Tag Archives: Tamoxifen

with a menopausal woman in mind ~ stormy weather

13 Saturday Sep 2014

Posted by in Abnormal Bleeding, After death of a spouse, Aging, Anxiety, Etta James, Holmes-Rahe Life Stress Inventory, Hot flashes, Irritability, Mad Men, Memoir, Memory Loss, Menopause, Only Women Bleed, Stress, Women and careers

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Do not do unto others as you would have them do unto you—they might have different tastes.

George Bernard Shaw

This past week began with rain in Phoenix, so much rain that for the first time since I emigrated here, the weather forced me to stay home from work and my daughter to miss school. Even my mother called from her sunny kitchen in rural Derry, where the weather is cooperating and will maybe stay dry for the On Home Ground Festival in honor of our Seamus Heaney this weekend.

Transformed by flash-flood warnings, power outages, cars abandoned on lakes that were freeways the day before, the Valley of the Sun was in a state of emergency, even making it into the record books as the 100 Year Flood. As for the rain, it was bucketing down for most of the day – a solid 10 on The 11 Levels of Irish Rain.

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Typically, Phoenicians welcome the rain, as you would if you only get five inches of the wet stuff each year. Myself, I can’t stand it. It reminds me of why I left Northern Ireland and its grey skies that weighed heavily on me at twenty-one – unemployed, restless, and always praying for the sun to shine.

But on Monday, I was grateful for the rain, especially when an e-mail came from work, informing me that I could work from home. Don’t get me wrong. I enjoy my job and my co-workers, many of whom have held me up on the darkest days over the past year and a half – and there have been dark days indeed since the death of my husband last November.  Of course there have. After all, “death of a spouse” is at the top of the Holmes-Rahe Stress Inventory. Still, I find myself making irreverent jokes about it, playing “the widow card” (when I’m not playing “the cancer card”).  Laughter is much more acceptable in the workplace than crying.

But I have felt like crying.

A week before the Monday Monsoon action, a familiar fear moved in again. Since January 2012, I have tried not to worry that the cancer that first showed up in my right breast will reintroduce itself in my bones or my brain or my liver.  I have tried not to think that it will sneakily take up residence in a vital organ, but the truth is that every little headache has been a warning bell, every little twinge in my left hip, a harbinger of disease (Number 6 on the Holmes Rahe Stress Inventory). I know I should know that living in fear is no way to live.  Growing up in Northern Ireland during the Troubles, I learned early on that you can’t not go outside for fear of being blown up by terrorists. If you succumb to that fear, you’ll never go out.

Mostly, I have told myself I’m fine. I have even permitted people to cajole me and tell me – with authority – that the cancer “is cured” or “in remission,” even though I know it has not even been three years since the diagnosis and that my oncologist would not use the word remission. (I am holding out for five years and a pronouncement of NED – No Evidence of Disease). I have allowed people to tell me that God would never give me more than I can handle, and I refrained from biting her head off when a woman I barely know admonished me to put “my big girl pants on.”

But when the blood appeared a week before the storm, I was angry at God for giving me more to handle, because I’m not sure I can.  Surely God knows that stress, by definition, is when “demands exceed the personal and social resources the individual is able to mobilize.”

My personal resources are maxed out.

It didn’t help – and I knew it wouldn’t – that even before calling the doctor, I consulted Google, and after an interminable trek through the Internet, I convinced myself that I must have endometrial cancer. I’m realizing that in spite of the shock in November 2011 when I heard, “You have cancer,” and the shock in November 2013 when I heard my best friend tell me on the phone, as she stood over my husband’s lifeless body, “Ken is gone,” I have reserved a little space inside to be shocked again.

Naturally, the bleeding began on a weekend, Labor Day weekend. Who wants to go the Emergency Room on a holiday weekend?  So I didn’t. I waited until the Tuesday to make an appointment with the best gynecologist in the world, the one who had cared for me 17 years ago, when I was pregnant with Sophie.  Of course I couldn’t remember when I had last been to see her. (Menopausal women are not known for their ability to recall details). As it turns out, I have been a bit negligent, so much so that I had to complete all the paperwork of a new patient.  Still, she saw me as soon as she could and before examining me told me we would be keeping our fingers crossed for a little polyp that she could just pluck off, but no. That would have been too convenient.

