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I’ve been doing a lot of it, waiting, that is.  Since we made the decision to relocate several months ago, it’s seemed like “hurry up and wait.”  Four months ago, I began sorting through books and clothing, optimistic that we’d be headed north sometime in late April or, at the latest, mid-May.  But it’s now June, and we are now waiting for escrow to close in just less than a month.  Even though I realize these next weeks will now be dominated by a flurry of activity,  our time thus far has seemed elongated and the waiting interminable.

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

Waiting.  We all do it–and often.  It can dominate our daily lives.  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 employers, editors or loved ones, for acceptances to schools, or the results of medical tests.  And  we wait in doctors’ waiting rooms for an appointment scheduled an hour earlier, thumbing impatiently through outdated magazines and checking the clock a dozen times, unable to concentrate on much of anything but the waiting.

Waiting, a novel by Ha Jin, captures the poignant dilemma of a Chinese man, Lin, whose life is dominated by duty.  He is caught in a loveless marriage arranged by his traditional parents Lin lives far away in an army hospital compound, visiting only once a year. He becomes attracted to a nurse in the hospital where he works, but Communist party rules prevent him from divorcing his wife without her permission until they have been separated for 18 years.  Year after year, Lin returns to his village to ask his wife for his freedom, and year after year, he returns, still married, unable to consummate his love affair.  The irony comes at the end, when Lin concludes that he “waited eighteen years just for the sake of waiting.”

The narrator in the short story, “Waiting,” by E.C. Osondu, also spends his days in wait.  War has destroyed his village, and he is one of many in a refugee camp faced with the threat of starvation.  They spend also their days waiting.

Here in the camp, we wait and wait and then wait some more. It is the only thing we do. We wait for the food trucks to come and then we form a straight line and then we wait a few minutes for the line to scatter, then we wait for the fight to begin, and then we fight and struggle and bite and kick and curse and tear and grab and run. And then we begin to watch the road and wait to see if the water trucks are coming, we watch for the dust trail, and then we go and fetch our containers and start waiting and then the trucks come and the first few containers are filled and the fight and struggle and tearing and scratching begin because someone has whispered to someone that the water tanker only has little water in it.  That is, if we are lucky and the water tanker comes; oftentimes, we just bring out our containers and start waiting and praying for rain to fall.

We are all forced to wait at many times in our lives. Those toe-tapping, check-our-wrist watches moments are minor irritations that we all endure.  But there is another kind of waiting that no one finds easy, waiting that is punctuated with worry and sleepless nights.  Waiting that could be a matter of life and death.  Anyone living with cancer knows this kind of waiting intimately.  In  the course of treatments and recovery, waiting can be torment, as writer Susan Gubar describes in her article, “Living With Cancer: Hurry Up and Wait.”

As a cancer patient, you endure “waiting for a doctor, waiting for radiation, waiting for the delivery of chemotherapy drugs, waiting through interminable infusions or transfusions, waiting for a scan or a biopsy, waiting for the results of a scan or a biopsy, waiting (sometimes starved and unclothed on a gurney in a hall) for surgery… 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? (In:  “Well,”  New York Times, December 3, 2015)

A 2011 research study reported in The Annals of Surgery found “wait times for cancer treatment have increased over the last decade… potentially resulting in additional treatment delay…Although cancer incidence rates have seen modest declines during the last decade, the overall number of patients diagnosed with a solid organ malignancy has been increasing, likely due to an increasing elderly population.”  An extended interval from diagnosis to treatment, the researchers concluded, “adds to patient anxiety, leads to gaps in care, and perhaps affects disease progression.”

If you or a loved one has been faced with the anxious period between any test for cancer and its results, your experience may be echoed in Muriel Fish’s poem, “In Cold Dreams Before Dawn,” as she captures the fear of waiting:

…The radiologist

Enters, snaps the x-ray film into a wall unit lit with

brisk efficiency…

…the bite of the biopsy needle reminds me

most lumps are benign…

…I wait, remembering long

Bittersweet days sitting with my mother and sister,

each with their own small malignancy and dead within three years.

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

Robert Carroll, MD, is a UCLA psychiatrist who utilizes poetry to help patients cope with their illnesses and struggles.  In a 2005 article, “Finding the Words to Say It:  The Healing Power of Poetry,” he explored how poetry can help us find the words to express trauma, illness, death and dying.  Remembering my father’s death from lung cancer several years ago, I was drawn to one of his featured poems:  “What Waiting Is.”

