I've become aware of a new phenomenon. Occasionally, and not preceded by any particular thought or event, my throat fills and my eyes well with unshed tears. Is this self-pity? Or perhaps it's a rush of gratitude that I discovered my cancer at an early stage and have a good chance of surviving it.
The tears don't fall and the moment passes.
Friday, September 28, 2007
Wednesday, September 26, 2007
No More Therapy
Last Thursday (September 20), I had my fourth and final session with Liron the psychologist. Although the sessions were slated to continue for three months, I could only agree with Liron that my anxiety was mainly under control and that the turmoil I’d felt that had caused me to seek psychological help in the first place was settling into broad acceptance of my fate. I guess there are patients who are unable to ‘hold’ their anxiety - as Liron put it, cupping his hands to indicate how anxiety metaphorically nestles - as well as I seem to be doing and therefore need his services more than I do. Also, if my fears and anxiety threaten to overwhelm me, I have several other options. In October, I’ll be beginning a yoga course called the Art of Living which has been adapted especially for breast cancer patients. (I understand that the difference between this course and the standard one is that we breathe more!) I’ve also made contact with the 1 in 9 organization and hopefully will be joining a support group very soon. I meditate and once a month have a session with Eran.
So the opportunity to plumb the depths of my sub-conscious and discover if there is anything there that contributed to my cancer is unavailable for now. Clearly, if I knew what thoughts and perceptions I have buried there, they would no longer be in my sub-conscious. I do think that the theory of flooding the mind with positive messages (I will survive, I am unique, and so on) to neutralize any sub-conscious negativity is seriously flawed. Any messages of this type would set up residence in my conscious mind rather than dislodge the contents of my unconscious mind.
But what if my sub-conscious is harboring massively positive, life affirming thoughts? I remember one afternoon in the waiting area for Accelerator 4 how one young woman was describing how her treatment was extended because the machine broke down so often and the thought that immediately leapt into my mind was, Well, that won’t happen to me! Of course it did, the very next day, and it hadn’t been repaired in time for my treatment the day after either. However faulty they might be, why would I want to expel such perceptions from my sub-conscious where all they are doing is making me happy and optimistic?
So the opportunity to plumb the depths of my sub-conscious and discover if there is anything there that contributed to my cancer is unavailable for now. Clearly, if I knew what thoughts and perceptions I have buried there, they would no longer be in my sub-conscious. I do think that the theory of flooding the mind with positive messages (I will survive, I am unique, and so on) to neutralize any sub-conscious negativity is seriously flawed. Any messages of this type would set up residence in my conscious mind rather than dislodge the contents of my unconscious mind.
But what if my sub-conscious is harboring massively positive, life affirming thoughts? I remember one afternoon in the waiting area for Accelerator 4 how one young woman was describing how her treatment was extended because the machine broke down so often and the thought that immediately leapt into my mind was, Well, that won’t happen to me! Of course it did, the very next day, and it hadn’t been repaired in time for my treatment the day after either. However faulty they might be, why would I want to expel such perceptions from my sub-conscious where all they are doing is making me happy and optimistic?
Wednesday, September 12, 2007
No More Radiation
Today I had my final radiation treatment. Out of a set of eight booster treatments, three had to be deferred because of a breakdown in the accelerator, bringing my last treatment right up to erev Rosh HaShana, a fitting start to the new year. Any cancer cells lurking anywhere in the vicinity of my breast should have been thoroughly nuked and expunged after the 33 treatments, leaving me, it is hoped, completely cancer-free. That’s the plan.
The angry-looking redness of my breast has now morphed into a rather nice tan color, with only slight redness around the scar, under which the lump, the original cause of all this trouble, was located. I was lucky that, unlike some women, I suffered no pain, no blistering or burns.
My next appointment with the oncologist is on October 10. On Sunday evening, on my first day back at work, I’ll be attending a meeting of participants in a yoga course for breast cancer patients called Art of Living.
The angry-looking redness of my breast has now morphed into a rather nice tan color, with only slight redness around the scar, under which the lump, the original cause of all this trouble, was located. I was lucky that, unlike some women, I suffered no pain, no blistering or burns.
