How Cancer Prepared Me for a COVID-19 World
I would never recommend cancer as a way of learning life lessons. But having “been there,” I have tried to “do that.” Cancer treatment required coping strategies. Surviving it taught important lessons. Both remain surprisingly relevant in an ongoing pandemic.
My Cancer Odyssey
In June of 2016, I was anticipating one more year of teaching sociology before a carefree retirement. Life was good in every way. But a routine physical revealed dangerously low white blood cell counts. My doctor referred me to a hematologist who recommended a bone marrow biopsy that detected acute myeloid leukemia. Within 48 hours, I was hospitalized and began a week-long, 24/7 chemotherapy cocktail.
My hospitalization continued for the next 35 days. After chemotherapy, I became severely immunosuppressed and battled a number of predictable side-effects. By my fourth week, things improved, and a repeat biopsy revealed no evidence of leukemia. That meant I would live long enough to explore options for further treatment.
My cancer had an “intermediate risk” of relapse so I faced a difficult decision between more chemotherapy or a stem cell transplant. After researching my options and getting second opinions, I chose transplant. My logic was that if I had more chemotherapy and it didn’t work out, I would regret not pursing the transplant. If I had the transplant and it didn’t work out, at least I would feel as if I gave it my best shot.
In October of 2016, I received a double cord blood stem cell transplant. It was preceded by high dose chemotherapy and full body radiation to gradually destroy my compromised immune system. It was followed by two and a half weeks of recuperation before hospital discharge.
Engraftment happened surprisingly quickly. I had playfully named my baby donors “Ralph” and “Gwen.” Three weeks after transplant, yet another biopsy revealed that Ralph was 99% engrafted. We’ve been getting along ever since.
After a month of extreme fatigue, bone aches, and lingering nausea, several milestones followed. One month out, my daily clinic visits became less frequent. Three months out, I began tapering my antirejection medications. Six months out, I stopped those and a dozen other medications.
Nine months out, I gave the keynote address at my transplant unit’s fundraiser before 400 people. One year out, Ralph and I got our childhood immunizations from dead viral sources. Two years out, we got additional immunizations from live viruses.
In retrospect, I hit the treatment trifecta. I got into remission on the first try. Ralph fully engrafted in three weeks. And I’ve had no graft-vs.-host-disease. In the sweet words of my transplant oncologist, “this is as good as it gets.”
My Coping Strategies
When I was told to expect an initial 5-week hospital stay, I was dumbfounded. I realized I needed ways to cope with how my world had suddenly become very small and quite precarious. Over the ensuing weeks, I cultivated several strategies.
I practiced mindfulness, meditation, and yoga. It helped me banish thoughts about the past and anxieties about the future, and to nonjudgmentally accept and live in each moment as it unfolded.
I did as much physical exercise as my circumstances allowed, including stretching, isometric exercises, and hall walking. I did it mindfully, and these routines increased my energy and lifted my spirits.
I was a pro-active patient. I made my bed, organized my hospital room, and structured my days with new routines of meditation, exercise, writing and yoga. I actively collaborated with my medical team in managing my care. Being in charge of these activities gave me agency and purpose when these were hard to come by.
I maintained my sense of humor. Sharing jokes and witty banter with my medical providers broke the ice and humanized our consults. It also gave friends and family a way to relate to me as the person I’d always been rather than the patient I’d recently become.
I relied on a supportive belief system. For some, that’s religion. For me, it was a secular worldview based on my social science background. It encouraged me to learn about my illness and treatment, and it fostered a practical, problem-solving approach to the challenges they posed.
Finally, I wrote my story. I sent detailed reports about my status and reflections to a large group of email correspondents. Writing for others forced me to understand my odyssey so I could articulate it for them. This writing became a psychic survival mechanism (and a memoir).
I’ll never know if these strategies contributed to my physical survival, but I always know they preserved my sanity and sustained my identity during one of the most harrowing periods of my life.