Because she knew I would spend the entire weekend Googling, she tried to schedule a hysterosonogram for that afternoon. No such luck.  It would be another week before that happened with another doctor and another three days before she would tell me that yes, the uterine lining is abnormally thick, there are polyps in the uterus, and we need to do a “mega biospy” next week.

. . . followed by more waiting. More bleeding. 

(Meanwhile, what if I bleed to death?)  Oh, and by the way, does this have anything to do with the Tamoxifen I took? Possibly. Possibly.  Was I wrong to have said no to chemo? Plenty of strangers thought I was and – in front of my daughter -scolded me for not partaking of the treatment and its side-effects. So did I bring this on myself? Did I?

Yes. I am stressed. And even though menopause is not explicitly called out on the Holmes Rahe Stress Inventory, I still score over 300 points which has stressed me out even more this morning.  Holmes-Rahe-Stress-Inventory

Come to think of it, why isn’t menopause on the list? It bloody well should be. Looking at items 34 – 40. I could check every one because of menopause, but I don’t want to score even more points thereby increasing my odds of developing a stress-induced health breakdown. It’s not quite a “major personal injury or illness,” but menopause is definitely a major change, and we don’t do a very good job talking about it or supporting women through it. Surely the time has come for us to address this given the numbers of women over fifty who are now in the workplace.

According to an AARP article:

“The rate for workers 55 and older . . . in 2013 was 40.3 percent. Although female workers still trail men in sheer numbers, look how far they’ve come. In 1975, the proportion of women 55 and older in the workforce stood at 23 percent, while the rate for men was more than double, at 49.4 percent. Last year, the labor force participation rate was 35.1 percent for older women.”

Yes. We’ve come a long way, baby. So much so that in its  Job Tips for 50+ Workers article, the nice folks at AARP used a Getty image of a man in a suit with the obligatory briefcase. He’s not quite Don Draper – he looks a tad too nervous. Still, he doesn’t have to worry about bleeding all over that nice white couch, does he? 420-Businessman-job-interview-tips-for-50plus-workers.imgcache.rev1327100490178.web.1280.1280Dealing with the symptoms of menopause while holding down a full-time job makes it difficult to appear poised, professional, confident, and competent all at the same time.  So we who suffer try to conceal it, and those who don’t might dismiss it as a “normal” part of the aging process. Thus the symptoms of menopause are often “under-recognized as a disruptive health condition” (Kleinman et al).  Were these same symptoms associated with male menopause, I think things might be a little different.

So what should we do? For a start, we should talk about it. When we design our workspaces, we should consider them from the perspective of a menopausal woman  – a hot one – drenched in sweat, with boiling hot flashes, unpredictable heavy bleeding, pain, bone-crushing fatigue, memory loss, and mood swings. We should think about temperature and ventilation, and the availability of feminine hygiene products – like a tampon machine in the restroom.

AAN3PYI’m ashamed to admit that until it happened to me, I relegated all the complexities of menopause – blithely unaware of chemical menopause brought on by breast cancer treatment – to a vague category of “female problems.”  It never even occurred to me to consider whether menopause “counted” or was covered by the law that requires employees to protect the health, safety, and welfare of all employees.

Citing research conducted by Amanda Griffiths of Nottingham University (Women’s Experience of Working through the Menopause), Michael Rubinstein offers the following tips for employers:

  1. Raising awareness of menopause in an occupational setting through health promotion programs and awareness training for managers.
  2. Organizing social support within the work place.  This could include information packs, mentoring schemes and lunch time support.
  3. Offer flexible working hours, job sharing, and opportunities to work from home.  Many women experience tiredness.
  4. The temperature of the work environment can be an issue, especially in refined spaces. Fans and temperature controls could be implemented.
  5. A “rest” room where women can relax, just to have some space.
  6. Cold drinking water – many organizations do not provide this.
  7. Prioritize work life balance and maintain firm boundaries in working life and non-working life. Adopt buffer zones so that women feel in control more effectively. Many menopausal women experience feelings of ‘not coping’. If work becomes an issue encourage a specific time each day so that worries can be written down and then discarded.
  8. Remain hopeful and optimistic – women experiencing the menopause often go through different types of emotions such as anxiety and depression. Remember these feelings do subside. Encourage women to discuss how they feel as these feelings are very normal.
  9. Become a supportive manager –  women are more likely to discuss menopausal issues with somebody they feel able to talk to. This also encourages organizational loyalty and less absenteeism which can only be a good thing for all companies.