My next appointment with the oncologist is on October 10. On Sunday evening, on my first day back at work, I’ll be attending a meeting of participants in a yoga course for breast cancer patients called Art of Living.
Friday, September 7, 2007
Why?
Why? This is the question I’ve asked since my diagnosis was confirmed. Not a plaintive ‘why me,’ but a practical question with tangible answers that can help identify the cause so that I can do or not do whatever it was so that it won’t happen again.
Is it the food I eat, the air I breathe, the electromagnetic emissions from computer, cell phone and remote control units I absorb? Does the plastic from the bottle leach into the water I drink; do the toxins in my deodorant, shampoo, conditioner and make-up silently attack my cells? Is it pressure from the tuck in my bath towel that I wrap around my body?
Is it due to a traumatic experience from childhood? Is there something I need to ‘get off my chest’? Do I have a range of negative thoughts which sent my cells on a frenzied journey of malformation? Am I not loved enough or do I not love enough? Am I subconsciously depressed, repressed and stressed?
I believed I had my life under control, that I was treating my body, mind and soul well and that I would be repaid with continued good health. I haven’t smoked for 22 years, I eat vegetables and fruit, fowl and fish, and have abjured eating the flesh of antibiotic and hormonally-fed cows for at least four years. We do not own a microwave oven. I exercised. I meditated. I worked and exercised my brain. I enjoyed fulfilling relationships. I rarely suppressed an opinion but exercised restraint—well, mostly—within the boundaries of acceptable social intercourse. I felt empowered, untrammeled by the insecurities of past years and was willing the remaining years before retirement to pass quickly so I’d could begin to really enjoy myself. Not since I was a teenager did I want time to move so fast. In short, my life was a perfect picture book example of the healthy lifestyle that self-help advocates urge us to adopt after contracting cancer! What irony. Clearly, it wasn’t enough to combat the risk factors...
I belong in quite a few high-risk groups: I am over 50; I have close blood relatives who contracted the disease; I began menstruating early, at the age of 11; and finally, I’d been taking HRT (hormone replacement therapy) for almost 11 years. For most of that time, the HRT was estrogen-based; in the last few years I took a non-estrogen-based therapy. However, cancer develops slowly over a long period, and in all likelihood the provenance of my cancer dates from those early years when all that concerned me was not to endure another hot flush. A combination of all these risk factors with HRT providing the clincher to cause all other risks to shrink and shrivel before it, seem to have outweighed the benefits of the healthy lifestyle that played by all the rules.
It’s been suggested that my cancer was inevitable and that my healthy lifestyle actually deferred the onset of cancer by many years. If this is the case, then I appear to have being doing everything right and all I need to do to live a long life free of cancer is to continue with more of the same - minus the HRT.
I have used various terms throughout this blog to describe myself in regard to living with cancer, most frequently as ‘cancer victim’. As the cancerous lump was scooped out of me by the surgeon, I am presumably cancer-free and all the subsequent treatments are designed to ensure that none of those pesky little cells remain in my body and that new cancerous ones will not develop. I think a more appropriate term is ‘cancer patient.’ ‘Patient’ implies endurance with an unavoidable process while ‘victim’ suggests bitterness.
I do not dismiss the body, mind, spirit connection. One of the women I meet during radiation treatments believes that stress from the Second Lebanon War precipitated the onset of her cancer. Conversely, my brother Tony defied predictions and lived for two and a half years following diagnosis instead of the year that the doctors gave him. I am convinced that my mother, who was almost completely blind, willed herself to die as she felt the increasing frailty of my brother when she hugged him, unable to face the death of yet another child.
If stress is the main factor in triggering cancer, I have never in my life undergone such intense stress as that emanating from contracting the disease itself.
Is it the food I eat, the air I breathe, the electromagnetic emissions from computer, cell phone and remote control units I absorb? Does the plastic from the bottle leach into the water I drink; do the toxins in my deodorant, shampoo, conditioner and make-up silently attack my cells? Is it pressure from the tuck in my bath towel that I wrap around my body?
Is it due to a traumatic experience from childhood? Is there something I need to ‘get off my chest’? Do I have a range of negative thoughts which sent my cells on a frenzied journey of malformation? Am I not loved enough or do I not love enough? Am I subconsciously depressed, repressed and stressed?
