Categories of Acceptance
"Even the smallest pleasures seem more meaningful when they are shared,
while the tragic moments are buffered by love. "
CHAPTER TWENTY-SIX
Categories Of Acceptance
I was home once again, and my greatest wish had been realized. Somehow
I thought my life would now be simplified, and that I could wield
complete control over the ways in which I desired to spend my time and
conduct my remaining life.
With something akin to fascination, I looked at myself in the mirror
and focused my eyes on my protruding stomach region which would one day
be the cause of my death. The subjects of death and other intense,
wrenching emotions possessed a magnetism which had always held me
spellbound. I was drawn to the startling views of human tragedy in
both literature and art forms; a life tottering precariously on the
edge of sanity or mortality could offer a glimpse of the more painful
aspects of reality which many often neglect to acknowledge. Images
which accurately depicted the horror of war or the anguish of a mother
of a stricken child were those which captured my attention; though
beautiful works would please my eye, only the gripping views of life
held the capacity to stir my senses.
The thought that I now shared a common bond with those gripping views
of existence similarly held my fascination. I wondered what my family
would undergo during the harsh period following my death; I pondered
whether I would see earthly lives when I no longer was part of the
world. I spent lovely afternoons in peaceful reflection, drinking in
the earth's beauty to somehow retain the days as if they were my last.
Time itself lost its importance as I embraced the cycles of nature and
my own life as one, rather than separate entities. I marveled at the
pitiable lack of control we, as humans, have over our lives; after
attempting to rule the world, we are at last brought to the level of
all things through the element of mortality. I shared a kinship with
autumn following the rediscovery of cancer. Like a tree divested
of its leaves, its only proof that life yet flourished deep within;
I questioned when my color, too, would fade, rendering me helpless
against winter's icy grasp (death). Death was no romantic notion which
smuggled lives on moonlit nights; it was merely an endless cycle.
Nov. 1981... I quieted my thoughts and listened as a distinctly
familiar echo of sadness resounded in the autumn air. It seemed as if
the old tree above me was attempting a futile last stand in the face of
the impending desolation of winter. A blast of northerly winds
scattered the furiously spinning leaves to form a semi-circle about my
feet.
I picked up the leaf, noting its fragility as it crumbled under my
touch. I realized that I was observing a change of seasons in which
only brittle remnants of spring remained to display that life had
actually existed. A gust sent the fragmented leaf to be buried
unceremoniously in the midst of thousands of other leaves, which were
rustling their distaste for their hapless plight.
I watched several more leaves rattle a loud protest as the wind
determined their fate. Another leaf, one which could easily be labeled
as a spectacular tribute to nature itself, was swaying gently in the
crisp breeze. It was different from the other leaves, seemingly
unafraid of its destiny. I continued to watch until it was slowly
delivered to the ground to rest in silence at my feet.
That is the way death was intended to be, I thought; stealing quickly
over its prepared and quietly waiting subject, death overcomes life
with no struggle and no outcry. I sighed and wondered when I, too,
would be beneath the dried and decaying vestiges of many summers passed.
I culminated my restful sojourn amongst the colorful show of leaves
with thoughts that have frequently entered my consciousness during
reflective intervals; one must first accept death if he is ever to
understand life.
I will never forget an incident which occurred shortly after my release
from the hospital. Seated in the middle of the shopping mall, I was
engaged in observing people hurry in and out of stores, and while my
face did not radiate feelings of great joy and elation, I did not wear
a mask of sorrow either. Just then, a man happened by and remarked,
"smile, you're not going to die!" I remember how idiotic that phrase
sounded to me, and it left me speechless. "Yes," I thought, "I shall
die. . . and sooner than you might suspect." Everyone dies.
Quite apart from denying my illness, I found myself quite preoccupied
with it, and initially it was difficult to carry on in a "normal"
fashion in the sense that I could not detach my mind from the fact that
I had cancer again. After learning of my recurrence I immediately
began thinking thoughts such as, "if I subscribe to this magazine,
I wonder whether I'll receive all of the copies. . . ," and while
driving down the road, "I wonder if I'll ever get a speeding ticket,"
or when in a pet shop, "if I got a parrot, it would outlive me."