Until then, this menopausal woman will “stay strong.” And, while I may not remember exactly what you have said or done over the past couple of years, I will never forget how you made me feel – mostly loved.

“For strong women” Marge Piercy

A strong woman is a woman who is straining.
A strong woman is a woman standing
on tiptoe and lifting a barbell
while trying to sing Boris Godunov.
A strong woman is a woman at work
cleaning out the cesspool of the ages,
and while she shovels, she talks about
how she doesn’t mind crying, it opens
the ducts of the eyes, and throwing up
develops the stomach muscles, and
she goes on shoveling with tears
in her nose.

A strong woman is a woman in whose head
a voice is repeating, I told you so,
ugly, bad girl, bitch, nag, shrill, witch,
ballbuster, nobody will ever love you back,
why aren’t you feminine, why aren’t
you soft, why aren’t you quiet, why
aren’t you dead?

A strong woman is a woman determined
to do something others are determined
not be done. She is pushing up on the bottom
of a lead coffin lid. She is trying to raise
a manhole cover with her head, she is trying
to butt her way through a steel wall.
Her head hurts. People waiting for the hole
to be made say, hurry, you’re so strong.

A strong woman is a woman bleeding
inside. A strong woman is a woman making
herself strong every morning while her teeth
loosen and her back throbs. Every baby,
a tooth, midwives used to say, and now
every battle a scar. A strong woman
is a mass of scar tissue that aches
when it rains and wounds that bleed
when you bump them and memories that get up
in the night and pace in boots to and fro.

A strong woman is a woman who craves love
like oxygen or she turns blue choking.
A strong woman is a woman who loves
strongly and weeps strongly and is strongly
terrified and has strong needs. A strong woman is strong
in words, in action, in connection, in feeling;
she is not strong as a stone but as a wolf
suckling her young. Strength is not in her, but she
enacts it as the wind fills a sail.

What comforts her is others loving
her equally for the strength and for the weakness
from which it issues, lightning from a cloud.
Lightning stuns. In rain, the clouds disperse.
Only water of connection remains,
flowing through us. Strong is what we make
each other. Until we are all strong together,
a strong woman is a woman strongly afraid.

a day without pain or pity

26 Friday Apr 2013

Posted by in Awesome Women, Blogging, Breast Cancer Treatment, Health Activist Writer's Challenge 2013, Language matters, Memory, Ordinary Things, Social Media

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A creature of habit, I count on certain rituals to know that all is well in my world. Breakfast, always the same, is a poached egg, toast, berries of some sort, an orange, and coffee from a favorite cup. When I wave goodbye to my love, in return he will blow a kiss, flash a peace sign, and watch from the window until I disappear from view. Predictably perfect. Let the day begin.

Phoenix is beautiful in April with hot days and cool nights. Already, I am thinking of vacation and our annual escape to another place, where one set of routines is temporarily traded for another. Long days, devoid of oppressive heat and work, with freeways abandoned by snowbirds for cooler climes, and air-conditioned cars and offices faking a chill. On the central California coast, the living is easier. Summer living happens without us even knowing what time it is. Days begin when we decide, with idle conversations over real food at Good Tides and a scan of the local newspaper for news about people we don’t even know. The only schedule of any import is that of the local Farmer’s Markets so my husband can make his annual pilgrimage to Atascadero for his favorite avocados. On a late afternoon, you will find me sprawled on a beach ostensibly reading a book I’ve been meaning to read since 1997, but in fact staring far beyond the words and out towards the horizon, delighted by the realization that the shimmer atop rocks the color of coal is rising from the glistening pelts of six seals basking in the sun at low tide.

Last summer was my first with cancer, thus qualifying it as some sort of milestone. Ensconced by a bay in a Bed and Breakfast the decor of which reminded us of a little house, indeed on a prairie, we fell asleep by the fire every evening and woke to a view of grey water that inspired the kinds of daydreams that made our summer-time pass too quickly. For the most part, cancer was absent. You couldn’t have paid me to think about it during that magical moment with those shimmering seals.

Still, there were reminders that I could always count on cancer to be there when I wasn’t looking for it. I panicked one evening, when I realized I had forgotten to refill the  Tamoxifen before leaving home. No need. We found a CVS pharmacist who kept the wheels turning. I remember being a bit sad that the people who worked there would no longer think of me as just another nameless vacationer looking for sunscreen or the best place to buy fireworks, but as another bloody cancer patient whose most personal information was at their fingertips. I remember the kind young pharmacist who wondered if I had any questions about the medication. She could not have known how that my brain was and is still teeming with questions about the Tamoxifen and what I thought it was doing to me. But, I was on vacation. She knew it. Thus, with empathy and efficiency, she had the prescription filled in less than fifteen minutes. I wonder if it was because she understood, perhaps better than I, cancer does not take a vacation.

