You mention to some friends that you’ve had to face some demon emotions in your battle to recover from the setbacks, sadness and sepsis of colorectal cancer. They want to know more about your struggles with worry, fear, anger and discouragement and they urge you to put the home-brewed program in writing so others might benefit from the strategies you’ve developed.
You’ve adopted a four-step program for facing each of these negative emotions: 1) reject, 2) reframe, 3) reinforce, and 4) give thanks. You begin by saying ’no’ in order to get to ‘yes.’ You recognize that there is a certain amount of self indulgence when you let these feelings hold sway over you, but you know they are toxic and harmful to your well-being. So, you resist the temptation to flirt with them; you shun them as implacable enemies of truly getting better. Next, you reframe each debilitating feeling, turning it into something far more helpful to the healing process.
Next, you make sure you get out of yourself: from people whose judgment you trust, you proactively seek help and reinforcement in approaching these troublesome feelings in new ways. Finally, you search through the circumstances that brought on these emotions and you identify some reasons to be grateful in the midst of it all. In spite of everything, even because of everything, you find that finding reasons to give thanks proves to be a viable alternative to living a worry-filled, fearful, angry, disheartened existence.
Turning first to the problem of constant worry, you can always count on it to be right there at your side in difficult circumstances. Fretting and worrying enjoy your companionship. What you mean by worry here is a kind of free-floating, unrelenting anxiety that is usually fixed on things over which you have little or no control. This is useless worry which has the power to consume you and drain your inner resources. This on-going, corrosive worry is a far different matter from being concerned about a situation that you can and should do something about.
Many people develop a love affair with useless worry; they see it as their duty to obsess. They tell themselves they wouldn’t be caring human beings if they didn’t fret and brood rather constantly about what’s happening to themselves, to those they love and to the world in general. But this unrestricted anguish leads nowhere and solves nothing. Unbounded worry is a dangerous dance with a debilitating partner. It saps your strength, narrows your vision and keeps you stewing in your own poisonous juices. To get the better of it you must see it for the destructive emotion that it is and summarily reject it.
Sometimes, however, things seem to cry out and insist: “worry about me!” You saw yourself naked in the full-length mirror the other day — your first close-up view since you began cancer treatment. You looked and were at first too startled to recognize yourself; you imagined you were looking at the skeletal body of a concentration camp survivor. Then you realize you’re staring at what happens to anyone when, over a period of almost four months, you’ve only been able to lie in bed and recover from three hospitalizations, two operations and four surgical procedures. You’ve lost thirty-five pounds in a weight-reduction program you don’t recommend for anyone!
So, you have a choice to make: you can worry that your body will remain so weak and thin that simply walking the length of the house will always feel like you’ve just run the Boston Marathon. Or, you can let go of the anxiety and reframe your view of what’s happening to you. Your medical team assures you that, with patience and perseverance over time, you are going to get better. You listen to them and you turn your focus from consuming worry to practical concerns. You concentrate instead on those things that you can do something about. You can keep yourself hydrated, slowly begin walking and weight-lifting exercises inside the house and you eat well, richly and often! Finally, you confirm your new approach through an exercise in gratitude. You take notice of the small improvements that show themselves every day, or most days, at least.
The same approach works with the negative emotions of fear and anger. You had to face what was certainly the most fearful moment of this protracted illness when your body, almost overwhelmed by infection, entered full-blown sepsis. For the first time ever, you thought your life might be slipping away. The situation was serious — you had to accept that you were in real danger. What you needed to focus on was not the festering fear, however, but the resources that were available to you to face squarely the threatening situation. Letting the scary monsters of your imagination intimidate you was not going to help you get better. Your job was to attend to what brings healing.
Even as you were being packed in ice to lower your body temperature, you knew you had a team of competent and caring professionals doing everything they could to fight the fever. You decide to trust what your doctors and nurses told you: that you will get through this, that a small surgery will help to lance the abscess at the center of the infection. You spurn fear and concentrate instead on how much you have to be grateful for: a team of professionals working round-the-clock to restore you to health, a faithful wife and daughter standing at your bedside, and the gift of hope at the center of your heart: hope in the promise of renewal, hope that Spring is finally on its way, hope and trusting confidence that you can and will be cured of this cancer.
Over the years you’ve learned that your anger is usually bound up with your fears. You wish you could just sit down and have a good cry when trouble arises, but the tears rarely come. Instead, you feel anger. You lash out in fury at what frightens you. What you fear the most, what you can’t control, can plunge you into a cauldron of rage.
You consider how you came to confronting your illness in the first place. Before changing doctors, you had one final session with a primary care physician in whom you had pretty much lost confidence. You presented your troubling symptoms to him on the eve of final preparations for a round-the-world cruise. He reminded you that you are on the once-every-ten years colonoscopy plan and you still had four more years to go before your next test. He told you simply to monitor what was happening. Within a fortnight, you met with your new family doctor who examined you and strongly urged you to get the colonoscopy you needed right away — a decision I followed that may have saved my life.
You also recall two traumatic experiences with the ‘port’ they implanted under your skin. It’s a device that’s essential to chemotherapy infusion. It provides direct access to an artery that supplies blood to a specific part of the body, in this case, to your colon. It’s a good way to attack any remaining cancer cells lingering from the tumor.
But that seemingly benevolent port has become a source of significant trauma for you. When you get chemotherapy, you wear home from the hospital a pump that remains attached to the port for forty-six hours until it’s time to disconnect. The first time you had port problems, a private nurse forgot to administer a requisite flushing with medication before disconnecting the pump. After a failed attempt to re-access the port you had to be rushed to the emergency room to correct the mistake.
