A few weeks ago, I was invited to give a presentation on the expressive writing programs I lead with cancer patients and survivors to a visiting group of medical students from Dokkyo University in Japan, part of an annual “observership” program hosted by Moores UCSD Cancer Center which I’ve participated in for several years.  My part in the program is to discuss the health benefits of expressive writing and the “Writing through Cancer” program series I lead for patients and survivors at the Center.

It’s always an enjoyable morning, but it’s a different presentation than I usually give to groups.  First, I’m challenged to explain the research highlights of expressive writing and how it’s put into practice in terms that are easily translatable to a group whose English language skills are not generally well developed.  The second and more interesting challenge lies in the cultural differences between American and Japanese populations.  To “tell the truth” about one’s difficult or traumatic experiences, as those in my cancer writing groups do, and expressive writing research demonstrates the health benefits of doing so with several different groups, it’s not appropriate in Japanese culture.  Thus, the medical students and I have an interesting discussion about how expressive writing could be used effectively with Japanese cancer patients and others.  That discussion has naturally migrated to a poetic form that is uniquely Japanese:  haiku.

Creating poetry out of life’s hardships is, of course, an acknowledged healing practice.  The poetry written by cancer patients, for example, has been featured in many magazines and books, like Karin Miller’s two volumes of The Cancer Poetry Project, first published in 2001, and filled with poetry that deals with every stage of the cancer journey.  Poetry was a way for people to express their grief and sorrow in the weeks after the World Trade Center attacks in 2001.  An article entitled “In Shelley or Auden, in the Sonnet or Free Verse, The Eerily Intimate Power of Poetry to Consoleappeared in the New York Times less than a month after the tragedyThe author, Dinitia Smith, noted “In the weeks since the terrorist attacks, people have been consoling themselves—and one another—with poetry in an almost unprecedented way…” (October 1, 2001). ‘In times of crisis it’s … always poetry,” former U.S. Poet Laureate Billy Collins remarked, “What we want to hear is a human voice speaking directly in our ear.”

Shortly after the catastrophic Japanese tsunami of 2011, the Los Angeles Times featured an article entitled “Capturing Japan’s pain in 17 syllables.”  Haiku, a centuries-old Japanese poetic form, commonly about fleeting moments in nature or its changing seasons, became a vehicle to capture and express the pain of the Japanese people in the days and weeks following the tsunami.  Reporter Julie Makinen described how it began:  Amid the cacophony of news bulletins and tweets and cellphone alerts registering yet another aftershock, Yoshikatsu Kurota quietly sent out his brief verse. It was published Thursday, in small type, on Page 14 of the mass-circulation Asahi Daily, in the corner that Japan’s newspapers still devote to such poetic endeavors… Seventeen Japanese syllables, radiating out into the universe, perhaps touching a few other distressed souls adrift in the chaos.

About the nuclear power plant

too much detail I hear

such unhappiness


Yo Yasuhara, a Buddhist monk living in Kyoto and a practitioner of haiku first wrote of the October 2004 earthquake which rocked his native Niigata after she spent an uneasy night in the frigid cold in the aftermath:

It’s cold and wet

camping outdoors

aftershocks multiplying

the misery

After the 2011 tsunami, Yasuhara again wrote a haiku, one ultimately carved into a memorial stone in the city of Kyoto:

Days of disaster

I can never forget

the cold and wet

Haiku, as it turned out, gave the Japanese medical students and me some possibilities for using writing, in this case, poetry, as part of healing.  Later, as I led them in some short writing exercises to demonstrate my workshop approach with cancer patients, we incorporated haiku writing, then discussed the possibilities and power of the form.

The essence of the haiku form lies in its brevity and visual intensity.  In seventeen short syllables, it paints a picture in the readers’ mind, calling our attention to an observation and the story hinted at behind the image.  Its most common form is written in three lines, the first line five syllables long, the second, seven, and the third, five, for a total of seventeen syllables, although when translated from Japanese, is not always perfect.

Haiku teaches us the power of observation, of being present to the here and now.  It’s a short-hand route to express suffering and pain, as the tsunami haiku shows us.  It can also be used to express the medical experience.  Pulse:  Voices from the Heart of Medicine, is an online magazine that features essays and poetry by patients and medical professionals, published every Friday.  Pulse also showcases haiku in every issue.  In three short lines, contributors describe their medical experience, for example:

hospital trolley

A nurse wakes me

with a sleeping pill

(–By Cynthia Rowe)


brain tumor on scan

springtime hues drain from my life

black and white remain

(–By Hedy S. Wald)


her bit fat arm

swinging happily at her side

breast cancer survivor

(–By Roz Levine)

Haiku can be a way to use poetry to express your sorrow and pain, but it has the potential to do much more than that.  Haiku takes us beyond sorrow and pain to notice the external world,  the fleeting moments and beauty in Nature, and that teaches us gratitude.  Focus on one small moment of Nature, and the noise from the external world vanishes.  You open your eyes—and heart—to the smallest details, the fleeting moments and beauty in the natural world.  You become aware of the feelings such moments evoke.   While the first level of Haiku is always located in Nature, the second is most often a reflection on Nature, often characterized by themes of  acceptance, aloneness, humor, silence, awakening, compassion, even death.  It’s why Haiku is a poetic form that can have such impact in emotional healing, because a dialogue with Nature is more than just observation; it takes us inside ourselves.  Writing haiku is a kind of meditation,  calming, and quiet. Perhaps haiku, poetry in its simplest form, offers not only a way to find words to express our suffering, but as it also expresses beauty, perhaps it is a prescription for a larger life.

