All of the side effects of cancer treatments are also symptoms of cancer. If I google “rib pain after breast cancer”, I scroll through pages and pages of women who are concerned about metastasis and awaiting results of scans. They never report back. Their silence suggests that whatever the results, strangers misspelled and rambling missives -- always bizarrely punctuated, each word born from fear beyond communication -- no longer offer any comfort. If I google “rib pain and tamoxifen” or “rib pain and radiotherapy” my pain is always listed in the side effects, nestled amongst dozens of other possible pains affecting every area of my body. Now every unusual sensation prompts a game of morbid bingo: is it cancer, is it my cancer medication or am I aging? In December, I spent a couple of days feeling so deeply fatigued and awful that I was convinced I had Covid. Until I woke up on the third morning feeling better and realised I had experienced my first two-day hangover. I was just getting older.
Everything in me that could be interpreted as resilience is a result of my bad memory. After I had my mastectomy and recovered, I promptly forgot about everything cancer related. I couldn’t and still can’t tell you what year I had surgery or the timeline of events that led up to it. I don’t think this is unique to me; our ability to move on, to remember only when we try very hard to, seems like a feature and not a bug. How else would we survive? When I was diagnosed with the cancer recurrence, I was also going through a terrible time at work. Speaking to a lawyer who was helping me navigate it, she explained that people who are diagnosed with cancer are always protected by the Equality Act because they live with the fear that it will come back. I felt sick at the realisation that she was talking about me. I was the person who had cancer. I am the person who is afraid.
I try to only talk about my cancer when I am not afraid. I try not to talk about it at all because it makes everyone scared. Especially with new people. If I ever mention it in passing, they react badly. I need to appropriately set the scene – perhaps queue up the abandoned puppy Sarah Mclachlan song and a slideshow of me looking sad – and demonstrate my remove from it. Cancer happened to me but now I’m here, better. This was easier the first time when I felt mostly unchanged by the experience; cancer almost never came up. Now it feels like I’m living with cancer. I did not expect the second diagnosis and now that it’s happened, it’s opened a trap door in my mind to all the hideous possibilities. It’s impossible for me to feel unchanged by cancer. It keeps showing up. Sometimes it shows up in ways that I find funny, like when the aesthetician told me I couldn’t get a particular kind of facial because they couldn’t guarantee that the new cells generated as a result wouldn’t be cancerous. Sometimes it shows up in ways that I find devastating, like when my oncologist told me I shouldn’t have children as I’m almost certainly going to die.
My first thought when I was told that the cancer had returned was that I deserved it for not taking it seriously enough the first time. Cancer had a lesson to teach me, and it was going to keep coming back until I learned it. I resist the framing of cancer as a learning experience so much because I do not want to learn anything. I do not want to be transformed, do not want to discover the meaning of life, do not want to be made wiser by my suffering, do not want to have to present all my experiences in a way that communicates me as morally good. I want to read books. I want to eat in restaurants. I want the joy of meeting a new close friend as an adult. I want to save up to buy an expensive item of furniture that is more beautiful than useful, and to spend afternoons admiring how the light falls on it, run my hands over it reverently in passing, and occasionally happily comment to Sam “look at our chair” as if I birthed it. I want to go on long walks to listen to podcasts, so that months later I can try to sound clever and start a sentence with “I was listening to a podcast…” and realise midway through that I’ve forgotten everything that was said. I want to watch every tv show ever made. What I want is a life entirely untouched by trauma - a small, silly, inconsequential existence - which is a childish and impossible desire, but I resent cancer for revealing just how childish it is.
I went into my follow up appointment with my oncologist totally guileless. It was the day after my 30thbirthday celebrations and I had spent the morning painstakingly trying to remove the confetti that had infiltrated every area of my apartment. My head was fuzzy; I was tired; I felt buoyed by love. I was unconcerned about the appointment. When I was first diagnosed with the recurrence, they thought it was worse than it turned out to be; my nurse laid out a long and hard treatment plan. But then: I was okay. I just needed minor surgery, radiotherapy, and an extension on my medication. I had again escaped needing to undergo any real change; I was merely inconvenienced. After radiotherapy, in my phone calls with my oncologist, I had brought up the question of children. I did not know if I wanted to become a mother; my relationship to motherhood vacillating for the last decade from outright rejection to ambivalence to curiosity. I was just committed to taking care of myself in new ways. I wanted to anticipate my future needs and I knew I could not conceive on the cancer medication. He suggested I come in to discuss it. I should have interpreted this as a bad sign.
He was not kind. He opened with no preamble: “You have to ask yourself: whose life would you prioritize?”
I was too fragile for the question. Fresh from a weekend in which my life was worthy of celebration, the introduction to a new decade an event important enough for the people who loved me to mark it in decadent ways, I felt like I mattered. And now he wanted me to look at that life, to look at myself, and decide whether I was more important than a future child. He introduced a new dichotomy: a world in which I was important and a world in which my child was. I could not have both. I couldn’t answer, so he continued, going for the kill, “And if you were to have a healthy pregnancy and then years later were to become ill again, would you be glad you brought this child into the world?”
Later, when I recounted this moment to a small handful of friends, their response was always the same: no one knows the future. No, they don’t. But I also don’t know anyone else who knows their percentage chance of developing an incurable cancer. Mine is 15% - a number that sounds insignificant but is considered high risk. This fact casts such a dark shadow over every imaginable future that I have to periodically forget it. I find it almost unbearable to consider in the context of my shared life with Sam. For my birthday weekend, he took me to a shepherd’s hut for two perfect days. I woke on my birthday to the sun rising above a soft pillow of clouds and Sam silhouetted in the doorway holding my birthday cake, with the downs unfolding behind him, geese calling to each other as their wings beat against the pond, and the light from my candles illuminating his still sleep-soft face, the whole scene as tender as a bruise, and I thought: I want to travel through my days scooping up every moment of joy and deliver them to him in cupped hands each evening for the rest of our lives. I want a life for him that is full to the brim with love, totally separate from me, but I also want a life for him that feels so exquisitely tender as a result of the special alchemy of us together. When I imagine having a child, it is the same. I want what everyone wants: to protect them from suffering, to cocoon them in my love, to give them every possible opportunity to experience joy. I can allow myself to imagine a reality where I try my best and fail; I cannot imagine a reality where I am not there, cannot imagine their suffering as a result of my absence.
I found it hard to recover from that appointment. I felt I had not paid close enough attention and as a result cancer was going to take from me what I had not thought to protect. For a few days, I pored over all of my cancer paperwork, looking for more optimism than my oncologist had offered. Then time passed and with it came survivor’s amnesia. Whole days pass where I do not think about cancer at all, where there is no phantom pain that gives me pause. Sam and I make plans for the future. We had an offer accepted on a new apartment and we spend our days planning our life there. We discuss paint choices, remodelling the bathroom, unrealistic furniture, the housewarming party we will host -- and on soft, hopeful evenings, the possibilities offered by the second bedroom and who we might welcome there.
The title of this post comes from Maggie Smith’s poem Good Bones
Life must always have hope and love. It would be an empty existence without. And I love you with all my heart. I pray God gives you wisdom and peace and helps you and Sam along every step of the way. ❤️