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ellastorm · 3 months

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I felt this post on a visceral level - the absurdity of the situation truly strikes sometimes.

A while ago I treated a young patient with an awful grade 4 brain tumour. It was a pretty somber first consultation to say the least, until we got to the last part: Before treatment we usually perform an MRI of the brain for treatment planning (I‘m working in radiation oncology), and at the end of the consultation I ask the patient if they have any electronic implants the magnetic field could theoretically meddle with to avoid unpleasant surprises at the machine. This particular patient had a very interesting answer to my question: Her gaze wandered down to her decolletage and, gingerly, she uttered „Yes, I do have implants.“ Whereupon I, dumbstruck and a little lost, because I - not considering that she might have misheard part of my question and wondering whether I’d completely missed the oncoming of a new generation of multi-functioning breast implants - doubled down with „But are they electronic? Like, do they beep or flicker?“

We stared at each other for ten solid seconds, blinking.

And then we started laughing, like proper eyes-watering, bellowing, exuberant laughter, because no, of course she‘d just misheard my question, of course they were REGULAR breast implants and NO there are no electronic multi-tool breast implants fresh on the market (though how fun would that be?), and yes, there was a high chance that she would die, much higher than for many others of her age, and doesn‘t that just make things weirdly, absurdly funny. Like, of course she would laugh about her breast implants. And, of course her doctor would, too.

Thank you for your very insightful post - and from the bottom of my heart, get well. I know how unhelpful statistics can be, but statistically speaking yours is a very treatable disease with high chances of curation. Hang on in there, and all the best to you.

the one thing I have heard probably the most consistently, from the most people, since being diagnosed with breast cancer, is that I have a "good attitude;" meaning, that I make jokes about having cancer, which makes whoever is listening to me feel better about the fact that I have cancer.

Here's the thing - the worst part of having cancer (so far, in my experience - I'll update as this progresses) is having to live with the constant, oppressive dread that right now, somewhere in my body, a cancer cell is taking root in my bones, or in my lungs. That it will silently grow, and spread, and eventually become rampant and untreatable, killing me decades before my time, and I won't know that I'm on that course until it's too late to do anything about it. That I will have to leave my wife alone, that she will have to watch me die painfully and without dignity, and that I will leave this world without having had the time to see so much of what makes it beautiful and strange.

this is not a funny thought!

However, the second worst part of having cancer is - okay, so they removed the tumor, right, and at the same time, they also removed a clump of lymph nodes in my armpit. They do that to test whether or not the cancer has spread. So coming out of surgery, I have two incision sites: one above where the tumor was, and the other one on my trunk right about where your bra passes under your arm.

And that means I'm not allowed to wear deodorant for ten days.

Imagine me: stinky, in my bed. I am an adult woman with a beating heart. I will not claim I have any greater share of dignity or wisdom than a typical example of my cohort, but I have lived and learned and erred, and amassed a small collection of accomplishments which I would not be ashamed to present to God at my reckoning, should such a being exist, and should such a reckoning take place. Times when I have shown meaningful kindness to someone when it would have been more convenient or popular to do nothing. Times when I have told a necessary truth to my own painful detriment. Things I have made that possessed, to at least a meager measure, a glimmer of genuine beauty. Trust I have earned, and not betrayed. I'm not a saint, but my soul is not nothing, and as I am forced to reckon with my own mortality in a way that few people my age ever do, I, like - I smell pretty bad? And like - my armpit is, like, clammy. I mean, how long has it been since you didn't wear deodorant for multiple days. There's a change in texture that I was not expecting. Just in the right armpit! The left armpit is fine, she gets to have deodorant.

But like, stress makes the B.O. situation not so hot, and I'm medically prohibited from doing the one thing that would rectify the situation. I own deodorant. It's right over there. I can see it from where I'm sitting. I am sure you understand of course that I am immersed in greater miseries. Even aside from the existential dread of having cancer - the incisions are painful. I'm very tired. I have two blown-out veins from when the anesthesiologist struggled to find a workable injection site before the surgery, so I have some wild bruising, and I can't really bend my left arm. But these are afflictions with some dignity. To have pain or fatigue after surgery is rather ennobled in the common discourse. But - do I have to smell like ham, too?

