Chemo? No, Thanks
"If I were you," said the radiologist, as I sat on the gurney discreetly wiping goo from my right breast, "I'd make an appointment with a breast surgeon as soon as possible." His somber tone of voice, the white blotch radiating ugly spider tendrils on his ultrasound screen...neither of these made me nervous. If anything, I felt mild interest: "How very odd. He must think I have breast cancer. Or something."
Ten days later, after a lumpectomy and sentinel lymph node biopsy, my husband and I sat in the breast surgeon's office. "I'm so sorry," he said. "You have Stage IIb breast cancer. There's a 1.1 cm tumor in your right breast, and the cancer has spread to three of your lymph nodes."
I looked first at his solemn face, then around the room. Who was he talking to? I believe the psychological term is "dissociation": a defense mechanism against painful emotions. Oddly, I didn't feel particularly frightened--just very, very tired. Neal drove me home and I took a five-hour nap.
When I woke up, I realized it was true. I had breast cancer.
Three days later, barely recovered from the lumpectomy, I had a second surgery to remove another cluster of lymph nodes (good news: all clear). "That surgery wasn't so bad," I chirped as I squeezed clear yellow fluid from the drain that dangled below my armpit. "I can handle this."
And then, in the oncologist's office, I heard the dread word "chemo." With no experience of cancer among my family or friends, I knew only one thing about this treatment: it was always discussed in grim whispers. I was suddenly, sickeningly terrified. Neal held me as I sobbed, "I'm not afraid of losing my hair...I'm afraid of losing my dignity." I imagined uncontrollable vomiting. Unbearable pain. Writhing in bed as Neal watched, horrified, unable to help me. It was these images, not the fear of dying, that made my heart pound. My terror, I realized, was of losing control. And the only way I could make it through was to take some of that control back.
As a writer, I believe strongly in the power of words. Over the next few days, I thought about chemo. An ugly sound: kee-mow. Being mowed down by a viciously sharp-beaked Kee monster, a cross between a vulture and a velociraptor. "We won't call it chemo," I announced firmly, as much to myself as to Neal. "We'll call it chemotherapy, and we'll say it like we mean it. It's medicine. It's going to save my life."
I read everything I could find about chemotherapy. I came across the concept of visualization: picture the chemicals killing the cancer cells, imagine them as little submarines firing torpedoes. Well, fine, but I'm essentially a pacifist. How could I go to war against my own body? Besides, it seemed to me that if I were a cancer cell being attacked by a torpedo, I'd find a quiet spot behind the liver and simply hide until the battle was over. Then I'd come out and multiply like crazy.
So, after some thought, I created a different metaphor. I had always been fond of Cinderella's plump little fairy godmother. At the start of each chemotherapy infusion, I imagined hundreds of miniature fairy godmothers wielding tiny magic wands, floating through my bloodstream searching for cancer cells. Whenever they discovered one they would gaily call out "Bibbidi-bobbidi-boo!" and transform it into...a rose. As the other cancer cells realized what was happening, I reasoned, they would come running. After all, who would want to be an--ugh--cancer cell when you could be a beautiful rose? People hate cancer cells. They love roses. Operating on the assumption that everyone (even a cancer cell) wants to be loved, I sent my fairy godmothers to offer the gift of transformation.
It became a group project. Neal bought me a book filled with lush pictures of roses; I flipped through its pages the night before each infusion. I bought myself a gaudy ring adorned with a big honking rose. Friends sent rose paraphernalia: soap, lotion and greeting cards. Everyone learned to say chemotherapy...and seemed to mean it. After the first infusion, my terror subsided: my oncologist prescribed medications that eliminated nausea and managed pain. I wrapped my Hermes scarves around my bald head and wore blusher every day. My dignity occasionally slipped a bit (as did the scarves), but it never crumbled.
I visualized fairy godmothers. And roses. I never called it chemo. Did any of this make a difference? I have no proof, but I'm convinced that it did. The treatment was hard (four months of biweekly five-hour infusions, an intravenous cocktail of three medications whose side effects included fatigue, diarrhea, mouth sores, muscle aches and bone pain). But it truly wasn't horrible. I believe that choosing my own word, creating my own metaphor, helped. It gave me a critical feeling of control.
I have been in remission for two-and-a-half years. I no longer think about roses or fairy godmothers. I exercise, eat a healthy diet, get regular exams and cherish every day. But, should the time come, I'll take the magic wand out of storage. The metaphor will be waiting for me. And I'll never call it chemo.
About the author:
Elaine Whitman EdD is professor emeritus in the Department of Family and Preventive Medicine at the University of Utah School of Medicine, where she taught students and faculty how to identify and support patients who were experiencing domestic abuse. Her 2005 breast cancer diagnosis put that work in her rearview mirror; she now plays the Native American flute for hospice patients and is a volunteer archivist at Robinson Jeffers Tor House in Carmel, California. She also enjoys bird-watching, hiking, knitting, hand spinning and painting.