Essay:Suffering
Cancer, or any debilitating injury or illness cannot be viewed as an act of God which is bestowed upon an unsuspecting public as randomly as winning tickets in a perverted lottery. I reject the thought that any supreme diety would choose certain individuals to suffer and allow others to live peaceful and fulfilled lives, or through their own choice, aimless, meaningless lives; I do not feel that a God would thus inflict an individual either to punish him for wrong-doing or through suffering, make him into a stronger human. Though it may be a consolation to believe that suffering has a purpose, I believe that an individual's pain has no more divine purpose than if he'd stubbed his toe. While the mastery and acceptance of ill fortune will make a person stronger, it would then seem that everyone could benefit from grief, and God would therefore assure each person of his parcel… but it doesn't happen that way. Grief is part of existence, and while certain people may have more than "their share" as far as statistical averages follow, nature does not operate through calculated averages. I believe cancer befalls individuals just as blight will infest a perfectly healthy tree and cut short its life expectancy. It is interesting to me that many individuals will always attempt to justify their illness in such manners in order to keep their faith intact; as far as they are concerned, a loving God must have a reason for doing such a thing to them. People have forgotten that illness is a part of life, and perhaps more prominent is the fact that many refuse to acknowledge their own mortality. Just as illness is an inherent factor in nature's infinitely complex cycle, death also belongs to the natural order of things.
"God will not give us any more than we can bear" is also a disagreeable reason (to my way of thinking) for explaining why suffering is God's gift to us. Far too often, the burden is too hard to bear and the person is unable to cope, leaving him bitter, enraged or even insane. This cannot be pigeonholed neatly as suffering which was to the benefit of the individual… or that which was "no more than he could bear." Moreover, why would a diety wish to dole out pain to some simply because they could "handle it" while allowing others to go their merry way through life because they would have "cracked" under the grief? The latter group may empathize with the former lot, yet they cannot "enlarge their spiritual horizons" through observation alone. Thus, while the former group grows in insight and reflection, the latter enjoys life's surface values and are bereft of the "enjoyment" which true suffering would bring. Who, then, is the better off?
Essay:Quality in Life
Another aspect concerning religion and death which never ceases to amaze me is the devout Christian who believes that one should strive for every possible breath 'til the end, as if life for life's sake is of foremost importance. To me, this is saying that heaven is not as great as proclaimed; if their faith, indeed, is so steadfast and secure, would not the proposition of the imminence of heaven produce more smiles than that of another painful breath of life?
I feel that life must contain an element of quality to be worth the actual existence. To me this would mean wrapping myself in thought, and perhaps, subsequently unleashing my hoard of mind-words onto paper, where they would then remain for later perusal. My thoughts and sense of self are more precious than any physical activity I might pursue, or monetary affluence I might acquire. This fact may be the reason why I am content despite physical limitations and inconveniences and my deformity in stature. Though if it were my choice, I would most definitely elect to be of stout health, I feel that I am yet rich in the far greater facets of character; for it is one's mind which makes the person, not the body.
When I see one who is healthy, I don't envy that person, nor do I feel I "deserve" health more than "so and so" who lives a wild life but remains healthy. In fact I would never trade my life for that of someone else. I would still want my mind, body and soul. While I may detest my body's waning functions, I would not care to live in another's body a life which had no meaning. Moreover, it is not possible to know the sorrow which he might have borne, or the gripping habits which have tortured his mind. If I've ever envied a person, it was only my former, healthier self.
Moreover, quality of life reigns over the quantity of one's days. If one has attained a level of consciousness with which he is content despite ill tidings, he has reached a sense of quality in existence, no amount of time will better that which only the mind can attain; after all, what is ordinary existence but the pursuit of aspirations which shall place shelter over our heads and feed our hungry bodies? For one fostering a higher ideal of life, every day matters are not a bore or resentment; they are inherent facets of life which easily yield to accomplishment when it has been acknowledged by that individual that there are unseen elements far greater than a comfortable lifestyle which renders life meaningful.
Essay:Bargaining and Prayer
The idea of "bargaining" for more time never really occurred to me, although I was quite aware that this type of reaction was often enacted by an individual whose life was to be lessened through physical incapacitation. I shall always smile to remember the movie "The End," wherein a terminally ill man determines that suicide is his only hope to retain dignity in death; he tries countless measures to kill himself, all of which fail due to their haphazard nature. Finally he swims out to sea in the hope that he will tire and drown, but at the last moment, decides he actually wants to live and calls upon God to give him the strength to swim ashore, tempting God with a 50% pledge and regular attendance in church. The movie was a humorous comparison to the way in which some people truly bargain for more time; I feel that this type of reasoning can only injure the individual, especially if God should "reject" his proposal through a worsening of his condition.
A healthier alternative, which also allows for the patient to maintain his religious stance…. if indeed religion is important in his life… is to instead "hope" for a longer life. Hope does not as easily fall into the realm of religion and therefore remains a separate source of emotional comfort; there is no dependency upon God, doctors or other people to cure him.
Given the fact that man was blessed with a mind of his own, which is essentially too complex for him to understand, it amazes me that he continues to speak of the mind of God as if bestowed with acknowledgeable characteristics, abilities, and functions. Often people will say, "God gives one the strength to bear loss… pain… hardship… etc." as if one bereft of inner fortitude can expect to be given that gift through prayer.
