I work with women who have cancer.
I work with them right after they discover their diagnosis, during treatment, and either into remission or as they die.
Every woman, every family, is unique in the way they approach this awful disease.
However, one common declaration is that of a “fight” against their cancer. Women will often (and their families or loved ones), when learning of their diagnosis, will set their jaws, narrow their eyes, sit up straighter, and declare that they are going to fight this. They won’t let “it” win. They refuse. They will get through this, they are tough, will work hard, they will see it to the other side. They will pray, they will meditate, they will do everything they can to live. They will be survivors.
I believe in chemotherapy and cancer treatments. I believe in a positive attitude. I believe in holistic approaches to treating illnesses, I believe in the mind/body connection. I believe in self advocacy. I believe in (most of the time) aggressive treatment when there is a chance at a cure.
I do not, however, believe in fighting cancer.
To fight anything— inherently implies there is a winner and a loser.
What does it mean, then, when my patient dies? Because so many of them do.
People often say when a person with cancer dies, that “they lost their battle”. What does this say of the dead?
Why must we attach a win or lose mentality to something we have such little control over? Why, when someone is already facing enough adversity and trauma such as a cancer diagnosis, do we then also tell them they have to “fight” this, they have to push, to be strong? How is this helping anyone?
To be diagnosed with cancer, to make it through treatment, remission and then to be able to establish a sense of a “normal” life (new normal, mind you – people are never the same after they have gone through something so traumatic) -- is something to be honored and respected.
However, to call this a victory over a battle, implies that those who do not live, or share the same fate, are losers.
And they? Those people, our people, who die? They are not losers. They, too, alongside those who face this and live, are some of the bravest humans I’ve ever met.
They don’t die because they didn’t want to live badly enough. Or because they did something wrong.
I’ve watched some women die feeling at peace. I’ve watched some women die and hate every single minute of the process. (Usually it is somewhere in-between, there is also no “right” way to die). I’ve watched some women say they are ready to go and it takes weeks (or longer) for their bodies to die and when they finally do, we are relieved for them.
These women? Did they lose a battle? Did they not want to live badly enough? Did they not pray hard enough, or ask hard enough, or eat enough kale, or try the latest and greatest treatment?
There has to be a better way.
I deeply believe in honoring all people who have experienced such trauma and are living and doing their best to heal not only their bodies -- but the wreckage and toll that cancer and cancer treatments have taken on their spirits, souls, and hearts (and finances!) I believe we need to support, rally, and hold these people up. They deserve our respect and love.
I also believe in honoring those, who when faced with a cancer diagnosis, do not “survive”. Meaning, they die from their disease. But to say they lost a battle is unfair and diminishes them. Certainly they lost their human life, they lost out on the life they could have lived (and should have been able to) if they were never diagnosed with such an awful disease. This is unfair and I never wish this fate on anyone.
But when our culture insists on the simplistic view that winning is living and losing is dying, we miss out on SO much -- The nuances of living and dying and the gifts and pain inherent in each.
Much of our culture is set upon the ideals of perfectionism, productivity equals worth, that those who are the strongest are those who fight their humanity the most. Our society is harsh. We play hard, work hard and don’t often value enough the softer, kinder ways of living (and dying).
So much of the time, I learn the most from my patients who learn how to live (and sometimes die) with the inherent vulnerability that this kind of diagnosis demands of you. They decide to pursue treatment or not, based on multiple factors. (Some of the bravest people I know, when faced with an incurable disease, are the ones who decline a treatment that will undoubtedly make them sicker and not live longer anyway). They understand that, based on multiple factors such as the stage and grade of their cancer, that they may go into remission or not. They understand that remission may last forever, or a few months, years, or not at all. They live (and die) with this knowledge every single day. They understand that most of this is out of their hands and can’t take responsibility for the outcome.
These people are no different than those who declare a battle against their disease. It’s just a kinder way to live and die. That is because they don’t have to make themselves wrong if their cancer kills them and they don’t have to hold themselves to some kind of unrealistic standard if they go into remission. They aren’t fighting a battle they can’t win. Because, friends? We are all going to die. We will ALL “lose” this battle.
The beauty of life and death, to me, is human connection. It’s pausing, being present. It’s naming how shitty life is sometimes, and in the same moment, how beautiful it can also be. It’s the complexity of what a gift if is to share a life with someone and how awful it is to have a body that can get sick and die.
It’s measuring the success of a life by the quality of connections, by speaking our truths, and hearing the truths of others, rather than by how long we are here or by how hard we work.
I understand that it’s easy for me to say, sitting here as a healthy 38 year old who was able to go to the gym today and isn’t having to stare down her mortality every day. I’m not trying to be unfair and I can’t pretend to know what it is like to have cancer, or to have a chronic illness that eats away at the life I wanted to live. I can’t pretend to know what it’s like to go to treatment that makes you sicker and feel awful and tears apart your life to treat something that would undoubtedly kill you without said treatment. If you have been through this, or are going through this, or love someone who is going through this, you have my utmost respect. I am in no way trying to take away from your complex and exceedingly difficult experience.
I do know, however, that it never helps a devastating situation, such as a cancer diagnosis, by attaching morality and character to the “outcome” of such trauma. Something so inherently vulnerable and unpredictable as a human body and the illnesses that can afflict it cannot be tamed by the strength of our character.
I also know we are tired of being wrong. Wrong for not being smart enough, thin enough, good enough, brave enough, fill-in-the-blank enough.
Let’s not attach ourselves to fighting a battle we are all ultimately going to lose. Let’s not define success as living and failure as dying. We miss out on so much that life (and death) has to offer when we do this to ourselves and each other.
Instead, let us choose to honor those who are going through this trauma and devastation by showing up in the best way we know how. Let’s support and surround them with love and empathy.
And when someone dies, may we also honor them and the strength and grace it took to inhabit an inherently vulnerable human body. May we honor them for lighting the way down the path we will all eventually go.