Must I smell like rank ham?

Of course the solution to the ham smell is just to take more showers, but bathing after surgery presents its own category of woes, which are also not particularly dignified. And it's here, caught betwixt the Scylla and Charybdis of 'smelling like old meat' and 'unwinding my boob from its surgical sling to take another ride around the wet room rodeo' that I find the humor in my situation. The feeble ape rails against her trivial but intractable stink!

And that humor spreads - much like cancer! - to everything else that it touches. It is, actually, very funny to tell someone that the joke Christmas gift they got for me is probably what gave me cancer. It's funny, when people find out I got my diagnosis on January 2nd, to blandly follow that up with "--So, 2024, not off to a great start, but 2025 is going to be my year." It's funny, when someone invites me to something we both know I probably don't want to go to, to suck air between my teeth and go, "Ooh, I would, but, you know--the cancer. Yeah, I can feel it flaring up right now. Maybe next time."

Things are funny when they subvert your expectations. People expect you to treat your cancer diagnosis very gravely, and so it's funny - to them, and to me - when I don't. And then they tell me I have "a great attitude."

"You'll be fine," I've heard over and over again. "You have a great attitude. That's the most important thing, in this kind of a situation - keeping a great attitude."

I certainly hope that's true! There is definitely plenty of science to support the idea that a positive mental attitude has an impact on health outcomes. I think the effectiveness of modern chemotherapy drugs, and the extent to which my particular cancer responds to them, will have a significantly larger impact; and that moreover, it's probably prudent to remember that people with great attitudes die of cancer every day. But I will not turn my nose up at a percentage point or two perhaps coming from the willingness to crack jokes about all the cancer I've got, and how surprised I was to learn that I'd got it.

As I suggested up top, I know that when people say "you have a great attitude," they sometimes genuinely mean that they are pleased to find me in a mental state that might increase my chances of recovering from a deadly disease, but mostly they mean "thanks for not being a huge bummer about your cancer. I appreciate you for not ruining my day about it." And I'm completely okay with that. Like, yeah - I am deliberately sparing you from the burden of having to Take Seriously my life-threatening condition. You're welcome. I, too, would rather avoid this conversation on one of the finite number of Thursdays God has seen fit to grant unto the measure of our lives. What the fuck are you supposed to do about any of this?

(Shout out to my one good work buddy who, on hearing the news, instantly responded with "Oh my god, Geri Hallwell aka Ginger Spice also got breast cancer young! You're like twins!" Thus far he is the only person who has said something in response to the news that actually made an immediate, positive impact.)

So anyway, obviously all I ever say in response to "you have a great attitude" is "Thanks! I'm just focusing on the positives and taking it a day at a time." Because that's true, and moreover, it's all anyone needs to hear.

What I'd like to say - not to them, because there's no point in burdening them any further than the embarrassing reminder of death burdens anyone - but maybe to someone, maybe just to You, maybe that's why I'm writing this -

What I'd like to say is: dogg, you have no idea how subverted my expectations have been lately. How could I not find this funny?

How profoundly alienated from the absurdity of death would I have to be to not laugh about this?

Like - I know this is so stupid, but listen: I could die. No, no - listen - no I know everyone dies - but like - are you listening? Are you actually listening? I could die. I could die. I could die. I could die.

Isn't that so funny? Isn't that actually so funny?

And this - this attitude that I'm in, right now, this one right here, where shaking my head ruefully and marveling at the - maybe belated, but I think probably actually quite premature - realization that oh no, 'everyone dies' means for me too, huh - and laughing at myself for never, apparently, really grasping that until now, and laughing at the incredible statistical unlikelihood my cancer - I've never won anything before! - and laughing at how woefully ill-prepared most people are to respond to news like this, and laughing about how, of everything terrible about cancer, the actual number-two-on-the-list worst thing about it so far is that I can't put on deodorant -

Is this the great attitude you're talking about?

I'm not angry, I'm not resentful, I'm curious, I'm really curious. Do you understand why I'm laughing?

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