There is something I want to tell you on Day 26 of this month of writing challenges. Today, I am supposed to be writing about a day when I wish I could have used a pain-free pass. I simply cannot do it. I know no pain. I am here. I am happy. I am much loved. My natural habitat is in some realm realm between great joy and uncertainty but I am still here. 

How I wish I could use a pain-free pass for someone I never knew.

Leaning back against a rock on Morro Bay Strand one day last summer, idly scrolling through favorite blogs and my Twitter feed, minimally distracted by short bursts of news about Tom Cruise’s diovrce or the unfolding events in Syria, I noticed from Elizabeth Whittington, this:“What a loss. Heartfelt condolences to u all @FightCRC: It is with great sadness we report Pat Steer passed away yesterday.”  

On the sandy edges of California, I may as well have found a message in a bottle. I did not know Elizabeth Whittington, nor did I know Pat Steer or what was represented by the acronym CRC. That changed. By the time the amber evening rolled in, bringing with it a cool mist and throngs of people intent on capturing forever a beautiful sunset, I was deep in thought about Pat Steer. Retracing my steps through the day’s Tweets, I rediscovered Elizabeth Whittington’s condolences. On I ventured, to Pat’s blog where I found a woman who had been a dog trainer, a writer, and a cook who loved exploring in Syracuse always on a quest for culinary novelties. Pat had been diagnosed with Stage IV rectal cancer in 2004, and she had stopped active treatment on March 28 2012.

On May 7, 2012, she wrote a guest post No More Room in the Bucket for the Fight ColoRectal Cancer website.  It was a poignant response to her friend, Janet, who wondered if there were perhaps some unfinished business, some loose ends, or bucket list items that Pat would like to fulfill. I imagine Janet was hoping for something grand, but Pat’s wish was for a pass of sorts, a pain-free pass that would grant her enough strength and mobility to go upstairs and do a load of laundry by herself. Strength and mobility.

Pat had no formal bucket list; she had long-term goals that were not written down but fulfilled nonetheless – paying off credit card debt and a mortgage, retiring from corporate life at 55, training her dogs, experiencing the vastness of North America by train. Following her diagnosis, I learned that she traveled to New York for consultations and treatments, and subsequently took advantage of the Amtrak points she earned. From coast to coast on sleeper train, she savored America and Canada, visiting relatives sprinkled in various states along the way. For Pat, it was leisurely travel, idyllic, and allowed her to build upon dreams of future destinations and how to get there.

In 2011, she was all set for another cross-country trip to Denver for the English Cocker Spaniel Club of America national specialty. Amtrak prohibits dogs, so Pat abandoned the idea of a train and decided to drive in her Jeep. Everything was coming together perfectly for a dream trip, until one of those New York city consultations revealed an inoperable recurrence of her stage IV rectal cancer. There were tumors in her lung and in her lower spine. Her oncologist confirmed metastatic cancer in her spine and hipbones. A weekly chemotherapy regimen abruptly ended those carefully thought out plans for a six week cross-country road trip.  How Pat cursed chemo for ruining her summer vacation, but she found consolation in learning that the tumors were shrinking. Her strength was returning, so much so that she felt strong enough to travel to New York for treatments. Her routines of writing and lunches with friends were once again part of her life. And, she had all those Amtrak rewards to use later.

The ironies of cancer are beyond cruel. Throughout Pat’s treatment and in her advocacy work, she always cautioned other patients to be prepared for the speed at which things can change in Stage 1V colorectal cancer. With a living will and an advanced directive, Pat was “officially” prepared. Her family knew her wishes. But Pat was wholly unprepared for the rapidity of cancer’s final, painful assaults on her  body. In No More Room in the Bucket she wrote that it took not even one month for her “to morph from full-time functional adult who could drive herself around to full-time cancer patient who is mostly bedridden.

I was done

Pain control became paramount, and in consultation with her team, she chose to stop treatment. She blogged about it at Life out Loud: Surviving Cancer Living Life where I discovered she had been held aloft, as I have, by virtual connections and the sheer kindness of online friends, including a woman she had never met who created a virtual tour of Seville, Spain for her, complete with well-wishes from Spanish waiters.

