It sounded like a simple question. Do I still have cancer, or not?
The surgeon got clear margins, and cancer wasn’t in the lymph nodes. But my oncologists strongly recommended chemotherapy in case microscopic cancer cells remained, undetectable by any test.
So I might not have cancer at all. And if I did have it, these drugs might not work. Dozens of serious side effects were possible, which might go away when chemo ended — or not. Or serious side effects might appear long after stopping treatment.
Did I still have cancer? The doctors thought so, enough to encourage me to take drugs not unlike the mustard gas banned by the Geneva Convention after World War I. But they didn’t know.
If I declined treatment, and the cancer returned, I’d think that maybe chemo would have prevented it. If I accepted treatment, and the cancer didn’t return, I’d think that maybe I would have survived without the drugs, and the risks and suffering they entailed.
In that state of not-knowing, I saw my choice not as taking deliberate aim at a target, but as falling backward into a pool of profound uncertainty, choosing nothing but the point of departure. Whatever I did, I was taking a risk. The only question was which risk to take.
Psychologists identify regret as an emotion that humans try hard to avoid. And of all the possible outcomes, the one I’d regret most would be to decline treatment and then have a recurrence, and die wondering if I might have lived. So, I took the chemo.
That was eight years ago. So far, no cancer. Did the chemo work? I’ll never know. It was debilitating at the time, and I permanently lost some hearing and got a compression fracture in my back. Perhaps I would have recovered without all that.
That doesn’t mean, though, that I don’t know if I made the right choice. Under circumstances like these, the right decision is the one that puts you on the road you’d rather be on now. It can’t be judged by a future outcome that’s unpredictable and subject to chance. A Sanskrit verse says it best: “Man, you control only your actions. Over the results of your actions, you have no control.” In that thought, I find not only wisdom, but peace.
Joan DelFattore
Newark, Delaware
2 thoughts on “Point of Departure”
Joan, this is such a thoughtful, grounded meditation on what it is not to know and yet to choose, and then to be with what happens. Thank you.
Joan, I have the same thoughts. My daughter’s friend, an oncologist, said that at her major hospital, they were abandoning chemo in favor of radiation. My oncologist was involved in a major study on that issue, and if I had signed up for the study, I wouldn’t know if I were the control group or the trial group. I went what appeared to be the safest route and did both chemo and radiation. It has been almost 6 years. I am okay for now. But I think my bone marrow is damaged. I get tired easily, need a nap every afternoon. But then, I’m almost 75. 🙂