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If this comes creased and creased again and soiled
as if I’d opened it a thousand times
to see if what I’d written here was right,
it’s all because I looked too long for you
to put in your pocket. Midnight says
the little gifts of loneliness come wrapped
by nervous fingers. What I wanted this
to say was that I want to be so close
that when you find it, it is warm from me.

“Pocket Poem,” By Ted Kooser; In:  Valentines: poems, 2008)

This past week, I addressed three brightly colored envelopes, red and pink, to the grandchildren who occupy such a big space in my heart.  I’ve been sending them valentines every February since they were first born, and for good measure, adding cards for their mothers, my daughters to the list.  One more card is hidden in my desk, which I’ll place on my husband’s desk early Thursday morning, a continuing tradition that, despite the many years that we’ve been together, remains intact.

Valentines, however entwined with rampant commercialism that accompanies all  holidays, began as a simple expression of love and gratitude, the first attributed to the Charles, Duke of Orleans, imprisoned in 1415 in the Tower of London after the Battle of Agincourt.  As the story goes, he passed his time writing romantic verses for his wife, who was still living in France.  Today, nearly sixty of the Duke’s poems remain and are considered as the first modern-day valentines.  Yet nearly three hundred years passed by before valentines became popular, their verses created by valentine writers in England in booklets that could be copied on decorative paper.  By the early 1800’s, valentines were constructed from simple black and white illustrations, painted and assembled in factories.  By the mid 1800’s, valentines were adorned with lace and ribbons, included affectionate messages and illustrations of turtle-doves, lovers’ knots in gold or silver, cupids and bleeding hearts.  Even though the valentines on display racks in card shops and drug stores now range from the flowery to the comical, I was surprised to learn that more cards are exchanged on Valentine’s Day than other time of the year except, perhaps, Christmas.

Like many of you, I first experienced the exchange of Valentine’s cards in kindergarten.  My teacher decorated a large hat box with red and white paper hearts, lace and ribbons. This, she explained was our valentine card mailbox, and each student was instructed to bring one valentine for each classmate, to be placed in the “mailbox” and exchanged at our Valentine’s Day party.  The excitement we all felt was palpable, and early on the morning of February 14, I awakened  and slipped out of bed quietly while my parents still slept.  I tiptoed into the living room of our upstairs apartment where a package of valentines lay on a card table, waiting to be addressed.

I was too excited to wait for my mother and went to work, painstakingly printing the one name I knew how to spell in dark blue ink.  By the time my mother walked into the room,  I’d addressed over two-thirds of the packet of 32 and proudly showed her my handiwork.  I didn’t expect her reaction, one of shock and “Oh, no, Sharon…what have you done?”  I’d addressed all the cards to my very best friend, another girl with the same name as mine, carefully printing, “To Sharon H., From Sharon B.” just as we were distinguished in our classroom.  My mother managed to salvage the remaining third for other children in the class, but the memory of that morning lingers.  As my teacher pulled one card after another from the decorated box and called out each recipient’s name, one classmate received many more valentines than anyone else.  “Why, here’s another card for Sharon H.,” she said, casting a knowing smile in my direction.  “I wonder who it’s from?”

Ted Kooser, former poet laureate of the U.S., began a Valentine’s tradition in 1986 that lasted nearly twenty years.  According to NPR, each February, many women around the country and found a postcard in their mailbox bearing a red heart with a poem on it-a valentine from Kooser.  He’d been inspired by a friend  who sent handmade valentines out each year, and in 1986, he sent his first Valentine, a “pocket poem,” to approximately 50 women he knew or had met at his poetry readings.

Over the years, whenever he made a public appearance, and with the blessing of his wife, Kooser invited women to add their names and addresses to his mailing list.  The list quickly grew from 50 in 1986 to 2700 by 2007, and his wife prompted him to “rein it in,” since by then he was spending nearly $1,000 in postage and printing. The enduring result was a collection of the poems he’d sent to the women on his mailing list, simply titled Valentines: poems (U. of Nebraska, 2008).  Valentine’s Day, he reminded his NPR audience in a 2008 All Things Considered broadcast, is a great holiday for a poet or anyone.  “It’s not tied up with anything other than expressions of sentiment,” he said.  Kooser remarked that his wife was very patient with the project, since he always wrote “special valentines” for her.

If  a loved one or friend is going through cancer treatment, showing your support in different ways can be like giving a valentine to them–ways that matter during the roller coaster ride of cancer diagnosis and treatment.  A dinner out or a gift of chocolates are unlikely to appeal to someone going through treatment, but there are, as MD and Oncologist/Hematologist  Cynthia Chua advises, “some wonderful things you can do for your Valentine… sometimes just ‘being there’ is a great gift. Just spend the day with your Valentine and show them how much you care.” She and writer Jennifer Mia offer some suggestions for celebrating Valentine’s Day together with someone who has cancer:

  1. Write a love note or make a card.
  2. Serve them breakfast in bed
  3. Pick up a stuffed animal for them to take to the next chemotherapy session.
  4. Rent a movie to watch together.
  5. Forgot to buy a card to send? Then send an e-card  or make time for a telephone call.
  6. Give the gift of journaling–a notebook of blank pages to write in.
  7. Offer a soft, cozy blanket for time in chemotherapy or a cold hospital room.