I remembered my china dishes and realized that my dad had been right;
I should never have purchased something which represented the future.
The future did not belong to me. . . it was dissolving before my eyes.
My dreams were changing out of necessity, since most dreams depended on
time for their fulfillment... and time was one amenity that I could not
hope to claim.
Nov. 1981... I dismissed modeling altogether after appearing in a
luncheon (style show), which I enjoyed entirely. I somehow felt unable
to accept the demands of the career when I felt my health situation was
so uncertain and unreliable. Admittedly, I could have modeled for a
short time. Somehow, though, it didn't seem important any more. I was
tired...
I thought of the teenager who had a car, yet lacked the fuel
to drive it.
I speculated as to whether or not I would witness the spring-time
again, and could not help but question absently if my 20th birthday
would prove to be my last. I was unable to release myself from the
thought of my impending death; I wasn't simply Lauren Isaacson. I was
"Lauren Isaacson, victim of cancer." I identified myself with the
disease and found my thoughts encompassing various subjects with cancer
continually in the back of my mind. I never denied the presence of the
disease, nor did I wish it on someone else, and perhaps this is what
allowed me to bridge a period of gray disillusionment so common in the
acceptance of solemn news; I would much rather face a heart-rending
truth than to live amid a cloud of fantasy derived of the mind. Tumors
have no conscience, and no amount of wishing, cursing, or bribery will
cause the disease to disappear. These mind-games will one day come to
an abrupt, emotionally wrenching halt or lead to personality
disturbances if not corrected; such reactions only injure the
individual or those with whom he must associate.
In coping with a weighty truth of such magnitude, the family as well as
the patient, will experience various and ever-changing emotions, and I
believe it is quite important that these feelings are ventilated.
Simply because the family is not afflicted with the illness does not
mean that the individuals are immune to its emotional nuances. In
fact, the family is sometimes the worse off; they essentially feel
helpless, unable to ease physical pain or shield their loved one from
his frightful pursuer.
When the family is able to openly converse on the topic of the
patient's illness and imminent death, the entire affair seems less
formidable, rather like a beam which is directed upon the unlit
recesses of a room, thereby dispelling the uncertainties which lay
dormant in the darkness. Because there are manifold reactions to
adversity, related conversation will evolve at varying rates. While
some people would be ready to speak candidly after a brief time, others
need to ingest the situation gradually and should not be pressed into
heavy conversation directly following a shock. Moreover, there exists
in most humans the great need to face life's circumstances with dignity
and composure and would not, therefore, relish a serious discussion
until they could do so without losing control of their emotions and
causing a tearful scene.
Although it is unhealthy to continually dwell on the plight of the
family, silence is debilitating. . . especially if it evolves through
avoidance of the problem, rather than simply the inability to verbalize
one's thoughts. True coping deals with self-expression, not the clever
avoidance thereof. One should never attempt to stifle grief, for to do
so will create unendurable stress; and what, I might add, is so
terrible about venting one's sorrow in the form of tears, when the
situation certainly merits that behavior?
Anger is an understandable reaction to the discovery that one harbors a
debilitating disease, for since everyone must eventually die, surely
there are more pleasant routes toward that destination if given the
right to choose. Moreover, anger is thought to be a less degrading
form of expressing depression. No one wants to suffer or restrict
himself in a manner unnatural to his lifestyle, nor lose his sense of
control, no matter how much or little he actually has.
If anger is a prevalent emotion, its release is necessary; yet
projecting that anger on undeserving family members or hospital
personnel is unfair. Anger is counter-productive when wrongly
displaced; fanatical rage and irate demands are increasingly ignored
and replaced by the unfortunate avoidance of the enraged individual.
No one can benefit from this chain reaction.
An alternative which could be used by the patient having the
objectivity to discover his outward rage is anger expressed through
writing or intelligent conversations rather than transforming the anger
into unfounded complaints. The problem is not the unsmiling intern,
or the wife who arrived ten minutes later than planned. The problem is
health, and if not dealt with, attitude as well.