This week, try using Haiku to express yourself—whether it’s an aspect of your cancer experience or a small moment of Nature that offers a metaphor for life.  Three lines, 5, 7, 5, for a total of seventeen syllables.  If you’ve been reluctant to try writing poetry, haiku offers you an very accessible way to begin.



Even in the cave

of the night when you


you push with your eyes till forever

comes in its twisted figure eight


and lies down in your head…

(From:  “Waking at 3 a.m., by William Stafford)

It’s 3 a.m.  You’re awake.  A parade of thoughts marches through your mind, worry, to-do lists, a snippet of a conversation you replay again and again.   Perhaps you keep a notepad by the bed, like I do, hoping that if you jot down the persistent nagging by your brain, you might lull yourself back to sleep.  But you can’t get comfortable, or your husband is storing, or you remember something you forgot to add to the list.  You close your eyes again, trying to focus on little but a steady rhythm of deep breathing.  Perhaps you doze off, awakening a short time later and checking the clock, annoyed to find that barely a half hour has passed since you last checked the time.  Five, ten, twenty more minutes pass.  A seeming infinity.  It’s hopeless now; you’re wide awake and throw back the covers to pad into the kitchen and try the age-old remedy of drinking a glass of warm milk.  Finally, perhaps an hour or so later, you sleep, only to be jolted awake by the alarm clock all too soon.  It’s happens to each of us some time or another.  Whether it’s the result of a tough day at work, finances, worry about a loved one or yourself– even just eating a late dinner–sleep seems elusive.  Worse, there are times during emotional upset, personal crises, or serious illness, when sleep disruption can last for weeks.

Writers know the darkness of early morning hours well.  Long, sleepless nights have been a theme in countless stories or essays or poems, for example, “Sleep now, O sleep now,” James Joyce wrote in his poem by the same name, “A voice crying “Sleep now”/is heard in my heart…”

And from Kim Addonizio’s “Mermaid Song,”

In the black hours when I lie sleepless,
near drowning, dread-heavy, your face
is the bright lure I look for, love’s hook
piercing me, hauling me cleanly up.

Even Winnie the Pooh had sleep problems:

But [Pooh] couldn’t sleep. The more he tried to sleep the more he couldn’t. He tried counting Sheep, which is sometimes a good way of getting to sleep, and, as that was no good, he tried counting Heffalumps. And that was worse. Because every Heffalump that he counted was making straight for a pot of Pooh’s honey, and eating it all. For some minutes he lay there miserably, but when the five hundred and eighty-seventh Heffalump was licking its jaws, and saying to itself, “Very good honey this, I don’t know when I’ve tasted better,” Pooh could bear it no longer.      

(–A.A. Milne, Winnie the Pooh)                       

Like those who have written of the inability to sleep, cancer patients know sleepless nights well.  I remember an early morning a few years ago when, unable to sleep, I went to my desk and turned on my computer.  I was not alone.  An email arrived from one of the women in my cancer writing group who was undergoing a new treatment regimen for metastatic breast cancer.  She too was awake and writing, trying to capture the myriad thoughts about her illness and her life, thoughts that kept her tossing and turning in her bed, unable to fall asleep.

In fact, sleep disorders are common among cancer patients.  Several recent studeies have shown that 30 to 50% of cancer patients have trouble sleeping, compared to 15% in the general population (Oncolink, July 25 , 2016). Even 2 to 5 years after treatment, symptoms of insomnia were found in 23 to 44% of patients.

Patients’ sleep disorders are caused by a number of factors associated with the disease:  physical pain, side effects of treatment, emotional stress, surgery and hospitalization.  The inability to go to sleep and stay asleep can have negative effects, including anxiety, depression, fatigue, headaches or even disrupt the body’s hormonal balance.  David Spiegel and his colleagues at Stanford University Medical School found that those who suffer from troubled sleep are more cancer prone.  When the circadian rhythm (the sleep/wake cycle) is disrupted, it may affect a person’s cancer prognosis.  They concluded that “A good night’s sleep may be one weapon in the fight against cancer” (Science Daily, October 1, 2003).