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…

In matters of death and dying, as Carroll describes,  we may be forced to do little but wait, but finding ways to express our pain and emotion–by writing or finding meaning in others’ poetry and prose–has therapeutic benefits.  In this poem,  Carroll captured another kind of waiting cancer imposes on us, the experience of waiting while a loved one ends his cancer journey.  As I read it, I recalled the experience of waiting while my beloved father was dying of lung cancer several years ago:

In the bathroom you look in the mirror.
What do you see?
Your father’s sad face?
Your mother’s eyes?
You catch the water cupped
in your thickened hands, splash it on your face,
and hope against hope you can wash it away—
the aging brown spots, the bags,
the swelling truth of waiting—…

you get home to see the light
flash on your answering machine…

you push the button,
and it’s your sister’s voice,
but it’s choked,
and she can’t speak…

 Waiting never seems to get easier, and there are times, particularly in the midst of illness, trauma and suffering, that the waiting we do seems never ending.  Yet, we learn, as we sometimes are forced to do, to wait.  And we hope, as T.S. Eliot once wrote, “The faith and the love and the hope are … in the waiting.  These words make me reconsider why life makes us wait.  I am still learning, even after all these years, to accept what I cannot control, to let things unfold as they will.  “This is life.  You learn to wait.”

Writing Suggestion:

The waiting I’ve been doing lately will, once it’s over, make me wonder why I expended on the energy on it I have.  But I, like you, have sat, worried and anxious, in waiting rooms while a child undergoes surgery, or waited, dreading the call I knew would come, when my father died, and waited, caught between hope and fear, for the results echocardiograms or a biopsy.   Think about all the times you’ve waited for something or someone.  Write about an experience you’ve had of waiting.

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.

Lisa Masters, “The Loneliness of Cancer,” Huffington Post, March 6, 2014.

In “The Anatomy of Loneliness,” an essay written by novelist Thomas Wolfe in 1941, he wrote: “The whole conviction of my life now rests upon the belief that loneliness, far from being a rare and curious phenomenon, peculiar to myself and to a few other solitary men, is the central and inevitable fact of human existence.”   Yet, there are periods in a person’s life that loneliness, while “inevitable,” is intensified by circumstance, for example, poverty, old age, loss of a partner or spouse, or having a serious or life-threatening illness that loneliness intensifies and worsens.  The experience of cancer, especially when we hear descriptors like “aggressive,” “terminal” or “progressive,” can thrust us into that state, once described by Susan Sontag as the “kingdom of the sick,” where we feel isolated and estranged, not only from those close to us, but from ourselves.

According to Ruth Livingston, PhD, founder and direction of Living with Medical Conditions, writing in a 2011 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 increases genetic activity related to inflammation, a risk factor for heart disease and cancer; and it reduces antibody production and antiviral responses, protective against health risks. Such patterns of gene expression are not, according to researchers, linked to other negative feelings such as depression.  Loneliness, then —all alone — is a hazard. 

In 2014, UK-based MacMillan Cancer Support 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.  For example, lonely patients skip treatment appointments, do not take medications as prescribed, refuse certain types of treatment or skip treatment altogether.  Ciaran Devane, MacMillan CEO, commenting on the research, said, “We already know loneliness may be as harmful as smoking, but this research shows…it is particularly toxic to cancer patients.”

Illness is solitary, because suffering is something you always do alone.  It impacts phenomenally on your world view and on your experiences and on how you see the external world.

Author Peter Hobbs, commenting in a 2008 Granta Magazine interview

In his book, The Lonely Patient:  How We Experience Illness (2008), Michael Stein, MD, wrote, “health is comfortable, predictable, unnoticed.  …illness seems to come out of nowhere.  It’s become the unknown, and we’re all frightened by the unknown.”  He noticed that the effect on many of his patients was a kind of withdrawal, becoming physically unavailable for a time, and asking the question, “Why me?”  Loneliness, he concluded, “is a word that captures the inward spiritual condition…by its very nature, it excludes others.  The patient begins to feel out-of-place, lonely, and loneliness if made worse by the severity of the illness.

Loneliness is not an accident or a choice.

It’s an uninvited and uncreated companion.

It slips in beside you when you are not aware…

It takes your hand and walks with you.  It lies down

with you.  It sits beside you.  It’s as dark as a shadow

but it has substance that is familiar…

(“Loneliness,” by Fanny Howe, in Second Childhood, 2014)

Loneliness is a theme expressed regularly in the cancer writing groups I lead.  There are common triggers to loneliness often shared among the members and echoed 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 the activities or social events 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.
  • Even when treatment is over, you can 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.

