Hot August Nights, Cool August Mornings

Saturday found a tired and depressed me lying on the couch with my equally tired and depressed husband, me being very careful not to bump my very sore arm in any way. Listening to music and to summer sounds coming in through the open window, reading, napping, my more minor aches and pains gradually receded a little. For a while, it felt very much like the cabana we had in Hawaii all those years ago, minus the warmth of course, and the breeze and the sound and smell of the ocean, it being a cool rainy August day in northern Alberta. But still, it was lovely, so lovely.

What is it that is most potent in making an ordinary, tired, post-treatment afternoon lovely? It can’t be the exotic extras of tropical breezes, not really, not when the feeling is the same as the one that comes from the simple presence of the human being faithfully sharing the moment with you, can it?

That sore arm–it’s throbbing with yet another damaged vein, inflamed and hard and the diameter of a pencil just underneath my skin. This is what my treatment does to my veins and other sensitive cells: it burns them.

Earlier this week, friends tell us about their daughter’s pain, about their anguish, sweeping and soul-threatening. I think of another friend with cancer, of her family’s grief and fatigue. My nights are restless, morning coming too soon, way too soon, 5:30 AM too soon. I’m tired and want the blissful escape of sleep, and on one particular morning am weepy and angry, not the tiniest bit capable of gratitude.

So I drop the bar a little. Gratitude can wait; it will return in due course. For now the task is to tolerate the emotional and physical realities of the moment. I’m sick. I’m trying to get well, and this is, as one astute friend put it a few days ago, a challenging job. It is an exhausting job, and a boring, lonely, uncomfortable, and frightening place to spend so many of my days.

The living room abruptly feels beyond familiar and boring, impossibly and endlessly the same. I’ve clearly spent too much time in here over the past eight months, time enough to develop a serious case of treatment fatigue and cabin fever.

It’s too early in this chemo cycle for the idea that has now popped into my head. My body is fatigued, my blood counts are low, and I probably shouldn’t, but I’m alone, and a little impulsive at the moment—I start pushing furniture around to rearrange it all, so it feels a little different, gives me a little different view. I don’t have stamina enough for a bike ride or a walk, but this, the little bursts of energy required for moving furniture, this feels good.

I try to keep a gratitude journal of sorts, to remind me when I feel anything but thankful; I learned this not from Oprah, but from my parents. I decide now, in this little window of opportunity, to visit it.

I felt well, relatively, with my week off treatment last week, and my Folk Music Festival experience was, as always, rich and wonderful, delivering hot August days and nights, and sound enough to fill thousands of hours and ears. Also wonderful was the supper we had with friends the night before this last treatment. And then it was back to the Cross Cancer Institute, gratitude becoming a little elusive again.

The best kind of medicine arrived again though, as it always does. This time on day two of my chemo cycle, in the form of a friend dropping by with an impromptu lunch, bringing rice rolls, beautiful sweet corn from her garden, a lovely pineapple coconut loaf of bread, and an open grounded spirit, ready to engage, to understand my experience, and to be real about her own.

Staying grounded is vital. I have a number of reasonably reliable tools to that end, but none more so than face-to-face human connection.

Is that vein infected, I wonder for the millionth time? It sure is red and swollen. I’ll call the hotline tomorrow, or take it in to Emergency if it gets worse, I promise myself. For now, I immerse myself in Gabor Maté’s In the Realm of Hungry Ghosts. I’ve read it before, but the title beckons. I’m living with hungry ghosts of my own right now, ghosts that seem to have grown larger with illness, with being unemployed, with not knowing my future, with being unsure of my role, my purpose.

Maté reminds me that addiction arises from the desire to be free of wanting, free of longing for a different state. “The addict craves the absence of the craving state. For a brief moment he’s liberated from emptiness, from boredom, from lack of meaning, from yearning, from being driven, or from pain.” He reminds me that that emotional isolation, disconnection, powerlessness and stress are the conditions that create the neurobiology of addiction in human beings.

