A bit of a hush went through the crowd, and another woman replied, "Oh, you haven't heard. She was diagnosed with Stage IV cancer." A collective moan of misery seemed to go through the virtual room. The sense of pity and sorrow was palpable. Now I'm not saying it wasn't right or decent for these women to feel sorry for their friend. That is a good thing. But, still, I was there, someone who has been dealing with Stage IV metastatic breast cancer for eight years. And hearing that "she's dead" energy was certainly not what I needed at the moment. The other women didn't know about my situation, so I can't fault them. It is a fact that a diagnosis of Stage IV cancer of any kind is a horrible thing. For too many, it is a fast decline and horrible death. I get it. Not good news, and certainly something that should engender sympathy.
In my case, however, I have been very, very lucky. Thanks to the hard work of life-saving medical researchers, I've been allowed to continue my life with good quality, relatively few side effects, and the ability to keep working for eight years, although I've recently left work on medical leave. This is a different story of cancer. There is a good chance that I will die earlier than my family's good genes would have allowed, but, still, I'm here. And the me that is here is tired of hearing about cancer and tired of hearing the automatic pity fill the room when the news of a Stage IV diagnosis is brought to light. Oh, for one day of no cancer pity, misery, or conversation. That would be a day of true relaxation.
Generally I do not talk about my cancer diagnosis. I've discovered the hard way that it's a bit like admitting to a mental illness. People make automatic assumptions about me, and too often I've had the tone or look of pity thrown my way. I'll never forget being introduced to the new head of nursing at the infusion unit I had been going to for several years. In a medical setting I will throw out my Stage IV diagnosis in my intro to a key person just because it's helpful for them to know this detail in their work with me. This nurse had previously worked on the hospital's oncology floor where she had dealt with many other cancer patients. Thinking about it now, I realize that she likely had been dealing with patients who were not doing well, those sick enough to need a bed in the hospital's oncology unit. But in my case, I had been living a life of targeted therapy, continued work, a recent marriage, and nice vacations. We were coming from different places. So, based on her experience, when I told her that I was one of the Stage IV folks in the infusion unit, her look of pity was immediate and piercing. And my reply was just as immediate.
"I don't need pity," I said. She was slightly embarrassed and chastened, and with a quick apology, she walked away. The gap between us was clearly my lack of knowledge of her previous cancer experience dealing with probably very sick patients, and she was clearly not realizing that she, as a medical professional needs to be aware that her patients likely look to someone like her as a barometer of possible survival and wellness. In this way, I have been very lucky as well. The nurses who worked with me for the first several years treated me the same as any other patient entering the infusion unit. They knew my survival would hinge on luck and good treatment, so didn't make assumptions on how I was going to respond. They joked with me, asked me about my life, behaved as if I had the same chance of survival as anyone else. Clearly, I responded well.
Cancer is a complicated topic. As I said, many with a Stage IV diagnosis do not do well. But there are others who are biologically lucky and respond to treatment. Sadly, currently there is no way to tell who is going to have which response. The trick of living with metastatic cancer is how to walk that thin line of which way will it go. Having strangers oooh and aaaah in pity does not help with this at all. I was tempted, during today's virtual meeting, to stand on a box and tell those women that they have no idea how this friend of theirs is going to fare. The best thing they could do for her, as a friend, is offer concrete support (cooked meals, grocery shopping, rides to appointments) and the hand of quiet support. But I did not stand on a box during today's Zoom chat. In fact, I didn't say anything at all. Frankly, sometimes I'm just tired.
I still don't know how to handle it when pitying cancer gossip happens and I'm in the room. In the past I have given myself permission to leave when the topic of cancer comes up, and I can still do that. So the question is why am I writing this? I guess it's just to let people know, from a cancer person's perspective, what it's like to be the unwitting subject of a conversation. Truth is there's really no way to know who is dealing with what illness at this point in time since targeted therapies are much more common, and these leave a person looking like anyone else (no lost hair, fewer side effects, etc.). Along with this, old outcomes of cancer have also changed. New therapies mean more people are living longer, better lives. So next time you hear about someone's cancer diagnosis, you can assume that this is hard news and that the diagnosed does need support. But don't assume an automatic immediate death sentence for your poor friend. You never know. That person may just outlive you. And you'd be offering a great kindness if you treated that person like any other friend going through a rough time, rather than a friend who has one foot in the grave.
Because as Valerie Harper said, after being diagnosed with metastatic lung cancer to the brain, "Don't go to the funeral until the day of the funeral." Remember, Valerie Harper lived six years after this Stage IV diagnosis, working much of that time. So it was a long journey to that funeral.