I have always believed it to be more fruitful to pray for strength rather than a cure when faced with terminal ailments. I do not believe that one can "lean on" God and await replenishment, since I cannot view the essence of God as a crutch or in any other way which would place Him outside of one's self. If God resides within an individual, He cannot be a crutch.
Perhaps it is better to say that one's belief in God gives him strength; for if God sent strength as an answer to prayer desiring strength, why do not all people receive the feeling of renewal? Why are some left to insanity, psychosomatic disorders or neurotic behavior? To credit God for one's strength would only serve to discredit His "unanswered" prayers, as is the case with physical disorders. I do not believe God would endow one with the fortitude to deliver himself from anguish and neglect the emotional appeals of others. Housing such thoughts can be devastating.
It is one's unrealistic expectations of God that can sometimes create turmoil for an individual, which again may result from the attempt to personify God. This attempt on the part of an individual to personify his deity often results from his need to feel guarded and loved; without family or friends he can still have a heavenly father and thus is not alone. My strength comes from within, and is augmented by loving family members. I tend to think, rather than to pray, for I feel the unity of all creation is within me and encompasses all things; thus even my most quiet thoughts are not spoken in emptiness.
When people said they prayed for me, I looked at their statement as one of thoughtful kindness because it demonstrated that they cared for me and my family. Yet within, a voice would scream that praying for health misused the idea behind prayer. Although prayer means vastly different things to each individual, I like to think of prayer as a way of communing with God; while there are many who ask God for favors in prayer, to me this cheapens it. I feel it should be used for the attempt of attaining oneness with the eternal spirit and nothing more, unless it is to unify one with himself and allow him to dismiss his selfishness to think of and unite with others. This well-known quote echoes my sentiments: "God, grant me the serenity to accept things I cannot change, courage to change those I can, and wisdom to know the difference."
To further elaborate on the subject, I would assume that an individual who divulged in prayer such a "bargain" would eventually feel the shame brought about by the realization that he would never have sought this plea or offered his humble services had he not first been stricken by physical illness. Most likely the thought would have never crossed his mind. One would think that the person would have waved God's flag in times of health and prosperity. But, as with the vast majority of people, thoughts of one's own death rarely occur to those caught up in the robust living of life. Thus guilt can both evoke, and be the product of, promises too great to keep.
"Even the smallest pleasures seem more meaningful when they are shared, while the tragic moments are buffered by love. "
Categories Of Acceptance
I was home once again, and my greatest wish had been realized. Somehow I thought my life would now be simplified, and that I could wield complete control over the ways in which I desired to spend my time and conduct my remaining life.
With something akin to fascination, I looked at myself in the mirror and focused my eyes on my protruding stomach region which would one day be the cause of my death. The subjects of death and other intense, wrenching emotions possessed a magnetism which had always held me spellbound. I was drawn to the startling views of human tragedy in both literature and art forms; a life tottering precariously on the edge of sanity or mortality could offer a glimpse of the more painful aspects of reality which many often neglect to acknowledge. Images which accurately depicted the horror of war or the anguish of a mother of a stricken child were those which captured my attention; though beautiful works would please my eye, only the gripping views of life held the capacity to stir my senses.
The thought that I now shared a common bond with those gripping views of existence similarly held my fascination. I wondered what my family would undergo during the harsh period following my death; I pondered whether I would see earthly lives when I no longer was part of the world. I spent lovely afternoons in peaceful reflection, drinking in the earth's beauty to somehow retain the days as if they were my last. Time itself lost its importance as I embraced the cycles of nature and my own life as one, rather than separate entities. I marveled at the pitiable lack of control we, as humans, have over our lives; after attempting to rule the world, we are at last brought to the level of all things through the element of mortality. I shared a kinship with autumn following the rediscovery of cancer. Like a tree divested of its leaves, its only proof that life yet flourished deep within; I questioned when my color, too, would fade, rendering me helpless against winter's icy grasp (death). Death was no romantic notion which smuggled lives on moonlit nights; it was merely an endless cycle.
Nov. 1981… I quieted my thoughts and listened as a distinctly familiar echo of sadness resounded in the autumn air. It seemed as if the old tree above me was attempting a futile last stand in the face of the impending desolation of winter. A blast of northerly winds scattered the furiously spinning leaves to form a semi-circle about my feet.
I picked up the leaf, noting its fragility as it crumbled under my touch. I realized that I was observing a change of seasons in which only brittle remnants of spring remained to display that life had actually existed. A gust sent the fragmented leaf to be buried unceremoniously in the midst of thousands of other leaves, which were rustling their distaste for their hapless plight.
I watched several more leaves rattle a loud protest as the wind determined their fate. Another leaf, one which could easily be labeled as a spectacular tribute to nature itself, was swaying gently in the crisp breeze. It was different from the other leaves, seemingly unafraid of its destiny. I continued to watch until it was slowly delivered to the ground to rest in silence at my feet.
That is the way death was intended to be, I thought; stealing quickly over its prepared and quietly waiting subject, death overcomes life with no struggle and no outcry. I sighed and wondered when I, too, would be beneath the dried and decaying vestiges of many summers passed.
I culminated my restful sojourn amongst the colorful show of leaves with thoughts that have frequently entered my consciousness during reflective intervals; one must first accept death if he is ever to understand life.