I also benefitted from some privileged circumstances. After a year of paid sick leave, I retired with a steady income and a home that’s paid for. Within that context of material security, my coping strategies have sustained my physical, psychological and emotional health.
Coping Strategies Redux
These strategies have also proven quite relevant during the coronavirus pandemic.
Mindfulness continues to keep me grounded in the present moment and allows me to banish anxieties if I cannot take specific actions to address the causes of my concerns. It also reminds me not to look too far ahead and rather take each day as it comes.
My repertoire of physical activity now includes a cautious return to my health club for lap swimming and strength training. The physical and psychological benefits during this pandemic are inestimable.
My proactive stance toward organizing my small hospital world now plays out in a slightly larger arena at home. But there remain limits and prohibitions on things I would like to do. I draw on my acquired skills to focus on what I can control. That helps me live within these limitations, find new projects, and structure my days with activities still available to me.
My sense of humor remains intact. It reminds me not to sweat the small stuff, and that it’s almost all small stuff. And for the few things that really are big stuff, black humor works well. I’m also participating (virtually) in a weekly “Improv for Life” class at my local Gilda’s Club where some seriously sick people share a very cathartic hour of silly banter and goofy storytelling.
The secular, problem-solving worldview that guided me through cancer treatment is especially apt for following and implementing the latest medical advice and cautions about living as safely as possible in the midst of an ever-evolving pandemic.
Finally, writing my story (including this blog post) still helps me make sense of my circumstances and find ways of acting intelligently and responding effectively to whatever life brings my way.
Further Lessons for a COVID-19 World
There are additional lessons from my cancer odyssey that are helpful in this pandemic.
Cancer taught me that asymptomatic people who feel healthy can in fact be quite ill. That describes me upon my leukemia diagnosis, and quite a few people who are unwittingly infecting others with coronavirus now.
Cancer vanquished my sense of invulnerability. Having been in good health for my first 64 years, I still harbored a teenager’s sense of invincibility. But now I know we can all get sick with little notice, for no particular rhyme or reason.
Cancer taught me to be at peace with isolation. I learned to spend time alone and be resolute, whether in a hospital room or a pandemic lockdown.
Cancer taught me to await test results calmly. “Scanxiety” doesn’t change the result but can be debilitating to our energy and outlook.
Cancer taught me to value masks. Whether protecting me during chemotherapy-induced immunosuppression or protecting others from a contagious virus, masks are essential to caring for ourselves and others.
Cancer taught me the value of patience during a prolonged and uncertain recovery. It was a marathon, not a sprint. Moreover, the marathon involved an obstacle course of impediments. The COVID-19 pandemic has become yet another marathon. During these times, patience is indeed a virtue.
Cancer taught me that much of life is a balancing act of risks vs. rewards. This was evident with every decision about cancer treatment. And now, risk/reward calculations arise every time I leave the house and put my health in jeopardy.
Cancer taught me resilience. One of my favorite images is a three-legged cat who doesn’t mope and withdraw, but just continues silly cat antics despite the handicap. Facing impediments, I’ve learned to just get on with things.
Cancer fostered a deep respect for the skill, wisdom, and dedication of doctors and nurses. It taught me to be the best patient I could be for them, and now to follow their evolving pandemic guidelines for everyone’s sake.
Cancer underscored the role of chance in life. Things sometimes happen for no apparent reason, but we still must make the best decisions we can with the incomplete, imperfect and ever-changing information we have.
Cancer made me humble about what I can control. It’s a lot less than I would like to think, but recognizing that saves a lot of energy and keeps me on an even keel.
Cancer left me a deep well of gratitude for the life I still have and taught me to live as judiciously and mindfully as I can … and to enjoy the ride.
As I said at the beginning, cancer is a terrible way to learn life lessons. But perhaps the most important lesson of all is to make the most of the hand you’re dealt.