But let’s be clear:  You don’t need a Valentine’s Day to express that you care for someone.  You can do this at any time by sending a card, note, email or simply giving him or her a call to show you are thinking about them.  What matters is that you take the time to do it.  You might be surprised at how much it means to someone simply to know that someone cares or is grateful for him or her.  A few weeks ago, I gave my cardiologist a note of gratitude, written in the form of a somewhat humorous poem,  and what I discovered, in doing so, was how very much she appreciated it.

What matters in this world of busy-ness, stress, economic downturns, political drama or the instant and abbreviated communication we’ve succumbed to on the internet, is simply taking the time to express appreciation, concern or gratitude for the people you care about.  It’s a great gift.  You don’t have to wait for February 14th or any other specified holiday.  The simple act of pausing to remember those we care about and those who have cared for us in times of struggle, hardship or illness, reminds us of what matters most in our lives:  people, friendship, love.

“A Perfect Heart”

To make a perfect heart you take a sheet

of red construction paper…fold it once,

and crease it really heard, so it feels

as if your thumb might light up a match

 

then choose your scissors from the box.  I like

those safety scissors with the sticky blades

and the rubber grips that pinch a little skin

as you snip along.  They make you careful,

just as you should be, cutting out a heart

 

for someone you love.  Don’t worry that your curve

won’t make a valentine; it will.  Rely

on chewing on your lip and symmetry

to guide your hand along with special art.

And there it is at last:  a heart, a heart!

(By Ted Kooser, in:  Valentines: poems, 2008)

Writing Suggestions

  • Try writing a valentine this week, a poem, a postcard, even a letter—to someone you appreciate.
  • Why not write yourself a valentine,  saving it for a time when you might need a little self-care.
  • Perhaps you have your own memory of a long-ago Valentine’s Day.  Write it.
  • If writing a card or poem is not something you find easy to do, then pick up your phone and make a call to someone you care about.   Send an email or a Facebook message.  Wish them a happy Valentine’s Day, and let them know you are thinking about them.

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Her death came quietly, and I suppose, unexpectedly for so many of us.  Her obituary, together with a photograph, appeared in the New York Times: “Mary Oliver, a Pulitzer Prize-winning poet, whose work, with its plain language and minute attention to the natural world… died at 83…”  Diagnosed and treated for lymphoma since 2015, the many obituaries paid tribute to her legacy of award-winning poetry and prose, noting how she “often described her vocation as the observation of life.”  Yet it was her poem,  “When Death Comes,” from her first volume of New and Selected Poems and appearing in the Washington Post obituary, that, for me,  truly captured the person behind the poetry, describing how she intended to approach death, and yet making it clear how she would continue to live for whatever time she had remaining.

When death comes
like the hungry bear in autumn;
when death comes and takes all the bright coins from his purse

to buy me, and snaps the purse shut;
when death comes
like the measle-pox;

when death comes
like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering:
what is it going to be like, that cottage of darkness?

And therefore I look upon everything
as a brotherhood and a sisterhood,
and I look upon time as no more than an idea,
and I consider eternity as another possibility,

and I think of each life as a flower, as common
as a field daisy, and as singular,

and each name a comfortable music in the mouth,
tending, as all music does, toward silence,

and each body a lion of courage, and something
precious to the earth.

When it’s over, I want to say: all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.

When it’s over, I don’t want to wonder
if I have made of my life something particular, and real.
I don’t want to find myself sighing and frightened,
or full of argument.

I don’t want to end up simply having visited this world.

(In:  New and Selected Poems, V. 1, 2004)

Oliver’s words lingered in my mind for days, not only a statement of how she lived and wrote, but the legacy she wished to leave behind.  It left me thinking about obituaries written for many I’ve known and they did not often capture the essence of the person.  I recalled an article I’d read several years ago by writer Lloyd Garvey, remarking that sometime earlier, “somebody quite wise–I think it was my rabbi–suggested that people should write their own obituaries.  Now.  Regardless of age or medical condition. That way,” he said, “you’ll think about how you want to be remembered and what you want to accomplish in the rest of your life.”  (The Huffington Post, January 16, 2009).

Former leadership guru, Peter Drucker, once told a story in The Daily Drucker: 366 Days of Insight and Motivation for Getting the Right Things Done:  “When I was thirteen I had an inspiring teacher of religion who one day went right through the class of boys asking each one, “What do you want to be remembered for? None of us, of course, could give an answer. So, he chuckled and said, “I didn’t expect you to be able to answer it. But if you still can’t answer it by the time you’re fifty, you will have wasted your life.”  The question, “What do you want to be remembered for?” is one, he stated, that induces you to renew yourself.  You’re forced to see yourself as a different person:  the person you want to become.

In her poem, “Cover Photograph,” Marilyn Nelson answers the question, “What do you want to be remembered for?”  with the repetition of the phrase “I want to be remembered” in each stanza,  describing the different aspects of herself  that define who she is but also, who she wants to become:

I want to be remembered
As a voice that was made to be singing
The lullaby of shadows
As a child fades into a dream…

I want to be remembered
as an autumn under maples:
a show of incredible leaves…

I want to be remembered
with a simple name, like Mama:
as an open door from creation,
as a picture of someone you know.

(In:  Mama’s Promises:  Poems, 1985)

As I grow older and perhaps, because my life has been touched by cancer and by heart failure, I think more often about how I’d like to be remembered when my time comes. While I’m not eager to consider mortality, asking myself how I want to be remembered raises the question of what else and what more I want to do with my life.   I agree with Drucker:  Asking yourself, “What do you want to be remembered for?” is one that induces you to renew the person you are…to be, as Mary Oliver described,  a “bride to amazement” or bridegroom “taking the world in his arms,” to be fully alive–and grateful– for however long we inhabit the earth.