Summer is already in the air again in Phoenix, and I have begun to prepare mentally for a break away from the city and into the cool fog of California. Tonight, I am thinking of Pat Steer and her bucket list; Pat Steer who wanted so little.

As you consider the gift of just one day without pain, consider Pat Steer. I never knew her, but I will always remember her. 

mePPavatar80x80.jpgThere is no more room in the bucket for big dreams like cross-country train trips. I feel a pang watching tv shows set in NYC, knowing that I’ll likely never visit my favorite city again. It aches to see puppies and kittens and know I’ll never own another one. I’ve never tasted foie gras, or truffles, or uni. I never got to visit the Food Network. I’ll never meet my friend Shawn in person or visit her in Seville, Spain.

And perhaps the hardest thing – I ran out of health and activity before I ran out of treatment options. My body quit on me before my brain has … In the greatest cancer race, hanging on until the next new thing becomes available, I didn’t quite make it to the finish line after eight years of trying.

Simple things are my goals now – and simple things are what I miss most. I miss spontaneous restaurant lunches with my friends. I miss being able to shop for fresh food every other day. I miss being strong enough to walk outside. I miss my dog, Madison, who I sent back to Virginia to be with her co-owner because I’m no longer healthy enough to care for her.

It’s frustrating to have to ask someone else to do laundry because I can’t safely climb the stairs to get it done. Knowing that I may never be independently mobile again – that’s what I miss the most in this phase of non-treatment. More strength and mobility – that’s what’s on my bucket list these days.

That and, well, I decided that at the very least, I could take care of a little desktop aquarium and a betta. Petsmart is delivering the aquarium, filter, gravel and betta food tomorrow. A friend has already agreed to pick out my new fish…and maybe my sister and brother-in-law will take the tank when the time comes. Until then, it’s a small goal that I can reach, one that will remind me every day of brightness, and color, and movement – even when I can’t always accomplish those things.”

Rest in Peace, Pat Steer

vintage me . . . I’m still here

19 Friday Apr 2013

Posted by in Arimidex, Feminism, Fiftieth Birthday, Health Activist Writer's Challenge 2013, Language of Cancer, Marge Piercy, Mother Daughter Relationship, Poetry, Tamoxifen

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200732_1019668373106_1267069810_30054034_3664_nOn the first day or the last day of every school year, I force my daughter to pose for a photograph. It’s just one of those non-negotiable traditional things that comes around but once a year. All I ask is that she smile while holding a sign declaring the grade level ahead of or behind her. She used to love it, but now she doesn’t and tries to avoid me in the rush of getting ready in the morning or in the throes of “really important” homework in the evening. The latter doesn’t fly on the last day of school, but I wouldn’t put it past my darling girl to tell me she’s simply too busy getting a head start on her summer reading and has no time for her mother’s antics with the camera. In the end, of course, she always indulges me with the most sincere smile she can muster. After all, she knows I’ll show it to her grandparents, and they always get the real smiles. On the other hand, a roll of the eyes involving her entire body is often reserved for yours truly. I know, I know. It’s just a phase. 

yw50Fitting then, that when my fiftieth birthday arrived last week, my daughter decided it was time for me to hold the sign, to proclaim to the world that I was about to enter a new chapter in my life, my Second Act. Turn about’s fair play after all . . .

For today’s WEGO Health Challenge, I’m supposed to post a vintage picture of myself and wax lyrical about “the condition” I was in when it was taken.

So here I am. My condition and me.  Standing in our back yard, an impatient hand on my hip, and fifty candles on a cake inside just waiting for me to make a wish. The sign says I have been on this earth for half a century.  Congratulations are in order. Happy Birthday. Make a wish. Make fifty of them.

Happy? Yes. Healthy? I don’t know for sure. It’s complicated.

Let’s see. I look healthy; although I have to start running again. Laziness is just easier. I still have my hair. I refused chemotherapy which gave some strangers free reign to judge me, because, you know, they knew the cousin of a brother of a friend in Chicago who had cancer. And she did chemo. And she is “just fine” now. And, lest I forget, the good Lord would never ever give me more than I can handle. If it doesn’t kill me, it will make me stronger. Really? Why, yes. After all, they reassure me, I am a fighter and very strong, and they just know I have this thing beat. In fact, I should try to find the good in it, consider it a gift. After all, it is the good cancer.   I can only imagine what they would say if they didn’t think I was a fighter or strong. I’ll never know.

