Day 1,025: "Cancer Ennui" or Depression?

One of my all-time favorite google searches that led someone to this blog was "cancer ennui." That phrase is so apt! Going through this process brings a decent amount of absurdity to your life and makes you suddenly appreciate words like ennui and verklempt. And what is this process? Well, it's being really sick, dying even, and not having a clue. It's cutting, poisoning and burning what appears to be a totally healthy body because if you don't you will probably not live past 35. This process means dealing with the aftermath of those decisions. It's losing friends and feeling isolated. It's going back to feeling healthy only to live every day with the knowledge that you will never be "cancer free," "cured," or "in remission," because all that there is for your cancer is the notion of "no evidence of disease," or, more accurately, "you could still have cancer in there but right now we can't see it and if it has spread to a distant part of your body we cannot cure you and you will die sooner or later but probably sooner."

And, remarkably, most of us do pretty damn well living with that reality. I have felt sad, scared, angry, wistful, resentful, and a lot of other emotions as a result of cancer. It's fair to say, however, that it has never made me depressed.

That's surprising, actually. Cancer is depressing. It is especially depressing when you are at a stage in life that should be about just about anything other than cancer. But something being depressing is different from depression itself.

I know this, because I am going to admit to something here that I haven't admitted to anyone over the past year until last night. I am battling depression on and off, and it is related to cancer, but only tangentially. And it's really, really hard. It's especially hard because it's new to me. I have always been a fairly happy-go-lucky, content, even-keeled person. I have been called "ultra-sane." I get pissed off and cranky, but I don't get depressed.

I've written about the absurdity of going through puberty in my 30s as a result of coming out of chemo-induced menopause. I've written about how my new, short, perfectly regular cycles have brought with them a huge range of PMS symptoms that I've never had in my life, even though I got my first period at age 11. One of those things, I've figured out, is a regular depression related to hormone changes in my cycles.

For a few days every month, I experience this crushing feeling of hopelessness. I am not talking about being irritable or moody. I'm not talking about having cramps or being bloated and feeling fat. Suddenly, I am useless. I have no friends. I'm a terrible mother. I'm worthless at my job. I've never been good at anything I've ever tried to do, except maybe writing, but even that is questionable. My kids don't like me. My husband doesn't really love me, he just wants me for sex. I will lose my job and sit at home doing nothing but make the world a worse place to live in. The pain in my chest is mets to the sternum. I won't live to be 40. My life is over.

Notice I did not say that I FEEL these things. For those days, these things are absolutely true to me.

Even if I chart these feelings, use my intellect to try to discern a pattern, I cannot escape them or think that those feelings of worthlessness are feelings when I am in the middle of it. When those days happen, that is my truth.

I've recently realized that these days coincide with extra pain in my chest, extra feelings of breathlessness, and extra weight. On the worst day or days I weigh the most. Three or four days ago, I weighed 121 pounds. I know that is not heavy, but it just gave me one more reason to hate myself. I am not just worthless but ugly, fat and covered in stretch marks and scars and lopsided breasts and I'm just a fucking mess of a woman. Then, the next day, I weigh a pound less. The day after that, I pee about 72 times and lose another pound and a half. The next day--today--I weigh under 118 pounds and I feel, well, normal.

I don't feel normal because of my weight, or because all of that water that was crushing my lungs has left my body. I feel normal because I am no longer depressed. Now that I feel normal, I can see those previous feelings as the abnormal part of life, not the reality. I have some perspective that is just lost in those moments of loss.

My life is the same. The things that are disappointing and hard are the same. A hard week at work is a hard week of work. My mammogram still looms. All of these things are normal parts of living life, well, except for the cancer part. But even that is the same--I had cancer or could have cancer on days when I'm feeling normal and days when that alien being invades my body. The difference is in how I interpret those things.



I still worry about mets in my chest, but it doesn't seem like such a foregone conclusion that I tell my husband that I need to get a pet scan and a chest xray because I know it's bad news and we have to turn in the life insurance policy and I'm going to die. I don't feel such sadness when I see my kids that I am unable or unwilling to put them to bed at night. I don't cry while taking walks, while sitting in the house alone, I don't cry at all because goddamn it, Katy Jacob doesn't cry and that's one of the things that makes her Katy Jacob. If Gabe comes up to me and kisses the back of my neck when I'm washing the dishes, I smile or playfully swat him away. I don't say things to him like "you're only nice to me when you want to fuck me." I see my totally normal for a working mother social life as a good trade from the times when I was younger and still busy but mostly with people my age.