I will never forget an incident which occurred shortly after my release from the hospital. Seated in the middle of the shopping mall, I was engaged in observing people hurry in and out of stores, and while my face did not radiate feelings of great joy and elation, I did not wear a mask of sorrow either. Just then, a man happened by and remarked, "smile, you're not going to die!" I remember how idiotic that phrase sounded to me, and it left me speechless. "Yes," I thought, "I shall die. . . and sooner than you might suspect." Everyone dies.
Quite apart from denying my illness, I found myself quite preoccupied with it, and initially it was difficult to carry on in a "normal" fashion in the sense that I could not detach my mind from the fact that I had cancer again. After learning of my recurrence I immediately began thinking thoughts such as, "if I subscribe to this magazine, I wonder whether I'll receive all of the copies. . . ," and while driving down the road, "I wonder if I'll ever get a speeding ticket," or when in a pet shop, "if I got a parrot, it would outlive me."
I remembered my china dishes and realized that my dad had been right; I should never have purchased something which represented the future. The future did not belong to me. . . it was dissolving before my eyes. My dreams were changing out of necessity, since most dreams depended on time for their fulfillment… and time was one amenity that I could not hope to claim.
Nov. 1981… I dismissed modeling altogether after appearing in a luncheon (style show), which I enjoyed entirely. I somehow felt unable to accept the demands of the career when I felt my health situation was so uncertain and unreliable. Admittedly, I could have modeled for a short time. Somehow, though, it didn't seem important any more. I was tired…
I thought of the teenager who had a car, yet lacked the fuel to drive it.
I speculated as to whether or not I would witness the spring-time again, and could not help but question absently if my 20th birthday would prove to be my last. I was unable to release myself from the thought of my impending death; I wasn't simply Lauren Isaacson. I was "Lauren Isaacson, victim of cancer." I identified myself with the disease and found my thoughts encompassing various subjects with cancer continually in the back of my mind. I never denied the presence of the disease, nor did I wish it on someone else, and perhaps this is what allowed me to bridge a period of gray disillusionment so common in the acceptance of solemn news; I would much rather face a heart-rending truth than to live amid a cloud of fantasy derived of the mind. Tumors have no conscience, and no amount of wishing, cursing, or bribery will cause the disease to disappear. These mind-games will one day come to an abrupt, emotionally wrenching halt or lead to personality disturbances if not corrected; such reactions only injure the individual or those with whom he must associate.
In coping with a weighty truth of such magnitude, the family as well as the patient, will experience various and ever-changing emotions, and I believe it is quite important that these feelings are ventilated. Simply because the family is not afflicted with the illness does not mean that the individuals are immune to its emotional nuances. In fact, the family is sometimes the worse off; they essentially feel helpless, unable to ease physical pain or shield their loved one from his frightful pursuer.
When the family is able to openly converse on the topic of the patient's illness and imminent death, the entire affair seems less formidable, rather like a beam which is directed upon the unlit recesses of a room, thereby dispelling the uncertainties which lay dormant in the darkness. Because there are manifold reactions to adversity, related conversation will evolve at varying rates. While some people would be ready to speak candidly after a brief time, others need to ingest the situation gradually and should not be pressed into heavy conversation directly following a shock. Moreover, there exists in most humans the great need to face life's circumstances with dignity and composure and would not, therefore, relish a serious discussion until they could do so without losing control of their emotions and causing a tearful scene.
Although it is unhealthy to continually dwell on the plight of the family, silence is debilitating. . . especially if it evolves through avoidance of the problem, rather than simply the inability to verbalize one's thoughts. True coping deals with self-expression, not the clever avoidance thereof. One should never attempt to stifle grief, for to do so will create unendurable stress; and what, I might add, is so terrible about venting one's sorrow in the form of tears, when the situation certainly merits that behavior?
Anger is an understandable reaction to the discovery that one harbors a debilitating disease, for since everyone must eventually die, surely there are more pleasant routes toward that destination if given the right to choose. Moreover, anger is thought to be a less degrading form of expressing depression. No one wants to suffer or restrict himself in a manner unnatural to his lifestyle, nor lose his sense of control, no matter how much or little he actually has.
If anger is a prevalent emotion, its release is necessary; yet projecting that anger on undeserving family members or hospital personnel is unfair. Anger is counter-productive when wrongly displaced; fanatical rage and irate demands are increasingly ignored and replaced by the unfortunate avoidance of the enraged individual. No one can benefit from this chain reaction.
An alternative which could be used by the patient having the objectivity to discover his outward rage is anger expressed through writing or intelligent conversations rather than transforming the anger into unfounded complaints. The problem is not the unsmiling intern, or the wife who arrived ten minutes later than planned. The problem is health, and if not dealt with, attitude as well.
A reasonable exception is when the patient's anger is derived of pain; it is virtually impossible to be civil if each breath heralds another moment of severe physical anguish. This belligerence should not be taken personally by either relatives or hospital staff, nor should the unfounded anger described above be ingested as relating to their presence or prescribed duties.
If it is attention the patient needs, it is more likely to be given if he behaves in a manner deserving of amenity. It is a pleasure to be near a person who, despite his personal problems, can retain humor and conduct himself in a respectable manner. If my experience is any indication of the quality of the residency in hospitals, I found the staff to be most personable if treated likewise. On the rare occasion that a patient is forced to abide a hostile nurse, or one who refuses to believe that he is suffering to the degree that he claims, a complaint is well within reason. One case in particular concerned an incontinent elderly woman who, after an accident over which she had no control, was chastised by a hostile nurse, resulting in tears which should never have been provoked. A patient is not paying for abuse; moreover, a hospital without patients is just a stone building, and its personnel is up for hire. Inflicting emotional anguish has no place in the medical profession.