I’m heavier than I was a  year ago, but that’s probably good, because I weighed not much more than 100 pounds following the shock, the surgery, and the stress of that damn cancer diagnosis. At just over 5’6″. the extra 30 pounds still find a way to fit into my clothes. Snug, but enough to merit going up another size. Who wants to turn 50 and go up another dress size? No. Far easier to take the dress and the denial  to the matronly Mexican seamstress who hems things and finds an extra quarter inch or two that wil make the dress fit perfectly. I found her at the back of a barber’s shop owned by a Russian immigrant. It amused me to think of Ireland, Mexico, and the former Soviet Union all represented in a tiny piece of real estate where people can also sell gold and buy replacement batteries for their watches.

The wise doctors won’t tell me I’m in remission yet, although everyone else has decided I must be. It’s too much trouble to explain to them that, actually, no, I’m not in remission, because it’s only been 18 months since I was diagnosed with Stage II Invasive Ductal Carcinoma, 16 months since the 8 hour surgery to remove and reconstruct  my right breast, 14 months ince I started taking Tamoxifen at 9 o’clock every night, and 3  months since I switched to Arimidex which I think might be responsible for the brief but boiling hot flashes and aching joints every morning not to mention the  unfathomable fatigue. As I see it, navy may be the new black, fifty may be the new forty, but fatigue is definitely the new “f” word.

Occasionally, I’ll forget that I am being treated for cancer, that there is no cure, and that metastasis is always a possibility, the thing that scares me most. When I sit down and allow myself to think about it, I realize I need to last at least four more years before some doctor will announce, “No Evidence of Disease” (NED) at which point an angel will surely get his wings.  And that will have to suffice, because I’m not convinced we’re going to figure out what caused my cancer or how to prevent it rearing its ugly head again any time soon. Call me cynical, but there are too many women who started out with the same diagnosis and they didn’t live long enough to hear NED.

But, enough of that for now. It’s a birthday celebration after all. I’m here, and as Glenn Close told Michael Douglas in Fatal Attraction, “I’m not going to be ignored.”  I don’t feel like being invisible. Not yet.

I met a woman who wasn’t there

Marge Piercy

The CIA should hire as spies
only women over fifty, because
we are the truly invisible.

We pass through checkpoints
as if through spider webs
with only a slime of derision.

Watch television, go to
the movies (if you can afford
the ticket prices; maybe not

since older women are the
unimportant poor) and you see
only children, young females.

Older men thrive, with escorts
half their age, but older
women must die off en masse.

In middle age even with botox,
liposuction, face lifts, tummy
tucks, whatever mad torture

to the poor hardworking flesh
surgeons can devise, we
begin to vanish. Walk through

a lobby, a crowded airport:
men, children will run into you
in the obvious opinion you

cannot possibly exist. We
are inaudible too. We speak
and people turn away. Although

we know more, our opinions
are dust on the wind. Nobody
collects or records them.

We are the age’s lepers.
They would like us penned out
of sight in colonies of hunger.

You have let yourself go. You
have not refused the years
politely, firmly like an anorexic

at a dinner party. A sitcom joke,
jealous witch, bag, you are in-
tangible, for who trained

on media will stroke your soft
quivering belly, your tingling breasts.
Survivor, crone, wise woman

history’s warnings are etched
on your bones. Like Cassandra
you have witnessed wars and famines

and you foresee that wind of ash
blowing in, but to your prophecies
only your cats will listen.

 

we’ll take a cup of kindness yet . . .

01 Tuesday Jan 2013

Posted by in Memoir, Themes of childhood

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January 1, 2013
2:00AM

All is quiet – the right time for taking stock. My parents are here, fast asleep having brought in this New Year far from their Castledawson home with the fireworks we’ve been saving for a special occasion and, for luck, my husband designated as the ‘first-footer’ after midnight. Sweet relief to shut the door against the worst of 2012 together, a year which started ominously, each of us terrified by the idea of breast cancer tearing the fabric of our lives to shreds.

Cancer. When I heard it got me, I cried as though I had just found out that someone dear to me had died. Inconsolable at first, I assumed those great fat tears flowed from the sheer fright of a disease that has no cure. Fourteen months later, I know my sorrow was more about wondering how to proceed toward the half-century mark without the woman I used to be. Oddly, nobody else seemed to notice she had vanished. Not even the person who delivered the news to me in much the same way as my mother might give me a ring to tell me that a childhood friend or a distant relative has died – reverent, hushed, kindly.

