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Archive for October, 2012

For October 28, 2012: Tell Me Something I Can’t Forget

 “Tell me,” I said
“something I can’t forget.” Then the story of
your mother, and when you finished
I said, “That’s good, that’s enough.”

(From “Each Bird Walking,”by Tess Gallagher)

Many years ago, I attended a summer creative writing workshop led by Pat Schneider, author of Writing Alone and with Others. Still numb and disbelieving from completing a seven-week regimen of radiation for early stage breast cancer, I’d signed up for the workshop at the urging of a dear friend.

The first morning, I sat in a circle of men and women, feeling empty.  Why was I there?  What was I going to write?  “Tell me something I can’t forget,” Pat said, quoting a line from Tess Gallagher’s poem.  Something she couldn’t forget?  I doubt that the first few stories I wrote were memorable.  I relied on what was most accessible:  old childhood memories, humorous stories  told and re-told at family gatherings.  It would take nearly the full week before I opened the door to my experience of cancer.  But once I did, I began to understand how cancer—even early stage—had altered my life.  I had embarked on my journey to healing.

“A patient is, at first, simply a storyteller,” Siddhartha Mukherjee wrote in The Emperor of Maladies:  A Biography of Cancer, “a narrator of suffering—a traveler who has visited the kingdom of the ill.  To relieve an illness, one must begin, then, by unburdening its story” (p.46).

Writing and sharing our stories of cancer can help repair the damage done to our lives, the sense of who we are, the disrupted futures we face.  “Decay is the beginning of all birth,” Kat Duff wrote in The Alchemy of Illness.  We are our stories, and in the act of sharing them, we affirm our uniqueness and discover is most meaningful. “I did not want my questions answered,” Arthur Frank wrote, describing, his illness in At the Will of the Body.  “I wanted my experience shared.”   In telling and sharing our stories, we remember who we were, and we learn who we are becoming.  While cancer–or any other serious illness–changes us, perhaps it has the capacity to “remodel us,” as poet Jane Hirshfield says, “for some new fate.”

Our stories do something else for us—they can help to alleviate loneliness.  Stories are the language of community.  We discover we are not alone and remember that suffering is part of the human condition.  The act of sharing our stories with one another is about telling the human story—the one  told and retold throughout human  existence, whether around a campfire, at a family gathering, or in the countless books, magazines and blogs we read.

“Tell me something I can’t forget…”  I still hear Pat’s voice from the Berkeley classroom than summer’s morning  so many years ago.  She offered an opening, a door into the “real” story I was struggling to tell at the time.  As my words poured onto the page, I realized how profoundly my life had changed—and was still changing—as a result of my experience.  I was being remodeled for “some new fate.”

“Recovery is only worth as much as what you learn about the life you’re regaining,” Frank wrote.   It’s not just cancer that teaches us—any momentous, challenging chapter of our lives has the potential for significant learning.  But to learn from our experiences requires something of us, the courage, as Maxine Hong Kingston tells the veterans who write with her, to “tell the truth.”  It’s difficult, sometimes, this act of writing and telling our cancer stories, because we have to be willing to dive deep beneath the surface of the events and do some hard soul-searching.  That’s where the real treasure lies, in the truth we discover, and in unearthing that truth, the potential for healing begins.

To relieve an illness, one must begin, then, by unburdening its story.  What is the story you want to tell?  Try beginning with the prompt:  “Tell me something I can’t forget.”

 

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October 21, 2012: To Everything There is a Season

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 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.

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For the Week of October 14, 2012: Cancer, Writing, & Spiritual Antibodies

Like so many Americans, I’ve become a lapsed church-goer over the years, discovering a different kind of meditation and prayer to sustain my daily life. It is my writing practice, a ritual that begins in the early morning, before the outside world intervenes to pull me into its noisy demands.   I open a notebook I’ve written in for years, the leather cover engraved with Celtic knots, and turn to a fresh blank page, one inviting me into quiet, and exploration of daily life.  I pick up my pen and begin.  My first words are often no more than a question posed:  “what did you notice?” But it is enough.  Writing has become my prayer, a door that opens to the landscape of my soul.  It is also my practice, helping others to express and explore their lives through writing—particularly those affected by cancer.  It is humbling work, and for the many years I’ve been doing it, I also realize how deeply spiritual it is for me—and, in witnessing others’ lives, for others.