Writing Suggestions:

How you want to be remembered?   What more do you envision for your life?  What things do you want yet to do before you die?  What is the legacy you wish to leave behind?

This week, try writing your own obituary or eulogy. What would you say about yourself?  Think about the things that really matter, the things that will ultimately define your life’s legacy, and the way in which you would like to be remembered by others.  What more do you want to do with your life?  You might even begin with Mary Oliver’s words, “When death comes,” or Marilyn Nelson’s, “I want to be remembered…”

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“Why is loneliness so toxic?”  It’s the question posed in a 2018 headline from  an article by Wendy Leung in the Health section of The Globe & Mail, Canada’s national newspaper.  Loneliness, according to Leung, in the context of cancer or any debilitating illness, is common. She describes a 2107 research study conducted  by a team at Rice University, which studied loneliness among ill people.  The findings suggested that “loneliness puts people at risk for premature mortality and all kinds of other physical illnesses.”  Why?  It’s a source of stress, but perhaps even more importantly, “a sense of being cared for and loved is a crucial factor in our well being.”

Loneliness often accompanies  cancer diagnosis and treatment.  Lisa Masters, living with metastatic breast cancer, offered a poignant description of the kind of loneliness she experienced in a 2014 Huffington Post article:

I am by nature an optimist. I am strong. I usually keep the sadness of myself to myself. I tell you that I’m not terminal and that I believe a cure will be found in time. I so want that to be true. I have Stage IV Metastatic Breast Cancer.

Today I write about a subject that I don’t often speak of, nor even give into its darkness very often.  Today I am lonely.  I wonder how many of you who also have Stage IV cancer are lonely.  I can’t be alone. I know I have my friends and my family who love me. They would do anything I needed them to do. All I need to do is ask. But, they really do not understand how alone someone with cancer can often be…

Today… it’s dark, it’s raining and I feel the loneliness of my cancer.  

So why is loneliness so toxic?  According to Ruth Livingston, PhD, founder and direction of Living with Medical Conditions, writing in a 2011 Psychology Today article, “Curing the Loneliness of Illness:

Being lonely can itself be dangerous to one’s health. Loneliness can double a person’s chances of catching a cold and, worse, lonely people are four times more likely to have a heart attack and, once they do, four times more likely to die from it…Further,… loneliness has an effect on the immune system: …it reduces antibody production and antiviral responses, protective against health risks. Loneliness, then —all alone — is a hazard. 

Summarizing the analysis of 70 studies on loneliness conducted at Brigham Young University,  Dr. Veronique Desaulniers reported that feelings of loneliness can increase an individual’s chance of dying by 26%.  Why?  Loneliness creates is stressful, and overtime, may lead to long-term stress, the “fight or flight” reactions that can have negative impact on our immune system functioning.

 

MacMillan Cancer Support, based in the UK, estimated loneliness put cancer patients’ recovery at risk, finding that cancer patients who are lonely are three times more likely to struggle with treatment plans than those who aren’t lonely,  skipping treatment appointments, not taking medications as prescribed, refusing certain types of treatment or skipping it altogether.   Commenting on the research, Ciaran Devane, CEO at MacMillan Cancer Support said, “We already know loneliness may be as harmful as smoking, but this research shows…it is particularly toxic to cancer patients.” https://www.macmillan.org.uk/aboutus/news/latest_news/lonelycancerpatientsthreetimesmorelikelytostrugglewithtreatment.aspx

Themes of loneliness often make their way into the writing shared by tcancer patients who attend my expressive writing workshops.  These are similar to those described by the National Cancer Institute:

  • Friends may have a hard time dealing with your diagnosis and not call or visit as they once did.
  • You feel sick post-treatments and aren’t able to participate in activities or social events as you once did.
  • It’s common to feel as if those around you—friends and loved ones—don’t understand what you are going through.
  • And even when treatment is over, you may suffer from loneliness, missing the support and understanding you received from your medical team and feeling vulnerable as your “safety net” of regular appointments is taken away from you.

Feelings of social inclusion and support, however, are an important factor in disease resistance.  Dr. Lisa Jaremka, a member of the Rice University research team, discussed the wealth of research showing that a sense of being cared for and loved is crucial to  well-being.  “The need to belong is a fundamental part of being human.  It’s like the air we breathe.  We need oxygen and we need healthy, thriving relationships equally as much.”

So what can you do to combat or overcome loneliness?  Although it’s a feeling we all may have at different points in our lives, it can be particularly prevalent during during cancer treatment and recovery, but let’s face it, it’s also unique to each person, and one works to alleviate loneliness in one person may be ineffective with another.  Overcoming loneliness requires many different approaches to discovering the emotional support we need to help contend with loneliness and its negative health effects.  When you’re feeling lonely, it can sometimes seem as if it’s just too much effort to reach out to others, so what are your options?

Thanks to The Globe & Mail article, I learned about Marissa Korda’s unique online community, “The Loneliness Project,”  initiated in the fall of 2017.  Korda, a Toronto graphic designer, invited people to share their stories and experiences of loneliness on her site.  It has inspired more than a few stories and grown into something much larger than she originally anticipated.  You can read more about Korda’s site and her inspiration for it here.  Writing, together with sharing their stories with one another, as participants in my writing groups will attest, is one antidote for loneliness.  An online community like Korda’s may be one way to to share your experience while sticking your toe in the water of reaching out and finding those important social connections that help you combat loneliness.