I don't have an intense desire to engage in what would be self-destructive behavior if I was a different person or in a different stage in life. During those days of depression, I could be talked into any bad habit out there. I want to get mind-numbingly drunk. I want to have sex, almost desperately, sadly. I want to have a cigarette, drive a car too fast, leave everyone I know and move to a cave in Mexico. I begin to understand why other people do drugs. I want to do anything that will make me feel something other than that hopelessness, anything that will enable me to see my body as something other than an aging and diseased bag of bones. I want to feel life in the face of the reality of death, which looms over me as surely as the feeling of metal at my temple or the coldness that coursed through my veins courtesy of the Red Devil.

In the confines of my life and my responsibilities, of course, I don't actually do these things--not most of them, anyway. I take walks away from the family, I work out too much or not enough. I have sex with my husband, who luckily is still the same guy and not someone I don't know or don't like, so even if I am not myself there are no negative consequences of my behavior. I have a few shots of tequila or a little more bourbon than I should but then I stop because I don't want to get a headache. I buy a new shirt that makes me feel like I'm not a fat disgusting pig.

All I can say is, thank God I didn't go through this when I was 14. I would have done so many things that I would have regretted.

I know I can't lose my shit because there are little kids depending on me. On those days, that is what keeps me in line, even though I believe that they hate me anyway. The knowledge that I will come out of that fog doesn't help, because that knowledge doesn't exist, not at the time, anyway.



And then, today happens. Or, really--last night happens. I go to a friend's house for her birthday and talk to people and don't drink anything. I come home and have a drink with my husband and I want to have sex with him because I'm attracted to him, not out of some existential sense of despair. I go work out, and I feel strong and fit. I help my daughter with her homework and laugh behind her back when she's losing her mind because she's too hungry and she doesn't realize that's her problem.

And I can know something about myself--that the feelings I had earlier were real as far as feelings go, but they were not real as far as reality goes. I tell myself that I will just have to gear up for next month, when this happens again. I remind my husband that I will be insane for a full week if not more before my mammogram. I hope that he has the wherewithal to deal with me at that time and at the times when I am deep into a depression but he knows better than to tell me it's hormones, so he says things like, hey Kate, I think you will feel better in a few days. I tell my mom that I'm good for nothing and she tells me I know that's not true, though I don't know it at the time, but I hope she keeps telling me that when the time comes. I don't think I need therapy, I cannot take hormone supplements and I will not take anti-depressants, so on the normal days--and most of them are normal days, at least in that "new normal" sense--I remind myself that THIS IS NORMAL, and that other stuff is not even me, it's a sickness of a different kind. It's just another thing I need to deal with, and I can do it, with a little bit of help from people who care about me.

It's not that all the things that bothered me were fake--especially the fear of cancer recurrence part. I mean, I probably should get that chest scan. Realistically, I SHOULD worry about being short of breath. And I know a lot of people deal with depression, short bouts and long term conditions, and this thing I deal with is relatively mild. But I want to make it clear that it is not depression that makes me think about having mets, or dying of cancer, or not living to see my kids grow up. It is whatever happened in my cell biology that made those maybe realities into very distinct possibilities. What depression does is bring that reality right in front of my face so that rather than dealing with the living parts of life, all I see is the suffering and death. So let me be the first to say that that suffering and death might happen to me, regardless of my attitude or cyclical depression. It happens to women with breast cancer every day. It's just an extra issue to deal with, and a very serious one, when depression hits.

It's the perspective of life that depression changes, not the life itself.

People say things to me, and I hear their words, and I don't interpret them as roundabout ways of telling me I'm a piece of shit who is doomed to nothing but an early grave. My spinning instructor puts her hand between my shoulder blades and then touches my shoulder on the cancer side and tells me that I look so strong and that I have amazing range of motion compared to what I used to have (a post cancer compliment if ever I've heard one!); my husband tells me I'm such a beautiful sexy woman; someone in senior management tells me I did an excellent job with that meeting; my friends say they miss me; a stranger compliments my shoes; my son says "I love you."



The difference is that this time, the fog has lifted. The difference is that this time, when I hear these words, I believe them.

Day 813: Don't Think Twice, it's All Right

So I think I'm going to be OK.

How is that for an understated, casual opening line?

I mean, I don't have a heart condition. And, I don't think I have lung mets.

Can I get an AMEN?