Remember, although loneliness is common, that “inevitable fact” of being human, it’s not good for your health.  We all need emotional support during cancer treatment and recovery, but each of us has different ways of finding the emotional support we need.  When you’re feeling lonely and blue, it may seem like it takes too much effort, yet it’s important to find something that can help you diminish your loneliness, whether an expressive writing, support or art therapy group or an activity, like yoga.   Perhaps it’s a long chat with a close friend, a loved one or even your pastor, rabbi or a counselor.  Even simple activities like taking a walk or sitting in the sunlight in the garden can help combat your loneliness.  Take it a step at a time, but do take steps to re-engage with the things that normally, make you feel better.

Writing is an antidote for loneliness. –Steven Berkoff

Writing Suggestions:

  • Write about what it is to experience loneliness, whether a poem or a narrative. What images or metaphors best capture what it is to be lonely?
  • Did you experience loneliness after treatment had ended? Describe what it was like.
  • What has helped you diminish the feelings of loneliness during cancer or another serious illness? What advice do you have for the newly diagnosed cancer patient or the cancer survivor completing treatment?

 

My husband and I will be celebrating another year of marriage this Sunday, a day after our anniversary date, since I’ll be returning home from Toronto. I managed, however, to surprise him by sending a bouquet of flowers through FTD with a note of affection and gratitude for all the years of our many adventures together. This time, he admitted he had forgotten to calendar the date, busy with readying our home for the stream of potential buyers who viewed it all week long. He is forgiven, because four years ago, I actually forgot our anniversary myself and had to scurry to make up for forgetting.

There have been many other anniversaries in our lives—losses of our parents, births of our grandchildren, birthdays of family and friends, and other dates that, when they arrive, trigger the remembrance of other important events in our lives—like the day I was rushed to the hospital after collapsing on the pavement with what was later diagnosed with heart failure, or that afternoon in May, seventeen years ago, when I first heard the word “cancerous” apply to my life and become part of my regular vocabulary. It was an important event, and it altered my life in ways I did not expect, opening the door to other discoveries and ways of being. I often think about how my life was changed—in good ways—in the years that followed. I’m grateful I had the chance to create a new chapter of life, grateful I had the love and support of my husband.

Anniversary dates have a particular poignancy attached to them, whether birth dates, weddings or the other events that alter our lives—cancer, a loved one’s death, a nation’s tragedy. Anniversaries serve as a reminder of who we were then, what we have endured or achieved, and how those events shaped or changed us.

In the first anniversaries of loss, trauma or tragedy, strong emotions are often re-ignited: grief, old fears, relief, or happiness. I’m a believer in rituals or celebrations to mark important anniversaries or milestones. My husband and I have one ritual, for example, we share each Thanksgiving Day, to honor my father, who died of lung cancer on Thanksgiving Day, 1992. In the days before his death, requested we celebrate invite all his existing family members and friends to a wake and toast his life with a glass of Jack Daniels whiskey, his perennial favorite. Now, each Thanksgiving, we remember him with that same ritual, toasting my father and sharing a favorite memory of him. It’s something that solidifies and preserves his memory each November, and inevitably, honors his life with story and laughter—just what he wanted.

Celebrations and rituals are important and meaningful in  healing, offering a way to acknowledge our experience and place it into the context of our larger lives. We remember. We’re reminded of who we were and how far we’ve come. We are reminded how much we have to be grateful for.

I no longer remember the day I heard the words, “it’s cancerous…” Mine was such an early stage diagnosis that it didn’t carry the same impact of those I now know whose lives have been profoundly altered by an aggressive cancer diagnosis. Yet, time softens the difficult memories, and some milestones even recede in importance as life goes on. The pain of loss diminishes. We discover new friends, new joys, even hope, and gradually, we move on to create new life chapters, no matter how long we live.

I often think of the words of novelist Alice Hoffman, who described her cancer experience in a 2001 New York Times article: “An insightful, experienced oncologist told me that cancer need not be a person’s whole book, only a chapter,” she said. That’s true of so many of the painful, sad or difficult chapters of our lives. As we heal, we have less need to mark the dates of suffering, instead, we live forward, fully immersed in life. It doesn’t mean we forget, but rather, we celebrate rather than mourn. We honor. We give thanks.

There are many ways to celebrate or honor important milestones in the in our lives. Here are some suggestions from Cancer Net, but they are applicable to many of the milestones and anniversary dates of life. 

Take time to reflect. Plan a quiet time to think about your cancer experience and reflect on the changes in your life.  Writing in a journal, taking a long walk through the redwoods, along the ocean, or anywhere you enjoy being, offers the quiet time for reflection.

