Vulnerable

What often takes up space in my brain since my Stage IV Metastatic Breast Cancer (MBC) diagnosis in 2017 isn’t just the cancer, it is the knowledge of how vulnerable you have become to everything else.

A virus. An infection. A fever. A blood count. A medication that stops working. A medication that causes a problem. A scan. A lab result. A new pain. A fall. A complication.

Something that would be a minor inconvenience in another life can become a major event in this one, because MBC changes the math and once you understand the math, you can’t unknow it.

You start to see the dominoes. One thing happens. Then that thing causes another thing and another and another. And suddenly you are somewhere you never imagined you would be.

That’s what living with MBC can feel like: like standing next to a row of dominoes that stretches farther than you can see. Most of the time, they’re standing and so are you. You go about your day, you work, you eat, you laugh. You make plans, you answer texts, you watch television. You worry about your kids, you complain about something stupid.

You live.

And from the outside, you may look completely fine, but you know the dominoes are there. You know how little it can take to knock one over. That is the part people don’t see. They see the appointment. They see the infusion. They see the scan. They see the medication list. They see the person who says, “I’m doing okay.”

They don’t see the calculation happening underneath: Is this normal? Is this something? Should I call? Should I wait? Is this just a cold? What if it isn’t? Can I afford to get sick right now? What happens if I have to stop treatment? What happens if my blood counts don’t recover? What happens if this treatment stops working? What happens if the next one doesn’t? What happens if…

There are an infinite number of ways for the sentence to end and sometimes you get tired of finishing it, because the truth is that we are living with a level of vulnerability that most people never have to contemplate. Our bodies are already resisting something enormous. Our immune systems may be compromised. Our organs may be carrying disease. Our treatments may be doing their own complicated work.

And then the world keeps happening. People get sick. People fall. People get infections. People have accidents. Things happen. Life doesn’t stop just because you have cancer.

It just becomes much less forgiving. That is the razor’s edge. Not that every day is terrible, it isn’t. Not that we spend every minute thinking about death, we don’t. Not that there isn’t joy, there is. There is so much joy.

Sometimes there is almost too much joy, because you understand how precious it is. A stupid joke. A good meal. A child’s laugh. A beautiful morning. A song that comes on at exactly the right moment. A hug that lasts a little longer than usual. A completely ordinary day.

Those things matter. Maybe they matter more because we know what is sitting in the background, because cancer doesn’t have to be in the room to be present. It is in the calendar. It is in the next scan. It is in the medicine cabinet. It is in the bloodwork. It is in the question you don’t ask because you’re afraid of the answer.

It is in the plans you make and the tiny voice in your head that says: if I’m here. If I’m well enough. If the treatment is still working. If nothing happens.

If.

If.

If.

That word can become its own kind of prison and maybe this is why people with terminal cancer sometimes seem disproportionately affected by things other people consider small. Maybe we aren’t reacting only to what is happening. Maybe we’re reacting to what could happen next. A fever isn’t necessarily a catastrophe, but we know that it could become an infection. An infection could mean a hospitalization. A hospitalization could mean treatment is delayed. A treatment delay could mean something else.

And something else could become something bigger.

Maybe none of that happens. Most of the time, it doesn’t. But we know the dominoes exist and knowing they exist changes the experience of simply standing near them. It takes energy to live like this. More energy than anyone can see. It takes energy to keep putting one foot in front of the other when you know that one unexpected variable could knock you completely off course.

It takes energy to make plans. It takes energy to be optimistic. It takes energy to keep showing up. It takes energy to answer, “How are you?” Because sometimes the honest answer is too complicated for the question.

How am I? I’m here. I’m doing my best. I’m trying not to think too far ahead. I’m trying to enjoy what is in front of me. I’m trying not to count the dominoes. I’m trying not to imagine which one might fall next.

And I’m tired, not necessarily physically tired. Although that, too. I’m tired in the way you become tired when you understand that the margin between okay and not okay is much narrower than it used to be.

I’m tired of knowing. I’m tired of knowing what can happen. I’m tired of knowing what the words mean. I’m tired of knowing how quickly things can change.

And yet, I get up. I put my feet on the floor. I take the medication. I go to the appointment. I answer the text. I laugh. I complain. I make plans. I keep going.

Not because I’m fearless, I’m not. Not because I have figured out how to accept everything. I haven’t. And certainly not because I’m stronger than everyone else. I’m not. I keep going because there isn’t really another choice, because somewhere between the fear and the uncertainty and the endless possibilities, there is still a life happening.

My life and I don’t want to miss it while worrying about the possibility of losing it. That may be the cruelest part of all. You can become so focused on protecting the life you have that you forget to actually live it.

So I’m trying to find the middle ground. Not pretending the dominoes aren’t there. Not pretending I’m invincible. Not pretending that one variable couldn’t change everything, but also not spending every waking moment staring at the row, waiting for something to fall. Because right now, they’re still standing.

And so am I.

That has to count for something. Maybe living with terminal cancer is learning to exist on that razor’s edge. To know how fragile everything is without allowing fragility to become the whole story. To acknowledge the fear without handing it the steering wheel. To understand that catastrophe is possible without living as though it is inevitable. To keep one foot in reality and the other in hope and some days, that is all I can do.

One foot. Then the other.

One day. Then the next.

The dominoes are still there. I know they are, but today, they haven’t fallen.

Today, I’m still here and for today, I’m going to live.

As we start 2026 Breast Cancer Awareness Month, please be on the lookout for PinkWashing and mark your calendars for the #LightUpMBC live show on October 13th, the ONE day all October set aside for those of us living with MBC.