Those issues I was having literally scared the shit out of me. It was not in my mind, and now I think I have an inkling of an understanding of what was really happening--but I'll get to that later. When my blood pressure shot up to 143/80, I was convinced my heart was having trouble. And no, it's not because I'm a hypochondriac. It's because I had radiation over my heart AFTER taking this heart-terrorizing medication affectionately known as either the Red Devil or the Red Death, because while it looks like cherry Koolaid in that syringe, when they push adriamicin into your body, you literally feel the coldness of something approaching death course through your veins, and the nurse looks at you to make sure you're still breathing, and then they do that shit to you again and again. So, you know, I wasn't nuts for worrying.

But when I saw that blood pressure reading, I said, screw this. If they want to put me on those damn beta blockers again I'm not doing it. I hated those. So I made a bunch of changes to my already healthy lifestyle. I love coffee, but I don't drink very much. At home I make it half-decaf and I pour it out as soon as it gets lukewarm. A few days a week I was going to starbucks for iced coffee, no sugar or milk, and since that's mostly ice, it didn't seem like a big deal. I was having one drink every night to help me relax. While we were up north, I was making "up north dinner," or crockpot dinners that could last us three nights and not necessitate going to the grocery store, which was really far away. Things like vegetarian chili made with canned beans. Chicken-rice stew/soup made with those packaged rice things. Homemade pizza. I don't eat a lot, but I do eat like a real person. I'm no "salad's enough for me" girl.

This crap was terrifying me so I just stopped. Cut out caffeine, stopped drinking, started looking closely at sodium content and getting annoyed at how much sodium there is in everything. Even if you give up bread, it's bad. How do low carb folks do it? Dairy products are the WORST with sodium. For a while I was overdoing it and basically eating fruit for dinner, spinach salad for lunch at work. I continued my same workout routine. I was HUNGRY.

And I felt better. I scheduled an acupuncture appointment for the first time in a year and a half, and that made me feel even better. My last memories of acupuncture are positive, but I was never truly comfortable when I was doing it. The first time, I was just suffering terribly from chemo. Even when I was done with treatment, I was in menopause, having hot flashes while lying on the table with needles sticking up out of my translucent newly-grown hair. My scar tissue pain made it difficult to lie comfortably. I always stayed for the minimum 25 minutes and got out of there. She expected me to do the same this time. When she came to get me, I sent her away. I am lying here with nothing to do and nothing to think about and I'M NOT LEAVING! She laughed at me, gave me as long as I wanted. I am naturally restless, so I made it about 45 minutes--a record.

I went in for the heart tests on Monday. It was 100 degrees and due to the scheduling, I needed to take the whole day off of work for the appointments, so I drove down to the hospital. The ecchocardiogram was painless, and relatively interesting. I had one done when I was admitted to the hospital for heart problems due to Taxol but that whole weekend was so difficult I don't remember much of what the tests were like--even though I will never forget the kindness of that one doctor. An eccho is basically an ultrasound of your heart. The technician showed me everything--this is your pulmonary artery, that sound you are hearing is the blood pumping, those colors mark different arteries. It looked and sounded just like those early ultrasounds you see of your fetus in the womb. I asked if she could give me results, and she said: "I can only tell you if something life threatening shows up, that would make me concerned you were about to have heart failure. Barring that, the physician needs to read it."

She sent me on my way. I went to get the Holter monitor. That was fast--leads and wires taped all over my torso after she literally used pumice on my skin to rub it raw and make sure they would stick. I had this bulging monitor on, tape up to my chin, and I was wearing short shorts and a tanktop. Oh well, that's one of the benefits of living in a place like Chicago. You walk around the Mag Mile like that, going shopping, and the androgynous employees at Zara just look at you with utter boredom in their eyes, and people texting on their phones almost run you down because they are paying so little attention to anything outside of themselves, and no one gives a shit, because there are much stranger things happening.

And then, I waited.

Tuesday evening I got an email message from my general physician. Your Eccho is normal.

Late in the afternoon yesterday, prompted by my email asking her for results, I got another message: Your Holter results were normal, even during the one indicated time when you felt your heart racing.

I had been given a diary, wherein I was supposed to write my symptoms if I experienced them. Shortly after eating an Mburger for lunch around 1 pm, as I was STARVING, my heart started racing. I recorded it. I drove home, laid down, read a book about typhus destroying Napoleon's grand army in 1812 because that's the kind of thing that puts my issues into the grander perspective, and it was still racing.

