Equal praise is due to those who accept an inevitable fate with grace and courage.
— Steven Goodman, quoted in Bill Keller’s poorly-researched and sloppily written New York Times column on cancer and death and patient activism, January 12th.
I’ve written before about hope, despair and the cult of optimism in the realm of cancer care. There’s a cultural expectation that we who are in such dire medical straits are to be positive and noble. This certainly makes life easier for family, caregivers and clinicians. There’s even some medical evidence that patients with positive attitude receive better care, presumably in part because they are easier and more emotionally rewarding for providers to deal with. (Sorry, having trouble finding the right link this morning — I will add later if it turns up.)
Understand that I don’t dispute the value of a positive attitude in people for whom it comes naturally. But insofar as I can tell, the only objective reason such an attitude is urged on patients is so that they’ll pursue their care diligently, take their medications, turn up for tests and appointments, and so on. Everything else seems to be about smoothing the path.
You can also make a quite reasonable philosophical argument about acceptance. But let me tell you, as a terminal cancer patient, my entire life is Kübler-Ross on fast spin. Acceptance doesn’t come naturally, and for some of us, is closely akin to surrender.
There’s a great deal of cultural pressure to accept the inevitable. To be optimistic and graceful. To suffer in quiet and noble silence.
Tell that to the cancer.
Cancer and its treatments are messy. They are painful. They are humiliating. Cancer undermines everything a patient knows about their life, their love, their place in the world. And for far too many of us, cancer steals away everything in end, ushering us into death years, decades, even generations before our time.
Why the hell shouldn’t we be angry? Why the hell shouldn’t I be angry? I am losing my life. I am losing my place in my daughter’s childhood and young adulthood and her future. I am losing my family, my friends and lovers, my writing. I am losing myself.
And when I say angry, I’m not talking about Dylan Thomas’ almost genteel rage against the dying of the light. I’m talking about a good, old-fashioned, trash can-kicking, screaming shitfit.
Damn it, of course I’m angry. Anger has kept me alive, kept me going, kept me dedicated to everything I can do to survive a little longer. I live angry, and I will die angry. Being me, I generally channel that anger constructively. I don’t actually kick trashcans or yell at people or throw tantrums. But it keeps me going, and I cannot pretend it isn’t real, dark and fiery down to the core of my soul.
And I will not moderate that anger to ease the feelings of some sanctimonious twit at the New York Times, or anyone else.
Live well, die angry. What else can a terminal cancer patient do?