So, How are You?

Once upon a time, "how are you?" wasn't such a loaded question. Nor wasv"how are things going?" Or, "hope you're well?" Or "how's the family," for that matter.

When you think of it, "how are you?" is an impossibly broad question if you think about it literally. Of course, most people don't think of it literally, but then, I'm not most people. I have a need for accuracy that I've been told by at least one person in my house, can occasionally stretch my stories to a somewhat unbearable length. Matthew, fortunately, has inherited this gift. While his brother is the talker of the two, if Matthew actually gets going on recounting, say how Messi scored in a recent Barcelona game, the story might take longer than the game, even with stoppage time. But you will know everything happened before -- and after-- that goal with preciseness, if not conciseness.

Which brings me back to, How are you?

The meaning of the question lies in the interpretation of the answerer. And for someone who feels the need to be fullly truthful in their answer, that can be tricky, leading to long answers and awkward exchanges. When I was first diagnosed, I always took the question, often asked by caring people with a tilt of the head and a touch on the arm, to mean: "I'm so sorry you have cancer. How are you dealing with it?"

When I was going through treatment, I heard the question differently. It sounded to me like: "Oh, you're going through chemo? But your hair is not falling out. And I saw you running last week. Are you really going through chemo? Because if you are, you seem okay. Are you?"

But now, as I'm a day away from three months post chemo, I'm almost ready for the meaning of "How are you" to return to its rightful place on the shelf of available small talk.

Almost.

There are still times when someone I haven't seen in a while will use the question, asked with a pronounced emphasis: "How are you?" to let me know that they know -- to inquire without inquiring, to ask about my cancer without having to say the "c" word. When you think about, it's a lot less awkward way of asking, than, say, "So, how's the old cancer doing?" as if my lymphoma was a bum knee that's been bothering me.

In the past, I might have tired to answer with an honest description including the results of my latest scans, and the details of symptoms related and unrelated to lymphoma. But after two years of being asked the question by a growing group of people in the know, I've learned to save the boring details for Dr. L, and answer, instead, based on my interpretation of the question:

"I'm doing well. Thanks for asking."

--michael

Perspective

Thinking Out Loud's been a bit quiet this last week. It's not as if there wasn't much to think about, or enough time to write about them -- I only worked Wednesday and Thursday this week but I was a weird emotional distance from the Boston Marathon Bombing. Fortunately, I wasn't close enough to have the traumatic emotional response that many have; I was three years removed from that. Nor was I far enough away to be completely insulated from what transpired -- I don't think anybody was.

Instead in the initial hours and days after the bombing, I seemed to occupy an emotional middle ground. I vividly remember 9/11 and how I felt then and this event was closer to me than that; yet I still felt slightly detached from the rawness that many people felt.

I was talking (and emailing) with a couple of card carrying members of the Cancer Club about this, and the sense of guilt that accompanied that partial detachment. It's not that any of us viewed the events with apathy or anything close to it, but the same cancer cocoon that protects us from too much negative information coming in, perhaps prevents too much emotion from spilling out, even in the most traumatic non-cancer events. It's as if there are two worlds -- our cancer world and the other world, and that other world is sometimes viewed through a haze from our world looking out.

On Saturday, I thought it right
 to wear my Dana-Farber
Marathon Challenge gear from
2010.  Not only Boston Strong
but also Dana-Farber Strong.

And then I went for a long run today.

I've been running a lot this week, in fact -- today was my 7th run in 9 days and the first time I've tackled my favorite 6-mile loop in probably 3 years. As I settled into my pace after the first mile, my mind settled down too, and I thought of how many of the victims of the attack were runners (either marathoners or casual runners), and how many months, or years, it might be before they can throw on a pair of running shoes and go out for a run on a beautiful spring day.

And I thought about an acquaintance of mine who contracted Lyme Disease and can no longer work.

And I thought of all the cancer patients who were recovering from surgery, or undergoing chemo, or stem cell transplants, or radiation, or all of the above.

A bit of the scenery on my favorite in-town run.
Photo by Mary Motte, from the Barrington
Virtual Art Gallery

Cancer comes with an ample amount of guilt, served up in many flavors. From guilt that what you did somehow caused your cancer to karmic guilt that wonders what you did to amass such dark karma, to guilt that your cancer is "easy" compared to other cancer patients to the more predictable guilt over being a burden to friends and families.

It's one of the perverse ironies about the mind that at a time when we should be most open to receiving, we often feel guilty about doing just that.

But guilt comes not only in flavors, but also in depths. Sometimes you can peel away those layers of guilt, and when you do, you're left at your emotional core...  with perspective.

