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Warrior vs Withdraw

Delaney brought me back a coaster from the trip she and Jack took with their dad.

It reads: inhale the good shit, exhale the bullshit.

And she explained that she picked it for me because it was how I approached cancer: “part meditation and part swearing.”

That’s not a bad insight for an 11-year old whose experience with my treatment started when she was seven. Although to be honest it didn’t start that way: over time I did a lot more meditation (if not much less swearing).

As I’ve been feeling better the past few weeks, I’ve been thinking a lot about what I’ve come to believe about a cancer journey; and also what I’d like to do about it.

One of the things that has come to bother me more and more is that there seem to be only two default “paths” or approaches to cancer treatment:

Warrior: wherein a patient is expected to be fierce and in fight mode; cancer is a battle to be won or lost, and the goal is to get back to normal as quickly as possible, or,

Withdraw: tell only a few people, if anyone, about your diagnosis, for fear they might treat you differently (or simply out of desire to maintain privacy), sharing the news only after treatment is complete, if then.

Not that these aren’t valid approaches - for many people they are, and that’s probably why they’ve become so commonly adopted and expected. But the polarity of the choice has really started to bother me; in part because one thing I’ve learned is how incredibly varied and personal an individual’s cancer journey can be.

Beyond that, I worry that both approaches potentially include aspects that aren’t so conducive to healing:

Being regularly in fight mode triggers adrenaline and cortisol, which can cause inflammation - and chronic low-grade inflammation can actually contribute to cancer, cardiovascular disease, and other conditions. I’ve known patients who bristle at the idea that someone who dies of cancer has “lost their battle,” and whatever happens to me, I hope nobody ever says that about my journey. I also worry that a warrior mindset, which casts cancer as an evil enemy to be escaped as soon as possible, may not leave people as open to the learning and transformation they may get along the way: as if it’s a prison, not a school.

Seeking treatment in private, on the other hand, may end up denying patients the social support they may find they end up needing (and which is one of the data-driven factors that is cited to help patients recover against the odds). Sometimes, it also creates confusion via pattern disruption, as friends or coworkers don’t understand why behavior is changing. I am told that my holding company’s CEO, who recently went through his own treatment, was struck by how many employees reached out to tell him they had been afraid to tell their manager they had cancer - and that he now worries that when performance changes or absences are noted without an understanding of why, employees could even be at risk of being fired - especially during Covid.

As I think of my own journey, and what I would like to do next, a big part of me is motivated to address the need for a patient’s freedom to choose a path that may live somewhere along the spectrum - one where both swearing and meditation might hold a role - and on which a patient can learn how to truly live while trying not to die.


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