This post is fifth in a series of seven. To read from the beginning click here.
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Part Two: Uncertainty Gets Very Personal
One of the greatest uncertainties in life is death. From the moment of birth each of us is moving inevitably toward the moment of death. I read recently an article in which a doctor wrote of his experience giving his patients the diagnosis of a serious illness such as cancer. He said the first question most of his patients ask is, “Will I die?” His answer, of course, is, “Yes you will die. Each of us will. But the cause of your death, when and how you will die depends in part on the decisions you make and the actions you take between now and then.” In my previous post I wrote that our lives are filled with almost nothing but the unexpected between the boundaries of birth and death, even though we would like to believe it is otherwise. The boundaries of life as we know it are birth and death—the beginning of life and the end of life. The specifics of birth and death—the what and how and when—are as uncertain and frequently unexpected as the details of all that happens between these boundaries of our lives.
Death is probably not a favorite subject of discussion for most people even though it is as much a part of life as anything else. As we get older, death seems to naturally become more a part of our consciousness, perhaps because we see more people dying who are in or near our own age group. Of course, people of all ages die from accidents, violence, suicide, illness, disease, and multiple other causes. At a recent fifty-fifth reunion of my high school class the list of our former classmates who had died over the years was long and was growing almost at the same time as we were gathering. A few of those classmates had died when we were still in school; the deaths of the others were scattered along the timeline since then. The deaths of all those people shouldn’t have been surprising since we all are now in our seventies, but it was somewhat startling to be confronted suddenly by the number of deaths of people we had lived with daily when we were younger.
My own extended family group also has gotten smaller and smaller with the passage of time. My grandparents all died before I finished high school. My parents, all my aunts and uncles, and my first cousins are also dead. More recently, my younger sister also died, leaving just my older brother and myself from our generation and those before us. I’m sure this is not unusual, but it does underscore the uncertainty and unexpectedness of our existence.
I began writing some of this post more than two years ago. I was then at the end of a four- month-long period of uncertainty in my own life. A routine annual blood test for PSA (prostate specific antigen, an indicator of the possibility of prostate cancer) had come back significantly elevated from the levels found in my yearly tests during the previous decade. Several weeks later a follow-up screening test also showed an elevated reading. The next step (a few more weeks later) was a more detailed test ordered by a specialist. That test showed a 35% possibility I had prostate cancer, the second leading cause of cancer deaths in men in the United States. A biopsy was recommended to get a definitive answer to the big question: cancer or no cancer.
My first memory of cancer was in 1952 when I was six years old. I don’t recall how I learned of my paternal grandfather’s cancer; I might have overheard my parents or aunts and uncles talking about his condition. Those were the days when people didn’t talk much about cancer, mainly because they didn’t know very much about the disease. People usually discussed cancer in quiet tones, probably just within the family. What people did know was that cancer was dreaded, was usually deadly, and was something people felt ashamed to acknowledge in themselves or their family. As I recall, Granddaddy was confined to a very dark rear bedroom in his home and we could only go into his room briefly to visit. I don’t remember details of the events following his death, only a vague memory of sad neighbors and family members gathered to say goodbye as my grandfather’s body lay in state in the front room of the old farmhouse prior to the funeral. I do still have a vivid memory of a spot in a field some distance from the house where a pile of glass bottles was discarded, remnants from fluids and medications used as part of his treatment during his final months. In reality there were few things which could benefit most cancer patients at the time.
It’s amazing to see developments which have occurred in the treatment of cancer during the years since my grandfather’s death. The discovery of DNA, research regarding causes of cancer, development of new anti-cancer drugs, better imaging procedures, new screening tests, improved and less radical surgical techniques, and advances in chemotherapy and radiation therapy have all led to better outcomes for people with a cancer diagnosis. Public awareness and knowledge about cancer are much greater now. Attitudes have changed regarding cancer and those people personally affected by it. But cancer is still the second leading cause of death in the United States. The very word ‘cancer’ can still bring up frightening images of pain and suffering and death. No one wants to hear cancer linked to friends or family or themselves.
Over the years since my grandfather’s illness I have known a number of family members and friends who have experienced cancer in their own lives. Many, many more have been touched by the reality of cancer in the circle of people around them; Carole was recently able to name more than eighty people she has known personally who have had cancer. At times cancer seems to be everywhere, not only in the obituaries and news stories of those people who have had the disease, but also in stories of promising research into cancer causes and treatments and in appeals for support to fund the efforts aimed at advancing medical knowledge. But whenever cancer becomes a part of someone’s life, it’s probably unexpected and certainly brings with it a multitude of uncertainties. The unexpected news of a cancer diagnosis jolts someone into a new reality, seeing everyday events in an entirely new light.
My tests had suddenly thrust the question of cancer or no cancer into the forefront of my own life. Faced with that big question and the even bigger unknown answer, I was confronted with the more immediate concern of how I would respond if I did have cancer. So many questions and uncertainties came to mind. If I did have cancer, how aggressive was it and how far advanced? What treatments were available and what might be the consequences and costs, not just financial costs, but personal costs to myself and those dear to me? Of the possible treatments available, which would I choose or would I choose no treatment? If the cancer were life threatening, would I want to seek to preserve my life at any cost or would the quality of my life and the lives of my family be the primary consideration? Questions which once might have been more abstract had now been brought into much more concrete personal reality. The uncertainties surrounding cancer had now become a part of my life, things to consider while waiting for my biopsy.
I remember in the 1950s when my grandmother was telling Mother and others about my great-aunt Jessie’s cancer diagnosis. They were huddled around the kitchen table almost whispering. I remember asking Mother later why the hushed tones, but I don’t quite recall her response. Was it because it was cancer of the breast, and that was a word never uttered aloud, or was it the word cancer itself? I think maybe some of both. There was still a lot of stigma; Some people thought it was contagious, so much so that if your family member had it, you might be carrying the contagion (like a Typhoid Mary) and they would want to avoid you at all costs.
So many different beliefs and misbeliefs affect our responses to happenings in our lives. Looking back, those attitudes and behaviors described seem inappropriate to us. But people continue to respond in similar ways to things which are not understood or which feel threatening in one way or another. Will we ever learn and change?
Thanks for adding your experience and your thoughts.
For me, cancer seems as scary now as it was when my father died of cancer in 1954. I was nine, my brother was seven, and my sister was not yet two. However, so much more is known now–and there is an increased emphasis on early detection.
Cancer is scary, no matter what our ages, especially when it occurs so close to us personally. Developments in so many areas have greatly improved the situation, but cancer still directly impacts the lives of an incredible number of people.
Thanks for sharing your experience, Leslie.
Ron, I appreciate your transparency as you share much of your thoughts and feelings. I didn’t know that your sister had recently died, and sadly, I had forgotten that you had a younger sister. My grandmother died of cancer while I was in college, and I have some of the same recollections of her diagnosis – hushed tones, sadness, back bedroom, unpleasant odors, and not a whole lot of connection with her during that time. That makes me sad.
Thanks for sharing your comment and your own experiences, Jan. I know you are very familiar with the difficulties faced by people who are dealing with cancer and with the impact the disease can have on family members and friends as well. I’m glad there is now much greater knowledge about cancer and more information available to the public so that cancer is no longer a hush-hush topic.
I’m pleased to be able to share some details about my own experiences and feelings about this and other parts of my life and hope doing so might be helpful in some way to others.