City of Hope, a leading research and treatment center for cancer, diabetes and other life-threatening diseases in Southern California, offers seven practical suggestions for helping to overcome the loneliness of cancer:

  • Ask for practical help, such as transportation, financial support or child care by telling your doctor, nurse or other support staff
  • Reach out to your loved ones and friends. Be honest about your feelings but be understanding of their schedules and limitations.
  • Find a support group. Whether a therapeutic support group or an expressive writing group, online or in person, it is an opportunity to share your experiences, hear those of other cancer patients, and learn from them too.
  • Talk to a therapist or your pastor or rabbi. Open up about your feelings in a safe and confidential place with a trained professional.
  • Join a spiritual or religious group to help relieve the loneliness of your cancer journey.
  • Find activities you can enjoy, staying busy as your energy and time allows. Whether a book club, yoga, meditation, expressive arts, taking an online class, or just having fun with a friend.

Remember, having social connections, particularly during the journey of cancer, is important to our health and well-being.  It’s important to have contact with friends, family and others to help diminish loneliness.   Start small:  even simple activities like taking a walk or sitting in the sunlight in a garden be a start to helping you combat loneliness.  Take it a step at a time, but gradually,  re-engage with the things and people that normally, help you feel better.  Reach out; reconnect with life and people.  It’s good for your health and a powerful way to overcome the debilitating effects of loneliness.  I remember how, during a very difficult period in my life, I turned to music, listening well into the late night after my daughters were in bed.  I had a favorite song and repeatedly listened to (and sang along with) Bette Midler’s “Friends” from her 1972 album, The Divine Miss M.:

...And I am all alone
There is no one here beside me
And my problems have all gone
There is no one to deride me

But you got to have friends
The feeling’s oh so strong
You got to have friends
To make that day last long…

I doubt Midler ever realized how much positive impact that one song had on my spirits–and my resolve to reach out to friends during a time I often felt like simply going to bed and covering my head with a pillow.  My friends helped me get through a tough time.  I’ve never forgotten how important to my healing they were.

Reach out; reconnect with life and people.  It’s good for your health and a powerful way to overcome the debilitating effects of loneliness.

Writing Suggestions:

  • What is your experience of loneliness? How did it feel?  What helped you overcome it?  What it was like to be lonely?  Write about it.
  • What images or metaphors best capture your experience or feelings of loneliness. Expand on them and create a poem.
  • Did you experience loneliness even after treatment had ended? Describe what it was like.
  • What has helped you diminish the feelings of loneliness during cancer or another serious illness?
  • How did friends and loved one help you combat loneliness?
  • What advice do you have for the newly diagnosed cancer patient or the cancer survivor completing treatment?

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i am running into a new year
and the old years blow back
like a wind
that i catch in my hair
like strong fingers like
all my old promises and
it will be hard to let go
of what i said to myself
about myself
when i was sixteen and
twenty-six and thirty-six

(From:  The Collected Poems of Lucille Clifton 1965-2010, Young & Miller, Eds., 2012)

“I am running into a new year,” the first line of a Lucille Clifton poem, came to mind early this morning as I greeted the first day of January, 2019–although “running” is not entirely accurate.  Rather, if I am honest about the vagaries of aging, I am sometimes limping into a new year, depending on the aches and pains of a knee now showing the effects of damage done in my more youthful, reckless years.  Nevertheless, I’m moving forward into a new year with every good intention to make it as happy and healthy as I possibly can.

This past year had, as I’ve written in earlier posts, more than a few health challenges, not just for me, but  my husband as well.  I live with heart failure, diagnosed in 2008, likely from damage to the heart muscle during radiation treatments I had nearly twenty years ago.  It is a condition that slowly, but steadily, tends to worsen.  I’m doing relatively well, thanks to medication and the care of an extraordinary cardiologist and her team, but frankly, sometimes that little shadow of fear awakens and trails after me late in the night.

My husband, who has been extraordinarily healthy throughout his life, was diagnosed, quite unexpectedly, with stage 3 kidney cancer in the fall and subsequently had the cancerous kidney removed.  Again, discussions of mortality, interspersed with disbelief, occupied our conversations and thoughts…”what if…?”  Happily, he’s recovered very well, and will, we hope, be granted several more years of healthy living.  Nonetheless, these are the events in our lives that can temporarily bring us to our knees, reminding us of life’s fragility and more, the awareness that we are both growing older, our bodies showing signs of age, and acknowledging we will not live forever.  It’s humbling, and yet, this is life, being human.  No one is immune to its ups and downs,  heartache, illnesses, losses and tragedies that sometimes bring us to our knees, and remind us of our mortality.

Now it is the first day of another year, and for the past few days, I have been writing about and exploring the intentions I have for myself during 2019–how I want to navigate this new year in word, deed and actions.  As I have done for the past many years, I choose a single word to frame my intentions for navigating another year, writing it out, framing it and placing it on my desk as a constant reminder of how I want to live, the actions I want to take.  With all that has happened in the past several months, health-related words have been top of mind.