Salt from the burger. Dehydration. My heart is fine--but there is something odd going on, and I think I now know what it is. I was thinking about this on Tuesday, when I finally got to take the tape and leads off around noon. I locked the door to my office, and thought I could just casually remove them. Wrong. It was like the smooth-chested female version of the 40 year old virgin up in here. Taking that shit off HURT. I still have red marks from it. I told Gabe he'd better keep his heart healthy so he never needs to have one of those monitors put on his hairy chest.

Jesus.

Water retention. In the eccho room, they took my blood pressure. Twice. It was 105/60. I was more nervous on Monday by a large margin than I was when my BP read high, so don't tell me that high reading was stress-related. I was also newly addicted to drinking water. For the 10 days or so that I've been on this experiment, my weight has not fluctuated much. I weighed 116.5 this morning. At night, I usually weigh about 118. When I was having the heart and breathing issues, I would sometimes weigh as much as 121 and I would complain about how fat I felt, how bloated I was. We make light of these issues as a society, even our husbands roll their eyes at us. We fail to recognize that what presents as vanity might actually be a real, honest to God PROBLEM. And like so many things, we trivialize it, sweep it under the rug, focus on the wrong thing--the "fat" days, when there's water pressing on your heart and lungs, the tits, when there's cancer trying to kill you. Well, no more. Some of us breast cancer ladies are getting testy enough to make our OWN shirts. Save second base? Really?

Water retention. In an extreme form. Water retention so bad, it put pressure on my heart and made it hard to breathe. Water retention that was worse at certain points in my cycle, but never absent. Yes, I realize that I'm self-diagnosing. But until I keel over, I'm going to make the unheard of assumption that I understand my body, perhaps better than anyone else. And my body has changed. The thing is, when your body changes drastically AFTER having some minor issues like CANCER, it can be hard to correctly place the problem and not sit around thinking about what your kids will look like when they're grown up and you're dead. Just saying.

Yesterday, I got myself an iced coffee for the first time in almost 2 weeks because it was so damn hot even at 5:30 in the morning while I was taking my walk. I drank two thirds of it but it took me a few hours. I got up from my desk to go to the bathroom, and I had one of these surreal post-cancer moments. I sat there--me, of the iron bladder, the woman who used to be able, even AFTER having kids, to go 7 hours without using the bathroom--for what must have been three full minutes, peeing. I mean seriously. Folks who came in after me were leaving and I was still taking a piss. My body was telling me, look lady, you're retaining too much of this shit. There's one more vice you just can't have.

Goddamn chemo-induced menopause leading me into a second puberty bullshit.

I got my first period at age 11. I went on the pill at age 18 and went off at age 29. I had my first child at 30 and my second at 33. I never, at any stage, had PMS symptoms. Heavy bleeding, vomiting, yeah I had that. But bloating? Depression? NEVER. And now I have days of the month where I get so down I literally feel almost worthless. I think, I am going to lose my job because I'm no good at it. My kids hate me. I don't have any friends. WHOA! KatydidNOT ever feel that way before these hormones blew up. Never.

Until now.

If I was 20, I wouldn't think about it. At my age, it's hard to believe my hormones could take me for this kind of ride. But there it is. I've been feeling like a rockstar at spinning, still a little out of breath, but better. And it's been 9 million degrees in Chicago and the air quality is horrible so that's not a huge shock. But here's the thing.

If you have lung mets, your symptoms don't get better. They might start out mild or barely noticeable and stay that way, but they don't get BETTER.

So screw that chest x-ray man. Just give me 47 bottles of water and I'm good.

Not just good but GREAT. I feel skinnier, more like myself. I won't throw out the order, but come September, I just don't think I'm doing the chest xray. Now, some of you will think I should get the xray anyway. Other survivors have said, now if it was ME and I had a chest xray order I couldn't get there fast enough! But you know what? I've had more radiation than any human being should ever have in her life and I don't need any more just in case radiation, any more my God I'm going out of my mind until I get those results, tests. I mean, I feel pretty damn good.

Last night it was 103 degrees and extremely humid at 6 pm. So of course, while the kids were at gymnastics, I went spinning. And I felt awesome. I drank two bottles of water in 45 minutes. I had to pee the second I got off the bike. BUT. The last song, during the stretch, was Purple Rain. And there I was AGAIN, tearing up in the gym, this time with happiness, passing it off as sweat as I realized that my heart is ok, my lungs are probably ok, there's something going on in my chest that might necessitate an xray, since it hurts so much, is so tender that if Gabe tries to touch that breast tears sometimes come to my eyes and if I push on the left side of my sternum I wince, but THAT IS NOT CANCER. Ruined pec or cracked bones from radiation, maybe.

