It is cancer.
I thought I remembered what it felt like to hear those words, and what those first, awful days after a cancer diagnosis feel like.
Like all cancer survivors, I remember some of the specifics in excruciating detail: the date and time of day, the spot in the kitchen where I picked up the phone, the tone of the kind doctor’s voice, delivering the news as clearly and gently as she could: “It is cancer.” I thought that I had held on to the most important part of that experience, and for the most noble of reasons. Without a clear memory of where the journey began, for example, I would not be able to fully appreciate the challenges and triumphs of this experience. I needed a clear memory of those first dark days to comfort the saddest and shakiest of my patients, to reassure them that their anxiety and grief is not, as they fear, beyond that from which they will recover.
I was running errands Monday morning, on the way to the countertop place, frustrated with the latest delay in the bathroom renovation. My cell phone rang, and it was my best friend, calling from her home in another city, the usual and frequent kind of calls that have sustained our friendship half a country apart. I knew she had had a biopsy last week, but I was not expecting news of any kind, and I greeted her without a flicker of guardedness. I could hear her faintly crying before she spoke. “It is cancer,” she said tearfully, her northern accent making it sound like “kyenser”. Maybe that was why it took a minute for me to take in the meaning of the words.
Or maybe, when it is someone you love, the words just sound different.
I guess it is like childbirth – you somehow forget the worst of it, and despite the fact that I work in and with cancer every day, my mind had mercifully erased so much. The visceral shock of life-changing news, out of the blue, on an ordinary Monday. The irreversible nature of the words (Take them back! Take them back! I wanted to say, as if in some Jumanji-like spell, it was the speaking of them which would unleash the flood of inevitable events to follow.) The fitful sleep, awakening during the night to the moment right before you remember the words, and then the moment after. The lack of appetite: for all food, most of the time, peppered by intermittent and irrational cravings for whatever tastes to you like comfort, and survival. The crying jags out of nowhere and the pall that, for a day or so, seems to hang over everything. The moments of panic, replaced with cautious optimism, and worst of all, the waiting.
But enough about my week. She is coping beautifully.
I have heard it questioned many times, the comparison of the degree of difficulty between being the patient and the caregiver: the sister, the husband, the mom, the best girlfriend. It is an understandable question, I suppose, though pain is pain and grief is grief, and I do not think differences between two kinds can be measured or compared, maybe not even described. There were times in my illness when I found my bald and chemotherapied self duct-taped together with adrenaline and steroids and prayers, oddly and unexplainably OK, and I wouldn’t have traded places with my friends and family for anything. This same friend’s sobs on the phone years ago, the time that I called to relay some particularly bad news, are among those clearly etched in my memory; it was clear on that day and many others that her pain and disappointment equaled, perhaps exceeded, my own. Even in the years since, she has never been able to discuss it too much without dissolving into tears. Now, however, facing her own diagnosis, she is taking it one step at a time. She does not dissolve, and she is far from inconsolable. She is clear-headed and optimistic. She is taking in all the information, learning a new language, making informed and intelligent decisions. She wisely avoids aimless searching on the internet. In short, she is doing a great job.
It is not important to me to know — or even to ask – if it is harder to be the patient or the friend. They are both hard and we don’t get to choose anyway. And for those of us who work in cancer care, these words, part of our lexicon, are naturally desensitized by their frequency and the need to move ahead with a plan.
What’s important to me is to be there for my friend, and for my patients too. To remember fully this truth: that when it is you, when it is your best friend or family member, nothing about this is routine. The words sound different.