I began the familiar process, brainstorming words for two or three days and narrowing the possibilities, settling on a shortened list of options.  I then consulted the internet for additional definitions and anything related to the exercise of choosing guiding words or intentions for one’s life.  That’s when I got derailed for a short time, discovering that my practice of choosing one word to frame each new year was now called the “guiding” or “one word movement.”  Huh?  I’ve been part of some movements in my lifetime, like civil rights, anti-war, or women’s rights.  But the act of finding a single word that captured my intentions for the coming year did not seem to be something I’d think of as a “movement.”  Not only that, but I found that there are workshops, coaching and commercial publications offered for this very act of finding one’s guiding word for a new year!  Ack!  I put my words lists aside for a day or two to try to regain a sense of the meaning this practice as for me.

Once I resumed my search and settled on a word which, when I told my husband what it was, he remarked, “that’s a good one.”  The word?  “Flourish.”

To flourish, according to the dictionary, is to thrive, achieve success and prosper.  It’s also associated with luxuriant growth or a sudden burst of activity.  One can trace its etymological roots to early Latin, “flor,” meaning to flower although the first known use of the word “flourish” in the English language didn’t appear until the 14th century.  Flourish, I decided, is an apt word in which to frame the intent for how I want to guide my life–and my health–in the coming year.

So I turned again to scouring the internet for uses of “flourish,” finding a recent definition from popular psychology that seemed consistent with the intentions underlying my choice of it as a guiding word for 2019:

To flourish is to find fulfillment in our lives, accomplishing meaningful and worthwhile tasks, and connecting with others at a deeper level—in essence, living the “good life” (Martin Seligman,PhD, 2011).

Seligman’s definition led me to the site, sub-titled “Your one stop positive psychology resource! ”  I remembered my husband had taken a course of Dr. Seligman’s.  I kept reading, discovering that he is now referred to as “the founding father  of flourishing,” due to his development of the Positive Psychology model and what flourishing includes, i.e.,  “positive emotions, engagement, relationships, meaning and accomplishments.”

But Seligman’s definitions aside,  I had another brief “WHAT?” moment and complained to my husband that not only had “flourish” been around for several centuries, but in this era of instant communication and social media, everything, even vocabulary definitions seemed to be reduced to fads, commercialism, and pop culture.  My husband, also a psychologist, countered my objections, told me again how inspired he’d been with Seligman’s course, positive psychology and more, that Seligman was a great teacher.

“I know, I know,” I sighed.  But Seligman’s definitions of flourishing was clouding my sense of meaning.  I stopped and put my word choice and musings on it aside for another day so that I could articulate and reclaim the meaning “flourish” signified for my life.   I found a favorite poem, a reminder, from William Stafford that helped:

There’s a thread you follow. It goes among
things that change. But it doesn’t change.
People wonder about what you are pursuing.
You have to explain about the thread.
But it is hard for others to see.
While you hold it you can’t get lost.
Tragedies happen; people get hurt
or die; and you suffer and get old.
Nothing you do can stop time’s unfolding.
You don’t ever let go of the thread.

(“The Way It Is,” By William Stafford, From: The Way It Is, 1998)

I returned to my contemplation, knowing I had to follow the thread of what I was exploring when I chose “flourish” as my guiding word for this year.  It is sometimes difficult to silence the voices of others, but it’s important to  struggle with and clarify what any word or set of definitions means in a way that honors our experience.  I spent yesterday writing about the meaning of “flourish” once again.

Flourishing, for me, is about living fully, not being weighed down emotionally and, to the extent I am actually able, physically.  It’s about being present to each day, the moments of simple beauty, kindness, and good in others.  It signifies finding new things to try or discover, time for play and fun with my grandchildren or my husband.  It is about staying active, whether I feel lead- footed in my dance class or not, whether I walk less briskly than I once did or not, or whether I wake up with stiff joints in the morning.  Flourishing is about renewed spirit, living with gratitude, and yes, a positive outlook.   To flourish means, for me, to be alive, truly alive, and participate in living to the fullest extent I can for as long as I can.

Today I’ll look for an image that is a metaphor for flourishing, print it out and place it with the word, “flourish,” written beneath it in the little frame reserved for my annual guiding words.  A constant reminder, this single word, which I claim as my guiding word, the one that will help to keep me on track with my intentions for living in 2019.

Perhaps you also have a guiding word or a list of intentions you wish to live this new year by.  Whatever you wish and intend for yourself and your life, I wish you a new year filled with new possibilities, discoveries, healing and hope.

Happy New Year.

Writing Suggestions:

Where can you find your inspiration for the coming year?

  • Start anywhere, with a single word, an image, a line from a favorite poem.
  • Try making a mind map, a brainstorming list, letting each word or association take you into new territory.
  • Alternatively, simply set the timer for five minutes; open your notebook and exploring all you want this New Year to be about.  You can even begin with “I don’t know where to begin, but…” and keep going, wherever those first words lead you.

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A Lesson

By Judy Rohm

 

At a breast cancer rally she rises

Above sixteen positive lymph nodes

To tell the world that cancer is a wakeup call

That resonates to the cell level.

It’s a lesson taught by trembling hands

That squeeze from today a second cup of coffee

On a sunny deck with someone you love.

It is a slap that sends you flying from Michigan

To Cozumel because cancer teaches that snorkeling

Coral reefs pays greater dividends than a savings account

And mowing summer grass can be postponed

For bike rides past wild flowers and country streams,

And vacuuming the carpet and washing the windows

Are low priority items when a friend drops by to visit.

Cancer is not a gift but a lesson

Full of loving now and living presently.

