Philosophy of Living with Lung Cancer | June 27 2023

Scans are done, reports are in, and yesterday, Dr. Oncology and I had the kind of discussion I wish all lung cancer patients and their docs would have. But first, the report.

1. Stable posttreatment changes in right lower lung.

2. No adenopathy or recurrent disease.

My first response: relief. And then, the slow surfacing of I am so, so lucky. Which is a way of saying, I’m grateful. I have a whole summer ahead of me, unencumbered by stupid cancer. Did I mention I was grateful? In a world where other lung cancer folks have run out of treatment options, osimertinib is still working for me. I have brain stuff in a couple of weeks, but with gamma knife as a possible (and likely) course of treatment, that feels like less of a threat. People usually have trouble with the brain MRI, Dr. O observed.  Oh, no, I said, lorazepam. (Shazam, lorazepam!) I can see why lorazepam is so addictive. I just look forward to an authorized day of not giving a crap about anything.

And then, suddenly, we were talking about living, really living with this horrible disease. What have I learned, she wanted to know. Now, I told her. Today. That’s what there is. The precision of attention to every detail. I don’t always do it, but it’s my intention to do what matters most and being fully engrossed in it. Do I meditate, she asked. Every day, I told her. Do I use guided meditation? No, just breath work. For how long? Twenty minutes, I said. Her eyebrows raised.  I qualified my response: well, I don’t always sit every day. Sometimes I work on digging a bush out of the garden. (Which I’m working on now. Damn that root system!) We agreed that could be a form of meditation. Then she said, the research shows that that 12 minutes is enough. I didn’t ask enough for what, but it doesn’t matter. My practice is my practice. (Although my sneaky little mind immediately grew gleeful at the prospect of less work. No, I told it.)

I described Frank Ostaseki’s Five Invitations and the challenge, seemingly impossible right now, of welcoming everything. I work on acknowledging, I told her. I’m a long way from welcoming. She laughed. She can never pronounce his name, she said– which means she reads him. She told me about philosopher John O’Donohue, who spent a stretch of time studying and working far from home. He was desperately homesick. One day, he decided it was time to make friends with his homesickness, so he sat with it, all day, learning about it, watching it. At the end of that day, he knew something different about it; it stopped plaguing him. She mentioned a couple of his books, which I ordered immediately after I got home. The problem is that most people don’t know how to ride the waves of powerful emotions, she observed. They don’t have the skills. And until they do, they are under the sway of grief, anger, loss.

Because we’d talked about that. I’d told her that the docs do a great job on the science part of treating cancer, but after you get far enough into treatment, you’re hit with anger, a grief so powerful you need to crawl under your bed. Oh, and then there’s the prospect of death, I said. And you do it completely alone. You need little pamphlets, I told her. Not to give out at the beginning– there’s too much coming at you. But down the road, the hard part becomes the emotions, and there’s nothing to help. Her attention snapped to a laser focus. I want to talk about that at your next visit she said.

Her belief is that people need skills to cope. Maybe, I said. But first, I think you have to choose to live, fully and authentically. If that means getting out of bed and getting dressed is what you can do, that’s where you start. (I was thinking of the day I earned an Olympic medal by walking 2200 steps.) She considered that for a minute. I never thought of that, she said. It’s a nuanced perspective. 

It was the end of my appointment time; we’d already gone way over. And she went to a place I’ll never understand. You’re an inspiration, thank you for being an amazing start to my day, blah blah blah. I truly don’t mean to minimize or dishonor her genuine perspectives, I just don’t get what’s so amazing about doing the work that’s in front of you. There are new parameters to your life, you have to learn how to live within them. I wouldn’t know the first thing about how to do that without my local support group, my online community, the contemplative prayer group at my church, Cancer Shrink. My family’s love and support is the cushion, but they have their own stuff to deal with regarding my cancer. (Plus my general crabbiness and withdrawal during my difficult times.) It’s not their job to work through pesky topics like death, anxiety, bone-crushing grief. This is the way I’ve chosen, and it’s brought me to a way of living that often affords me a sense of peace. Maybe other people would benefit for hearing about it, but it doesn’t change my practice.

Anyway, this is the kind of conversation that builds a foundation for the hard times that are inevitable, even decades ahead. Because, as I told her, there’s no cure yet, and stupid lung cancer is complex enough that a cure isn’t imminent. I’m convinced if there’s a base of understanding between us, it will open the door to frank discussion about possibilities.

I need to tell you about training for cycling, but that will wait. In the meantime. thanks for reading. I hope you dwell in moments of your own peace today.