I believed I had my life under control, that I was treating my body, mind and soul well and that I would be repaid with continued good health. I haven’t smoked for 22 years, I eat vegetables and fruit, fowl and fish, and have abjured eating the flesh of antibiotic and hormonally-fed cows for at least four years. We do not own a microwave oven. I exercised. I meditated. I worked and exercised my brain. I enjoyed fulfilling relationships. I rarely suppressed an opinion but exercised restraint—well, mostly—within the boundaries of acceptable social intercourse. I felt empowered, untrammeled by the insecurities of past years and was willing the remaining years before retirement to pass quickly so I’d could begin to really enjoy myself. Not since I was a teenager did I want time to move so fast. In short, my life was a perfect picture book example of the healthy lifestyle that self-help advocates urge us to adopt after contracting cancer! What irony. Clearly, it wasn’t enough to combat the risk factors...
I belong in quite a few high-risk groups: I am over 50; I have close blood relatives who contracted the disease; I began menstruating early, at the age of 11; and finally, I’d been taking HRT (hormone replacement therapy) for almost 11 years. For most of that time, the HRT was estrogen-based; in the last few years I took a non-estrogen-based therapy. However, cancer develops slowly over a long period, and in all likelihood the provenance of my cancer dates from those early years when all that concerned me was not to endure another hot flush. A combination of all these risk factors with HRT providing the clincher to cause all other risks to shrink and shrivel before it, seem to have outweighed the benefits of the healthy lifestyle that played by all the rules.
It’s been suggested that my cancer was inevitable and that my healthy lifestyle actually deferred the onset of cancer by many years. If this is the case, then I appear to have being doing everything right and all I need to do to live a long life free of cancer is to continue with more of the same - minus the HRT.
I have used various terms throughout this blog to describe myself in regard to living with cancer, most frequently as ‘cancer victim’. As the cancerous lump was scooped out of me by the surgeon, I am presumably cancer-free and all the subsequent treatments are designed to ensure that none of those pesky little cells remain in my body and that new cancerous ones will not develop. I think a more appropriate term is ‘cancer patient.’ ‘Patient’ implies endurance with an unavoidable process while ‘victim’ suggests bitterness.
I do not dismiss the body, mind, spirit connection. One of the women I meet during radiation treatments believes that stress from the Second Lebanon War precipitated the onset of her cancer. Conversely, my brother Tony defied predictions and lived for two and a half years following diagnosis instead of the year that the doctors gave him. I am convinced that my mother, who was almost completely blind, willed herself to die as she felt the increasing frailty of my brother when she hugged him, unable to face the death of yet another child.
If stress is the main factor in triggering cancer, I have never in my life undergone such intense stress as that emanating from contracting the disease itself.
Coping
The internet is awash with advice and stratagems to prevent or cure cancer. Much of it is contradictory, unproven or unattributed. Serious sites, those that belong to or are endorsed by recognized institutions describe, inter alia, a range of clinical trials, the results of which frequently present conflicting evidence. The world of information, whether via the net, professionals in the field or the grapevine is a morass of confusion which no person who wishes to maintain a modicum of sanity can hope to fully navigate with inpunity.
From the beginning, I have tried to understand the facts of cancer and to find a path to follow that would best ensure my continued survival. Some of the questions I ask either have no answers or have answers I would need a degree in medicine or biology to begin to understand.
However, there was no doubt in my mind that I would entrust myself to the medical establishment and conventional treatment. Whatever the shortcomings of modern medicine and the fact that much about cancer remains mysterious, new information about the disease and innovations in treatment are constantly evolving and survival rates of cancer patients are increasing.
There are myriad alternative treatments out there on the internet, ranging from the practical to the mystical to the crackpot. Although I investigate and might even adopt an approach here and there, none of these treatments are subject to the intense and objective research of medical science. They therefore remain unproven and any examples of their purported success are anecdotal, unsupported by accepted norms of scientific research.
Whether I gravitated towards technical writing due to my almost obsessive need to understand the fundaments of any given issue or the profession simply honed my skill in doing so, my coping strategy has been to dissipate the fog that suffused me when I first received my diagnosis. Educating myself with solid data about the disease and the treatments I undergo promotes a semblance of control. I try to be methodical, but digressions, especially on the internet, are so tempting. Nonetheless, developing additional strategies to play a supporting role in my treatment is an ongoing process as their effectivity is tested over time.