A reasonable exception is when the patient's anger is derived of pain;
it is virtually impossible to be civil if each breath heralds another
moment of severe physical anguish. This belligerence should not be
taken personally by either relatives or hospital staff, nor should the
unfounded anger described above be ingested as relating to their
presence or prescribed duties.
If it is attention the patient needs, it is more likely to be given
if he behaves in a manner deserving of amenity. It is a pleasure to be
near a person who, despite his personal problems, can retain humor and
conduct himself in a respectable manner. If my experience is any
indication of the quality of the residency in hospitals, I found the
staff to be most personable if treated likewise. On the rare occasion
that a patient is forced to abide a hostile nurse, or one who refuses
to believe that he is suffering to the degree that he claims, a
complaint is well within reason. One case in particular concerned an
incontinent elderly woman who, after an accident over which she had no
control, was chastised by a hostile nurse, resulting in tears which
should never have been provoked. A patient is not paying for abuse;
moreover, a hospital without patients is just a stone building, and its
personnel is up for hire. Inflicting emotional anguish has no place
in the medical profession.
When I felt frustrated by the constraints which resulted from my
cancer, I encountered no pervasive or continual anger. Furthermore,
the anger was targeted at the source of my inability to function
properly, rather than projecting it toward an innocent companion. Mine
was the self-contained anger similar to that which I would feel after
entertaining influenza for nearly a week; weary of its limiting effect
on my mobility and general well-being, I would hurl devastating
thoughts inward, then later proceed to calm my cantankerous spirit
and await the arrival of health.
My father held a rather negative view of the possibility that good
could prevail over evil; he always expected the worst, and often was
quite right in his assumptions. Even so, expectation does not cancel
one's disappointment at having supposed correctly, and his broken heart
was obvious. A touching moment in a movie, a poignant verse of song or
the reading of one of my poems was enough to send a tremor through his
voice in a later attempt to speak. Often depressed or angry, he was
tormented by the many adversities which had befallen our family. It
just didn't seem quite right that he should have such difficult burdens
after he had lived a morally conscious life; others, lacking all sense
of moral responsibility, seemed to live long and healthy lives, or died
simply because of their own ignorance and gluttonous indulgences.
Hounded by such sources of resentment, acceptance was gained, then lost
once again at varying intervals when he viewed the healthy, but empty
lives whose health, he thought, should have been my own.
Aside from the family, my dad had no confidant or close friend. He,
like many members of the family, was quite self-sufficient.
Unfortunately, one's self-sufficiency, displayed in grave situations,
can discourage closeness, whether consciously or not. Thus, when such
an individual truly desires someone to hear his concerns, no one is
near enough to care. Even persons with whom one had worked on a daily
basis can prove to be unenthused listeners; often their association
clearly ends within the confines of the job description.
Though not always apparent, my dad was a highly sensitive individual.
An injustice or injury persisted, inflicting pain and stress. More
than anything I believe my father needed unsolicited affection and
demonstrations of sympathy; lacking these, especially from his
co-workers, Dad felt himself betrayed by the one group with whom he had
spent so much of his time. He could easily have drowned in self-pity,
for no one wished to help with the bailing out of his broken heart;
sorrow was like a hat which only he could wear.
My father would, on occasion, mention that if he had not married, or
had children, he would not have had to experience the pain of losing
dear children or seeing them riddled with health disorders. Life
without emotional grief would be "easier" and more stable, yet to
shelter ones self from close relationships would also be an enormous
deprivation; love is the foremost joy of living, and it cannot grow
through alienation from society. Even the smallest pleasures seem more
meaningful when they are shared, while the tragic moments are buffered
by love. To separate ones self from affection for others denies a
virtuous human potential to develop, as it simultaneously creates more
emptiness than that which occurs upon the death of a loved one; the
grief-stricken survivor has memories, but the emotional hermit has only
stability. There was indeed, a sacrifice for love. It was one that my
dad was willing to take.
