In a recent appointment with my medical oncologist after we’d finished with the medical part of the visit, we began talking about support groups. She knows that I’m involved in a few, sometimes as a participant, sometimes a moderator and she often asks me questions about those experiences. My medical oncologist is also on the board of an organization that focuses on educating and supporting women in South Florida with breast cancer and has her finger on the pulse of a unique group of men and women.
As we talked about ideas and thoughts about what would be productive for what she was working on, brainstorming and interacting, she sat back for a second, regarded me thoughtfully and said “the way you approach breast cancer is unique, Abigail.” She’s also told my mom that I’d missed my calling, that instead of going to law school, I should’ve been a medical researcher.
I never know what to say when people like my doctors make comments like this and I responded as I typically do in these situations by saying “I just don’t know any other way to do hard things.”
And I don’t.
Nothing in my life has been so hard as dealing with Stage IV Metastatic Breast Cancer (MBC) and yet my life certainly hasn’t been a bed of roses, so I’ve had quite a few opportunities to learn and practice resiliency. Sometimes, as I survey what has happened and where I am now, sometimes I think that what I’ve experienced through the years has simply led to this place, this experience. I suppose it is always easier to see or imagine patterns in hindsight and I can certainly see the forks in the road, where I could have chosen something different.
But I didn’t.
And I find myself here.
I’m not saying that I chose to get cancer or did anything to contribute to that diagnosis, far from it. I mean that that my choices led to the circumstances/context within which I’m living with MBC. Where I am now, my living situation, financial situation, support system, etc., much of this is contingent on the choices I made in the decades I’ve lived before my diagnosis and cannot help but inform how I handle life in general.
So, what does it all mean when people say these things? What is it about what I’ve done to prompt these comments? And, more broadly, is this a good thing?
Before I opine on these issues, let me just say that hearing or responding to these sorts of comments does depend on the source. For instance, if a stranger or random person told me something like what my medical oncologist told me, I’d probably not think about it at all. But, when someone who has spent time getting to know me and is integrally involved in keeping me alive says it, there is a different weight. Or that’s how I think about it.
Anyway, I digress …
Here’s what I think my doctor and others are responding to:
- In law school, they taught us to look for the worst possible outcome of each case/situation and to prepare for that. Anything less than the worst outcome is then a lesser evil and preparation is already done. While it hasn’t always been healthy emotionally for me and real life isn’t like a litigation case, I’m always looking and preparing for the worst outcomes generally. Part of this preparation includes looking as directly as possible at the consequences of my death from MBC and to plan as unflinchingly as possible. While it can be excruciating, I have felt better once the plans and details are done and in place.
- Knowing that I am the one who cares the most about my medical care, I have consciously and intentionally taken responsibility for understanding as much as I feasibly can and looking towards next steps. Doing so has necessitated getting an education in the mechanisms of breast cancer on a cellular and molecular level as well as immersing myself in the current research. Having a plan for next steps and why has kept my stress and anxiety at a more manageable level and I think it helps in a variety of ways to keep focused on something tangible.
- I’ve always been a direct and precise person, seeking to carefully name and place in context my experiences. This has gotten worse since my MBC diagnosis since I honestly don’t have the time to avoid dealing with what’s really going on. Consistently, I work to cut through the “fluff” and platitudes to get to the bottom line details of diagnosis, prognosis, and everything in between. While this desire has meant that some (many) of the conversations are heavy, I find that I work better when I understand the parameters that my medical team is working with so that we’re all on the same page. My team has often been taken aback when issues that are often avoided by patients generally are dealt with head on with me.
- I think like an advocate 24/7. When a situation happens to me, I assume that I’m not the only one and work to get the details of why it happened and where the system failed. Understanding the breakdowns in the systems (electronic or personnel or other) and how to correct the issue has led to many a meeting with the administrators at my cancer center. This effort takes a lot of energy and I don’t always think I’ve accomplished my goals, but I keep at it and that’s often very different from other people.
- From a personality and training perspective, I am motivated by things being right and wanting to fix things that are wrong. This internal motivation means that I do keep going when others walk away or that I don’t mind taking on issues that might be combative. While I am seeing that my ability to do this on an ongoing basis has diminished since my energy levels are just not the same as they used to me, it is still my gut instinct to say something, report things and follow up.
I’m sure there are others things that my doctor or others might have been thinking about when she said this to me, but these are the items that come to mind generally. I wish I had a better response when people say this to me and perhaps I should ask more questions to find out what they are talking about. I do need to have a better rejoinder.
Here’s the thing … I think we each handle hard things in our own ways. We don’t become different people just because we’re dealing with something difficult. Who we are does shine through and I think that’s ok. Maybe there are tweaks that we could each make — for me, it’s not being so combative and hard-headed — but overall, I think there’s no right or wrong way to do hard things.
Now, it’s your turn … how do you do hard things? Pros/cons? What tweaks do you think would make your life easier/smoother?