To Hell & Back: Cancer, Myth and Meaning
Introduction
By Alysa Cummings
The lab technician pats and slaps and stares intently at the crook of my left arm. She presses down purposefully, first in one spot, then another. Her gloved fingers inch bit by bit across the skin on my inner arm, stopping to pat, slap and pat some more. Finally she frowns and shakes her head in frustration. This is my cue to smile sympathetically and ask for her honest professional opinion. "So what do you think? Was I born without veins, or what?"
While my chatter does little to ease the rising tension in the room, I confess I just can't help myself. (Would an apology help? Make the needle sting a little less?) "Listen, I'm sorry I'm such a 'tough stick.' But there's got to be a half decent vein in there somewhere, right?"
Still determined to win her over, I smile again and offer up the same hollow words of encouragement I always do in this situation: "Hey, from what I hear through the grapevine, you're the best. I have a good feeling you'll hit me first time out."
As the old saying goes, if only wishing could make it so. Unfortunately this scene has played out over the years with so many other lab techs that I know in my heart of hearts, that the odds are stacked against us both. Still this find-my-vein-I-know-you-can patter is quickly becoming a staple in my cancer patient routine. One thing's for sure: pre-admissions testing before surgery is giving my lab tech shtick a major workout; I've run this routine three times today alone.
Why do I bother? Well, when it comes to hospitals, it just makes sense to stay on the good side of anyone dressed in white, pointing a sharp object in my direction. If you have either a needle or a scalpel in your hand, I want to be your new best friend. At the very least, let me be more than a disease, more than just another anonymous patient passing through. So I crack bad jokes. And fake bravado I rarely feel. But considering the challenges ahead of me right now as I begin cancer treatment, leading with my personality feels like a reasonable "get along to get through this" strategy. Bottom line: I am doing the very best that I can, shuffling the lousy cards I've been dealt.
Unfortunately, the bad news is that after four hours straight of pre-admission testing, this Cancer Comedian is not holding up wonderfully well. Cracks are starting to appear in my carefully constructed facade and there might be lots of good reasons why. Maybe I'm sick of roaming hospital hallways not knowing where I'm going. And tired of following colored lines on the floor down and around the bowels of the hospital, gripping my pre-admission test itinerary in my clammy hands like a treasure map (...andonce you have received your contrast injection, proceed to room L14...). Some of today's tests only work on an empty stomach and the fasting has made me feel altered, spacey and disoriented. Then there are the interviews. I have filled out countless forms with the same information and recited the identical medical history to so many strangers in white coats (oncologist, anesthesiologist, physician assistant) that my head is spinning. I feel the stress slowly building to a critical mass. Still, the reality is that the cancer journey for me has barely begun.
So for right now, I try to focus. Another scan means more directions, more instructions. Put your clothes in the basket. Tie your gown in the front. Wait here. Go there. Don't breathe. Good. Now breathe. More burning needle sticks. Dye going in. Lights clicking off and on. Holding still in awkward positions. If someone would just stop all this hideous "patient processing" for a minute and give me a chance to say something, I just might holler: Ladies and gentlemen of the healthcare delivery system, I have had more than enough pre-admission testing, thank you very much! Enough already! Please. Stop. NOW!
However, until that fantasy becomes a reality, won't somebody kindly tell me that I've passed my initiation with flying colors? That I'm this close to being accepted into The Club? That in a few more hours, give or take, I'll be an official Card Carrying Cancer Patient in Treatment? That I'm almost there with the finish line in sight? How about a few words of encouragement here? Perhaps in the final analysis, when all the whining is said and done, pre-admission testing has succeeded mostly in getting on my very last nerve.
So here I am, flat on my back, gazing up at a large white circular machine. From this angle, it's just a big metal doughnut to me. In the meantime, the lab technician gamely continues her search for a decent vein in a bruised arm that has already been tapped twice in the same day. Maybe if I focus on the machine I can avoid looking directly at a huge needle with my name on it sitting on a tray. But even out of the corner of my eye, I can see the lab tech and she looks tense. Not confident at all. Maybe that's why I start babbling, " ... is Tom around? You know Tom from Nuclear Medicine? Nice guy. Soft touch, a touch like an angel, I swear. He found a vein on me early this morning, first time out, no problem and..."
But she doesn't call Tom, and in a moment I find out firsthand that my lab tech is definitely not the best because she takes a stab at a vein and misses. It rolled on me. Damn! (That's right. Go ahead and blame the vein. Bad vein. Bad, bad vein). I breathe in and out, in and out, as she gets ready to stick me again. I'm really sorry, hon. Hang in there, will you? We have to try at least twice before we go for help.
This time the tech wriggles the needle under my skin and it hurts so much I suddenly tune into what sounds like a song, a chant actually, with the strangest lyrics: I'm losing it I'm losing it I'm losing it I'm losing it I'm losing itI'm losing it I'm losing it. What I'm hearing is my own voice bouncing back at me. In fact I am broadcasting my pre-admissions testing breakdown to anyone who might be listening. And that's exactly what I proceed to do in the next moment: break down, melt down, lose it.