When I felt frustrated by the constraints which resulted from my cancer, I encountered no pervasive or continual anger. Furthermore, the anger was targeted at the source of my inability to function properly, rather than projecting it toward an innocent companion. Mine was the self-contained anger similar to that which I would feel after entertaining influenza for nearly a week; weary of its limiting effect on my mobility and general well-being, I would hurl devastating thoughts inward, then later proceed to calm my cantankerous spirit and await the arrival of health.
My father held a rather negative view of the possibility that good could prevail over evil; he always expected the worst, and often was quite right in his assumptions. Even so, expectation does not cancel one's disappointment at having supposed correctly, and his broken heart was obvious. A touching moment in a movie, a poignant verse of song or the reading of one of my poems was enough to send a tremor through his voice in a later attempt to speak. Often depressed or angry, he was tormented by the many adversities which had befallen our family. It just didn't seem quite right that he should have such difficult burdens after he had lived a morally conscious life; others, lacking all sense of moral responsibility, seemed to live long and healthy lives, or died simply because of their own ignorance and gluttonous indulgences. Hounded by such sources of resentment, acceptance was gained, then lost once again at varying intervals when he viewed the healthy, but empty lives whose health, he thought, should have been my own.
Aside from the family, my dad had no confidant or close friend. He, like many members of the family, was quite self-sufficient. Unfortunately, one's self-sufficiency, displayed in grave situations, can discourage closeness, whether consciously or not. Thus, when such an individual truly desires someone to hear his concerns, no one is near enough to care. Even persons with whom one had worked on a daily basis can prove to be unenthused listeners; often their association clearly ends within the confines of the job description.
Though not always apparent, my dad was a highly sensitive individual. An injustice or injury persisted, inflicting pain and stress. More than anything I believe my father needed unsolicited affection and demonstrations of sympathy; lacking these, especially from his co-workers, Dad felt himself betrayed by the one group with whom he had spent so much of his time. He could easily have drowned in self-pity, for no one wished to help with the bailing out of his broken heart; sorrow was like a hat which only he could wear.
My father would, on occasion, mention that if he had not married, or had children, he would not have had to experience the pain of losing dear children or seeing them riddled with health disorders. Life without emotional grief would be "easier" and more stable, yet to shelter ones self from close relationships would also be an enormous deprivation; love is the foremost joy of living, and it cannot grow through alienation from society. Even the smallest pleasures seem more meaningful when they are shared, while the tragic moments are buffered by love. To separate ones self from affection for others denies a virtuous human potential to develop, as it simultaneously creates more emptiness than that which occurs upon the death of a loved one; the grief-stricken survivor has memories, but the emotional hermit has only stability. There was indeed, a sacrifice for love. It was one that my dad was willing to take.
In one of our conversations, I once asked my father if he thought he had basically accepted my health disorder. He replied, "I don"t think I will ever accept it, because it's not acceptable." For his part, maybe he just lives with it. What other choice does one have, excluding madness or suicide, but to live with it? (It just doesn't mean that he has to like it!)
Guilt very often accompanies the illness or death of a loved one, and can be released through conversation. The unfounded sort, stemming from regrets such as a patient's unfulfilled dream which the relative felt he impeded, or a mother's inability to detect subtle changes in her child's health, is a counterproductive, if not debilitating, manner of reacting to the problem. These emotions are quite corrosive to the individual, and it is important that they are quickly corrected; this can be done through attentive listening and positive reinforcement.
After discovering the malignancy in my stomach, my mother effectively chastised herself by asserting that she "should have noticed that I was eating less and getting thinner." She held on to her belief while I tried to assure her that the extent to which the cancer had spread was not her fault. I reminded her that many children are rather lanky and thin when they are growing too rapidly for any food which they eat to transform into fat; the body needs the nourishment to sustain itself, and has no excess for insulating purposes. With time and reassurance, she finally dismissed her guilt; I listened to her statements, returning not with, "You shouldn't feel that way," but with reasons which effectively reinforced the pointlessness of her guilt. As with any invitation to change one's outlook, a person fostering guilt must be shown why his view is unreasonable and needs to be altered. Statements such as "Don't feel guilty" define the desired destination, but offer no direction as to the means of attaining that goal. I have sometimes wondered whether this type of guilt is not merely a subconscious means of inflicting punishment upon ones self in order to more deeply share the pain felt by the ill person. Guilt which is evoked through hateful thoughts or malicious wishes toward the ill person is sometimes more difficult to manage, due to the fervor with which the mental darts were hurled at the patient before the onset of illness. Abreast a wave of superstition, the guilty party quietly blames himself, feeling responsible for the evil which befell his victim. It is important for the guilt-stricken individual to realize he does not control the hands of fate. To further complicate matters, often the dying or deceased individual is surrounded by an aura of purity, and it is deemed unfit to denounce his character despite the validity of the statements. Though loss makes memories all the more dear to the heart, I feel that one should not forget that these people, sick though they are, are human; they possess irksome habits and have made foolish mistakes as does all humanity. To elevate an individual beyond his former limitations is an open invitation toward the housing of personal guilt, since any negative emotions concerning the patient will be thought of as hostile and unfounded; one is not only denying the disturbing propensities of the patient, but also, and more important, he is denying his true feelings, thereby trapping himself.