Plan a special event.  One of the women in my writing groups celebrated with a trip to Costa Rica after completing her treatment for a recurrence.   Why not plan something special, like a hot air balloon ride a trip somewhere you’ve always wanted to take, or plan a gathering with family and friends.

Donate or volunteer. When I first joined the ranks of “cancer survivor,” I was the interim director for Breast Cancer Connections, a Palo Alto, CA nonprofit.  I was impressed by the number of cancer survivors who, daily, gave their time to volunteer at BCC.  Many cancer survivors find that donating or volunteering helps give positive meaning to their cancer experience.

Join an established celebration. Many of us have walked, run, or participated in support of one of the annual cancer survivor walks hosted by patient advocacy groups and cancer organizations. Communities and cancer centers around the country also celebrate National Cancer Survivors Day, which is the first Sunday in June.
Do something you truly enjoy. Celebrating can just be taking time to do something you enjoy, husband taking a walk along the seashore or through a public garden, going to a film or the theater with a friend, placing flowers on a loved one’s gravesite, or, as I will tomorrow, sharing a special dinner together with my spouse, grateful for this gentle man who so willingly embraced not only me, but my then adolescent daughters, weathering their storms in the wake of a father’s death to create a loving and enduring bond between them.
Writing Suggestions:

.  Of the anniversary dates are important to you, which do you remember most vividly?
.  What images or feelings do those dates evoke?
.  Write the story of that date. What happened?
.  Why was it important to you?
.  How did your life change because of it?

Dear Readers,

I am traveling this week and spending time with my eldest daughter and her daughter, my third grandchild.  I take pride in watching my daughter as a mother, and I hope that I have passed along lessons of love and wisdom as well as the recognition that mothering is both joyous and, at times, frustrating, challenging, sometimes full of self doubt, and surely the most important role one can have.  Our mothers are fundamental to the development and character of the children who grow to shape and lead the next generation.

As a mother and now a grandmother, I remember my mother and grandmothers, understanding now what I may not have fully understood about their struggles, achievements hard won, or even the lessons they strove to instill in a headstrong and yet tender-hearted young girl.  In honor of mothers everywhere, living or deceased,  l invite you to pause and remember, with gratitude, all that You’ve learned from your mothers.

Happy Mother’s Day.

(post previously published May, 2016)

WHAT WE LEARN FROM OUR MOTHERS

I learned from my mother how to love
the living, to have plenty of vases on hand
in case you have to rush to the hospital
with peonies cut from the lawn, black ants
still stuck to the buds. I learned to save jars
large enough to hold fruit salad for a whole
grieving household, to cube home-canned pears
and peaches, to slice through maroon grape skins
and flick out the sexual seeds with a knife point…

(From: “What I Learned from My Mother, by Julia Kasdorf, in:  Sleeping Preacher,  1992)

There’s much that I learned from my mother, just as you may have, much of it more useful as I grew into adulthood, but not the lessons she might have intended for me.  I learned less about the domestic tasks Kasdorf describes and more about my mother’s struggle with the prescribed roles of wife, mother and homemaker.

My mother had two faces and a frying pot   

where she cooked up her daughters 

into girls 

before she fixed our dinner…

(From:From the House of Yemanjá” by Audre Lorde, in:  The Selected Poems of Audre Lorde, 1997)

My mother was not like the mothers  my friends had.  She was different, even difficult.  She wasn’t the most versatile of cooks, nor did she  inherit her mother’s talent in the kitchen.  In truth, she took little pleasure in producing the daily meals for her family.  She preferred physical labor, daily scrubbing and housecleaning, yard work and gardening, and in turn, she believed those tasks were necessary to build good, solid character in her children.

We were assigned daily tasks and chores which had to be completed before school or play.  Every Saturday, we protested and complained as we were forced to scrub walls and floors while our friends waited impatiently for us outside.  Of my parents, Mother was the strict disciplinarian, and she prided herself on the role.  She was quick to remind us that any successes we had in school or life were due to the discipline she imposed.  My father, naturally playful and soft-hearted, had my heart; my mother had my obedience, but also my embarrassment and rebellion.

Many years later, as the mother of two strong-willed daughters, I began to understand some of my mother’s struggles more than I had in my earlier years.  I weathered the storms of adolescence as a single mother, experiencing their affection one day and rebelliousness the next, all while I attempted to parent, earn a living and build a career.  I developed greater empathy for much of my mother’s struggles—and much greater appreciation of what it meant to be a mother.