What can you do if you are one of those who suffer from sleepless nights or insomnia?  MD Anderson Cancer Center offers several helpful suggestions to help you get a better night’s sleep, among them:

  • Power down. The blue light from cell phones, tablets, TV and computer screens suppresses melatonin, which directly interferes with sleep.
  • Rituals.  Make sure you keep a bedtime and wake up ritual, even on the weekends.
  • Cool it down. Check the temperature of your bedroom. The optimum bedroom temperature should be between 65 to 72 degrees for sound sleep.
  • Leave the room. If you cannot sleep within 5 to 10 minutes of lying down, get out of bed and read a magazine or book that is soothing or boring. Spend time in prayer or meditation to calm the mind.
  • Limit your food and drink intake. Avoid heavy meals, alcohol, chocolate or caffeine products, such as soda, coffee or tea, three to four hours before bedtime.
  • Avoid naps. Keep your daytime naps to 30 minutes or less. And, don’t take a nap within several hours of bedtime.
  • Exercise.  The American Cancer Society recommends that cancer patients and survivors do at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week.
  • Pull down the shades. Your bedroom should be like a cave.  It should be dark, cool and quiet.  Cover clocks or other electronic devices that emit light in your bedroom.
  • Write it out. Keep a pen and paper by your bed if you are prone to wake up and worry about the next day’s events.

Although these tips are aimed at the person living with cancer, they are helpful advice for anyone who has trouble getting (and staying) asleep from time to time, just like I do!  May your nights be filled with with more sound sleep  and pleasant dreams than worries and restlessness.

Writing Suggestion:

  • Write about sleepless nights. What do you remember most about a particular sleepless night? Describe it in as much detail as you can.
  • What thoughts or images invade your mind and keep you awake?
  • Have you ever “birthed” an idea for a poem or story in the darkness of the night?  Write it.
  • What’s helped you coax yourself back to sleep? Write about your rituals or calming practices that help you overcome the agony of a sleepless night.

What you do with time

is what a grandmother clock

does with it: strike twelve

and take its time doing it.

You’re the clock: time passes

you remain. And wait.

(From:  “Mother,” by From The Plural of Happiness: Selected Poems of Herman de Coninck, 2006)


I was too restless to concentrate on writing a prompt yesterday morning, and I was preoccupied with leading a writing workshop in the afternoon.  I promised myself I’d get the post written in the evening, but by then, thinking about my daughter’s impending dissertation defense,  my husband and I began reminiscing, remembering our doctoral defenses, and while it was an innocent conversation, it ignited my agitation.  I slept well enough until five a.m., waking with my eldest daughter dominating my thoughts.  She’s on Eastern Time, so I knew she would soon be leaving for her university.  Despite my confidence in her, I felt anxious and hoped she was prepared for what is often a grueling two-hour doctoral dissertation defense.  I knew she was well grounded in her research area, living and working in Lebanon for several years as she interviewed countless Lebanese youth and experts in her field of study.  Her research took years, due, in part, to work assignments, developing a long-term relationship with her spouse, and giving birth to a daughter, now five, and writing a lengthy dissertation in Mid-East studies.  Yet she persisted, finishing the dissertation a few months ago and today finally charged with defending her work.

It’s little surprise that I couldn’t go back to sleep.  Six a.m. for me, nine a.m. for her, and I pictured her entering the conference room, dissertation committee and external examiner seated at the table.  Seven a.m., and I tried deep breathing, thinking positive thoughts, and willing myself back to sleep.  I was unsuccessful.  So I gave up, got out of bed and waited, nervously jumping up every time the telephone rang.  A business call for my husband.  A call from a friend.  A delivery.  And still I waited.

Standing at the baggage passing time: 

Austin Texas airport—my ride hasn’t come yet. 

(Gary Snyder, “Waiting for A Ride,” in Danger On Peaks, 2004)

Waiting.  You stare at the clock; the hands seem to move in slow motion.  We do a lot of waiting in our lifetimes, and there are periods in our lives when waiting seems to be the dominate feature of each day.  We wait in lines for tickets or to get through security at the airport.  We wait to be served in restaurants or for a train in the subway station.  We wait for calls or letters from loved ones, for acceptances to schools, or the results of medical tests,( as I did this past weekend), or for a loved one undergoing surgery.  We wait in doctors’ waiting rooms for an appointment scheduled an hour earlier, thumbing impatiently through outdated magazines and checking the clock a dozen times.

You will have to wait. Until it. Until …
Until the doctor enters the waiting room, and His expression betrays all, and you wish He’d take his God-damned hand off your shoulder.

(From:  “Waiting,” The Collected Poems of Robert Penn Warren, 1998)

We wait with hope; and sometimes, we wait with dread.  And many of us wait impatiently, unable to concentrate on much of anything but the waiting.

Some days will be rainy and you will sit waiting

And the letter you wait for won’t come,

And I will sit watching the sky tear off gray and gray

And the letter I wait for won’t come.

(From “Caboose Thoughts,” by Carl Sandburg, 1878 – 1967)

No amount of sighing and toe tapping diminishes the waiting.  It does little good to pace the hallway or sit at the table, foot twitching restlessly, willing something or someone to speed up.  As Robert Penn Warren is to have said, If something takes too long, something happens to you. You become all and only the thing you want and nothing else, for you have paid too much for it, too much in wanting and too much in waiting and too much in getting.”

Time—and events—move as they will.  Still we wait.  It’s difficult to focus on anything else, and yet, if impatience becomes our master, how much of the life around us might we fail to notice?