If I shut my eyes, I can just discern the shadow of my former self standing up and walking out the door, mortally offended by that nice Breast Cancer Navigator informing my husband and me that I had cancer.

Conspiratorial and quiet, reminiscent of whispered speculations about a cause of death when all the evidence points to hard living, on and on she talked. Her scary words filled our ears with fear, even as she stressed that what we were hearing that day in her dimly-lit office was definitely not a death sentence. Nonetheless, I heard a crack. The sound of a life altered that, over a year later,  has me wondering how I should respond to Muriel Rukeyser:

What would happen if one woman told the truth about her life? The world would split open.

Is it because it is invisible, like the actor who, having exited the stage, falls silent and slips behind the scenes until the encore?  Or is it the treatment that belies cancer’s smugness, mine so cleverly concealed in 1,825 innocent-looking pills that I have promised to consume over the next five years? Whatever it is, I have found that many of my friends and acquaintances are skilled in deftly averting their eyes from mine and not talking about it. I suppose what ails me is easy enough to avoid. Listlessness, a gnawing dread, brief but boiling hot flashes, aching joints, nausea, and fatigue can swoop below the radar in a way that a head made vulnerable and bald by chemotherapy cannot.  What had I expected? The details of my pathology report on a perpetual crawl across the bottom of the CNN screen so no one would forget about me? My name spelled out in pink lights across the front of a Safeway store in October? No. I craved good old-fashioned sympathy, long phone conversations into the night, and endless cups of tea. I did not want people telling me I was in their prayers or that cancer was a gift or that it was part of God’s plan for me or that there must have been something – something –  I did or didn’t do that contributed to the cancer that was crashing in on us and turning everything upside down, inside out.

I wanted home. I wanted my mother, but she was so far away. I wanted to hear those comforting colloquialisms from rainy, rural Northern Ireland, phrases that remain elusive in the desert southwest of the United States with its predictable sunshine. Home brings the language I know and love, like the words of a neighbor from my childhood that leaped from a Facebook message: “It must be so difficult to cope with that burden when you are so far from your mammy. I’m sure she is all you want at the minute, as always, when trouble visits your door.” When trouble visits your door … I had not heard that phrase in years. In an instant, I was 12 years old once again, in the house where I grew up, stretched out on the good settee, trying to concentrate on a new Enid Blyton book rather than the blistering chicken pox my mother tried to soothe with great pieces of cotton wool saturated in Calamine lotion.

For me and the woman I used to be, cancer became the scariest thing in my life, because, like every scary thing that actually happens, it had never crossed my mind. I am not proud to say I still waste precious minutes fretting over things that most likely will never happen. But cancer did happen, and I wanted everyone to feel as sorry for me as I did for myself and howl about the unfairness of it all. I wanted a no-holds-barred pity party. I could not have predicted the impact of the let-down, placated by people I consider my friends who said I had nothing to worry about, my being so strong and someone to whom God would give only as much as I could handle and not one drop more. I was told the luck was hanging out of me because I had the “good cancer.” I was on the pig’s back, beyond lucky to be the beneficiary of what they deemed a fine consolation prize, a veritable bonus – the tummy tuck and the boob job following the amputation of the right breast I wish I still had. I was even congratulated on still looking like myself – you’d never know you had cancer –  and five minutes later chided by someone who barely knew me when she found out I wasn’t “doing chemo,” as if it were something akin to laundry or a pile of dishes or sit-ups. There was the woman who told me to just get on with it and “put my big girl pants on,” with a nod to God because, you know, I could handle what He had given me. There were others who have yet to utter the word C-A-N-C-E-R in my presence, let alone inquire about how I’m faring. I make excuses for them, guilty that I make them uncomfortable, showing up in the world every day, reminding them that cancer gets people like the person I used to be, people like them. I envy their good health. More guilt.

So the dance continues. If I don’t mention it, they won’t mention it, and maybe it will go away. Or maybe it won’t, and then what will we do? Will we swallow the words we are too scared to say and instead spit out tired cliches about doing battle and platitudes about the power of positive thinking? Trickier, I suspect, to ignore the recurrence of cancer, to feign indifference to it, once it has been roused from its slumber. How odd to sit in the light of a twinkling Christmas tree, pondering this and Macbeth in the wee hours of the first day of the year:

To-morrow, and to-morrow, and to-morrow,
Creeps in this petty pace from day to day,
To the last syllable of recorded time;
And all our yesterdays have lighted fools
The way to dusty death. Out, out, brief candle!
Life’s but a walking shadow, a poor player,
That struts and frets his hour upon the stage,
And then is heard no more. It is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.