The panic attack erupts with a sharp, pounding pain behind my eyes. I wrench my throbbing arm away from the lab tech and howl, Noooooooooo... , I rage and rant like some cornered, wounded animal. No, no, no, no more, no more. I shake. I kick. I curse. I roll to my right to jump off the table. Call it fight or flight. Or even a jailbreak. The need to flee is compelling; I'll do anything to get away from her. If I can't run away from my cancer, then putting some space between that hateful needle in her hand and my sore arm right now strikes me as the next best thing.
The darkened control room next door is filled with lots of lady techs busily tracking pale, ghostly images on screens. At the sound of my yelling, they stop pressing buttons and spinning dials on high tech control panels to peer through the tinted glass at me instead. (Here's the main event of the afternoon, folks; a patient freaking out right before your very eyes). Three female techs immediately bolt across the room to reach me before I fall off the table. Then three more appear and suddenly there's a crowd, at least seven techs shoulder to shoulder in the suite and one after another they surround the table and throw themselves across me like human blankets. Their combined weight tackles me back onto the table.
Despite the frenzy of activity in the room, no one actually says a word. Quiet moments pass as this panic attack drill team, this circle of women holding me down, works its magic. Their collective body heat spreads deep comfort and soon my tantrum is little more than aftershocks of trembling and lots of congested breathing. I lie there exhausted, beaten up like a boxer gone too many rounds in the ring. Then feelings of intense shame wash over me as I replay mentally what has just happened. And, of course, what has to happen next.
I silently surrender my left arm, extend it willingly. A superstar lab tech (the one who always hits the tough sticks the first time out) takes me in hand and elegantly hits a vein. Bravo! The dye finally flows where it has to go. I lay back and listen to the whirrrrrs and clicks of the big white doughnut shaped machine. Breathe, says the mechanical voice. Hold your breath, says the mechanical voice. Breathe, says the mechanical voice. I do my best to follow orders.
When the scan is over, I stumble out of the imaging suite and bump right into my oncologist, Dr. C., standing there in the hallway. "Isn't this a coincidence..." I begin weakly. He pats the small black gadget hooked to his belt. "My showing up down here is never an accident. But more importantly, are you feeling any better?" My face turns red. They paged him. I'm totally mortified. We walk down the hall together to my last scheduled appointment. All that's left on my list of tests is a simple chest x-ray, but it's a grim reminder of why I'm here today. Dr. C. hovers nearby until it's done.
Despite the fact that it has been over five years since my pre-admission testing "incident", the memory of that day played back vividly in my mind like a movie on videotape when I read Close to the Bone: Life Threatening Illness and the Search for Meaning. In her book, Jungian analyst and clinical professor of psychiatry Dr. Jean Shinoda Bolen, describes eloquently the power of illness to wake us up and jolt us into a new reality.
"Whenever or however that line from health to illness is crossed, we enter this realm of soul. Illness is both soul-shaking and soul-evoking for the patient... We lose an innocence, we know vulnerability, we are no longer who we were before this event, and we will never be the same."
For me "soul-shaking" clarity arrived on the heels of one pre-admission test too many; when I got a sharp and bitter taste of what the next chapter of my life would be like as I left the healthy world and dropped feet first into Cancerland. Other key insights soon followed: I could not control cancer. I could not run away from my condition or wisecrack my way through it either. Still, I desperately wanted to find my way back to whatever my "new normal" would be as a cancer survivor once treatment ended.
According to Dr. Bolen, tuning into such harsh new realities brings a person "close to the bone," and can trigger a transformation, a reevaluation, a shifting of priorities after deep soul level consideration of "what matters, who matters and what we have been doing with our lives."
Dr. Bolen uses the Greek myth of Persephone, that dramatic story of an innocent taken into the darkness of the underworld, as a way of describing the experience of serious illness, when "the ground gives way under us." Close to the Bone goes on to describe the value of myth and poetic metaphor to help us make sense of the intense feelings that arise as we move through sickness towards recovery.
Which leads us finally to the latest in a series of Oncolink Poetry Projects, To Hell & Back: Cancer, Myth & Meaning. We have collected poetry from cancer survivors and caregivers and organized it into two sections that mirror Persephone's adventure in Hades: the descent and the journey back. There's also a section of quotable quotes describing the illness experience and the healing process. In addition, we thank Dr. Bolen for agreeing to a virtual interview conducted entirely by email. Finally there's an assortment of digital pictures illustrating the writing throughout and a handful of new Instant Fill in the Blanks Poetry Forms for poets interested in some online interactive creative expression.
Our hope is that the poetic words and images of To Hell & Back help you find your way.
The Descent
- Waiting Room
Jane Yolen - In the Biopsy Room
Jean Trounstine - From The Medical Record
Alysa Cummings - Womb of the Night Sky
Anne Silver - The Mastectomy Poems: 2. The Gurney
Alicia Suskin Ostriker - In the Hospital
Patricia Goedicke - One Hundred and Ten Days
Julie Moulds - Lifting My Shirt
Patricia Fontaine
The Journey Back
- Got to Get Down to Know
Marion Weber - You Will Be Just Fine
Lois Tschetter Hjelmstad - For Those Who Wait
Shannon Olin Kresge - O Body
Rachel Naomi Remen, MD - Moonsets
Patricia Fontaine - Recovery
Patricia Wellingham-Jones - A Promise to Eurydice
Jane Yolen - After Cancer
Shannon Olin Kresge - One Good Thing About My Yearly Mammogram
Alysa Cummings