When Alma first felt a lump in her right breast, she assumed it was a meaningless skin lesion. But it grew, ultimately taking over the breast. Then her skin blistered, thickened, and turned red. Alma knew it was breast cancer—she’d looked up online images of advanced disease but abruptly closed the web pages. She told herself that “cancer doesn’t happen to me.” Though in her 40s, she was her father’s “mini-me,” adored and indulged.
Alma secluded herself in her apartment. She was months behind in rent. She was a chef but stopped working. Having always been healthy, she had no medical insurance, which justified not seeking help: “I assumed no doctor would see me.”
In time, Alma was certain her cancer had metastasized. She decided to sell everything, leave New York, and move to South America. She had relatives there, and the weather was warm. That was where she’d die.
Instead, she told a friend about her breast, and the friend brought her to our center. A biopsy confirmed the cancer, but imaging showed no metastasis; chemotherapy was started, since the tumor was inoperable at that point. I met Alma during her chemotherapy, to plan her subsequent surgery. On reviewing her original PET scan, I was astonished. Her breast glared like a blinding light. Cancer erupted into her skin. Yellow flowed and orange streaked through her underlying pectoral muscle, and cancer-filled axillary lymph nodes resembled multiple small suns.
But Alma was far more than just a patient. From the beginning, she joined all the center’s activities—yoga, Pilates, nutrition, arts, group support. Everyone liked her. One evening, passing through a yoga class, I navigated around Alma’s mat and whispered, “I think you spend more time here than I do.”
Alma did well on all the treatments—chemotherapy, mastectomy, radiation, and hormonal therapy.
There was a scare four years post-treatment, when I felt a mass in her neck that was worrisome for recurrence. Alma couldn’t sleep, fearing “we were back at the beginning.” She had just learned of the death of a woman in her breast cancer support group. But she came for imaging as instructed, and we were both immensely relieved by the benign results.
Now, eight years later, Alma is fine. She no longer spends much time at the breast center, nor does she need to. She knows that the cancer could recur, but she lives a full life. The woman who had come undone had acknowledged and treated her cancer and become whole again.
Christina Weltz
New York, New York
6 thoughts on “Denial and Beyond”
Thank you Christina for this beautiful example of how easy it is to fall into the trap of denial when facing difficult situations, and the critical role of support to help people through that – in all its shapes: friendship; yoga; a caring surgeon!
A very insightful account of the importance of empathy between doctor and patient! Clearly, the patient’s despair flows from innate fear, on one hand, and prevailing personal circumstances on the other. The instinct is to run away; in panic rather than in hope! In this incidence, the serendipity of the encounter with Dr. Weltz led to wonderful outcomes, on two fronts, for the patient. I expect that both parties have gained huge enrichment from the journey they’ve travelled together. An inspirational cameo! Well done, Dr. Weltz!
Stories like this give hope to patients, an important reminder to caregivers of the critical importance of seeing the whole person and compassionately understanding what they are experiencing. More stories like this will only help. A profound thank you to Dr. Weltz.
Dr Weltz writes so beautifully about Alma’s long journey from terrifying thoughts and denial to total acceptance. It is a situation that translates into so many lives and worries when reliant on oneself. Dr Weltz illustrates so well and clearly the importance of observation we all need to have towards one another and to not be afraid to voice a concern leading to professional care. Clearly, the trust Alma had in Dr Weltz is paramount to her continuing to deal with any recurring symptoms. A great life affirming story.
“Denial and Beyond” is a stunning example of how good – really good – – writing can transform what could have been a bland case history into a deeply moving character study. In only a few hundred words, Dr. Weltz has managed to not merely describe Alma’s eight-year clinical history but to portray her in the full complexity of her humanity.
Beyond describing the particulars of Alma’s diagnosis, treatment and recovery, Dr. Weltz’ underlying theme is how denial can turn a treatable disease into a fatal one. I used to think denying clear evidence of your body’s frailties was a guy thing. For most of my 77 years, I would flippantly tell friends, “My doctor told me I should do this-or-that but I decided to go for a second opinion…myself!” In my case, a basal-cell carcinoma diagnosis was my wake-up call.
Dr. Weltz makes it clear that denial is gender-blind. “Cancer doesn’t happen to me,” Alma told herself; after my friend M. was diagnosed with breast cancer, she told me, “I can’t have breast cancer. No one in my family ever had breast cancer.” Like Alma, M. decided she would return to her native country; fortunately, like Alma, friends convinced M. to seek treatment at the very same center; and, today, like Alma, she “lives a full life…is whole again.”
I am not an evolutionary biologist but I can imagine that the “denial gene” – if such a gene actually exists – had served useful purposes for our species’ survival at certain times in human history; its continued persistence and prevalence today, however, is both puzzling and, at least as a response to unwelcome medical diagnoses, potentially deadly . For far too many, the only “beyond” for those who deny what they know to be true is the great beyond.
DENIAL AND BEYOND by Christina Weltz is a life affirming story and yet another illustration of the benefits of yoga and the support of those who love us. Post Covid it is remarkable the increase in the number of people who are tuning in to their own bodies.