But it's not cancer. Cancer doesn't present like that.

So there I was, flying on the bike in the sweaty gym, wearing a bright blue bandana on my head that I bought at the wig shop when I had my head shaved two years ago. Suddenly I had this image of myself when I was 25, wearing this mod dress, showing up at night at class in graudate school after I got off of a full day's work. Another student told me I reminded him of Mary Tyler Moore. I thanked him, though that hadn't been my goal.

Maybe it should have been. I lived in Minnesota for years. And you know what?

I think I'm gonna make it after all.

Day 690: Going Through Puberty...In Your Thirties

So, I’ve been thinking about writing about this forever, but it just seems too absurd to even put out there. And yet, that’s why I do this, right? I write this blog to bring a little bit of the absurdity of cancer into the consciousness of some portion of the general public.

Today I’m going to tell you what it’s like to go through puberty. When you’re in your thirties.

I had a fairly mellow real puberty experience a quarter century or so ago. I was a major tomboy from the age of 8 to about 12, but I was pretty comfortable with myself at that time. I resented my mom for making me buy a training bra when I was 10 (I mean, she stopped wearing them when she was 17, so what the hell?), and I found it more than a little annoying when I got my first period a few months shy of my twelfth birthday. I read all those Judy Blume books and didn’t relate to any of them, except maybe Tiger Eyes, because the girl in the book had some legitimate problems. Even Forever seemed cheesy, and I knew I didn’t want to ever have sex with boys who named their penises and expected me to use said names in conversation.

I wore some strange clothes in junior high, in part because it was the late 80s, and in part because I was figuring out how to actually dress like a girl again. I liked boys who would never like me back, and I was vague and indifferent to the ones who did like me. I would give anything to get a little bit of my dating haughtiness back from the golden ages of 12-14. I would say things to boys like “I don’t want to talk to you on the phone right now.” “I’m sorry, I don’t like you that way.” A boy would say please, I would say no. When did I learn to hide my feelings and lie?

But I digress. The point is, I went through the horror of 8th grade like everyone else (I think that’s the nadir of American children’s lives), and yet my awkwardness was relatively muted. I was pretty comfortable with my body and saw no reason to either hide it or show it off. I dated a lot, and almost all the boys I dated fell into the category of “kids who were so nice to me their friends made fun of them.” I liked fooling around and eventually I liked having sex and I never felt any regret about the things I chose to do or not do. I never had acne. Shit, I never even had bangs. I look at pictures of myself from that time and I look shockingly normal, given the fashion trends in the early 90s.

I did have some issues—my periods were so heavy that I was anemic in 7th grade and was almost put on birth control pills to help, until they realized that would interfere with my epilepsy medication. I got sick every month, and my cycles were long. But I never had any PMS (just violent vomiting for a day once my period actually started), my moods were fairly constant, and transitioning from being a girl to a woman was neither difficult nor surprising.

Then, I went on the pill when I was 18, something I would give anything to do over, given how sure I am that 11 years on the pill eventually led to my contracting triple negative breast cancer, but again I digress. My cycles suddenly became regular, short, and painless. I never got sick. I didn’t gain weight—well, not right away. I think the pill made me gain 15 pounds or so, but it took several years.

Then, fast forward. I went off the pill at age 29 in order to conceive a baby, and it worked. A few months later, Lenny was growing in me. I have never gone back on the pill, but of course I spent much of 2005-2010 either pregnant or nursing, so I had no idea what a “normal” cycle would be for me. When I began having normal, regular periods when Augie was less than 3 months old, even though I was exclusively nursing him, it seemed strange, but I figured what the hell. Let’s see what happens when I stop nursing.

I never really got to find out. I was nursing, then I found out I had breast cancer, and within four months I was in chemo-induced menopause. IT hit me like a truck. I literally had hot flashes every ten minutes all day long. ALL DAY AND ALL NIGHT, I would feel that fire tear through my body. I lost my natural lubrication and sex, while possible and eventually pleasurable, was depressing to me. Sex had always been so easy and so fun for me, I was more like a guy than a girl in the way I perceived it. I thought about it all the time—until menopause, when I never thought about it at all. How can hormones change your actual thought process? I never would have believed in the close mind-body connection of sexuality if I hadn’t seen the disastrous effects of menopause on my body and my desire. Menopause depressed me so completely. And then, it left me—so completely. I was desperate with hot flashes and sadly missing my sexual mojo when BAM. I was back in business.