I said to my soul, be still, and wait without hope

For hope would be hope for the wrong thing; wait without love

For love would be love of the wrong thing; there is yet faith

But the faith and the love and the hope are all in the waiting.


(From The Four Quartets, by T.S. Eliot, 1943)

The faith and the love and the hope are … in the waiting.  These words remind me to reconsider why life seems to make us wait.  I am still learning, despite my age, to accept what I cannot control, to let things unfold as they will–even if it’s as simple as waiting for the call from my eldest daughter to tell me her news…  And she did, an hour ago, entering the defense as a graduate student and exiting with her new title, “Dr.” as she left the university nearly three hours later.  She called a short time afterward with the good news, and it was worth the wait.

Writing Suggestion:

  • What are you waiting for now?
  • Do you remember a particular time when your life seemed to be consumed by waiting?
  • Write about waiting for news, good or bad.  What was the situation?  How did you feel waiting?  How did you feel once the wait was up?


And we pray, not
for new earth or heaven, but to be
quiet in heart, and in eye
clear.  What we need is here.

From:  “The Wild Geese,” by Wendell Berry

Throughout my childhood and undergraduate years, I was active in the Methodist church, involved in the youth groups and later, in the Methodist Student Movement, which was very involved in civil rights and social justice.  Some of my most enduring friendships were formed during that period, but for the better part of my adult life,  I’ve been a lapsed church-goer, craving a deeper spiritual practice than I experienced in the Sunday morning services.   For years, I dabbled with other religious traditions, tried practicing meditation, but nothing seemed to fill my need for the spiritual life I once knew.

Ironically, I’ve led workshops with the bereaved and the terminally ill, and in all of them, one’s faith and spirituality are central.  Still, I searched for something more in my life, even beginning a chaplaincy program several years ago, only to withdraw after a few weeks because, as I told the other participants, I didn’t feel I was “religious” enough to be a chaplain.

And yet, questions of spirituality and faith have always been important and central to my life.  It was only after a spiritual retreat I co-led a couple of years ago, I realized I had had overlooked the spiritual practice I’ve had for years:  a daily routine of writing—freely and deeply—something which began in my teens as I pondered life’s meaning and a later became a refuge, and a virtual sanctuary in my daily adult life.  Writing, as some writers have said, is like a kind of prayer, something I’d always felt about my daily writing practice, but I hadn’t acknowledged how it had, over a period of many years, become my spiritual practice.

Nearly twenty years ago,  I was struggling with a near perfect storm of losses—my father was dead from lung cancer, my mother had begun her descent into the darkness of Alzheimer’s disease, and our family’s dynamics resulted in my becoming estranged from my siblings.   At the same time, I was in the midst of a soul wrenching experience of having to downsize a dying nonprofit organization,  when an unexpected diagnosis of early stage breast cancer–while not life threatening–finally thrust me into a period of complete numbness.  Writing, as it had always been, was my refuge, the only way I could express the grief and heartache I felt,  The only way I could make sense of everything that was happening.  Writing not only helped me cope, it became a fundamental part of my spiritual life.

I have since maintained a daily writing practice, a ritual of quiet meditation that begins in the pre-dawn hours of each day, well before the outside world pulls me into its noisy demands.  I settle in my chair and open the pages of leather bound journal I’ve written in for years.  A new page awaits, blank and inviting, and I recall Rita Dove’s words in, “Dawn Revisited:”  the whole sky is yours/ to write on, blown open/ to a blank page…

The whole sky is yours to write on…  I write every morning, without expectation, beginning with one small observation–something I notice in the moment—fog lifting from the canyon floor, the red breasted hummingbird who appears each morning at the garden fountain, a hawk’s wings spread wide as he glides over the canyon below; the graceful movement of eucalyptus trees in the morning breeze, the smell of freshly brewed coffee—whatever captures my attention.

Sometimes, a short poem emerges on the page, and other times, it’s a feeling or memory, a door open into a longer narrative.  It matters less what I write than simply that I write, embracing the solitude, intertwining the external world with my internal one, exploring whatever words or sentences appear on the page.

“At a certain point you say to the woods, to the sea, to the mountains, the world~ now I am ready. Now I will stop and be wholly attentive. You empty yourself and wait, listening.                                         Annie Dillard, Teaching a Stone to Talk.

Writing is my daily meditation and prayer.  It opens me, ensures I am “paying attention” to what is before me or inside me. It informs my intentions for each day and ultimately, the work I do.  Writing isn’t for everyone, and that hardly matters, because anything that opens you to quiet contemplation and the deeper parts of your lives can be a spiritual practice, for example, art, music, meditation, yoga, hiking, dance…  As Thomas Merton said, “Art enables us to find ourselves and and lose ourselves at the same time.”