In one of our conversations, I once asked my father if he thought he
had basically accepted my health disorder. He replied, "I don"t think
I will ever accept it, because it's not acceptable." For his part,
maybe he just lives with it. What other choice does one have,
excluding madness or suicide, but to live with it? (It just doesn't
mean that he has to like it!)
Guilt very often accompanies the illness or death of a loved one, and
can be released through conversation. The unfounded sort, stemming
from regrets such as a patient's unfulfilled dream which the relative
felt he impeded, or a mother's inability to detect subtle changes in
her child's health, is a counterproductive, if not debilitating, manner
of reacting to the problem. These emotions are quite corrosive to the
individual, and it is important that they are quickly corrected; this
can be done through attentive listening and positive reinforcement.
After discovering the malignancy in my stomach, my mother effectively
chastised herself by asserting that she "should have noticed that I was
eating less and getting thinner." She held on to her belief while I
tried to assure her that the extent to which the cancer had spread was
not her fault. I reminded her that many children are rather lanky and
thin when they are growing too rapidly for any food which they eat to
transform into fat; the body needs the nourishment to sustain itself,
and has no excess for insulating purposes. With time and reassurance,
she finally dismissed her guilt; I listened to her statements,
returning not with, "You shouldn't feel that way," but with reasons
which effectively reinforced the pointlessness of her guilt. As with
any invitation to change one's outlook, a person fostering guilt must
be shown why his view is unreasonable and needs to be altered.
Statements such as "Don't feel guilty" define the desired destination,
but offer no direction as to the means of attaining that goal. I have
sometimes wondered whether this type of guilt is not merely a
subconscious means of inflicting punishment upon ones self in order to
more deeply share the pain felt by the ill person. Guilt which is
evoked through hateful thoughts or malicious wishes toward the ill
person is sometimes more difficult to manage, due to the fervor with
which the mental darts were hurled at the patient before the onset of
illness. Abreast a wave of superstition, the guilty party quietly
blames himself, feeling responsible for the evil which befell his
victim. It is important for the guilt-stricken individual to realize
he does not control the hands of fate. To further complicate matters,
often the dying or deceased individual is surrounded by an aura of
purity, and it is deemed unfit to denounce his character despite the
validity of the statements. Though loss makes memories all the more
dear to the heart, I feel that one should not forget that these people,
sick though they are, are human; they possess irksome habits and have
made foolish mistakes as does all humanity. To elevate an individual
beyond his former limitations is an open invitation toward the housing
of personal guilt, since any negative emotions concerning the patient
will be thought of as hostile and unfounded; one is not only denying
the disturbing propensities of the patient, but also, and more
important, he is denying his true feelings, thereby trapping himself.
In this scope, I might add that elevating a person who has not yet died
can create an undesirable situation for him, in that he may feel
threatened by this new and unrealistic public opinion of himself which,
consequently, is greater than he is able to uphold.
Another sort of guilt, planted by the patient, is somewhat related to
the above. Although conversation is generally thought to be a healthy
exchange between concerned individuals, there are those who,
unfortunately, take the business of sharing their health problem
wholeheartedly. Applying no restrictions on themselves, they
continually voice their complaints until a situation is created wherein
the complaints are more of a burden to the family than is the illness.
I feel that reactions such as these on the part of the afflicted are
unfair and completely selfish. Forcing constant awareness of an
illness upon a loved one is cruel and emotionally debilitating.
When a situation such as the one described occurs, I wonder whether the
patient truly loves his "subjects"; a caring individual would still
want his family to derive joy from living despite his inability to
actively take part. Jealousy has no place in love, especially when a
loving relationship is placed in jeopardy by the imminence of death.
A patient's jealousy can often promote guilt; ultimately, however,
it begets only resentment, not true love and devotion.
My father was acquainted with a man whose wife was a constant source of
worry. She was what I would call "the delicate type," in need of
constant attention and sympathy whether she truly needed it or not.