And I started going through puberty.

You might think I'm exaggerating, but think about it. After Augie was born, I lost weight like crazy, and I've been hanging out in this size 0/size 2 reality ever since. Because of this, I shop in the juniors department at my local department store, where the salesladies have taken to setting aside size 26 Silver jeans for me. I think they like talking to people who don't have to come into the store with their mothers. Look, she has her own credit card. Go help her! God knows I need it.

Plus, I have new hair, and people treat me differently. I am like a tween in my bathroom, awkwardly trying to figure out how to use a straightening iron. After being bald and generally not worrying about what people thought of my looks, I am surprised when I get attention from men. And it's an adolescent surprise, full of flattery and pleasure but trepidation and suspicion as well. It makes me feel 14 again. I am in better shape than I have been in years--I might be in the best shape of my life in some ways, with my relative musculature and strength given this petite little frame. And yet I feel unsure of myself. I worry that I am too fat, or too skinny, or too something, which I never have really worried about, at least not for more than a fleeting minute. I look at and feel my breasts a lot, not to try to detect cancer, but out of some kind of absurd appreciation for what I've got left.

Are you there, God? It's me, Katy. I think I've lost my damn mind.

Anyway, for the last year, I have had periods every 24-28 days. These cycles are shorter and more regular than any I have had in my 25 years of menses. They are completely different, as well—the pattern of bleeding is very consistent but nothing like what I have ever had before in my life. Add on to that the fact that for the first time—EVER—I have every PMS symptom you can name, and it’s like 9th grade up in here sometimes.

I gain 3 pounds in the week before my period every month and my clothes don’t fit right. Then I pee nonstop for 24 hours and it’s all good. I get bitchy, or I yell at Gabe for no reason, or I start to cry on the train, and it’s like a little hormonal alien has invaded my body. I get headaches the day before my period starts, and I have a night of almost complete insomnia (with less than an hour of sleep) like clockwork once a month. I have bad cramps on that first day. My libido, which was always fairly constant, disappears for several days about a week before each cycle, and then comes roaring back and for most of the month I’m like some kid who’s discovering how awesome sex is.

Oh wait, I am actually that kid, because I had six months on the other side, and now I’m trying to make up for it.

But again, I digress.

I am too old for this shit. Pregnancy hormones, fine, I can handle that. It’s expected and you can talk to other moms about it, because everyone goes through that to some extent. But who do I talk to about this? How do I get used to new cycles, new hormones, new patterns that disrupt my life WHEN I AM 36 YEARS OLD AND I SHOULD HAVE BEEN DONE WITH THIS 20 YEARS AGO?!

I mean damn. My oncologist always asks me if I’m still having cycles, and he always seems surprised when I tell him how freakishly NORMAL everything is. “Well I guess we reset you with that chemo!” Ha ha, mother…

You know what I’m saying.

Every month it’s new to me. Every symptom comes as a surprise, and I feel ignorant, and young, but not in a good way. It’s just another sign that I’m not used to my body—the body that I have always felt fairly at home in, no matter what it was doing to thwart me.

Stupid cancer.

I’m starting to get it, starting to adjust to this new normal, but it’s tough. Cancer brings you to these weird places, because you can’t appreciate things in the same way that other people do. I could be happy with the regularity of my cycles, with my raging hormones, but it just makes me worry that somehow that will trigger cancer cells to blow up on me again. I worry that my cycles are short and that I have more periods every year than I should have. I think about menopause, about how awful it is, and that Flowers for Algernon feeling comes back to me and I want to rage against the possibility that I will deal with that again in 5, 10, 15 years, that I will lose all of this.

Shouldn’t I just be glad if I get to those 5, 10, 15 years, you ask?

You don’t ask that if you’ve had cancer. Everyone who is a survivor needs to be able to think like you do, that those 10 years will come, and we will still be here. If we didn’t think that way, we would be insufferable to be around. And yet…we all acknowledge that those years might not be intended for us. We acknowledge that while others go through middle and old age, we might not get there ourselves.

We know that most people don’t think about dying while they’re going through puberty.

So what is there to do but laugh? I’m in on the joke, but you can see it, can’t you? There’s something there, behind those eyes, something that knows that it’s funny and knows that it’s not. I’m just doing my best to live inside that something.