I am still at a crossroads in terms of my eating habits. I find myself skipping from one nutrition authority to another, with no clear idea of what to adopt and what to eschew. In the meantime, I’m trying to maintain what is referred to as a well-balanced diet, and to eat plenty of salad greens and vegetables, limited but varied fruits and plenty of protein; to shun cow’s dairy products; reduce dairy and sugar intake. Some websites recommend eating only wholewheat products while others prohibit eating wheat at all. It’s very confusing.
I aim to introduce more harmony into my life. When going to work each day became a burden halfway through my radiation treatments, I decided to take a break until they were finished and felt an immediate lightness. In November, I will attend an Art of Living course, a yoga workshop specifically designed for breast cancer patients. I also spend more time meditating than in the past. This morning I tried a visualization exercise whereby bright, white little muscle-men killer cells hunted down ugly little bilious-green cancer cells and found a couple of them copulating behind a lobule. Unfortunately, the buzzer rang indicating the meditation session was over before the muscle-men could pulverize the bad guys. And I took Eran’s advice to cease double-checking the equipment and interrogating the technicians and instead had a conversation with God during my radiation treatments. It was actually very liberating but I’m relieved that the conversation remained one-sided.
I have been very gratified by the number of people who have offered to include me in their prayers. The intensity of the warmth I experience each time a request for my mother’s name is made must, at the very least, be equal to the efficacy of the act itself.
As for repressed childhood traumas and suppressed memories, well, they’re repressed and suppressed so I guess they’ll continue to remain unidentified until they present themselves in some recognizable form.
Caring people with the best of intentions need to draw on deep resources of sensitivity when offering suggestions, and recognize that we cancer patients are emotionally vulnerable. Sometimes it takes a while to find the path that is right for us but in the end, we adopt coping strategies that are based on our personal choice and inclinations, in the same way that we reach decisions regarding our religious beliefs or the way we style our hair. New insights and open discussion are stimulating, but there is a thin line between giving supportive advice and invalidating another person’s choices, for some, arrived at through painful and time-consuming enquiry. Confidence in our coping strategies can be fragile and their invalidation can cause us uncertainty and stress.
One of the best articles I’ve read on the web touches on this point: Being Positive
From the beginning, I have tried to understand the facts of cancer and to find a path to follow that would best ensure my continued survival. Some of the questions I ask either have no answers or have answers I would need a degree in medicine or biology to begin to understand.
However, there was no doubt in my mind that I would entrust myself to the medical establishment and conventional treatment. Whatever the shortcomings of modern medicine and the fact that much about cancer remains mysterious, new information about the disease and innovations in treatment are constantly evolving and survival rates of cancer patients are increasing.
There are myriad alternative treatments out there on the internet, ranging from the practical to the mystical to the crackpot. Although I investigate and might even adopt an approach here and there, none of these treatments are subject to the intense and objective research of medical science. They therefore remain unproven and any examples of their purported success are anecdotal, unsupported by accepted norms of scientific research.
Whether I gravitated towards technical writing due to my almost obsessive need to understand the fundaments of any given issue or the profession simply honed my skill in doing so, my coping strategy has been to dissipate the fog that suffused me when I first received my diagnosis. Educating myself with solid data about the disease and the treatments I undergo promotes a semblance of control. I try to be methodical, but digressions, especially on the internet, are so tempting. Nonetheless, developing additional strategies to play a supporting role in my treatment is an ongoing process as their effectivity is tested over time.
I am still at a crossroads in terms of my eating habits. I find myself skipping from one nutrition authority to another, with no clear idea of what to adopt and what to eschew. In the meantime, I’m trying to maintain what is referred to as a well-balanced diet, and to eat plenty of salad greens and vegetables, limited but varied fruits and plenty of protein; to shun cow’s dairy products; reduce dairy and sugar intake. Some websites recommend eating only wholewheat products while others prohibit eating wheat at all. It’s very confusing.