I see her doing something simple, paying bills,

or leafing through a magazine or book,

and wish that I could say, and she could hear,

 

that now I start to understand her love

for all of us, the fullness of it.

 

It burns there in the past, beyond my reach,

a modest lamp.

(“Mother’s Day,” by David Young, in:  Field of Light and Shadow, 2011)

A dozen years ago, my mother died peacefully in a home for Alzheimer’s patients.  Her descent into senility escalated as my father passed away from lung cancer.  The woman who was always in control of everything –or so we thought—wasn’t in control at all.  My father had quietly been covering the signs of her illness as best he could.  The irony was, of course, that as the disease progressed, my mother became docile, sweet and affectionate in ways we’d rarely experienced her.  Yet out of the darkness, a moment of clarity, the mother we remembered would reappear, if only for a few seconds.  She loved her children as ferociously as she attacked life, yet she remained critical of us even as her mind deteriorated.  She was proud of what we each had accomplished, and yet she had always expected more of us.  She left a legacy of conflicted feelings among her children, wounds that were never healed, and old jealousies bred in the competition she fostered between us.  But I realize now that my mother did the best she could do.  It wasn’t ideal or even good mothering at times, but she wanted the best for us always.

I choose, on this Mother’s Day to remember that she did the best she could and that although her kind of love was difficult sometimes, it was love just the same.  I recall one of the last times I visited her, a month or so before she died.  She had, by then, lost the ability to walk, and she wasn’t aware of much, including me.  I resorted to pushing her in her wheelchair, going round and round the garden of the Alzheimer’s home.  As I grew weary, I positioned her chair by a brilliant red Bougainvillea  and took her hand.  At a loss, I began singing, “Let me call you sweetheart…,” something she had often sung to us as children.  As I sang, she slowly raised her head and looked at me for several seconds before speaking.

“Why, it’s Sha-ron!”  She spoke my name slowly, elongating the syllables.

“Yes Mom, it’s me.  Your eldest daughter,” I said, tears filling my eyes.  I squeezed her hand.

“I’m…happy,” she said slowly, smiling a little, as she closed her eyes.  Then her head fell to her chest.  Once again, she had disappeared into her darkness.  A few weeks later, my mother passed away.

It’s taken me time to sift through all that my mother was and meant to me.  The relationships we have with our mothers can be complicated as well as close.  Mine was both.  Yet she was my mother, and I am her daughter.  There are mornings I look in the mirror and see something of her in my face or expression, just as each of her three children likely do.   If I could, I would tell her now all that’s in my heart, maybe write her that long overdue letter I always meant to write, but like Wallace Stegner, writing to his mother long after her death, it’s too little, “much too late.”

 “All you can do is try,” you used to tell me when I was scared of undertaking something.  You got me to undertake many things I would have not dared undertake without your encouragement.  You also taught me how to take defeat when it came, and it was bound to now and then.  You taught me that if it hadn’t killed me it was probably good for me…

(From: “Letter, Much Too Late, in: Where the Bluebird Sings to the Lemonade Springs:  Living and Writing in the West, 1992)

To all mothers everywhere, Happy Mother’s Day.

Writing Suggestions:

We learn from our mothers lessons of love and life, some of them not appreciated until we’re much older.  What lessons did your mother teach you?  How have those lessons or experiences influenced your life?  If you have since become a mother, do you find yourself acting in ways as you remember your mother did?  Write about the relationship you had with your mother.  Was it close?  Conflicted?  Distant?  Explore the things that made it so.  What do you want to say to your mother this Mother’s Day?

Dear Readers,

Our house went on the market this past week, and daily, my husband, our dog, and I vacate our home for a few hours to allow real estate agents to show the property to prospective buyers.  There’s no way to express the upheaval that accompanies this phase, and I doubt you’ll be surprised to learn that my sleep has been significantly disrupted in the stress of this entire–and lengthy–process of relocating to another city.  I awaken more than once during the night, check the clock and discover only an hour or at most, two, has passed since I last checked.  By 5 a.m., I give up and wearily shuffle to the kitchen to make the morning coffee, taking some comfort in the continuation of one small ritual:  grinding the beans, brewing the coffee, and settling into my favorite chair to write–even if the time to do it has been disrupted by the necessity to be out of the house during much of the day.

I’ve searched through the archive of my older posts and cobbled together this week’s piece on sleepless nights–something that afflicts many of us during times of stress, worry, and change.  I hope you enjoy it and find some inspiration to write about those nights you’ve lain awake too, unable to sleep.