(In:  The Cancer Poetry Project, V. 1, 2001)

“Cancer is not a gift, but a lesson…” Judy Rohm tells us in her poem.  We don’t wish for the pain of the lessons it teaches us, and yet, we’re often forced to re-examine our lives and change our perspectives.   Like it or not, life throws us curve balls, unexpected and difficult chapters in our lives we have trouble believing have happened.  Cancer is one of those, yet as more than a few survivors have said, “It is a great teacher.”

Cancer, like any life threatening illness, puts us face-to-face with the prospect of our mortality, perhaps sooner than anticipated.  It makes the lessons of our experience and the learning all the more potent.  Alice Hoffman, novelist, writing after her recovery from cancer,  aggressive cancer, expressed it this way:

“In my experience, ill people become more themselves, as if once the excess was stripped away only the truest core of themselves remained.   …novelists know that some chapters inform all others. These are the chapters of your life that wallop you and teach you and bring you to tears, that invite you to step to the other side of the curtain, the one that divides those of us who must face our destiny sooner rather than later.” (New York Times, August 14, 2000)

That transformation to one’s “truest core” was something I have been witnessing each week among those cancer patients and survivors who have written with me in the Fall session of the “Writing Through Cancer” workshop series I lead at Gilda’s Club here in Toronto.  This past Wednesday was our final meeting of the series, and I began the session by reading Judy Rohm’s “The Lesson,” using it to inspire the group to answer the question, “What have you learned from your cancer experience?”  Within moments, pens were moving quickly across their notebook pages.  When I asked who would like to share what they’d written aloud, one by one, each person shared aspects of their lives they wished to change, strengthen or enrich as a result of having and living with cancer.

As I listened to each person read, I remembered John, no longer living, but who had written with me at the Stanford Cancer Center several years ago.  John was a remarkable person,  diagnosed with acute lymphoblastic leukemia in 2005, suffering a relapse in 2008 and undergoing a bone marrow transplant at Stanford that fall.  Two years later, he suffered another setback, and yet, his spirit and tenacity remained strong.  He continued to share his experience, writing honestly, humorously and with poignancy as his illness worsened, even  beginning a blog to share his experience with other patients, family and friends.   J. and I had stayed in touch despite his inability to travel and participate in the writing group.   Early in 2010, just months before he died, he sent me an essay entitled, “What I’ve Learned,”  saying he’d taken inspiration from Esquire Magazine’s then series by the same name.  Here are a few of the things John felt he’d learned from his cancer:

  • If you have a problem, admit it, then you can start to fix it.
  • Work at what you love, forget about the money.
  • Tell your wife how beautiful she is every day, and how much you love her.
  • Tell your kids that you love them, unconditionally. Hug them and encourage them to follow their dream.
  • Listen more and talk less. Be interested in other people’s stories.
  • Don’t assume what you see and believe is the same as what others see and believe. Respect other viewpoints.
  • In the end, all your physical beauty and prowess will leave you. You must still love that person in the mirror.
  • Travel light.
  • We all will die eventually, so find a way to face death without fear. Don’t dwell on death, but enjoy each day as best you can.

Other survivors have also reflected on cancer’s lessons. Writing for a January 2018 issue of Cure Today, cancer survivor Bonnie Annis described what she has learned:  … cancer taught me was to give myself permission to grieve …This did not happen suddenly. It took days and weeks and months, but gradually, the sadness grew less heavy…cancer taught me how to process my anger. At first, I didn’t realize I was angry. …as I thought about all I’d endured, I realized I was angry. I was bitter. I was hurt… And then cancer did the unexpected… [It] taught me how to find gratitude…gratitude can replace grief and anger… Cancer, even with all of its horrible ugliness, can be kind in the lessons we learn from it. But we have to be willing to look for the lessons.             

Author Jenny Nash, diagnosed with breast cancer several years ago, described her cancer experience in her book, The Victoria’s Secret Catalogue Never Stops Coming,” (Scribner, 2001). Each of the thirteen chapters bears the title of one Nash’s lessons.  Here are a few:

            Survival is a matter of instinct.
Bad news does less damage when it’s shared.
Caregivers are human.
Sometimes crying is the point.
Take the gifts people have to give.
Make the experience matter.

The power and lessons of the cancer experience aren’t reserved for survivors alone.  The experience of a loved one’s cancer diagnosis and treatment also affects those close to us. During a 2006 CBS television broadcast, National Geographic photographer Joel Sartore, whose wife was treated for cancer, spoke from a spousal perspective:

     Now, forgive me for saying this, but cancer can also be …an amazing experience that forces us to make amends, to set things right… now I’ve changed, and for good. I appreciate what I have instead of lamenting what I don’t … a new life and a new way of seeing, all from one malicious lump.
On our drives home from the doctor, I’d often look around at stoplights. I’d see people talking on their cell phones, putting on makeup, eating. They’re all in a hurry. It all seems so important. But is it?
In the end, each of us has so little time… we try to make it all count now, appreciating every part of every day.  Sometimes, we sit together on our porch at sunset. We don’t talk much. We just hold hands. We listen to the crickets chirp, soft and cautious, as if they know that first frost might come tonight. We stay a while, until the last of the light is gone, until we can’t see anything. Until we’re just two hearts in the darkness. We’re in no hurry at all.
(CBS Sunday Morning, October 23, 2006).

There are common themes among the lessons shared by cancer survivors, but it’s Sartore’s words that linger in my mind as he reminds us to “try to make it all count now, appreciating every part of every day.”  It’s about being present and living fully.  “Make the experience matter,” Jenny Nash advised.  If we don’t pause and consider what has changed in our lives and what we have learned, the tendency to lapse into old ways of being begins its slow and steady reclamation.   Life is short, and cancer or any other serious illnesses makes us sit up and pay attention to life, having it and being grateful for it.  Perhaps this is best expressed in a short poem written by As Ted Kooser, former poet laureate of the U.S., inspired by one of his long walks in the Nebraska countryside while he was recovering from cancer.