The day finally came when she found herself bedridden, demonstrating
the symptoms of an actual health disorder, and her personality took on
the shrieking demeanor of an angry bird. She expected constant
nurturing care from her husband, yet nothing he did would please her.
After hounding him relentlessly to pick up an item at the store,
she would be enraged because of his "lengthy" absence.
Eventually the poor man agreed to place his wife in a rest home in her
home town. However, through her injection of guilt, he still felt
obliged to maintain a daily vigil by her side. The man became
emotionally and physically exhausted, and suffered to such an extent
that his sanity was nearly obliterated; in tearful, emotional outbursts
he would relate the "sad" condition of his wife, and elaborate in
detail their conversations and prayers, never thinking that her's was a
very disturbed mind. Bereft of any other communicational outlet or
friendships, he accepted the blame for his wife's unhappiness. In
effect, he was starving for conversation and emotional support, causing
an irrational view of reality.
Although, toward the last portion of her life, the wife was mentally
incompetent concerning her nasty behavior, she would have been capable
of changing her actions earlier in life, yet, through a jealous and
self-centered need, she obtained a constant awareness of her presence
by lamenting any flaw in her well being. The husband may have enjoyed
the initial pampering as a means of elevating his feeling of
self-worth; here was a woman who needed him. However, as any excess
can be overwhelming, her preoccupation for comfort was his final
undoing. Had she thought less of herself and allowed him the freedom
to breathe, the obsessive guilt she strove to plant would never have
taken root in his mind.
It is essential that the patient allows his family to continue in a
"normal" fashion, for it must be accepted that there will be a time
when life must carry on without the sick individual. This is not to
say that a husband should start to seek another mate before his wife
meets her demise; behavior of this nature is cruel and, I believe, says
that his wife was not loved but only needed for the beneficial comforts
she could provide. However, continuing attendance in a church, or
meeting with friends should in no way be thought of as frivolous or
forgetful of the sick, but rather as a form of therapy for the living.
I wanted my family to continue its current lifestyle, and for the most
part, that was no problem. However, Mom continued to feel guilty about
her health and ability to do anything she desired while her young
daughter was forced to stay home.
As my cancer progressed and I did less in the social realm, spending
week-end nights at home, my mother became concerned about leaving me
alone when they went on a small excursion or nighttime gatherings; she
worried that I might be lonesome or scared, or need help of some kind.
It was somewhat of a chore to assure her that I would be fine; should I
be scared or lonesome, it would pass, and with regard to my health, she
would be powerless to aid in my comfort even if she was at home. As a
final effort I confessed that I truly enjoyed being alone sometimes.
I too needed room to breathe, to feel that, even with my severe
limitations, I was yet in control of my life. It was important that
I knew I could take care of myself if the need would arise.
Guilt may derive from actual wrong-doing on the part of the
guilt-ridden as well as the causes described above. Whether spurred
from emotional neglect, mental abuse, infidelity, or another source,
this guilt is the only type which I feel is worthy of its keeper. When
an individual knowingly hurts another, yet makes no attempt to correct
himself, the former deserves to feel the grasp of pain. No apology, no
matter how magnificent, can take the place of past injustice.
Therefore, while the past is history, perhaps these regrets can best be
handled by a silent oath to behave differently on future occasions.
The refusal of friends to face my health situation always brought about
a keen sense of frustration on my behalf, modified to a certain extent
by pity. It is impossible to attain any depth in such relationships,
since continual avoidance of reality cannot be upheld.
One such relationship, in which a friend would not acknowledge the
presence of my illness, was eventually transformed into a virtual
charade. Conversations revolved solely around trivial matters or
reminiscent revelries. Discussions of the present surrounded her
doings only, for the least hint of my illness would leave the
conversation stunted. Because I never cared to dwell on my ill health,
any remark was of the passing sort, yet even these seemed too much for
her to abide. It was as if the pre-cancerous person was the only "me"
which existed for her; my entire self was no longer acceptable. As no
change occurred, our rendezvous became less and less frequent, and
eventually subsided altogether. I felt uncomfortable having to hide
behind a mask of my former health for my company to be tolerable; it
was better to be alone. Friendship must be built upon honesty if its
true potential is to be realized.
