There are only three possible outcomes after a major life event: things get worse, things get better, or things stay the same. Once you’ve had cancer, it’s not too likely that your life will ever be the same. OK, maybe with a tiny skin cancer. But I mean the big, scary CANCER, where your existence is threatened, the treatment costs you every last hair, and the mental losses are unaffordable by anyone’s standards.
My background in family systems draws me to the relationship trauma of cancer. Fear, pretending, supporting, depending–all may shift the expectations of love and care between family members. Needing, crying, looking bad, feeling unsexy–pile it on. For children–young or grown, patients or family members–the fast track of family change involves new fears, new responsibilities, new secrets, new guilt. Social isolation or its opposite–the in-rush of friend and family caretakers–changes the family dynamics too rapidly for at least some of the members.
Sometimes one adult sibling becomes the main caretaker, perhaps permanently magnifying or altering underlying family cracks. A parent of college age children may keep her diagnosis a secret so as not to interfere with the student’s finals. She may tell the sibling(s) living at home, requesting secrecy from them as well. How do both choices affect future trust? Guilt? How do you express anger to the irritable, moody, undependable cancer sufferer, especially the deep resentment you feel over having your life wrecked? How do you live up to the heroic model of cancer patient or avoid judgment on the opposite type?
And money. Even for the insured, cancer costs. It might be the new experimental medical treatment; could you swing $140,000 for 9 drug-filled weeks? Do you borrow from friends or family, mortgage the house, cash in the IRA? Maybe your drugs are covered, but you have to leave work temporarily or permanently, another rapid, unplanned-for shift in family dynamics. The smell of cooking doesn’t agree with your queasy life, so add in the cost of take-out, then childcare, more housekeeping assistance. Financial planning telescopes into a few frantic months or years, while the consequence continue long after.
So what’s good about this? To quote Obama when the world economy trembled and quaked, “A crisis is a terrible thing to waste.” Having exchanged everything you took as a given for a new set of realities, you’ve got an opportunity to make new.
Let’s start with the financial hit. Cancer survivors may see a fresh new world in which the must-haves of the previous life seem trivial. A simpler life maybe, where a day without pain is the new free lunch. Raindrops on roses and whiskers on kittens; they cancel out time in the X-ray dungeon. Some clients, having quit a job, find a new way to spend the recently acquired free hours. One wanted a small sewing nook in her tiny house–a dream her partner helped her to accomplish for under $50.
Relationships can surprise during treatment. Many cancer clients tell me their disappointment over a special friend or relative who didn’t call, didn’t visit, didn’t cook–nothing. That is often balanced by the unexpected giver, an unpredicted someone who means everything during the crisis. I’ve worked with couples whose flat , uninspired marriages received a permanent vitamin injection from the cancer crisis. One woman who had struggled in marital therapy for years joyously experienced a “born-again husband.” And the reverse can be positive in its own right–the woman or man who leaves a loveless marriage in the middle or end of treatment. These too are victories, as one woman put it, “If I could survive cancer, I can survive being on my own. I’m not afraid any more.”
Fear isn’t the only upside-down emotion in the cancer survivor’s jumble. Guilt, depression, hopelessness? I’ve learned from clients who tell me they felt so blue they didn’t want to live, until they received a cancer diagnosis. Fighting spirit revived, these individuals found life again. Some revisit family issues, now more open and honest. Some volunteer for support groups or continue with the health food, yoga, or tai chi they started during treatment. An adult daughter of a woman with a family-linked cancer returned to grad school for a career in genetic counseling. Some get religion, some give it up.
For you survivors– both the patients and friends or relatives of the patient–who now lead a more authentic life, today marks an anniversary of success. Happy anniversary, and many more.