~ Macbeth Act V, Scene V, 19 – 28

It is time, I know, for Auld Lang Syne and to settle in somewhere between reminiscing and resolving. I am stuck on words …

What words will come my way in 2013?

From the people sleeping down the hall, I know to expect words of great kindness and courage. When she calls every weekend, my lovely mother will lay into the cancer and the treatments and the shocking number of new cases she hears about back home. She will curse it for the thief that it is, and she will ask me if I’m sure I’m looking after myself and tell me not to let anyone make little of me. Mind you, she has been telling me that for years. She will worry about the toll the cancer has taken on my daughter whose adolescence was so unfairly interrupted by my diagnosis. She will remind me I am married to the best man in the world and wonder aloud how I would ever manage without him since he waits on me hand and foot. She is right, of course, as she is at those times when she wonders how in the name of God he puts up with me, so I know how lucky I am. She will reminisce about this wonderful New Year’s Eve and bemoan the miles and miles between us, and I will fall into the rhythm of home as we talk about how distance makes everything surreal. From far away, she and my father will continue to dote over my darling girl who, in their eyes, can do no wrong. They are smitten. I will ask myself if they were even remotely like this when I was 15 and if perhaps I missed it.  Then I’ll remember that they were every bit as over-protective and uptight as I am, possibly more so, when it comes to child-rearing and also that my grandparents always took my side, slipped me money, and satisfied my sweet tooth. In the past three weeks, my daughter has learned how to make fruit scones and Pavlova and a good cup of tea. My mother has learned how to like things on Facebook.

My father has been up at the “scrake of dawn” every day, actively seeking out things to fix, a few small repairs to make life a wee bit easier. He may as well be a man of 35 again, up on our roof fixing the gutters, then cleaning windows and shining them with newspaper until they sparkle, hanging pictures and cabinets, tightening things that are loose and the reverse. The electric drill and the level are never far away. A creature of habit, daddy reads the paper every day, chortles at Andy Capp’s mishaps, does the crossword, and beats the daily Sudoku into submission. As industrious as he is, he does not work on a Sunday. He never has, not since that Sunday afternoon a million years ago when he hung wallpaper in my bedroom and it bubbled. A divine reprimand, perhaps.  Like me, he is drawn to things that are old, with a good story behind them, and he can carry a tune. Forever, he has been enthralled by antique clocks and their inner workings, and he had a fine collection that he sometimes set to clang and chime at the same time, waking the entire household and probably the neighbors. My favorite is the old Regulator with its stolid, steady tick-tock and its rich chime. He has regretted for years that he didn’t buy the Grandfather Clock he spotted while we were on a camping holiday in Scotland in the early 1970s. At the time, it would have meant dipping into the emergency fund, and my mother, ever the pragmatist, was afraid of the emergency that never transpired. By coincidence, when my husband and I took our first trip to Colorado, we passed on a Regulator clock in an antique shop in Ouray. We have regretted it, too. So wasn’t it a lovely turn of fate that this New Year’s Eve, my mother and father spied a Regulator clock in an antique store in Arizona. Not to miss out again, my father had that clock purchased and wrapped up for me two minutes before the store closed. 2013 will begin with the soft tick-tock that I have been missing for thirty odd years, and the chimes on the hour and the half-hour. Magic time, like these moments between an old and new year that find me recalling Ted Kooser’s Local Wonders.  For Kooser, life is “. . . a long walk forward through the crowded cars of a passenger train, the bright world racing past beyond the windows, people on either side of the aisle, strangers whose stories we never learn, dear friends whose names we long remember and passing acquaintances whose names and faces we take in like a breath and soon breathe away …”

Looking towards tomorrow, I am with Mr. Kooser, ready to walk through the cars ahead:

But there are still so many cars ahead, and the next and the next and the next clatter to clatter to clatter. And we close the door against the wind and find a new year, a club car brightly lit, fresh flowers in vases on the tables, green meadows beyond the windows and lots of people who together — stranger, acquaintance and friend — turn toward you and, smiling broadly, lift their glasses.

Happy New Year to you and yours.

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