Life’s hardships thrust us into what can only be defined as a deeply spiritual journey, although we may not recognize it as such.  We may kick and scream, rail against the injustices of those events, but like it or not, we’re forced to re-examine our lives in ways we have not done before.  We learn to pay attention, really pay attention, to what truly matters to us.   In times of hardship, life-threatening illness, or other suffering, it’s often our spiritual lives that keep us from losing hope, that keep us whole.  As New York Times editor, Dana Jennings, wrote in his blog “One Man’s Cancer,” our spiritual lives sustain us through life’s most challenging chapters:

I am not a fool. I am a patient with Stage T3B cancer and a Gleason score of 9. I need the skills and the insights of the nurses and doctors who care for me. But they don’t treat the whole man. Medicine cares about physical outcomes, not the soul. I also need — even crave — the spiritual antibodies of prayer, song and sacred study.  (New York Times, June 2009)

I also need—even crave–the spiritual antibodies of prayer, song and sacred study…  Among cancer patients, studies show that faith and spirituality are important factors in the quality of life. I witness this in my writing groups.  Faith or spirituality are  often expressed in the poetry and stories written and shared with each other.  As one member said “The community I am building with my fellow writers …is… a form of spirituality.”  Sharing the stories of one’s experience of cancer is one way our spiritual lives deepen and solidify.

Through the exchange of stories, we help heal each other’s spirits…Isn’t this what a spiritual life is about?          -–Patrice Vecchione, Writing and the Spiritual Life                                                                      

However you define your spiritual practice, it can comfort you in times of struggle, but it also gives you the opportunity to deepen your understanding and compassion for yourself and others.  You learn to pay attention to what, in your lives, truly matters, what is essential and important.  You learn to remember gratitude and appreciation for the ordinary gifts life offers you each day.

Varda, who died of metastatic breast cancer nearly fifteen years ago, wrote with me the last two years of her life.  I’ve never forgotten her writing, often humorously, sometimes poignant, but always honest, voicing what others were sometimes afraid to express.  Varda was thrust into a journey that may have brought her to her knees, but she continued to write deeply about her life, her faith and her cancer during the many remaining months of her life.  Her stories were her “spiritual antibodies”—not her cure, but part of her courage to face and help others face her death with grace, love, and even shared laughter.  It was the evidence of the depth of her spiritual life. Near the final weeks of her life, she wrote a poem expressing her spiritual journey:

God and I always had a special relationship,

sealed in ancient Hebrew prayers

and stained glass windows.

The Shofar blown on Yom Kippur.

The Book of Life open for ten days a year,

and then my fate sealed.


But our relationship has changed.

In asking me to surrender to this illness,

God has asked me to let go—to trust—float free.

And I have found this to be a most precious time.


My cancer has challenged my faith,

and I have found an incredible well I did not know I had.

I have found true surrender,

enormous peace.

(From:  “Faith,” by Varda Nowack Goldstein, in:  A Healing Journey:  Writing Together Through Breast Cancer, by Sharon Bray, 2004).)

Writing Suggestions:

  • What nourishes your spiritual life?
  • What spiritual practices or rituals have helped sustain you in times of illness, hardship or struggle?
  • Where have you found your solace, your strength, your source for “spiritual antibodies?”

You just call out my name
And you know wherever I am
I’ll come running to see you again
Winter, spring, summer or fall
All you have to do is call
And I’ll be there
You’ve got a friend…

(“You’ve Got a Friend,” Carole King, 1971)

Remember the song “You’ve got a friend?”  Written and recorded by Carole King in 1971.  James Taylor’s recording of it the same year was the number 1 song on Billboard’s “Hot 100.”  Since then, it’s been sung and recorded by dozens of vocalists, including those as diverse as Michael Jackson, Barbra Streisand, Aretha Franklin, Roberta Flack, Barry Manilow and Ella Fitzgerald, among many others, testimony to the importance of the enduring, and true friendships in our lives.

It’s the song I listened to this morning, tears streaming down my face, James Taylor singing the lyrics that captured the words that failed me yesterday, when my dear friend, C., whom I’ve known for over a half century, called to tell me the news I hoped I not to hear.  I wrote about C. a few weeks ago in my post on scars.

My husband and I visited C. and his wife in late May, and we noticed the bandage on his neck, there to cover a weeping lesion on his neck.  It was skin cancer—melanoma—he’d already had two removed in recent years.  Yet this one was larger and more dangerous looking.  He had it removed shortly after we left, and after surgery, his doctors declared the margins clear.  He called to share the happy news, he and his wife obviously relieved, as I was.

Yesterday morning, as I was ending a call with two of my grandchildren, my desk phone began ringing.  I saw C.’s name on the screen.  He’d tried to call me the night before, but I’d been out for the evening.   I picked up the receiver and said hello.

“What’s up?” I asked.  “I saw that you’d tried to call me last night.  I was just about to call you, but my grandchildren called before I could.”

He didn’t waste any time getting to the purpose of his call.  He’d been seen by a team at a top notch cancer treatment center, and his tests and scans revealed some bad news:   his melanoma has metastasized to his spine and liver.  “How long do I have?”  He asked the doctors.

“Without treatment, nine to twelve months,” they told him.  My hand instinctively flew to my mouth to muffle my gasp as he continued to talk.  He opted for treatment of course, determined to live as long as he can.  Two new immunotherapies, approved in late 2015, have recently shown to extend the survival rates for melanoma patients.  “Let’s keep this ship afloat for as long as we can,” he told his medical team. (C. is an avid sailor.)  They arranged to begin his treatment regimen soon.