In this scope, I might add that elevating a person who has not yet died can create an undesirable situation for him, in that he may feel threatened by this new and unrealistic public opinion of himself which, consequently, is greater than he is able to uphold.
Another sort of guilt, planted by the patient, is somewhat related to the above. Although conversation is generally thought to be a healthy exchange between concerned individuals, there are those who, unfortunately, take the business of sharing their health problem wholeheartedly. Applying no restrictions on themselves, they continually voice their complaints until a situation is created wherein the complaints are more of a burden to the family than is the illness. I feel that reactions such as these on the part of the afflicted are unfair and completely selfish. Forcing constant awareness of an illness upon a loved one is cruel and emotionally debilitating.
When a situation such as the one described occurs, I wonder whether the patient truly loves his "subjects"; a caring individual would still want his family to derive joy from living despite his inability to actively take part. Jealousy has no place in love, especially when a loving relationship is placed in jeopardy by the imminence of death. A patient's jealousy can often promote guilt; ultimately, however, it begets only resentment, not true love and devotion.
My father was acquainted with a man whose wife was a constant source of worry. She was what I would call "the delicate type," in need of constant attention and sympathy whether she truly needed it or not. The day finally came when she found herself bedridden, demonstrating the symptoms of an actual health disorder, and her personality took on the shrieking demeanor of an angry bird. She expected constant nurturing care from her husband, yet nothing he did would please her. After hounding him relentlessly to pick up an item at the store, she would be enraged because of his "lengthy" absence.
Eventually the poor man agreed to place his wife in a rest home in her home town. However, through her injection of guilt, he still felt obliged to maintain a daily vigil by her side. The man became emotionally and physically exhausted, and suffered to such an extent that his sanity was nearly obliterated; in tearful, emotional outbursts he would relate the "sad" condition of his wife, and elaborate in detail their conversations and prayers, never thinking that her's was a very disturbed mind. Bereft of any other communicational outlet or friendships, he accepted the blame for his wife's unhappiness. In effect, he was starving for conversation and emotional support, causing an irrational view of reality.
Although, toward the last portion of her life, the wife was mentally incompetent concerning her nasty behavior, she would have been capable of changing her actions earlier in life, yet, through a jealous and self-centered need, she obtained a constant awareness of her presence by lamenting any flaw in her well being. The husband may have enjoyed the initial pampering as a means of elevating his feeling of self-worth; here was a woman who needed him. However, as any excess can be overwhelming, her preoccupation for comfort was his final undoing. Had she thought less of herself and allowed him the freedom to breathe, the obsessive guilt she strove to plant would never have taken root in his mind.
It is essential that the patient allows his family to continue in a "normal" fashion, for it must be accepted that there will be a time when life must carry on without the sick individual. This is not to say that a husband should start to seek another mate before his wife meets her demise; behavior of this nature is cruel and, I believe, says that his wife was not loved but only needed for the beneficial comforts she could provide. However, continuing attendance in a church, or meeting with friends should in no way be thought of as frivolous or forgetful of the sick, but rather as a form of therapy for the living.
I wanted my family to continue its current lifestyle, and for the most part, that was no problem. However, Mom continued to feel guilty about her health and ability to do anything she desired while her young daughter was forced to stay home.
As my cancer progressed and I did less in the social realm, spending week-end nights at home, my mother became concerned about leaving me alone when they went on a small excursion or nighttime gatherings; she worried that I might be lonesome or scared, or need help of some kind. It was somewhat of a chore to assure her that I would be fine; should I be scared or lonesome, it would pass, and with regard to my health, she would be powerless to aid in my comfort even if she was at home. As a final effort I confessed that I truly enjoyed being alone sometimes. I too needed room to breathe, to feel that, even with my severe limitations, I was yet in control of my life. It was important that I knew I could take care of myself if the need would arise.
Guilt may derive from actual wrong-doing on the part of the guilt-ridden as well as the causes described above. Whether spurred from emotional neglect, mental abuse, infidelity, or another source, this guilt is the only type which I feel is worthy of its keeper. When an individual knowingly hurts another, yet makes no attempt to correct himself, the former deserves to feel the grasp of pain. No apology, no matter how magnificent, can take the place of past injustice. Therefore, while the past is history, perhaps these regrets can best be handled by a silent oath to behave differently on future occasions.
The refusal of friends to face my health situation always brought about a keen sense of frustration on my behalf, modified to a certain extent by pity. It is impossible to attain any depth in such relationships, since continual avoidance of reality cannot be upheld.
One such relationship, in which a friend would not acknowledge the presence of my illness, was eventually transformed into a virtual charade. Conversations revolved solely around trivial matters or reminiscent revelries. Discussions of the present surrounded her doings only, for the least hint of my illness would leave the conversation stunted. Because I never cared to dwell on my ill health, any remark was of the passing sort, yet even these seemed too much for her to abide. It was as if the pre-cancerous person was the only "me" which existed for her; my entire self was no longer acceptable. As no change occurred, our rendezvous became less and less frequent, and eventually subsided altogether. I felt uncomfortable having to hide behind a mask of my former health for my company to be tolerable; it was better to be alone. Friendship must be built upon honesty if its true potential is to be realized.