Art enables us to find ourselves and lose ourselves at the same time—Thomas Merton

Faith and spirituality are  important in improving the quality of life among many cancer patients and frequently written about in books, articles and blogs.   “One Man’s Cancer,”a blog written by New York Times editor Dana Jennings, after his diagnosis with aggressive prostate cancer, documented his journey, and among his many reflections, he wrote about the importance of “spiritual antibodies” in his cancer journey.

I converted to Judaism five years ago, after decades spent stumbling toward God. That faith has helped sustain me this past year, from the diagnosis of my prostate cancer, through surgery, and through radiation and hormone treatment when it was learned that I had an aggressive cancer.

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.

Whatever your religious or spiritual beliefs, they can provide strength and comfort in a difficult and painful chapter of life.  A diagnosis of cancer is nothing anyone chooses.  It can feel like a death sentence, and it may challenge your faith.  But cancer offers a chance to deepen self-understanding and compassion, an opportunity to define what is essential and important in life, a reminder to pay attention to and appreciate the ordinary gifts of each day.  “Each moment holds out the promise of revelation,” Jennings wrote. (He ultimately survived his cancer ordeal and continues to enjoy life with his wife and sons).

The experience of cancer, of getting through treatment and recovery, as Jennings so eloquently expressed, is a deeply spiritual journey. Cancer forces us to pay attention, really pay attention, to what matters in our lives.  So many times, when I ask members in my writing groups what sustains them during the long months of surgery, treatment and recovery, I will hear the words, “My faith grew, and I prayed a lot.”

While faith and spirituality are related, they’re not synonymous, yet whatever your beliefs, your faith or your spiritual life can provide an important source of strength and comfort.  Stephen Levine, best known for his work in death and dying, and quoted from a 1989 interview with The Sun, said, “As part of our wholeness, we need our woundedness.  It seems written into spirituality that there’s a dark side to which we must expose ourselves.”

Cancer plunges us into that dark night of the soul.  And while it may challenge our faith, it also offers the chance to explore what is truly essential—and soul nurturing—in our lives. Meditation and prayer are a way to explore one’s faith or spirituality.  Writing also offers a way into the deepest realms of our being.

“When you’re caught up in writing…” poet Denise Levertov remarked in her final interview, “it can be a form of prayer.”  When we write from our lives, we must have the courage to take a deep dive into our inner lives.  “Tell the truth,” Maxine Hong Kingston tells her war veterans as they meet to write their stories of battle.  Writing, whether of cancer, war, or other momentous events in our lives, cracks us open.  We embark on a deeply spiritual journey.  It’s why so many established writers will tell you, “writing is a courageous act.”

Varda, a writer in my first group, died of metastatic breast cancer several years ago.  She wrote throughout her cancer journey, often humorously, sometimes poignantly, but always honestly.  She became one of our most beloved group members.  Nearing the final weeks of her life, she wrote “Faith,” a poem that examined her relationship with God:

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.

 

I have come home to God, and we have renewed

our friendship.

(In:  When Words Heal:  Writing Through Cancer by Sharon Bray, Ed.D., 2006)

I think of Varda’s words often.  To trust—float free…an incredible well I did not know I had.  Has your faith been challenged in the experience of cancer or other suffering? What has sustained you in times of illness, hardship or struggle? Perhaps you have embarked on a spiritual journey you never imagined could be possible as a result of  cancer.  Where have you found your solace, your strength?  Write about how cancer has challenged or deepened your faith or your spirituality.  What “spiritual antibodies” were most nourishing and sustaining for you?

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For the Week of October 7, 2012: “Now I will stop and be wholly attentive”

This past Tuesday evening, I led the first fall session of The Writers’ Workshop at Stanford Medical School, a creative writing group for faculty, medical students and alumni of the school.  I look forward to these sessions.  The writing always delights and amazes me, and the camaraderie that develops out of writing and sharing our words aloud is simply wonderful.  In the midst of a demanding schedule of study, teaching, seeing patients or research, the writing group offers a little oasis where one’s professional masks can be removed, and poems and stories birthed from the material of life.