“What can I do to help?” I asked.

“Come see me,” he said.  C. and his wife live in in the Pacific Northwest, where we visited them in May while on an anniversary road trip.

“Of course,” I said.  “We will,” adding, “perhaps you and I will finally take that long beach walk we promised each other.”

It’s a promise made decades ago, years after we met at a summer church camp as teenagers.  That last night at camp, we sat together on a split rail fence among the redwood trees, our arms linked, talking well past midnight about our hopes, dreams and the meaning—as we understood it then—of life.  We were, we discovered, kindred spirits, and despite our youth, our friendship blossomed and endured time, marriages, children, living in different countries, and the ups and downs of our respective lives.

A friend is one that knows you as you are, understands where you have been, accepts what you have become, and still, gently allows you to grow. – William Shakespeare

We wrote one another for decades, since we always lived several hundred or more miles apart.  C., who became a journalist for many years, instilled in me a love of the written word.  He grew up near San Francisco.  I grew up in a small Northern California town.  His letters, begun the summer we met, enlarged my world.  Two years later, when I left California to be an AFS exchange student to the Netherlands, he came to the airport to see me off.  It was my turn to enlarge his world, writing  him multi-paged letters about my experience living in a Friesian village.

There were lapses between us over the years–the Vietnam war, marriage, children, losses, re-marriage, relocations, illness—but we always found one another again, our friendship resumed, deepened, and grew to include our spouses.  Throughout it all, we held on to the promise to have a long walk together, talk about our lives and the friendship between us, as we once did so long ago on that star-lit night in the redwoods.  A walk we have yet to take.

The good thing about friends
is not having to finish sentences.

I sat a whole summer afternoon with my friend once
on a river bank, bashing heels on the baked mud
and watching the small chunks slide into the water
and listening to them – plop plop plop.
He said, ‘I like the twigs when they…you know…
like that.’ I said, ‘There’s that branch…’
We both said, ‘Mmmm’. The river flowed and flowed
and there were lots of butterflies, that afternoon.

(From:  “About Friends,” by Brian Jones, in:  The Spitfire on the Northern Line, 1975)

I guess our telephone conversation was a bit like Brian Jones’ sentence:  “the good thing about friends/is not having to finish sentences.”  So much was running through my head as he talked, so much banging against my heart as he told me about his diagnosis.

“You hear this a lot,” he said, “I know you understand…”

My voice caught as I replied, “Yes, but it’s not the same as hearing it from someone who is such a part of your life…”

Now I’m staring at the computer screen trying to figure out what to write next.  Words fail me.  You know how important our friends are to us, and there’s plenty of research to affirm the benefits of friendship.  Yet this morning, I don’t feel like quoting those studies. What consumes me now is that my dearest friend has been delivered a wallop—the news so many of you have heard yourselves—and his journey through treatment and recovery is just beginning.  There are no guarantees.  But we can hope.

My heart aches for C., and I am at a loss for words.  All I can do is reach out my hand and say, “You’ve got a friend…”

Writing Suggestion:

Write about friendship—being a friend, having friends and even losing them.  What has friendship meant to you during cancer or other challenging life events?

School began for my grandchildren this past week, as it has for the children in my neighborhood.  The energy on the street in early morning punctuated with children’s voices, and the preponderance of and “back to school” displays in the department stores igniting my childhood memories of excitement:  the new shoes, school clothes, notebooks, rulers and pencils.  But I have already returned “to school,” as I began, in mid-July, teaching an online writing course for UCLA extension Writers’ Program.   Now, as the fall series of my “Writing Through Cancer” workshops begin soon,  I, like all instructors,  have again been busy with preparation.

Yesterday, however, despite a lengthy “to-do” list, I played hooky.   I put my work aside and focused on simpler things—re-organizing my office after moving in a new (and more ergonomic) desk, playing my favorite classical music as I weeded through closets and drawers, boxing clothing to donate, taking an hour to finish a novel, and  enjoying an iced tea as I sat quietly on the deck in the shade of the pergola.  By the end of the day, I felt more relaxed and happier than I’d been all week.

“It’s ironic that we forget so often how wonderful life really is,” novelist Anna Quindlen writes.  “Life is made up of moments, small pieces of glittering mica in a long stretch of gray cement.  It would be wonderful if they came to us un-summoned, but particularly in lives as busy as the ones most of us lead now, that won’t happen.  We have to teach ourselves how to make room for them…”  (From:  A Short Guide to a Happy Life, Random House, 2000.)

I admit it.  I routinely fall prey to the infectious disease of busyness too often, and when I do, it begins to consume my life.  I began to notice the aches and stiffness of an aging body.  I feel irritable and impatient—sure signs from my body reminding me to slow down and take some time to refocus my attention, notice and smell those roses, or allow myself a lazy afternoon of puttering, sitting in the backyard and listening to the perpetual chirping and tweeting of the birds.