I aim to introduce more harmony into my life. When going to work each day became a burden halfway through my radiation treatments, I decided to take a break until they were finished and felt an immediate lightness. In November, I will attend an Art of Living course, a yoga workshop specifically designed for breast cancer patients. I also spend more time meditating than in the past. This morning I tried a visualization exercise whereby bright, white little muscle-men killer cells hunted down ugly little bilious-green cancer cells and found a couple of them copulating behind a lobule. Unfortunately, the buzzer rang indicating the meditation session was over before the muscle-men could pulverize the bad guys. And I took Eran’s advice to cease double-checking the equipment and interrogating the technicians and instead had a conversation with God during my radiation treatments. It was actually very liberating but I’m relieved that the conversation remained one-sided.
I have been very gratified by the number of people who have offered to include me in their prayers. The intensity of the warmth I experience each time a request for my mother’s name is made must, at the very least, be equal to the efficacy of the act itself.
As for repressed childhood traumas and suppressed memories, well, they’re repressed and suppressed so I guess they’ll continue to remain unidentified until they present themselves in some recognizable form.
Caring people with the best of intentions need to draw on deep resources of sensitivity when offering suggestions, and recognize that we cancer patients are emotionally vulnerable. Sometimes it takes a while to find the path that is right for us but in the end, we adopt coping strategies that are based on our personal choice and inclinations, in the same way that we reach decisions regarding our religious beliefs or the way we style our hair. New insights and open discussion are stimulating, but there is a thin line between giving supportive advice and invalidating another person’s choices, for some, arrived at through painful and time-consuming enquiry. Confidence in our coping strategies can be fragile and their invalidation can cause us uncertainty and stress.
One of the best articles I’ve read on the web touches on this point: Being Positive
My Sister Jo
Jo (Josephine) was my elder sister. She died in 1985 at the age of 47 after the breast cancer she contracted three years earlier had metastasized to her bones and other parts of her body. When I think of what happened to her, I am gripped by fear because I am afraid it will happen to me. The way I’ve chosen to cope with this is to try to furnish myself with as much information as possible about her cancer and the procedures and treatment she would have undergone in 1982 in the hope that I will discover why she died and why, 22 years later I won’t. There is no-one alive today that I am aware of who has any information about her, not even where she was hospitalized.
There’s not much I remember about her cancer. At the time, the word inspired such fear (it still does, but the subject is discussed so much more and there is such a glut of information about it that the word loses some of the mystique of earlier times), I had no idea what to ask or even how to digest what she’d told me.
I knew nothing about her illness until the day I received a letter from her informing me that she’d had an operation and that the tumor had been encapsulated. She described how for six months, she had to cover her breast and not allow it to get wet when taking a bath. When I visited England some time later, I remember her telling me that she was going into early menopause and that her breasts were becoming very large. I remember my mother mentioning it in worried tones.
At the time, our family doctor told me that an encapsulated tumor presented the best chance for survival and when I asked why in that case Jo had died, she theorized that a cell must have escaped. From the little information I have, it seems likely that Jo too underwent radiation treatment and that she was also taking hormonal treatment, probably Tomoxifen—which I will be taking in another month.
My questions focus on the differences in knowledge about the disease and the efficacy of diagnoses and different treatments in 1982 and 2007. Although there is no way of ever finding out, I wonder if an errant cell escaped and metastasized or did Jo have a recurrence which remained unidentified? This question is as imperative today as it was then.
I would assume that laboratory techniques for analyzing tumors in 1982 were less sophisticated than they are today. What would they not have known then that they regularly test for today?
I don’t have to avoid wetting the radiated area, on the contrary, I’m supposed to smother it in creams. How do radiation treatments differ in the last 22 years? What radiation treatment is it likely she received?
Have the components of Tomoxifen improved over the last 22 years or has it remained essentially the same?
Were lymph nodes automatically removed in the case of an encapsulated tumor? Is it possible that hers were not removed and that the cancer had already migrated to her lymph nodes?
According to a document published by the Breast Cancer Campaign called The History of Breast Cancer, the gene HER2/neu and its role in aggressive breast cancers had been discovered in the 1980s, although it’s not clear during which part of the decade and whether its discovery impacted in any way on my sister’s treatment.
Locating hospital records from 1982 is problematic. So far, I’ve learned that she was not hospitalized in St. Mary’s or St. George’s. I’m still waiting to hear from the Royal Marsden.