–Sharon

For the Week of May 7, 2017:  Lying Awake in the Night

Even in the cave

of the night when you

wake…

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)

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 something I’ve been experiencing for the past few weeks, my head buzzing with “to do” lists and the kind of stress that comes with moving to another city.  But whatever the reason, sleeplessness happens to each of us at 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 is elusive.  Even worse, during emotional upset, personal crises, or serious illness, sleep disruption can last for weeks.

Sleeplessness, the New York Times’ Health Guide suggests,  “can involve difficulty falling asleep…waking up too early in the morning, or waking up often during the night…or combinations of these patterns.” Everyone has an occasional sleepless night…as many as 25% of Americans report occasional sleeping problems. Chronic sleeping problems, however, affect about 10% of people. The lack of restful sleep can affect your ability to carry out daily responsibilities because you are too tired or have trouble concentrating. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning.”

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…”  Charles Dickens suffered from sleepless nights too.  In an essay titled, “Lying Awake,” he wrote:

But, it happened to me the other night to be lying: not with my eyes half closed, but with my eyes wide open… my hair pitchforked and touzled all over the pillow; …glaringly, persistently, and obstinately, broad awake. Perhaps, with no scientific intention or invention, I was illustrating the theory of the Duality of the Brain; perhaps one part of my brain, being wakeful, sat up to watch the other part which was sleepy. Be that as it may, something in me was as desirous to go to sleep as it possibly could be, but something else in me WOULD NOT go to sleep, and was as obstinate as George the Third. http://www.online-literature.com/dickens/reprinted-pieces/8/

Like those who’ve written of the inability to sleep, cancer patients know sleepless nights well.  I recall how a few years ago when I was unable to sleep, I turned on my computer soon discovered  I was not alone.  An email arrived in my inbox from a woman in my cancer writing group who was undergoing a new treatment regimen for metastatic breast cancer.  She was awake and writing me in an attempt to capture the myriad thoughts about her illness and  life, thoughts that kept her tossing and turning in her bed, unable to fall asleep.

What she was experiencing was not unusual.  Sleep disorders are common among cancer patients.  Several recent studies have shown that 30 to 50% of cancer patients have trouble sleeping, compared to 15% in the general population (Oncolink, July 2016).   Even 2 to 5 years after treatment, symptoms of insomnia were found in 23 to 44% of patients.

A number of factors associated with cancer can contribute to sleeping difficulties:  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.  Stanford University’s David Spiegel and his colleagues found that those who suffer from troubled sleep are also more cancer prone.  When our circadian rhythms (the sleep/wake cycle) are disrupted, it can affect a person’s cancer prognosis.  “A good night’s sleep may be one weapon in the fight against cancer,” the research team concluded.  (Science Daily, October 1, 2003).

What can you do if you are one of those who suffer from sleepless nights or insomnia?  Here are a few helpful suggestions for a better night’s sleep from the MD Anderson Cancer Center:

  • 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.

And just in case you think it’s only adults who suffer from sleep difficulties, perhaps there’s comfort in knowing that even the beloved Winnie the Pooh was afflicted with them:

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… Pooh could bear it no longer…
–A.A. Milne, Winnie the Pooh, 1926

Writing Suggestions:

  • 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.

 

Dear Readers,

Our house goes on the market this Wednesday, and for the past many days, we’ve been getting it ready to be shown—small repairs, removing personal objects, trimming the growth in the garden, rolling up rugs to expose the wooden floors, and a host of other time-consuming tasks.  Moving is, as everyone knows, nothing but stressful.  My husband and I have nipped at each other’s heels, just as our befuddled little dog has with strangers who come to the door—hired by us to repair or assist in heavy lifting.  We have had to remind ourselves that stress, whether from moving, empty nest, relationship mishaps, becoming parents, or the ups and downs of recovery from serious illness is real, but simply not good for either one of us.  So we’ve borrowed a lesson from Norman Cousins, who famously used laughter to cure himself from a serious illness many years ago.  Exhausted at the end of the day, we’ve developed a habit of watching comedies, whether films on Netflix, Amazon or reruns of “The Big Bang Theory.”  We laugh—a lot—together, and somehow, the anxiety and stress over the mountain of tasks that still await us each day, begin to recede, and we end the evening more relaxed and happy.

Since we’re swamped with getting the house ready for its market debut this coming week, my weekly blog posts are taking a back seat.  Instead, I’m offering a post from 2011 that, today, seems especially relevant.  I hope you enjoy it—and find some applicability to your life.