Then, two weeks later, as you turned over while lying on the couch, the tubing that pumps the toxic chemotherapy into your body broke apart. Arterial blood spurted everywhere. You looked like you were in the middle of a crime scene. You called the visiting nurse, were told to sit tight and then had to wait for an hour and a half before the nurse was able to find her way to your home. She took one look at the situation and said there was no way she could be of help. Again you were off to the hospital emergency room in an attempt to reinstate the clotted port. That drama lasted half the night and continued the next morning at a second hospital before the situation was finally resolved.
Anger and frustration welled up inside you: you had put your trust in the competency of the professionals who treat you: you expect to rely on them, and then they disappoint. You can’t help but be furious, and yet you know your anger won’t be much help in the long run. Beyond serving as a short-term response to a dangerous situation, prolonged anger will only play a destructive role. You’ve seen how your ire, when you give it its head, consumes and paralyzes you. There’s nothing healing in that.
You’ve learned the hard way to choose an alternative emotion: acceptance, a begrudging acknowledgement that life is full of difficulty but that these trials need not have the power to consume you emotionally. You know you can live with the difficulties because they will not last forever. Acceptance calms you so you can look for the way through to the strategies and solutions that are available to you.
Acceptance in place of anger is not an easy emotional strategy to adopt. Anger you will always have with you — of that you’re certain. But you can work at, and even become adept at cultivating the virtue of acceptance as a way to find freedom from unhealthy emotional bondage. The word’s root meaning is “to take or receive willingly what is offered.” Acceptance gives you the breathing room to find ways to survive and perhaps even thrive in the midst of distress.
Finally, there is discouragement: this you find to be the hardest of all these vexing emotions to deal with. If everything had gone as hoped for, recovery from this cancer should have taken a matter of just a few weeks. But nothing has gone according to plan, and now here it is, five months into treatment with almost as many months to go. In those first five months, you have endured countless tests and imagings, two surgeries, two drain insertions, one drain removal, three surgical procedures, intense pain that early on was not properly treated. Then there were the port problems and the pump complications, the lingering infection, the full-blown sepsis, some episodes of rapid heartbeats, and still there is a way to go. You can summarize your disappointment in a phrase: you’re just sick of being sick!
While you are in the middle of an extended crisis, sometimes there is little else you can do but be patient and take the long view. Two things you know you must avoid are self-pity and asking unanswerable questions. When you overindulge in feeling sorry for yourself, in effect you declare yourself to be a victim; think of yourself as defeated. It doesn’t do much to console you, and it is certainly not going to make you better.
And when you’re tempted to ask questions like “why me?“ you know you’re not going to be satisfied with the answer, because there is none. And yet, sometimes you can’t help but wonder. You ask, “Why now, why is this happening to me, after a life of vibrant good health and many successes and more joy than you surely deserved? Why were you chosen for this cancer cruise just as you were about to set out on the trip of a lifetime traveling around-the-world?“ You did come up with your own answer which almost satisfies: as you look back on such a blessed life, you consider that perhaps you were deemed strong enough to become so weak.
In the end, the only effective antidote to prolonged discouragement and continuing disappointment is patience. True patience has nothing to do with passive submission. Instead, it is an active waiting, a conviction that present circumstances will never last forever and need not be determinative of your future. In that spirit, you think of what the surgical team wrote in your medical record as their treatment goal for you. It’s a single word: “curative.“
That’s your future — a complete cure. In the midst of your discouragement about how long things have taken, you steer clear of self-pity and focus on the promise that you will be cancer-free one day. You expect soon not simply to be a survivor, but to be a thriver. On every hospital visit, you’ve taken along a photo of yourself and your dog Molly sailing in Southern Bay on the Bagaduce River. You know that you’ll be out there soon again this summer, doing what you love, leaving everything behind, becoming one with the wind, the sky, the water and the God-given beauty of it all.
How realistic is it to choose patience instead of pity, concern instead of free-floating anxiety, acceptance instead of fear? Some might see these strategies for getting through a crisis as quixotic escapes into avoidance, denial and delusion. There is a psychological disorder called reaction formation where, instead of facing reality, you create scenarios for avoiding it. But this is not that. In every case you acknowledge that you’re dealing with a challenging, sometimes ruthless reality. You know that ‘the way to’ must always be ‘through.’ And as you continue on through, you decide to rely on others whose wisdom you trust: family, caregivers, friends, good people of faith who share this hope-filled view of your future, who love you and passionately want to see your health and well-being restored as much as you do.
You’ve said nothing so far about how personal faith might come into play in all this. That’s been deliberate because this approach, you believe, can prove successful for almost everyone, whether you are a person of no faith or of little faith or of great faith. For you personally, it is true that your trust in a God with healing in God’s wings and your belief in Jesus Christ who dedicated his life to healing and gave his life in great part because of it, (John 11:47-53), are behind every strategy you pursue in your own healing, inform every change of perspective you opt for, are in every instance when you trust a wise and compassionate supporter, and surely are there every time you choose gratitude over resentment. This approach to confronting problematic feelings is certainly a faith-friendly, even faith-based initiative, but it is also something that everyone, whatever their spiritual convictions, can benefit from.
Reject, reframe, reinforce and be grateful: that’s what keeps useless worry, fear, anger and disheartening experiences from taking over your life, undermining your health and threatening your well-being. These are the hard lessons that severe illness and a complicated, slow recovery can school you in.
Perhaps an alternative title for this essay could be: “What having cancer teaches you that you probably wouldn’t have learned on a round-the-world cruise.” But now, as you look ahead, you’ve decided to step up and apply for an assignment as chaplain on next year’s world cruise. And, despite all the worry, the fears, the anger and discouragement of the past year, you hope you’ll get the position. God knows you’re ready for it!