I don’t want to encourage this kind of neurobiology, and resolve yet again to resist the temptation to allow feelings of powerlessness and disconnection to grow during this period of unusual stress. I drag my husband and my throbbing arm to see a musical radio play at The Fringe Festival. I love Edmonton for these things. The play is funny and silly, the singing beautiful, and it keeps me smiling.

Afterwards, we do what we do less often now that I’m not well, but used to do regularly: on our way home, we stop at a little wine bar across the street from where we live. I have a blueberry tea, and we share some snacks, and I’m still uncomfortable with my arm, but it’s lovely to be out.

When I wake this morning, another overcast and very cool August morning—eight degrees when I first check—I gingerly check my arm. It’s still tender, but not throbbing, and less red, just an angry, enlarged vein. Friends have suggested brunch. We end up on a rooftop under heat lamps, and, again, it turns out to be a couple of hours of the most excellent kind of medicine. My vein will heal, as will the rest of me.

Smoking, Emotional Integrity, and Cancer

“Smoking no more causes cancer of the lung than being thrown into deep water causes drowning,” writes Gabor Maté, Vancouver’s Downtown Eastside physician, addiction expert, and mind-body health guru, in his book When the Body Says No. “Smoking vastly increases the risk of cancer, not only of the lung but also of the bladder, the throat and other organs. But logic alone tells us it cannot, by itself, cause any of these malignancies… even if, in most cases, it might be a major and perhaps necessary contributing factor.”

No, I’m not a smoker, and no, I don’t think this absolves tobacco companies in any way. What is interesting to me here are the psychological factors involved, the mind-body connection. The scientific literature is now filled with studies that confirm stress to be a major contributing factor in pretty much all disease.

But life is stress, so how can we mitigate it, and exactly what kinds of stress are implicated here?

This is sensitive, because, being a cancer survivor myself, I definitely don’t want to be guilty of blaming the victim here. But cancer research has focused excessively on genetics (which play a very minor role in most cancers), and on unavoidable and isolated environmental carcinogens, and not enough on factors we have some control over.

That’s what I want to talk about right now: the risk factors we have some control over.

One study Maté cites in his discussion is a European one that found smokers had no incidence of lung cancer unless they also scored high in the emotional repression questionnaire.

So much for telling ourselves to suck it up and get on with it.

Why is emotional repression such a big risk? Cancer is most apt to occur in those with helplessness-prone personalities. And emotional repression, says Maté, is the first domino in the chain that leads to helplessness. It goes like this: emotional repression results in feelings of isolation because the true self is hidden, which inevitably results in feelings of loneliness, depression and helplessness. And to feel chronically helpless is of course to become truly helpless.

Note to self: the risks of not being true to myself, to what I think and feel and like, are greater than those that come with putting myself out there and risking judgment and disapproval. Emotional expression and integrity are essential to empowerment and to good health.

Thankfully, the traditional Western medical view of discrete mind and body is rapidly being discarded as archaic. Mind and body are inextricably interconnected. Though extremely unwieldy, the term psychoneuroimmunoendocrinology captures well the complexity of constant chemical communication between our thoughts, our nervous systems, our immune cells, and our endocrine glands.

The stress response can then clearly be triggered either psychologically or chemically, and it never hurts to avoid known carcinogens. But to worry about hidden ones everywhere is to cause more harm than it can possibly prevent—the most powerful psychic triggers of disease-inducing stress include uncertainty, lack of control, and feelings of being powerless to affect the course of our lives. A sense of control immediately rebalances and normalizes stress hormones.

In one experiment cited by Maté, where the relationships between female monkeys were manipulated, stress hormone production went up in animals forced to become subordinate, and down in those newly dominant. Stress hormones are interesting though. While chronically elevated stress hormones increase cancer risk, temporarily and sporadically elevated ones decrease it.

Final note to self (for today): avoid both chronic boredom and chronic stress, and remember to take a turn at asserting yourself.