Sharon

 

Previously posted May 29 2011: “When You’re Smiling”

If you’ve ever begun even a small house improvement project, as I did two months ago, then spent weeks of frustration as workers failed to show up, my calls unreturned by the project manager, or, at the last-minute,  told that the granite counter top, the one you picked out nine weeks earlier, was no longer available–then you know the way frustration can escalate and infect your life.  I became irritable, wore a perpetual frown a between my eyebrows, and I began to think of little else.  I engaged in repetitive tirades about the lack of customer service each night over dinner. “Lighten up,” my husband remarked on more than one occasion.  As much as his comment annoyed me, he was right. The stress and frustration were unpleasant for him and worse, not good for me.

Of course, these things finally get sorted out, and the dark cloud that inhabited my days all these many weeks has vanished.  Our bathroom upgrade was completed yesterday morning. I fairly danced as the workers finished up and carried their tools to the truck. I was smiling the entire time, and I could see the surprise in their faces when, grinning from ear-to-ear, I handed them each a bag of homemade chocolate chip cookies.  That’s we began laughing together over the project mishaps—the frustration I felt with the project manager, and theirs, trying to make “right” his mistakes.  Shared smiles go a long way to smoothing out the wrinkles of daily living, even the frustration of a bathroom renovation.

When you’re smilin’
When you’re smilin’
The whole world smiles with you.
And when you’re laughin’
When you’re laughin’
The sun comes shinin’ through.

When you’re cryin’,
You bring on the rain,
So, stop you’re sighin’,
Won’t you be happy again!

When you’re smiling,
Keep on smilin’
And the whole world smiles with you.

I hear Louis Armstrong’s gravelly voice in my head. He made the song, “When You’re Smiling,” popular decades ago, although I didn’t always like hearing it then.  My mother sang it to me whenever I cried over some disappointment or pouted and acted recalcitrant.  My reaction, like any child who resists their parent’s wisdom, was to put my hands over my ears.  I didn’t want to listen.  I wanted to wallow in my misery.

“The whole world smiles with you.”  Who would have imagined that these lyrics, first recorded by Armstrong in 1929, would later be supported by scientific research?  The fact is that a smile can brighten up a room. Studies have shown us that people who frequently smile are perceived as more in control, at ease and attractive than those who don’t (Lau, 1982).  Smiles do more than that, however.  A genuine smile not only improves our appearance but there is a strong connection between smiling and health. Here are a few things smiling does for us:

We feel better. Smiling lifts our spirits. A study conducted by the British Dental Health Foundation showed the act of smiling dramatically improves your mood. Dr. Nigel Carter, the Foundation’s CEO, stated, “A healthy smile can improve your confidence, help you make friends and help you to succeed in your career.”

Smile and its positive effects multiplies among others. Smiling connects us to people. Those who smile have a more positive effect on their environment and are better received by people around them (Abel, MH, Hester, R. (2002). Workers who serve customers with a smile receive larger tips (Tidd & Lockard, 1978) and repeat business (Tsai, 2001).

Smiling also helps to shift our focus away from negative emotions.  It reduces stress and the symptoms associated with anxiety.  We know chronic stress does significant damage to our bodies and minds, but smiling and laughter offer us physical and emotional release–lower blood pressure, improved digestion, and lessening of negative effects of prolonged anxiety. 

I did a lot of smiling and laughing last night.  My husband and I went out to dinner with friends, a mini-celebration of a tiresome project completed.  “The human race,” Mark Twain wrote, “has only one really effective weapon, and that’s laughter.  The moment it arises, all our hardnesses yield, all our irritations and resentments slip away, and a sunny spirit takes their place.” Despite my late evening, I awakened this morning feeling lighter.  The irritation of all the past few weeks is gone.
Why not do a little experiment this week?  Feeling glum?  Try smiling. Feel better? Or, if you encounter someone who’s irritable or grim-faced, what happens when you flash a big smile at them? Chances are a smile will brighten up your life or someone else’s.  Smiling helps us reframe the way we’re feeling, even find humor in what can otherwise seem insurmountable. Find reasons to smile.  Write about something that always makes you smile whenever you think about it. Remember, “When you’re smiling, keep on smilin’, and the whole world smiles with you.”

Writing Suggestion:

  • Write about a time you felt overwhelmed, glum or stressed and what helped you “lighten up” and deal more effectively with the tension, worry or frustration you were feeling?
  • Fill in the blank, ________________  is the best medicine and keep writing for 15 or 20 minutes.  Were there any surprises?