--Michael

p.s. Adding a link about my fellow DFMC runners, http://www.necn.com/04/18/13/Runners-gather-in-Bostons-Back-Bay/landing.html?blockID=838291

If It Weren't For Cancer . . .

This post was going to start like this: Oh for god's sake, not another post about running. I formulated some ideas for this post as I was out enjoying a beautiful spring run on a day off. Then before I even made it inside my house, Stacy told me the news from Boston.

I don't know what I can add to the discussion that will consume us. There will be grief, sadness, anger, frustration. There will be relief, joy, appreciation and gratitude. Many will feel some of those emotions. Some will feel all of them. It seems a natural human reaction to tragedy to gauge our proximity to the event. We measure the degrees that separate us from disaster.

Three years ago, when cancer was something I witnessed and not experienced, I finished my Boston Marathon in an official time of 4:11. The first explosion went off at between 4:09 and 4:10 and the second one shortly thereafter. But for three years, I would have been running down Boylston Street in smoke.

I had though of volunteering for this year's race -- to thank all the Dana-Farber runners for their dedication and fundraising. I was going to ask to be at the finish line to help escort runners from the finish line back to the Dana-Farber Marathon Challenge headquarters. In the end, my boys are off this week and I wanted to spend some time with them... and not have to deal with the crazy traffic that usually ensues on Marathon Day. So instead of volunteering, or even working today, I took a vacation day and spent it suburban Rhode Island.

Crazy indeed.

Friends and family who know the Dana-Farber connection to the Marathon (and my connection to running and Dana-Farber) have reached out to me and Stacy to make sure I'm okay. When one found out I was fine, she commented, "You must have a guardian angel watching over you."
"Yes," we replied. "It's called cancer."

If it weren't for cancer -- for six months of chemo, would I have been running the marathon today? If it weren't for cancer, would I have turned a milestone birthday (50, last December) into a reason to run? I've done that before. If it weren't for cancer, would I have been as concerned about taking time off to drive my kids to soccer camps and dentist appointments and ice cream shops on their school vacation week.

Who knows? It's likely that my knees and my wish to remain married would have kept me from another marathon. But it's hard to think of what decisions I would have made if I didn't have cancer. It's hard to think of how I even thought before I had cancer. And, in some respects, it's pointless to try.

There are thousands of decisions over the course of my life that took me to Dana-Farber five years ago. And who knows whether any decisions I made in my life had any affect on my developing cancer. It's likely.

I'd like to think that there is some kind of positive life force -- karma, God, human conscience, whatever -- that balances things out. But at times like this, it's hard to see how things balance out. It's hard not to think that it -- all of it -- is anything but serendipity. A string of connecting decisions that map out our fate from day to day, from year to year, from cancer diagnosis to safety.

The Capacity for Joy

I was going to write about fear and guilt but I'll get back to that topic in a later post. Instead I want to talk about the flip side of that coin:  joy. 

One of the things that cancer -- or any serious disease -- threatens to steal is not just happiness, but the capacity for joy. Mired in the day-to-day struggle of symptom or side-effect management, the disease becomes not just the oft-cited "new normal" but it becomes the new routine. Instead of a daily dose of happiness, we look for a serving of "am I okay today?" 

At best, our answer is yes. At worst, it's answered by uncertainty, ambiguity, and a day of obsession (or worse, Internet searches.)

In the process, the constant thinking about the question adds layers of clouds to your emotional weather that become harder to penetrate.The little things that once gave us joy can't make it through and even the larger bursts of sunshine are muted by the time they reach us.

That's the danger. But it doesn't have to be the reality. While the events that occupy our days and lives help shape how we feel, it's often true that the emotion you find is the one you're looking for. Looking for an argument? I'm sure you'll find one in pretty short order. Want to get mad? Good bet, you'll be able to find something in your day to sate that appetite for anger. 

I often look back at moments in my day and wonder why I deprived myself of joy. Was that offense really so egregious? Where was the harm? Why instead of laughing it off, did I pile on another layer? 

If you want moments of happiness to visit, then you have to have the capacity for joy. You have to be able to put aside the worries and obsessions, and decide that you're going to receive the joy that surrounds you. It becomes self-fulfilling - clouds beget more clouds; sunshine produces more sunshine.

* * * * *

There's a great little article that's circulating around social media and blogs from the LA Times. It's somewhat on topic here, but probably more related to item # 6 in my list of 10 Things I've Learned, and the impact that cancer has on those near the center of the storm. A short, but well-worth it read.