Frustrating to a lesser degree were those who could withstand a cursory
mentioning of my illness, but would then perform a mental backflip and
begin discussing another topic as if I had no problem at all. It
seemed that their understanding of my health condition was not
congruent with the activities which they considered me capable of
negotiating. Stifling an open-mouthed, incredulous stare, I would then
attempt to explain that I was unfit for that particular suggestion, but
perhaps we could find a mutually agreeable alternative. I always tried
to coax one's realization of my health situation, rather than
attempting to "cram" the truth down uncooperative throats.
It is so difficult for society to abide the thought of terminal illness
and death, especially in those we love, and therefore it is often
ignored in a conscious effort to prove its nonexistence. Though it is
natural to attempt to flee that which seeks to invade one's happiness,
running, unfortunately, shall not make the menace disappear; the young
are not the only group of people who, when faced with the illness of a
loved-one or friend, search desperately for their "running shoes."
While the voicing of feelings is very difficult, it can bring peace of
immeasurable degree to yield to their expression; after a loved one
dies, one can no longer deny that he was terminally ill, and is left to
cope not only with the disease, but with its ultimate effect. Where
there might have been memories of a loving farewell, there is
emptiness. Just as spoken words cannot be recalled, words which are
left unsaid are merely lifeless fragments of conversations which might
have been, and forever plague the happiness of the individual who
elected silence instead of self-expression.
The utilization of excessive denial toward the fact that a disease is
incurable can jeopardize one's time and quality of life. Denial
alienates its victims from family and friends. While the patient, or
conversely, his relative, continually galavants across the country in
search of a miracle drug or pretends the truth shall not come to pass,
lost days can never again be regained. The feeling of hope afforded by
such futile excursions and mental conjurings is, I believe, less
beneficial than are the quiet and intimate interludes which might have
taken their place. The longer one avoids the unfaltering truthfulness
of such a situation, the less time he has to enjoy his remaining days
in a "normal" fashion.
Unlike certain studies on illness and death, I cannot feel that denial
is parallel to hope, nor can I think of the need for hope as a lack of
acceptance. As I soon discovered, self-absorption in a traumatic
illness eventually becomes monotonous, and one will naturally turn his
mind to encompass other interests. This is perhaps more prominent with
extended illness, as the patient and his family pursue routine
activities while a "lack" of symptoms permits. Although cancer is
definitely part of my life, it is not my whole life. While I have
never thought a cure was likely to be discovered, I know there are many
involved in cancer research; thus, as I live day to day, a ray of hope
shines through a door which is not completely closed. Hope injects an
element of pleasure in lives which would otherwise be stagnant
reflections of death itself. While there is yet a chance to survive,
and discomfort is not the primary essence of each day, one tends to
think of life; it is all we, as humans, truly know.
Luckily my family and better friends did not avoid my problem. There
were times when we felt pressed to talk, and let go of the tears which
were usually held at bay throughout the day. Disappointment and faded
dreams stabbed my father through the heart, and he lamented the many
sadnesses with an angry vengeance. Mom's aching for that which could
not be often liquified into tears. Norm, on one of our walks, would
blandly state, "No luck at all . . ." The need to speak, and the
responsibility to listen, alternated between us, and strengthened our
relationships; the patient is not the only one in need of a tireless
ear.
I had to be able to be free to talk and joke of my illness, not hide
its existence in the corner of my mind. It was part of my life,
becoming as natural as eating and sleeping. Had I been forced to
conceal my feelings my life would have been one of loneliness and
despair; I would only have been what people wanted to see...
an image, not a real person.
I was alive, housing an alien growth, indeed nurturing it, so that it
may fulfill its purpose. To try to impede its fixed intent seemed
futile; cancer desired to squeeze life from my body many years ago...
and now it truly appeared that it would succeed. Thus, almost pleased
with the belief that my life had found its rut, from which it could not
be removed, I wanted to live in a manner conducive to good spirits.
No one, I thought, would interfere with my peace.
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