(A note from Sharon:  Yes, the post/writing suggestions for the coming week are early.  The reason?  I’m traveling for the next few days and will be away from my office and computer.   I’ll be back on regular Sunday postings April 30th.)

—————

I’m crossing a border this week, traveling from San Diego to Toronto, Canada for a short visit with my daughter and her family.  I’ve done this dozens of times over many years, so it’s slightly amusing to me that I’ve never gotten used the feeling of timidity that sweeps over me when I step forward and face a customs officer, whether the US or Canadian border.
“Passport please.” I hand over my passport and smile like an obedient first grader.  Some customs officials are welcoming, even smiling back at me.  Other times, their faces are stony and expressionless.  I want to reassure them.  I’m a nice person, I want to say, really I am.

“Reason for your visit?” I offer another smile.  I’m silently thanking the fact that I have gray hair and am no doubt seen as a senior citizen and the mother of adult daughters.

“I’m here to visit my daughter.”

“How long will you be staying?”

I answer appropriately, a week, a month, or in this case, just four days.  Thwack.  Thwack.  My passport is stamped.   “Enjoy your stay,” the customs official says as he hands me my passport.   I’m approved for entry.

Of course, I’m not quite free of the lines and the terminal.  I stand in the baggage area with other weary travelers waiting for my suitcase to appear.  Then I stand in line again, this time to hand in my customs form before I leave walk through the sliding doors to the throng of waiting families and friends.  I turn right and walk out of the terminal in a haze of long distance travel.   Despite the fact I’ve traveled frequently and far in the world, the first slap of culture shock, even mild, is always a surprise.  It takes me an hour to two to regain my sense of familiarity with a place I once lived.

But there are other border crossings that may not go as smoothly as a trip to this country’s northern neighbor.  These are ones that involve a major life transition or serious illness.  You move you’re your familiar life to an unfamiliar one in a matter of moments.  It’s often abrupt and thrust upon you with little warning–not unlike the moment you first heard these words from your doctor: “you have cancer.” You’re catapulted into an unfamiliar country, one Susan Sontag called “The Kingdom of the Sick.”

Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place. (Susan Sontag, in The New York Times, Jan. 26, 1978)

In the “Kingdom of the Sick,” no one asks for your passport or offers a welcoming, “Enjoy your stay.”  You’re thrust into unfamiliar and rugged terrain.  Perhaps you’ve been given a roadmap of sorts, but it is a maze of choices to make, each of them branching into multiple—and equally confusing—pathways.  Worse, there’s the strange-sounding terminology to decipher –those colloquialisms and multi-syllabic utterances from your physician’s lips that leave you feeling dizzy and confused.  Cancer teaches you a new language.  You’re forced to leave behind what you took for granted, and cross into a new reality that you feel ill prepared for.

There’s a moment, not necessarily when you hear your diagnosis, maybe weeks later, when you cross that border and know in your heart and soul that this is really serious… The hardest thing is to leave yourself, the innocent, healthy you that never had to face her own mortality, at the border.  That old relationship with your body, careless but friendly, taken for granted, suddenly ends.  Your body becomes enemy territory …The sudden crossing over into illness or disability, becoming a patient, can feel like you’re landing on another planet, or entering another country… (Barbara Abercrombie, Writing Out the Storm, 2002).

This is the foreign territory of your body’s betrayal, where nothing seems quite real, and fear is your constant companion.  It’s lonely–You feel lost.  You’re traveling without an interpreter in a confusing and difficult place.  Try as you might, there’s no escape, no going back, no refund for your ticket.  You must learn how to cope and navigate your way through it all, and you must learn it quickly.  Your life may depend on it.

But along the way, a glimmer of hope—and you discover it as you find other travelers, men and women like you, who are also struggling to make sense of this foreboding landscape..  You feel discover comfort and support in the community of other survivors.  You feel less alone and together, find comfort in the sharing of fears and hopes, making them seem more manageable.  You join hands and together, begin to find your way through this dark and fearful kingdom.

Somewhere out there in that darkness are hundreds of thousands … like myself …new citizens of this other country… In one moment of discovery, these lives have been transformed, just as mine has been, as surely as if they had been  plucked from their native land and forced to survive in a hostile new landscape, fraught with dangers, real and imagined. (Musa Mayer, Examining Myself:  One Woman’s Story of Breast Cancer Treatment and Recovery, 1994.).      

Writing Suggestions:

  • Write about crossing the border into the unknown territory of life threatening illness.
  • What was it like at first?
  • What old assumptions did you have to leave behind?
  • How did your relationship with your body changed?
  • What was most helpful to you as you entered “the kingdom of the sick?”