When it comes to the hazards of my tendency to “busyness,” I know better, of course, but actually stopping to re-calibrate and truly pay attention, to life is sometimes more difficult than it should be.   I, like most of you, occasionally need a little whack on the side of the head.  Ironically, I hear myself telling students that “a writer’s work is to notice and pay attention, to make room for the quiet that creativity demands,” but meanwhile I’ve gradually reverted to old, bad behavior, putting my “to-do” list ahead of my life, adding unnecessary stress, and filling my days with tasks that seem important but often crowd out the simple pleasure of being present in the here and now.

We have to teach ourselves how to make room for them [those small moments] to love them, and to live, really live.

Ted Kooser, former poet laureate of the U.S., has written and published over ten books of poetry.   For 35 years he was also an insurance company executive, retiring after his treatment for oral cancer in 1998.  Even as a busy executive, Kooser  honored his art, each day rising at 4:30 or 5 a.m.  to write poetry before he had to get ready for work at 7 a.m.

During his cancer treatment, Kooser described himself as “depressed by my illness, preoccupied by the routines of my treatment, and feeling miserably sorry for myself… During the period when I was in surgery and going through radiation, I really didn’t do any writing. But as I came up out of radiation and was trying to get myself back in some sort of physical shape, I would walk a couple of miles every morning and then find something along that route to write about. (NPR interview, PBS News Hour, Oct. 21, 2004)

He began a routine of early morning walks, and one November morning, surprised himself by “trying my hand at a poem.  Soon I was writing every day…”  He did more than just write.  He pasted his poems on the backs of postcards and sent them to his friend, author Jim Harrison.  The postcards ultimately became a collection of poetry, Winter Morning Walks:  One Hundred Postcards to Jim Harrison, published in 2001 by Carnegie Mellon.

The early morning walks and poetry writing were good medicine for Kooser, as he noted in the NPR interview:   It was very important for me to see something from each day that I could do something with and find some order in, because I was surrounded by medical chaos or health chaos of some kind.  His book portrays what most cancer patients experience,  a man whose life was consumed, for a time, by the ravages of illness and treatment before he reawakened to those small moments of beauty in the natural world–the ones so necessary for poetry.

The sky a pale yellow this morning

like the skin of an onion

and here at the center…

…A poet,

and cupped in his hands, the green shoot

of one word.

In Early Morning Walks,” we see Kooser reclaim his life as he begins again to notice  “the small pieces of glittering mica”  Quindlen describes, a life he began to make time for and notice again.  In his poems, we see not only his recovery from cancer, but life and its endless array of small gifts of beauty.  He reminds us how important it is—how fuller our lives are if only we stop to pay attention to the life all around us.

I saw the season’s first bluebird
this morning, one month ahead
of its scheduled arrival.  Lucky I am
to go off to my cancer appointment
having been given a bluebird, and,
for a lifetime, have been given
this world.

I heard from another cancer survivor last night, a friend, writer, and  former member of one of my cancer writing groups .  She lives with the knowledge that her cancer is “relentless,” despite being in remission for several years.  As she enters a new decade, she is more aware than ever that “life is short,” and that she—and we all—need to be reminded not to waste it, not to be consumed by things that don’t make us feel fulfilled or happy.  Quindlen puts it another way, and with words I’m not likely to forget:

This is not a dress rehearsal…today is the only guarantee that you get…consider the lilies of the field…fuzz on a baby’s ear.  Read in the backyard with the sun on your face…And think of life as a terminal illness, because if you do, you will live it with joy and passion, as it ought to be lived.

Life as a terminal illnessToday is the only guarantee you get.  Embrace the life you have and time for the things that truly matter and give you joy.  It’s good medicine; you’ll feel better.

Then you hold life like a face
between your palms, a plain face,
no charming smile, no violet eyes,
and you say, yes, I will take you
I will love you, again.

(“The Thing Is, by Ellen Bass, In Mules of Love, BOA Editions, 2002)

Writing Suggestions

  • Take an early morning walk—but without your cellphone, music or earphones. Notice at least three small moments of beauty.  Try writing a poem about one or more of them.
  • Use Quindlen’s phrase, “Life is a terminal illness…” and keep writing, without stopping, for twenty minutes. See where it goes.
  • Borrowing from Ellen Bass’s poem, how can you love your life again? Write about it.

Last night my husband and I saw a friend at a jazz concert.  Twice married and divorced, he longs to find a partner to share the rest of his life and has begun dating in hopes of finding lasting romance.  We met his date he brought to the concert, and I learned she was recently widowed, as was another woman our friend had recently dated for awhile.

“Another widow,” he said as his new date left to find the bathroom.  He shrugged his shoulders and sighed.  “I don’t if I’m ready for this”—“this” meaning the emotional roller coaster that often accompanies new romances or relationships after a spouse’s death.

“Be patient,” I said, “it takes so much longer than you think it will to recover from the loss of a spouse.”  He smiled and nodded, but I wondered if he really understood what I meant.