We began with the usual introductions and segued into a few short warm-up exercises.  As everyone relaxed, I walked to the wall with an array of light switches on it.  I instructed them to turn off their laptops, put pen and paper aside, and close their eyes.  Then I turned out the lights.  “For three full minutes,” I said, “we’re going to sit quietly in the dark without the distractions of our busy, outer worlds.  Pay attention:  to what you’re feeling, the thoughts or images that spring up, your breath or body, anything that goes through your head.”  At the end of three minutes, I turned the lights on one by one.  “Now write,” I said, “anything that came up; anything that begged to be noticed.”

We wrote for fifteen minutes before reading aloud,  and to a person, the writing was deep, moving, and rich in sensory detail and description.  Paying attention, the act of being fully present to our outer and inner worlds is the writer’s work. But in the everyday demands of our busy lives or the aftermath of a cancer diagnosis, our attention is most often pulled in a dozen different directions.  It’s difficult to quiet our minds, to notice and be attentive to the gifts life offers.

Ted Kooser, former poet laureate and a cancer survivor, knows how paying attention to life’s myriad gifts inspires writing and helps us heal.  Written during his recovery from cancer treatment, Winter Morning Walks:  One Hundred Postcards to Jim Harrison is a book of poetry created from the postcards written to his friend and colleague  during his recovery from surgery and treatment.  In his preface Kooser describes how the book came to be:

“In the autumn of 1968, during my recovery from surgery and radiation for cancer, I began taking a two-mile walk each morning…hiking in the isolated country roads near where I live…During the previous summer, depressed by my illness, preoccupied by the routines of my treatment, and feeling miserably sorry for myself, I’d all but given up on reading and writing…  One morning in November, following my walk, I surprised myself by trying my hand at a poem.  Soon I was writing every day… I began pasting my morning poems on postcards and sending them to Jim…”

The long walks,  the act of noticing and writing each day, helped him heal.  In his book, we find a touching portrayal of a poet, a man recovering from , the ravages of illness and treatment, whose spirit and sensibilities are reawakened as he begins paying attention to the life and the beauty in the natural world.

Each of Kooser’s poems begins with a note on the weather, for example, “Sunny and clear,” or “Quiet and cold at 6 a.m.,”  followed by his observations, rich in detail and imagery, and leading to a reflection and  insight.  For example:

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.

Despite his recovery from surgery and radiation, Kooser’s poems do not focus on cancer.   In fact, “cancer” enters into his vocabulary only a few times, yet the reader is acutely aware of its presence.

My wife and I walk the cold road 

In silence, asking for thirty more years…

 

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.

Kooser reminds us of the importance of noticing, of paying attention, and being fully present in the world around us.  As he notices  the smallest details of life around him, we witness his recovery.  But it’s the spiritual recovery we are most touched by, not the physical one.

“Gratitude,” a poem Mary Oliver, whose observations of the natural world are so beautifully described in her poetry, asks–and answers—eight simple questions.  She begins by asking, “What did you notice?”  and  responds:

The dew snail;

the low-flying sparrow;

the bat, on the wind, in the dark…

The poem continues, a question to the narrator and her response, each a treasure of richly described observations of the natural world.  At the end of the poem, she poses one last question, one that takes us deeper into awareness.

What did you think was happening?

She responds:  …so the gods shake us from our sleep.

(From:  What Do We Know:  Poems & Prose Poems, 2003)

Paying attention, as Oliver, Kooser, and other writers remind us, is about slowing down and being attentive to the present, to what’s inside or right in front of our eyes, of being shaken from our sleep,  and in doing so, we embark on a deeply spiritual exploration.  As Anne Lamott observed, “There is ecstasy in paying attention.”

Pay attention.  Try sitting quietly in the dark or with your eyes closed, noticing what comes up in your mind as you do.  Or meander along a trail, near the sea, in the woods, even a long walk along city streets.  Take in the sights, sounds, smells, and  movements.  Write about what you’ve seen.  Try focusing on just one thing you noticed, describe it, and keep writing, following it wherever it takes you.  What do you learn from what you’ve written?

          “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, Pilgrim at Tinker Creek

 

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