Frustrating to a lesser degree were those who could withstand a cursory mentioning of my illness, but would then perform a mental backflip and begin discussing another topic as if I had no problem at all. It seemed that their understanding of my health condition was not congruent with the activities which they considered me capable of negotiating. Stifling an open-mouthed, incredulous stare, I would then attempt to explain that I was unfit for that particular suggestion, but perhaps we could find a mutually agreeable alternative. I always tried to coax one's realization of my health situation, rather than attempting to "cram" the truth down uncooperative throats.
It is so difficult for society to abide the thought of terminal illness and death, especially in those we love, and therefore it is often ignored in a conscious effort to prove its nonexistence. Though it is natural to attempt to flee that which seeks to invade one's happiness, running, unfortunately, shall not make the menace disappear; the young are not the only group of people who, when faced with the illness of a loved-one or friend, search desperately for their "running shoes."
While the voicing of feelings is very difficult, it can bring peace of immeasurable degree to yield to their expression; after a loved one dies, one can no longer deny that he was terminally ill, and is left to cope not only with the disease, but with its ultimate effect. Where there might have been memories of a loving farewell, there is emptiness. Just as spoken words cannot be recalled, words which are left unsaid are merely lifeless fragments of conversations which might have been, and forever plague the happiness of the individual who elected silence instead of self-expression.
The utilization of excessive denial toward the fact that a disease is incurable can jeopardize one's time and quality of life. Denial alienates its victims from family and friends. While the patient, or conversely, his relative, continually galavants across the country in search of a miracle drug or pretends the truth shall not come to pass, lost days can never again be regained. The feeling of hope afforded by such futile excursions and mental conjurings is, I believe, less beneficial than are the quiet and intimate interludes which might have taken their place. The longer one avoids the unfaltering truthfulness of such a situation, the less time he has to enjoy his remaining days in a "normal" fashion.
Unlike certain studies on illness and death, I cannot feel that denial is parallel to hope, nor can I think of the need for hope as a lack of acceptance. As I soon discovered, self-absorption in a traumatic illness eventually becomes monotonous, and one will naturally turn his mind to encompass other interests. This is perhaps more prominent with extended illness, as the patient and his family pursue routine activities while a "lack" of symptoms permits. Although cancer is definitely part of my life, it is not my whole life. While I have never thought a cure was likely to be discovered, I know there are many involved in cancer research; thus, as I live day to day, a ray of hope shines through a door which is not completely closed. Hope injects an element of pleasure in lives which would otherwise be stagnant reflections of death itself. While there is yet a chance to survive, and discomfort is not the primary essence of each day, one tends to think of life; it is all we, as humans, truly know.
Luckily my family and better friends did not avoid my problem. There were times when we felt pressed to talk, and let go of the tears which were usually held at bay throughout the day. Disappointment and faded dreams stabbed my father through the heart, and he lamented the many sadnesses with an angry vengeance. Mom's aching for that which could not be often liquified into tears. Norm, on one of our walks, would blandly state, "No luck at all . . ." The need to speak, and the responsibility to listen, alternated between us, and strengthened our relationships; the patient is not the only one in need of a tireless ear.
I had to be able to be free to talk and joke of my illness, not hide its existence in the corner of my mind. It was part of my life, becoming as natural as eating and sleeping. Had I been forced to conceal my feelings my life would have been one of loneliness and despair; I would only have been what people wanted to see… an image, not a real person.
I was alive, housing an alien growth, indeed nurturing it, so that it may fulfill its purpose. To try to impede its fixed intent seemed futile; cancer desired to squeeze life from my body many years ago… and now it truly appeared that it would succeed. Thus, almost pleased with the belief that my life had found its rut, from which it could not be removed, I wanted to live in a manner conducive to good spirits. No one, I thought, would interfere with my peace.
". . . I did not want to exist on a roller coaster, constantly grasping an inflated balloon of hope for each successive "cure" . . ."
Frustrations
Returning to college was difficult, as it prompted numerous explanations as to the cause of my absence. I was honest, relating my situation as gently as the English vocabulary allowed. I wished no pity, simply the same cordiality which before had greeted my entry into the room, and happily this I did receive. Yet more than this, I found within many eyes a deep incredulousness, as if they were simultaneously amazed and frightened that such a horrid disorder had pounced so near to their own lives. Their faces proclaimed "it cannot be!" while they tried desperately to transform my words into a statement which they found reasonable and within their capacity to understand. How could such a thing happen to someone "so young."
One particularly agreeable friend wasted no time in asserting that I would follow a plan consisting of health food and soon find myself "detoxified" and on my way to full recovery. Dubious, and rather self-protective, I hesitantly agreed to accompany her to the local natural food store to see if the owner knew of any promising, no-fail treatments for cancer. Once there I was shown a variety of self-cures, ranging from herbal diets, to drinking carrot juice and exorbitantly priced tea. I failed to see how such measures could possibly help, for if they did, would not everyone with cancer be flooding into the store, rather than laying bedridden in a hospital ward? I looked around at the people. They appeared to be ill. Carrot juice drinkers, I presumed! At any rate, water infused with plain tea sounded more appealing to me, and my friend and I sat down at one of their tables to peruse several books on the subject of cancer.