Jo was my senior by nine years. She didn’t take much notice of me when I was a child but we began to establish a rapport around about the time I was 12 and she was 21, or, more precisely, when I began to exhibit an interest in boys and make-up. She was fun, her wit made me laugh, she was tall and elegant and always seemed so confident. If any facet of her personality stands out, it was her sense of humor.
She chose not to die in a hospital. I arrived too late to find her alive at the home of her friend Sylvia, who, with incredible charity and compassion, had lent her home to Jo in her last days. Sylvia told me how she broke the news to Jo that her situation was terminal but she refused to accept it, saying she would go kicking and screaming. When Sylvia suggested that Jo call her place of work, she declined, saying, What if they take away my car and then they find a cure!
I often think how Jo would have enjoyed the world of advanced communications we live in today, how she would have been amongst the first to take advantage of the internet. She was an artist, though she claimed she wasn’t a very good one because our parents tried to force her, a left-hander, to use her right hand. Instead of art, she built a career in public relations and at the time of her death was doing PR for a firm producing 5.5 in floppy disks. She never had children of her own but was a perfect aunt to my three kids and my brother Tony’s son, Jonathan.
Jo’s death left me shocked. It dispelled any notion I might have had that death didn’t exist, at least, not in my family. And inevitably, the reality of her death brought into question my own mortality. For years, her lifestyle was the talisman I conjured to rationalize why I would not suffer her fate. She smoked, she’d never given birth, she ate mainly unhealthy restaurant or pre-packaged meals, she’d been on birth control pills for over 15 years. I’d given up smoking, I’d had three children, I ate healthy home-cooked meals and I used an IUD.
How smug I was! Today, in order to avoid smugness, I fall foul of the other side of the coin which is fear of meeting the same fate.
About nine months before she died, Jo and I had an argument as a result of some miscommunication. I remember writing a long letter to her explaining exactly why she was wrong and I was right and then I threw it away. But I was surprised, and not a little distressed, that for the first time, Jo didn’t send David a birthday card. At the time, I thought it was because she was still angry with me. Now I realize that it was more likely an oversight and that it was not in her nature to be spiteful to a child because of differences with his mother. When I returned home to Israel after her funeral, I found an anniversary card from her in which she wrote that I should expect a letter from her soon. Of course, there never was a letter from her ever again.
There’s not much I remember about her cancer. At the time, the word inspired such fear (it still does, but the subject is discussed so much more and there is such a glut of information about it that the word loses some of the mystique of earlier times), I had no idea what to ask or even how to digest what she’d told me.
I knew nothing about her illness until the day I received a letter from her informing me that she’d had an operation and that the tumor had been encapsulated. She described how for six months, she had to cover her breast and not allow it to get wet when taking a bath. When I visited England some time later, I remember her telling me that she was going into early menopause and that her breasts were becoming very large. I remember my mother mentioning it in worried tones.
At the time, our family doctor told me that an encapsulated tumor presented the best chance for survival and when I asked why in that case Jo had died, she theorized that a cell must have escaped. From the little information I have, it seems likely that Jo too underwent radiation treatment and that she was also taking hormonal treatment, probably Tomoxifen—which I will be taking in another month.
My questions focus on the differences in knowledge about the disease and the efficacy of diagnoses and different treatments in 1982 and 2007. Although there is no way of ever finding out, I wonder if an errant cell escaped and metastasized or did Jo have a recurrence which remained unidentified? This question is as imperative today as it was then.
I would assume that laboratory techniques for analyzing tumors in 1982 were less sophisticated than they are today. What would they not have known then that they regularly test for today?
I don’t have to avoid wetting the radiated area, on the contrary, I’m supposed to smother it in creams. How do radiation treatments differ in the last 22 years? What radiation treatment is it likely she received?
Have the components of Tomoxifen improved over the last 22 years or has it remained essentially the same?
Were lymph nodes automatically removed in the case of an encapsulated tumor? Is it possible that hers were not removed and that the cancer had already migrated to her lymph nodes?
According to a document published by the Breast Cancer Campaign called The History of Breast Cancer, the gene HER2/neu and its role in aggressive breast cancers had been discovered in the 1980s, although it’s not clear during which part of the decade and whether its discovery impacted in any way on my sister’s treatment.
