October 2, 2002 Nancy's advice to Cancer patients.

Dear J and J,

Please excuse this computered letter; you are being spared my handwriting.

I’m so terribly sorry that you have been given this maddening disease. DAMN!

There it is, we can’t change it, BUT if I ever find my magic wand, you will get to use it first.

If some angel came to me and said, “ Choose, Nancy: go back to your life

before cancer & never have it, or go on as you are.” I honestly don’t think I would go back because cancer has changed me. It certainly has not made me a better person, but it has validated the things I value most and has done exactly what you said on the phone: up front, cancer asks us to live the way we have always said we intended to live, second by second, breath by breath, present in the moment, and to the light in each of us. It’s a worthy task master with very heavy feet, stepping on a lot of toes, but, just the same, it has been a gift to me. 

There are aspects of this BIG C trauma that I wanted to tell you about.

Unlike a heart attack, stroke, Alzheimer’s, or sudden death by accident,

cancer gives us some time to get ourselves and our families ready for the next step, for the rest of our journey, and I think this is a great gift because it tells us in no uncertain terms: “This is your time, use it well.” Even so, the time is too short because, in our remaining days, we, sometimes painfully even, KNOW vividly and deeply how beautiful this world is, how graceful and lovely are those we love, and how little we want to leave them.

Just the realistic thought of it breaks our hearts over and over. All around me, I see people avoiding the heartbreak, operating in a forced bravado, hiding their tears, but somehow the tears are healing, necessary, and in themselves, transforming. Danish storyteller Isak Dinesen says that all of the troubles of the world are eased by salt: sweat, tears,and the sea!

Isak Dineson

My tears help my children because my tears acknowledge their tears and we grow

closer within them. So, both of you cry, let everyone see it, ride the roller

coaster of this journey the way Larry Gillick had to ride that real roller coaster in his past when he stepped into the gap between the cars. Terrified when he realized where he was, he had to trust the hands of his friends to pull him in.

Cancer also allows us to prepare for a good death. This preparation and

process is something we give to those who love us and follow us. Harry was able to do this eminently well. Patiently and gracefully, he became filled with light and

drifted away from us as he flew into the arms of God. We were all there. We held his hands. Even two year-old Bea and Weezie. Unconsciously, he waited for Guy to come back from the zoo with the kids. It was natural. It was essential. He taught us how to a way to do it.

I know that this is not always possible for everyone; sometimes pain management robs us of the ability to think, and I hear tales daily of deaths that are made tense and painful by the struggle of doctors to keep the patient alive and the patient’s need to go.

Cancer allows you some time to make this clear to yourself and to your family and to facilitate your transformation with dignity. Hospice is a brilliant assistance in this struggle. Harry benefited from their work. I intend to do so, too if at all possible.

My young friend David Barker’s suicide this summer still has me reeling in grief and anger. I feel as though he meant, by killing himself, to kill all of us who

loved him. I know he was on some kind of downward spin with medication, but his death underscores the gift of cancer. It allows us to say goodbye, allows those who love us to grieve with us, to love us openly, and to be able to help us (especially when we are so used to being the helper and don’t know very well how to receive the gifts of love) - this is a true gift. And knowing you both, I know that you will, in your own unique ways, make good use of this time.

 

Realize quickly that you are in charge and you have to be for your own sake.

No one doctor, surgeon, oncologist, internist, nurse, no one person was overseeing all my treatment - I had to do it and make the decisions as I saw fit - and it meant educating myself more than I wanted to be educated about breast cancer.

In the meantime, live and try to live, because HOPE is perhaps the most potent and resilient healer. I am staying alive because of the work my weekly doses of

antibody. I suspect this drug will work for another three years or so if I’m lucky, and then my cancer will figure out a way to get around it. But by then, there may be a new drug!

Pancreatic cancer is totally different, but so is every single cancer, totally different

because of our own unique chemistries and attitudes. In three years, there may be a cure, or another drug to extend my life. I’m looking for that drug, but I also know that if I have to go through the horror of chemotherapy again, I am not sure I will choose it.

Through genome experiments and the use of a person’s own cells to heal them, scientists are finding clues to what’s really going on with cancer and how to defeat it. So, I’d recommend going to M.D. Anderson, to Mayo, or UNMC and get yourself into a trial for one of these techniques. They are so much less invasive than traditional chemotherapy and perhaps you’ll be given the days that I’ve been given by the antibody, days of sweetness.

I also recommend finding a doctor you like, with a nurse who likes you. It makes a huge difference. Stefanie found me such a doctor & nurse at UNMC, Beth Reed & Anne Privitera, and even though I felt I had to do therapy with Beth every time I

saw her for the first two years because she seemed to shield herself rigidly from knowing me as a person (ARGH- doctors are taught to shield themselves; it’s got to be a damaging and dangerous training), we broke through that when my cancer metastasized.

This makes a difference to ME. I am happy to be going in for treatment and happy to receive it because I have a relationship with them that is not JUST illness.

What I am most afraid of for myself in this journey is that I will lose my mind to pain, so I’ve asked my internist, Ed Taylor, to watch for me, and if I’m unable to

think for myself, to allow my family to think for me and to help them let me go when my body says “enough, already, enough!” That’s a good time when it comes, because it’s natural, it’s the way it is meant to be.

OK, enough already!