Whether the loss of a spouse, a child or a friend from serious illnesses like cancer, ALS, or a sudden heart attack, there is a great deal written about dealing with the loss of a loved one.  Despite that, grief is not well understood by those who haven’t experienced it.  Some may think of grief as a single instance or just a short time of pain or sadness in response to loss, but the American Cancer Society reminds us that the real process of grieving lasts much longer.

When we experience grief and mourning, it can be hard on our friends or acquaintances, even family members.  Well meaning friends may not understand how important it is to allow grief to take its normal course, particularly in our culture.  “Aren’t you better  yet?” may be something you hear more than once.  It’s painful to see someone we care about dealing with the heartache and sorrow that accompanies the death of another, but it’s important the bereaved are allowed to express their grief and feel supported through the process.  Sometimes it’s hardest for those closest to us to understand what we’re feeling.   It’s why we have bereavement support groups, therapists and pastors who specialize in grief counseling.  Grief, while similar in a general way, is experienced differently for everyone, but what’s important is accepting and honoring however the bereaved person chooses to express sorrow and grief.

This morning, my husband and I talked about the grief process when a loved one’s life ends, remembering the agonizing four year battle with bladder cancer my husband’s brother in-law endured before he finally died.  I recall telephoning my husband’s sister the day after his death, rehearsing what I could say that didn’t sound trite while the telephone rang and rang before she answered.

“Hello?” I knew immediately she had been crying.  “I’m sorry,” she said.  “I just went into his room and saw how empty it is, and then…”  She began sobbing again. “He’s gone, Sharon,” her voice was heavy with grief and exhaustion.  “He’s been my life for sixty-four years.”

It is hard to give up after months of making lists,

phoning doctors, fighting entropy.  But when the end comes,

a bending takes over, empties the blood of opposition

and with a gentle skill, injects a blessed numbness…


After sixty-four years together with her husband, my sister-in-law may be grieving for a long time.  We are grateful her children all live near her to offer support.  According to the American Cancer Society,” studies have identified emotional states that people may go through during grief. The first feelings usually include shock or numbness. Then, as the person sees how his or her life is affected by the loss, emotions start to surface. The early sense of disbelief is often replaced by emotional upheaval, which can involve anger, loneliness, uncertainty, or denial. These feelings can come and go over a long period of time. The final phase of grief is the one in which people find ways to come to terms with and accept the loss” (p.2)

Perhaps this surrender foreshadows my own old age

when I have raged to exhaustion and finally have to go.  For now,

the numbness wears off.  I drive to the market, cook my own food,

take scant note of desire

with no one to consider or contradict my choices.

Something in me will never recover.  Something in me will go on


(From “Numb,” by Florence Weinberger, in The Cancer Poetry Project, 2001)

Yet I believe that some losses are far more difficult to accept than others.  Death from a protracted illness has, at least, a cause that we understand, and it allows the survivor time to come to terms with the inevitability of a loved one’s death.  But unexpected loss or the sudden death of a spouse or child, comes as a complete shock, defies our sense of what is “supposed” to happen in life, and can complicate and extend the grieving process for years.

Life changes fast.
Life changes in the instant.
You sit down to dinner and life as you know it ends.

(Joan Didion, The Year of Magical Thinking)

I remembered my emotional state in the aftermath of my first husband’s drowning, recalling how his parents, now deceased, and his siblings never fully recovered from his sudden death.  My daughters, then nine and ten, still carry remnants of the grief and loss they experienced in the wake of his death.  And it took me more than a few years to work through the grief and emotional ups and downs of losing a spouse in such an unnecesary accident at 36.  But I was lonely, so I began to date again in the year that followed, hoping to ease the constant heartache I felt.  It didn’t work, and I made poor choices in the process before I realized I hadn’t acknowledged how every un-ready I was to begin a new relationship.  Healing had its own time schedule, and it couldn’t be rushed.  It took eight years before I met and finally married my present husband.  Even then, I carried an exaggerated fear of loss in the first few years of our marriage.

In the turbulent days following my first husband’s death,  a friend and English professor offered this distraught then-36 year-old the poem, “And Death Shall Have No Dominion,” by the Welsh poet, Dylan Thomas,.  Thomas’s poem celebrates the undying and everlasting strength of the human spirit—and reading and sharing it provided me with some degree of solace in the face of tragedy, reminding me that even in death, loved ones are not lost to us. I later used to honor my husband by sharing it with family and  close friends.  Perhaps you will find as much power in it as I did.

And death shall have no dominion.

       Dead men naked they shall be one

       With the man in the wind and the west moon;

       When their bones are picked clean and the clean bones gone,

       They shall have stars at elbow and foot;

       Though they go mad they shall be sane,

       Though they sink through the sea they shall rise again;

       Though lovers be lost love shall not;

       And death shall have no dominion.


(From:  Twenty-Five Poems, 1936)

Writing Suggestion

This week, consider the process of grief and mourning:

  • Have you lost a loved one to cancer or an unexpected tragedy? Write the memory of the day someone you loved died.
  • What did you experience in the aftermath death? Write about the emotional ups and downs of grief.
  • What helped you deal with the loss and gave you the strength to go on? Write about the gradual process of healing from the death of a loved one.