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.

(In:  Winter Morning Walks:  One Hundred Postcards to Jim Harrison, 2001)

 Writing Suggestions:

  • Have you reflected upon and written about the lessons you’ve learned from cancer?  Why not set a timer for 15 minutes and, writing without stopping, list as many of the lessons cancer has taught you as you can.  Once you’ve finished your list, read it over and, noting the most important in the list, begin writing again, only this time, expand on those lessons.  Imagine you’re writing to a friend or someone who is experiencing cancer treatment.  What would you highlight as your greatest lessons from cancer?
  • “Cancer is a great teacher.” Do you agree?  Why or why not?  Elaborate.
  • What do you intend to do differently in your life as a cancer survivor?
  • Try writing a short poem in the style of Kooser’s that expresses the lessons of cancer and the gifts of your life.

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“I guess I’ve become a cancer survivor,” my husband announced over our morning coffee.  It seemed strange to hear him say it, even though his use of the label is correct.  The National Coalition for Cancer Survivorship (NCCS) originally defined survivor as “any person diagnosed with cancer, from the time of initial diagnosis until his or her death.”  Less than two weeks after his surgery, he’d joined the ranks of those living with cancer, a survivor.

We received his pathologist’s report earlier last week, learning that his chances of recurrence in the next five years were lower than we expected, although he will be participating in a clinical trial at the recommendation of the doctor, which he readily agreed to do.  Minus one of his two kidneys post-surgery, you’d hardly know that a month ago, he was dogged by fear and worry.  Now, his mood is lighter, his humor has returned, and he’s begun to resume normal activity.  But our conversations are different–quieter in tone, deeper in subject matter, with a stronger sense of gratitude for the life we have and a determination to live as fully as we possibly can for as long as we can.

Cancer teaches us, whether we are the patient or the caregiver, about what’s important in our lives–what truly matters.   My husband, who rarely shows emotion, is much more likely to exhibit his softer side, whether he is relating a touching life story heard in his Toastmasters Club or has written notes of gratitude to the several Toronto friends who have offered their help and support to us in the past weeks.   Life, I think, seems much more precious to him in the wake of his cancer experience.

In the preface of her book, Survival Lessons (2015), Alice Hoffman wrote of her cancer journey and becoming a survivor, saying I forgot that our lives are made up of equal parts sorrow and joy, and that it is impossible to have one without the other.  This is what makes us human…I wrote to remind myself that in the darkest hour the roses still bloom, the stars still come out at night.  And to remind myself that, despite everything that was happening to me, there were still choices I could make.

Lynne Eldridge, MD, in her recent article about positive changes in people after a cancer diagnosis, stated “Research tells us that most people experience some degree of “post traumatic growth”…describing these changes with words and phrases such as:

  • Silver linings
  • The benefits of cancer
  • “What cancer has taught me”
  • Meaning making, sense-making, or benefit finding
  • Life transforming changes
  • The blessings of cancer

While she acknowledges not all cancer survivors experience positive personal growth, “one-half to two-thirds of survivors admit to some positive changes,” and find more the longer the time since their diagnoses.   Examples of these positive growth changes include:

A greater appreciation for life, enriched personal relationships, compassion for others, deepening spirituality and the discovery of “benefits”–or silver linings–in one’s cancer journey.  As one person said, “I wouldn’t wish cancer on anyone, but looking back, there are ways that I’m a better person than if I’d never had cancer.”

Dana Jennings, a New York Times editor, who published regular blog posts throughout his diagnosis, surgery and treatment for prostate cancer, reflected on life after cancer, saying, Living in the shadow of cancer has granted me a kind of high-definition gratitude. I’ve found that when you’re grateful, the world turns from funereal gray to incandescent Technicolor…The small moments of gratitude are the most poignant to me because they indicate that I’m still paying close attention to the life I’m living, that I haven’t yet succumbed to numbing obliviousness.

When you have cancer, when you’re being cut open and radiated and who knows what else, it can take a great effort to be thankful for the gift of the one life that we have been blessed with. Believe me, I know.

And sometimes, in the amnesia of sickness, we forget to be grateful. But if we let our cancers consume our spirits in addition to our bodies, then we risk forgetting who we truly are, of contracting a kind of Alzheimer’s of the soul.

And so to our lives. My husband and I are more aware now of our mortality, the reality of being human, growing older, and having survived more than one serious illness.  There’s a sense of peacefulness, perhaps, that has become more present in our day-to-day living than we knew in the years of chasing careers, moving across the country four times, and running as fast as we could.  Serious illness teaches you to slow down, smell those roses, and enjoy, truly enjoy, the simple pleasures found in your daily life.

We’re grateful for the fact that my husband’s cancer surgery was successful and for the fact that his chances of recurrence are slimmer than we thought.  We are focused more on the simple pleasures of living and being together, reminded again of the preciousness of life, family, and friends.  “Cancer is not a gift/but a lesson,” Judy Rohm writes in her poem, “The Lesson, “full of seeing now and living presently.”  (In:  The Cancer Poetry Project, V. 1, 2001).  Living fully, presently, is what we are striving to do in our lives.