Locating hospital records from 1982 is problematic. So far, I’ve learned that she was not hospitalized in St. Mary’s or St. George’s. I’m still waiting to hear from the Royal Marsden.
Jo was my senior by nine years. She didn’t take much notice of me when I was a child but we began to establish a rapport around about the time I was 12 and she was 21, or, more precisely, when I began to exhibit an interest in boys and make-up. She was fun, her wit made me laugh, she was tall and elegant and always seemed so confident. If any facet of her personality stands out, it was her sense of humor.
She chose not to die in a hospital. I arrived too late to find her alive at the home of her friend Sylvia, who, with incredible charity and compassion, had lent her home to Jo in her last days. Sylvia told me how she broke the news to Jo that her situation was terminal but she refused to accept it, saying she would go kicking and screaming. When Sylvia suggested that Jo call her place of work, she declined, saying, What if they take away my car and then they find a cure!
I often think how Jo would have enjoyed the world of advanced communications we live in today, how she would have been amongst the first to take advantage of the internet. She was an artist, though she claimed she wasn’t a very good one because our parents tried to force her, a left-hander, to use her right hand. Instead of art, she built a career in public relations and at the time of her death was doing PR for a firm producing 5.5 in floppy disks. She never had children of her own but was a perfect aunt to my three kids and my brother Tony’s son, Jonathan.
Jo’s death left me shocked. It dispelled any notion I might have had that death didn’t exist, at least, not in my family. And inevitably, the reality of her death brought into question my own mortality. For years, her lifestyle was the talisman I conjured to rationalize why I would not suffer her fate. She smoked, she’d never given birth, she ate mainly unhealthy restaurant or pre-packaged meals, she’d been on birth control pills for over 15 years. I’d given up smoking, I’d had three children, I ate healthy home-cooked meals and I used an IUD.
How smug I was! Today, in order to avoid smugness, I fall foul of the other side of the coin which is fear of meeting the same fate.
About nine months before she died, Jo and I had an argument as a result of some miscommunication. I remember writing a long letter to her explaining exactly why she was wrong and I was right and then I threw it away. But I was surprised, and not a little distressed, that for the first time, Jo didn’t send David a birthday card. At the time, I thought it was because she was still angry with me. Now I realize that it was more likely an oversight and that it was not in her nature to be spiteful to a child because of differences with his mother. When I returned home to Israel after her funeral, I found an anniversary card from her in which she wrote that I should expect a letter from her soon. Of course, there never was a letter from her ever again.
My Brother Tony
Tony was older than me by seven years. Our relationship was not particularly close but, like Jo, he made me laugh. He’d been married twice, had one son and at the time of his death, was in a close relationship with his live-in girlfriend. He was a partner in a firm of solicitors and had been an extraordinarily successful musician since his teens. He played keyboard, saxophone (alto and contralto) and clarinet.
As with Jo, I knew nothing about his cancer until I received a letter from him with the bad news. Later, visiting the UK, he described how one day he’d felt a hardness in his side and had been pleased because he’d spent some time working out and he thought it was having a effect. A few weeks later, he peed blood and soon after was diagnosed with very advanced cancer of the kidney.
Like Jo, Tony refused to acknowledge that he was dying, continuing to go to work everyday and lead an otherwise normal life. This superhuman determination is probably what led to Tony surviving at least a year and a half beyond the year the doctors' had predicted. The last time I spoke to him was about a fortnight before he died. It was clear that the cancer had already metastasized to his lungs as he tried to fit as many words as possible into each exhaled breath. He was looking forward to the new millenium but died a mere 16 days before it.
A few weeks before my own cancer diagnosis, I’d thought how ironic it was that I, the bratty little sister, living in a country beset by the dangers of war and terrorism, was still alive while my sister and brother were not.
As with Jo, I knew nothing about his cancer until I received a letter from him with the bad news. Later, visiting the UK, he described how one day he’d felt a hardness in his side and had been pleased because he’d spent some time working out and he thought it was having a effect. A few weeks later, he peed blood and soon after was diagnosed with very advanced cancer of the kidney.
