Writing Through Cancer

I awakened to the sound of rain during the night, the sure evidence that the seasons were finally turning in Southern California.  I lay awake and listened to the gentle patter of raindrops against my bedroom window, grateful that autumn, however mild it might be, had finally arrived.  I grew up nearly a thousand miles north of here, where four distinct seasons seemed to arrive precisely on their designated calendar dates.  There was no season I loved more than autumn:  leaves turning color, nights cool enough to pile blankets on the bed, the morning air crisp and bracing, and the excitement of returning to school after summer vacation.

When the song, “Turn! Turn! Turn!” was  released by the rock group, The Byrds, I was a college student,  caught up, like so many others,  in the idealism and fervor of the sixties.  “Turn! Turn! Turn!” captured the sentiments of the time and quickly became number one on Billboard’s “Hot 100.”  We barely noted that the lyrics were nearly verbatim from Ecclesiastes (3:1) in the King James Version of the Bible.

To everything there is a season, and a time to every purpose under the heaven:

A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted;

A time to kill, and a time to heal; a time to break down, and a time to build up;

A time to weep, and a time to laugh; a time to mourn, and a time to dance;

A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing;

A time to get, and a time to lose; a time to keep, and a time to cast away;

A time to rend, and a time to sew; a time to keep silence, and a time to speak;

A time to love, and a time to hate; a time of war, and a time of peace.

The Byrds weren’t the first to sing “Turn! Turn! Turn!,” despite its success.  It first appeared on an album recorded by The Limelighters, a folk group, in 1962.  A few months later, Pete Seeger released his own version of the song on his album, The Bitter and the Sweet. Over the next several years, many other artists recording the song, including Judy Collins, Joe Cocker, The Seekers, Dolly Parton, and Nina Simone.

Is it any wonder?  The words from Ecclesiastes describe life’s journey, the inevitability of its cycles and seasons, the story of the entire lifespan.  As John Kotre and Elizabeth Hall described in their book, The Seasons of Life:  The Dramatic Journey from Birth to Seasons are apt metaphors for our life journey and none more intimately connected to the seasons of nature:  the times of day, circling of the planets, phases of the moon, or growth and harvesting of the crops (University of Michigan Press, 1997).  The notion of seeing human development as similar to the seasons of nature is a powerful attraction for our imaginations. In fact, the ancient Greeks used seasons as a way to view life’s stages: childhood was spring; youth became summer; autumn described adulthood, and winter was the metaphor for old age.

Seasons are also used to describe aspects of cancer.   In a 2009 article in Cure Today, Kenneth Miller, MD  described four distinct phases or “seasons” of survivorship.

1. Acute survivorship: when a person is diagnosed and treated.
2. Transitional survivorship: when celebration is blended with worry and loss as a patient pulls away from the treatment team.
3. Extended survivorship: includes those who are living with cancer as a chronic disease and individuals in remission because of ongoing treatment.
4. Permanent survivorship: people who are in remission and asymptomatic, or, cancer-free but not free of cancer because of chronic late and long-term health or psychosocial problems. Others may even develop secondary cancers related to cancer treatment, or develop second cancers not related to the first cancer or its treatment.

Miller’s observations were informed not only by the experience of his patients, but of his wife’s.  He reflected on his observations and learning and compared her stages of cancer and recovery to the seasons of nature:

I have learned just as much about cancer and the seasons of survivorship in my work as a medical oncologist as I have alongside my wife, Joan, he wrote, who was treated 10 years ago for acute leukemia and more recently for breast cancer. Her diagnosis was certainly like the cold, bleak winter, and transition like the rebirth of spring. And while each season was different than the others, each was beautiful in its own way.

It turns out that seasons also may have some effect on cancer survival.  In a 2007 study, researchers from Norway and Oregon found evidence to suggest that  men diagnosed with prostate cancer in summer or autumn had  better survival rates.   Vitamin D—the sunshine vitamin-plays a part.  In additional studies with lung cancer patients,  researchers discovered that high concentrations of Vitamin D contributed to a better survival rate post-surgery among those with early stage lung cancer.  Patients whose surgeries occurred in sunny months (May – August) had a 30% higher survival rate than those who had surgery in winter. “Season,” epidemiologist David Christiani noted, “had a pretty strong effect.”

Whether we’re diagnosed or treated with cancer in summer or winter, seasons of the illness dominate our lives.  Marilyn Hacker’s 1994 collection of poetry, Winter Numbers, invokes the darkness and cold of winter as she details the loss of  friends to AIDS or cancer and  her struggle with breast cancer.  Dan Matthews, using seasons as metaphor, chronicled the journey of his wife’s terminal breast cancer in a poetry collection,  Rain, Heavy at Times: Life in the Cancer Months (2007).  John Sokol described his cancer experience in his 2003 poetry collection, In the Summer of Cancer.  And in the poem, “For a Friend Lying in Intensive Care Waiting For Her White Blood Cells to Rejuvenate After a Bone Marrow Transplant,” Barbara Crocker builds on the season of springtime, a time renewal and rejuvenation:

The jonquils. They come back. They split the earth with

their green swords, bearing cups of light. ‘

The forsythia comes back, spraying its thin whips with

blossom, one loud yellow shout.

The robins. They come back. They pull the sun on the

silver thread of their song.

The iris come back. They dance in the soft air in silken

gowns of midnight blue.

The lilacs come back. They trail their perfume like a scarf

of violet chiffon.

And the leaves come back, on every tree and bush, millions

and millions of small green hands applauding your return.

(From:  The Cancer Poetry Project, 2007)

This week, why not  explore how seasons can be metaphors for aspects of your life?  Perhaps  your cancer journey can be described as particular seasons, or they may provide metaphors for a marriage, for loss of a loved one, bereavement,  adulthood, or  parenting–any of life’s chapters that are important or significant to you in some way.