This is what life does.  It lets you walk up to
the store to buy breakfast and the paper…

Life lets you take the dog for a walk down to the
pond, where whole generations of biological
processes are boiling beneath the mud…

…And then life lets you go home to think
about all this.  Which you do, for quite a long time.

Later, you wake up beside your old love, the one
who never had any conditions, the one who waited
you out.  This is life’s way of letting you know that you are lucky…

(In:   Our Post Soviet History Unfolds, 2005)

Writing Suggestions:

  • Write about being a survivor of cancer and how having experienced cancer has change you:  your life, your outlook, how you approach each day.
  • Have you become more or less grateful for your life post-cancer?  Why?
  • What matters most to you in life now?  Try capturing your sentiments in a poem or personal essay.
  • A way to begin?  Try making a list of “Before Cancer, I was…” then do the same with “After Cancer, I am…”  Choose one or two and develop those feelings into a narrative.

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We sit on the bench in the hospital corridor
next to the cafeteria, and we wait.
You know what waiting is.
If you know anything, you know what waiting is.
It’s not about you.
This is about
illness and hospitals and life and death…

(From: “What Waiting Is,” by Robert Carroll, 1998)

We are all forced to wait many times in our lives, and this week, I’ll be in the role of the loved one, the spouse, who will likely be experiencing the toe-tapping, check-my-wrist watches moments where I am rendered powerless to do anything but wait.  As my husband’s surgery date has drawn closer, the undercurrent of worry and restless nights has increased.  By day, I am calm and supportive, by night, the concern and anxiety rise to the surface as I lie in the dark.  Anyone who is living, as the patient undergoing surgery or the family member restlessly sitting in the surgical waiting room, knows the tension and anxiety of waiting intimately.  This kind of waiting, whether patient or family member, is torment, as writer Susan Gubar describes:

Hurrying up to wait is, of course, the fate of most patients, whether or not they have cancer and no matter how impatient they may be. But for cancer patients, waiting entails being enveloped in heightened fears about harmful protocols and the difficulty of eradicating or containing the disease. While I’m waiting, who knows what appalling cells are conspiring within my body to destroy my being? (From:  Well, “Living With Cancer: Hurry Up and Wait,” The New York Times, December 3, 2015).

But for the family members confined to the surgical waiting room, the experience of waiting during the surgery and for the news of the surgical outcome, the hands of the clock on the wall move slowly, despite how many times we check it or our watches.  It’s a different kind of agony.  

“Here, stress, anxiety, uncertainty and fear serve to make even the shortest of waits seem unbearable.  Families sit crouched forward in their uncomfortable chairs watching the door in hopes of preservation of a life or, unfortunately, sometimes by a less desirable outcome.”  –Kevin Campbell, MD, “The Psychology of the Surgical Waiting Room: Personal Adventures in Waiting,” 2012)

It’s been decades since I waited for more than an hour in a hospital waiting room for anything more than a loved one’s minor surgical procedure.  Thursday’s surgery will be much longer; a two-hour pre-op  process, the actual surgery estimated to be three and one half hours. Time will, I know, seem elongated, as if it stands still.  “Every watch is broken in the waiting room, ” Nurse Sonja Schwartzbach writes in a recent Huffington Post article, “better to count your blessings than to measure the seconds.”  Kevin Campbell, MD,  notes there are four common themes to the psychology of waiting:

  • Unoccupied time feels longer than occupied time.  I’m armed with novels and my computer to help the time pass.  Weather permitting, I may take a walk.
  • Anxiety makes waits seem longer.  Like it or not, we feel anxiety when a loved one is under the knife.  Endurance may be the only solution–that and deep breathing.
  • Uncertain waits seem longer than finite waits.  I have an estimate of the total time before my husband is out of surgery from the moment he is admitted for the pre-op procedure.  That helps, but I doubt it will have only minimum impact on the monotony, anxiety and fatigue of waiting.
  • Solo waits seem longer than group waits.  I expect this may well be true for many people.  I’m not one of them, preferring to keep my worry quiet.  The well-intentioned concern expressed as questions about next steps, treatment options, referrals to another specialist tend to exacerbate the anxiety I feel.

“For family members…the moment my patient is wheeled into the operating room is when loved-one-limbo begins,” Schwartzbach states.  “Everyone feels like an uninvited guest in an unfamiliar residence…the element of the unknown prevails…”  She describes the difference in the way strangers interact in a hospital waiting room:  some share laughs and jokes; some sit still and lifeless, waiting for a surgical update.  Others, and I am in this category, sit, observing the dynamic, waiting for what has been unraveled in one’s life to be stitched back together.  “Doctors use sutures and glue.  Writers use moments and moods.  One heals the body…the other heals the soul.”

Waiting has never been easy for me.  I am action-oriented, even impatient at times, yet I know that while time may seem unending on Thursday, I will have no choice but to accept what I cannot control, to let things unfold as they will.  It’s life– it requires I learn to wait.

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

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

 

Writing Suggestions

  • Write about an experience of having tests, biopsies, or surgeries as part of your treatment for cancer.  Describe the waiting, what you felt and why.  You might try writing a poem that also captures the experience of waiting for results when the outcome could be either positive or negative.
  • If you are the partner or family member of a person who has undergone serious surgery, write about the waiting, the waiting room, the emotions that accompanied your wait in either narrative or poetic form.
  • If you have any advice to those who are going through treatments, tests and surgeries and waiting for the outcomes, what would it be.  Try writing an open letter to these individuals.

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