[cancer] Dying angry

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?

16 thoughts on “[cancer] Dying angry

  1. For gawd sake people, don’t want to read the anger, the angst, the hope, the despair, then don’t read the blogs!!

    For many of us this is as close to dealing with it as we will get, reading someone who can articulate the emotions.

    For some of us, Jay says what we feel, but with just a brick wall of emptiness sitting in front of us feel. leaving no way to express hopelessness.

    Every hope he has, we think may be our hope, every despair, allows us say “that’s how I feel too!”

    Cancer isn’t Hollywood. Its a stalker of death. Too often succeeding. And for that why should Jay sanitise the event for you?

  2. monica mcnally says:

    How shameful that this article in the NY Times has upset so many people. I’m sure the article would be all about “fighting the good fight and never giving up” if Mr. Keller was diagnosed with an agressive cancer. Shameful!!!
    Don’t waste anymore time on this Jake….you have a lot of important work to do shortly!! Best wishes.

  3. Jaws says:

    The real problem that Mr & Mrs Keller have (because they clearly agree with Mr Goodman) is that they’re incorrectly equating “grace and courage” with “quiet.”

    Tell that to MLK (or, for that matter, his namesake Martin Luther).

    Tell that to Ghandi.

    Tell that to Mandela.

    That is, tell anyone engaged in fighting for their life and identity — especially if that fight is entirely involuntary — to use their “library voices,” because that will be less disturbing to those not engaged in that same struggle.

  4. If angry is what you feel, it’s what you feel. To pretend optimism is to be dishonest, not only with the world but with yourself.

  5. Stevie says:

    It does seem to me that even if one was optimistic about the eventual outcome then anger is a very sensible and normal reaction to having to go through the process.
    In reality the Guardian published a badly written, exploitive article in the hope of generating interest on the web. This is not the first time that they have done so, and they are now frantically back pedalling because normally they pick on people without the capacity to retaliate, and this time they miscalculated.
    I wish you didn’t have to waste your time on this but I am very glad that you have weighed in; the Guardian and the NYT deserve to be pilloried for their abuse of power.
    And you do it so well…

  6. AnnaB says:

    When I watched my mother fight cancer the ‘nobly suffering’ attitude would only have made me angrier. You deserve your anger. Thank you for this (& for “sanctimonious twit”—wonderful).

  7. Dave Baker says:

    Lots of people seem to want that tool who gave “the last lecture.” Not me. Never has something so trite also felt so false. Thank you for giving me an honest *and unsparing* look at the cancer patient’s dying process.

  8. skiffy_grrl says:

    I’m of the opinion that anger is a reasonable response to injustice.

  9. Megaera says:

    If I were you, I would be so furiously angry that all you’d see on my blog is shouting and sputtering.

  10. Cora says:

    Every cancer patient deals with the disease in their own way. And if they’re angry or depressed or talk about their illness in great detail, then it’s their business and no one else’s.

    I have serious issues with the whole optimism approach to cancer or other serious illnesses, especially when it turns into sick people being blamed for their own illness, because they are too angry or depressed or just not positive enough. Because cheerful positivity cures cancer, don’t you know, while pessimism apparently causes it. I was actually told this with reference to a deceased relative. The relative in question had died of cancer because she was a pessimist and if I was always so pessimistic, I’d get cancer, too. This crap makes me sick.

  11. Paula Helm Murray says:

    Go you! Hugs across the e-ways.

  12. Raine says:

    I have a huge problem with the whole “battle” metaphor for illness. we have “heroic” patients who “fight the good fight” and we have the “cowards” who “lose the will to fight”. Both constructs place the blame for the outcome on the person who is ill. It is just wrong, and it is untrue. Each and every person alive will have to meet their death, in a way that makes sense to them if they are lucky, and completely unprepared, if they are not. That’s all. To talk of battles is to try and take the fear out of death for those of us who are not currently suffering; we want the illusion of control over a situation that frightens us. Why not give each person the dignity and respect they deserve, and assume they are handling a deeply personal thing the only way they know how?

  13. TrendSearcher says:

    I agree, anger is as good (and maybe a better) choice of attitude as bliss. And you’ve have decided to take your anger to a better place. While you could have descended into a purely destructive outlet for your anger, you didn’t. Instead you’ve analyzed the anger. You’ve shared your perspective. The anger lives in you and moves you. Peale called your type of anger, “inspirational dissatisfaction”. I know his words are not nearly charged enough for you, but the spirit is there. You are pissed and you are doing what you can, where you can… even if it means kicking a trash can.
    I am sure if we took a survey in a graveyard, you’d get a majority opinion that life is far, far too short. None of us is getting out of here alive. I think we should all be pissed about that. Much love to ya Jay.

  14. Danny Adams says:

    “There’s a great deal of cultural pressure to accept the inevitable. To be optimistic and graceful. To suffer in quiet and noble silence.”

    Generally uttered by people who aren’t actually facing anything remotely as serious as terminal cancer.

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