Because I had so thoroughly resigned myself to my inevitable death, I did not relish the thought of inquiring into cures; it was as if these "cures" threatened my happiness and sense of emotional security, for once acceptance has been attained it is not easy to smile upon that which may destroy one's inner peace. When I would try to explain this feeling, people often thought I housed a "death wish" or that I had no zest for life. It was a chore to explain this was not true, but rather, that I did not want to exist on a roller coaster, constantly grasping an inflated balloon of hope for each successive "cure" and then falling into the despair of disillusionment when it failed to enact its promise. I hoped my attitude did not injure my friend's good intentions; ironically we were each looking out for my well-being… she wished for my health and I for my sanity.
Scrawling several book titles and clinics on a piece of note paper I dismissed myself from the store into the fresh autumn breeze. I determined to check out a book on vitamin C therapy at the library before going home, although I honestly hoped that the information therein would prove doubtful and not merit further investigation. Maybe I was some sort of an odd-ball, I thought, toting the book under my arm. . .everyone wants to see me cured but me; I wanted that also, but without the lies and shams that treatment often entailed.
After thoroughly scouring the book for details, I found my previous assumptions to be correct. It was not proven that vitamin C increased one's life expectancy and, as I had also surmised, the ingestion of large amounts could render some ill effects, ranging from mild discomforts to more serious complications. I was relieved to read this, as I disliked the idea of taking massive doses of anything; I respected moderation.
The toxic effects of vitamin C were excessive gas, nausea and diarrhea (of which I felt I already had enough), urinary burning, irritations of the mouth, and injury to the tooth enamel, dehydration, a depletion of minerals in the body, and finally, a temporary increase in pain for terminal patients and possible risk of hemorrhaging for those with advanced cancers. Additionally, I found it interesting that vitamin C in massive doses could speed one's demise if he was near to death, while bestowing more energy upon those who were not; as I had no way of discovering in which stage I was classified, should I have been near my death, I felt no urge to roll out the red carpet of welcome by taking vitamin C.
So it was that one option of treatment had been thankfully discarded, and my friend reluctantly nodded in appreciation of my rejection of vitamin C. I shared an affinity with normalcy and serenity in life, yet in time I began to see the many trials which lay before me and my goal; even simplicity is difficult to attain when love and concern are one's barriers.
Another reaction to a dreaded diagnosis is what I would call "a feeling of desperation" by the relatives. Flooded by the reality that a family member may soon die, a relative may override his usual rationality by playing doctor and assuming what is best for the patient. This type of behavior is understandable; often a person who loves another will attempt to do all that is within his capabilities to comfort the sick. Through fulfilling his own emotional needs, the relative is then better able to cope with the illness, for he feels he has not simply watched his loved one fade away.
The relative's source of emotional comfort may lie in the steady pursuit of all hopeful treatment, reading any related publications on the disease spanning diet strategies to mega-dosages of vitamins as a potential cure, or perhaps arranging prayer sessions to pray the disease away. When one boasts an array of caring friends and relatives, the suggestions fly; it is quite a compliment and should be viewed as such. The patient, however, should not feel pressed by these informative offerings, and always remember that he has the right to decline their pursuit.
In dealing with an over-zealous relative, it is imperative that a patient communicates his desires to the relative in a manner that will accommodate and acknowledge the concern, yet enable him to follow his own needs. Everyone has a right to decide that which is best for his emotional well-being, and to assume that an individual's needs are identical to one's own is, indeed, a great folly and disservice to the other.
When a person makes choices for another without first consulting him, it is a direct violation of personal freedom; reactions to this type of treatment vary. A generally meek person may feel obliged to abide by his captor's urgings, either through fear of opposition or an indisposition to openly hurt, an act derived, supposedly, of pure concern. This type of person is quite vulnerable unless his relatives are protective of his wishes and do not extend their boundaries when decisions must be made through making personal demands. When a plan is devised, fully knowing both the quiet disposition of the patient and the fact that the plan in question would prove to have a disagreeable impact on him, the enactment of such a plan would be nothing short of overt maliciousness.
Another reaction to this decision-making effort may be fury, with the patient recklessly attacking the relative's "good intentions." Although anger is justifiable in such situations wherein the patient's desires were completely overlooked, I feel that wrath is punishment more harsh than the over-wrought relative merits. One might argue that if the relative truly had the patient's well-being in mind, he would have inquired into his wishes before enacting his own. Though basically true the argument cannot stand alone without also expressing the necessity for the patient to accept the chaotic mental states possessed by his relatives as a natural reaction to their own sorrow. Anger demeans its subject's need to retain hope, whereas a thoughtful explanation will yield a greater understanding of the entire situation as faced by all those concerned.
Because I value the ability to choose the routes which I wish my life to follow, I have similarly felt it is only fair to allow others that freedom as well; while I may have voiced an opinion toward a subject concerning someone other than myself, I would never feel it was acceptable behavior for me to take any action toward the fulfillment of that opinion. My oldest brother was different from myself in this regard, as the following story will demonstrate.
Often Todd would take issues into his own hands, apparently feeling that his way was undoubtedly THE way. It was virtually impossible to illustrate another viewpoint. Consequently when I received the diagnosis that I had cancer once again, the dark cloud which fell over the family receded somewhat after my resolution to forgo chemotherapy, yet Todd, who lived some distance away from the immediate family, was unfortunately less informed as to my generally good state of health at the present time and proceeded to think only of my rapid demise. Telephones, unhappily, cannot relate the entire picture of one's health; had he been able to actually see for himself that I was not fading away with each passing moment, I'm sure the turn of events would have been different. As it was, however, he decided we were not preparing ourselves for the onslaught of my disease, and unbeknownst to us, made an appointment for us to speak with the director of the "family hospice" service at the local hospital.
