this life, to my life. I want, with all my heart, to fill that frame with everything good in me.

In other words, to borrow from the ongoing World Cup soccer tournament, to which I've become addicted: I'm going for GOALLLLLLL!!!!

Carla Seaquist, a playwright, is author of the play "Who Cares?: The Washington-Sarajevo Talks" and is working on a new play, "Prodigal." Her book, "Manufacturing Hope: Post-9/11 Notes on Politics, Culture, Torture, and the American Character," a collection of op-eds, essays, and dialogues, is now out (www.carlaseaquist.com).

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