Like Jo, Tony refused to acknowledge that he was dying, continuing to go to work everyday and lead an otherwise normal life. This superhuman determination is probably what led to Tony surviving at least a year and a half beyond the year the doctors' had predicted. The last time I spoke to him was about a fortnight before he died. It was clear that the cancer had already metastasized to his lungs as he tried to fit as many words as possible into each exhaled breath. He was looking forward to the new millenium but died a mere 16 days before it.
A few weeks before my own cancer diagnosis, I’d thought how ironic it was that I, the bratty little sister, living in a country beset by the dangers of war and terrorism, was still alive while my sister and brother were not.
Wednesday, September 5, 2007
Booster Days
I’ve completed the 25 radiation treatments and started a series of eight booster treatments. The boosters are carried out in Accelerator 4 and differ from the treatments I had in Accelerator 2 in a number of ways. First of all, the ray is electronic and directly targets the location of my erstwhile lump, instead of photon, which, if I understood the explanation correctly, bores deep and spreads in the area until it meets the resistance of the inner contours of my breast. Secondly, instead of the reflection of interlocking red guidelines on my body, a yellowish light is beamed directly on to my scar and there is only one, 20+-second blast, instead of two. And most significantly, the radiation team in Accelerator 4 seems to favor a more upbeat background music than their colleagues in Accelerator 2, who preferred the gentler rhythms of Julio Iglesias and Beethoven; I need to remind myself to remain still and not to twitch in time to the music.
A small coterie of women, with whom I compared lump size and respective treatments, has migrated with me from Accelerator 2 to Accelerator 4 where we continue to wish each other luck.
My breast looks like it’s been left out in the sun too long. It’s red and patchy and I faithfully apply the creams that the nurse, Rahel, recommends—so far there’s no discomfort or blistering. It’s also larger than its twin, although I accept that the lack of symmetry is discernible only to myself. I tire easily and disconcertingly, tend to drop off while watching movies that, now that I’ve taken a break from work, I have the time to watch.
I view everything through the prism of my emotions. I’m quick to tears and feelings of anger and frustration. The slightest aggravation or disappointment can trigger any one or all of these emotions. When my first appointment in Accelerator 4 was cancelled due to a malfunction, I felt so let down I could barely resist the impulse to burst into tears and stamp my foot. My daily treatments, while a pain in the ass, bestow a sense of being cared for. They also serve as a framework within which I function as if my life were normal and any deviation from it disproportionately undermines my ability to cope. A cancelled appointment is equivalent to a loose thread that threatens to unravel the fabric of my life.
The hospital allocates three months for therapy and I have had three sessions to date. My psychologist’s mission is to help me regain the well-being I had before my diagnosis and to combat my fear that I meet the same fate as my sister.
Between them—the doctors and radiation technicians, Liron the psychologist and Eran, my mediatation guide—I would seem to have body, mind and spirit covered.
A small coterie of women, with whom I compared lump size and respective treatments, has migrated with me from Accelerator 2 to Accelerator 4 where we continue to wish each other luck.
My breast looks like it’s been left out in the sun too long. It’s red and patchy and I faithfully apply the creams that the nurse, Rahel, recommends—so far there’s no discomfort or blistering. It’s also larger than its twin, although I accept that the lack of symmetry is discernible only to myself. I tire easily and disconcertingly, tend to drop off while watching movies that, now that I’ve taken a break from work, I have the time to watch.
I view everything through the prism of my emotions. I’m quick to tears and feelings of anger and frustration. The slightest aggravation or disappointment can trigger any one or all of these emotions. When my first appointment in Accelerator 4 was cancelled due to a malfunction, I felt so let down I could barely resist the impulse to burst into tears and stamp my foot. My daily treatments, while a pain in the ass, bestow a sense of being cared for. They also serve as a framework within which I function as if my life were normal and any deviation from it disproportionately undermines my ability to cope. A cancelled appointment is equivalent to a loose thread that threatens to unravel the fabric of my life.
The hospital allocates three months for therapy and I have had three sessions to date. My psychologist’s mission is to help me regain the well-being I had before my diagnosis and to combat my fear that I meet the same fate as my sister.
Between them—the doctors and radiation technicians, Liron the psychologist and Eran, my mediatation guide—I would seem to have body, mind and spirit covered.
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