On Thanksgiving weekend everyone came home. I was in immensely good spirits, as I felt so very fortunate to be out of the hospital and with those I loved. Moreover, I was happy with my decisions and glad to feel physically well so soon after the exploratory surgery; I knew my health would not decline before the holidays, and in this I found contentment.
In the afternoon I dismissed myself from the festivities so that I could rest. Shortly after my disappearance, Todd and his wife found their way upstairs to my room and asked if they could talk to me. They entered and we discussed my health; I was glad to answer any questions which might have been forgotten, or otherwise left unanswered. They then gave me several books, two of which concerned the topic of death, namely, "On Death and Dying," and "On Dying With Dignity." Todd quickly made the statement that I didn't have to read them if I didn't want to, slightly embarrassed by the whole affair. I wasn't offended by the gifts, but thought them to be rather humorous. I thanked Todd nevertheless, acknowledging that many people have benefited from reading those books. I further said that although I felt in no need of assistance with regard to my handling the disease and eventual death, I would perhaps read the books simply to see what the doctors had to say about their keen observances of the dying.
Before our discussion had come to a close my mother came upstairs to join the group. Todd tried to conceal the books he'd given to me. I wondered about his effort of secrecy; did he have second thoughts as to the appropriateness of the gift, or was he concerned about Mom's reaction? I once again squelched a smile, noting how death is a characteristically dismal and uncomfortable subject; we all made our way to the main floor.
The following day everyone was gathering up their belongings for their journey homeward. As the day progressed and Todd had made no effort to pack, I became suspicious. He finally voiced the plan that he had in store for us, that being to talk with the director at the hospice service. We immediately rejected the idea, saying we had no intention of utilizing the service at the present time. It was then that he told us he had actually made an appointment for us, and the director would be expecting us in a few hours. Since we had first thought the idea was a mere suggestion, the negative feelings of anger did not surface until now.
Norm, sensing as I, the trouble which was bound to occur, excused himself before making a scene. He decided to take a walk to displace his rage. I firmly told everyone that I was not going; I didn't want to start digging my grave before my demise, not to mention the fact that I did not wish to die in the hospital if it could be avoided. But above all else, it was the principle of the whole affair that set off my self-protective behavior; I would not have my decisions made for me. My parents were also angered at the thought of their being entirely left out of the decision to see this man, multiplied by their lack of preparation for the discussion which was about to take place. At last, understanding Todd's concern, they agreed to accompany him. As I watched them file into the car, I wasn't quite sure if a battle had been lost or won; perhaps in the forgetting of principle, followed by the acceptance of the former, no one truly wins.
Letting one be free is sometimes the hardest gift to bestow upon another person, yet it can be the one of greatest value. Without personal choice, freedom is but a laughable reality.
Another case which was marked by what I would consider faulty and injurious judgment involved a couple who had been married for 52 years. This couple was a classic example of opposing personalities living together under one roof; she was a rational, mild-mannered lady, while he was obnoxious in every possible sense of the word, needing to be the constant attraction and principal authority presiding over any group or function. He had to have his way or he would make life truly miserable for the unfortunate individual who attempted to voice an opinion, carrying out his revenge with cruel indignance.
After suffering what appeared to have been a stroke, the woman was hospitalized only to discover that a tumor had formed in her brain. It was evident she would not have long to live, so she decided to forgo the torture which would accompany chemotherapy, the sole option of treatment, and explicitly informed her husband of her wishes. As time passed and her condition grew worse, she eventually lost all ability to verbally communicate; it was at this point that her husband bid the doctors to administer chemotherapy, with the supposed hope that she would regain some of her lost functions. Consciously aware of the decision which had been made by her husband on her behalf, yet incapable of voicing her opposition as to its commencement, she was forced to submit, for the last time, to her husband's self-centered dominance. He saw in her eyes that she begged to be released from the treatment, but he played the ignorant fool and watched as she quietly faded into the obscure limbo of unconsciousness.
All through their life together, until her quiet end, the man thought only of securing enjoyment for himself. When he felt his well-being was in danger, he sought only to maintain his happiness, which had little to do with the welfare of his dying wife. This was apparent in his total lack of empathy regarding her wishes, and the merciless ignorance of her speechless plea.
It is difficult for me to believe that such selfish persons exist, for I hope the vast majority of people will conquer their selfish tendencies in order to facilitate the desires of their loved one, even if it shall mean a more rapid decline in health. It is important to realize that only the patient suffers bodily pain; it is ultimately he who must undergo the treatment, which could in fact, significantly alter his overall comfort.
For these combined reasons, I feel it is fair to allow a mentally intact individual to decide how his remaining days shall he spent; this is why open conversation among family members is of such great consequence. When the illness prevents further decisions on the part of the patient, it is then up to the family to respect his previously stated wishes and, should further decisions need to be made beyond those which had been specified, strive to make new options benefit the patient's comfort. Above all else, kindness should prevail and guide in the solutions to any questions which might occur concerning the patient's death. A patient should not be made to suffer through a lack of acceptance on the part of the family; behavior of this sort not only uses the dying, it overtly abuses them.