Writing Through Cancer

With only the pages of People

and Time for amusement, who would not

feel afraid?

(From:  “In the Waiting Room,” by David Bergman,  Poetry, December 1986)

We are all forced to wait more than a few times in our lives. Those toe-tapping, check-our-wrist watches moments are minor irritations that we all endure.  We wait in lines for tickets or to get through security at the airport.  We wait to be served in restaurants or for a train in the subway station.  We wait for calls or letters from employers, editors or loved ones, for acceptances to schools, or the results of medical tests.  And we wait in hospital or physician’s waiting rooms for the appointment scheduled well over an hour earlier, thumbing impatiently through outdated magazines and checking the clock a dozen times, unable to concentrate on much of anything but the waiting.

Three of my mornings last week were spent in hospital waiting rooms.  I sat with other patients and waited for my name to be called for tests, blood work, and physician consultations.  Thankfully, most of my appointments were completed without too many delays, but occasionally, as I experienced earlier this summer, the time spent in a waiting room can be extreme, testing my patience, ability to “hear” what a physician says by the time he finally walks into the examination room, or undermining the sense of confidence I might have felt about his medical advice and conclusions. In that instance, the impact of an extremely long period of waiting was so extreme I requested a second opinion, which occurred last week.  Thankfully, this physician was on time, listened patiently and took the time for a thorough assessment.  I was armed for a wait, however, arriving with a novel to read and a notebook to write in.

Dr. Sheila Wijayasinghe, writing in a recent Globe and Mail column, offered a physician’s perspective on the time patients’ spend waiting.  “No doctor likes running behind,” she wrote, “and most try to keep on time out of respect for patients’ schedules and busy lives. But even with the best of intentions, we end up running behind due to unpredictable circumstances. She offers examples of the common reasons that lead to patients’ waiting.

.  Getting a call from a specialist that a patient has been admitted to hospital.

.  Urgent walk-in patients arriving who need to be seen quickly

.  A patient arriving late for her appointment

.  A patient with a condition requiring additional time

.  And in some cases, double or triple booking in an attempt to accommodate all patients needing to be seen.

Yet, no matter the reasons, there is a kind of waiting no one finds easy, the kind of waiting punctuated with worry and sleepless nights, waiting that may become a matter of life and death. Anyone diagnosed and living with cancer knows this kind of waiting intimately.  In the course of treatments and recovery, waiting can be torment, as writer Susan Gubar describes in “Living With Cancer: Hurry Up and Wait.”

As a cancer patient, you endure “waiting for a doctor, waiting for radiation, waiting for the delivery of chemotherapy drugs, waiting through interminable infusions or transfusions, waiting for a scan or a biopsy, waiting for the results of a scan or a biopsy, waiting (sometimes starved and unclothed on a gurney in a hall) for surgery… Hurrying up to wait is, of course, the fate of most patients, whether or not they have cancer and no matter how impatient they may be. But for cancer patients, waiting entails being enveloped in heightened fears about harmful protocols and the difficulty of eradicating or containing the disease. While I’m waiting, who knows what appalling cells are conspiring within my body to destroy my being? (In:  “Well,”  New York Times, December 3, 2015)

A 2011 research study reported in The Annals of Surgery found “wait times for cancer treatment have increased over the last decade… potentially resulting in additional treatment delay…Although cancer incidence rates have seen modest declines during the last decade, the overall number of patients diagnosed with a solid organ malignancy has been increasing, likely due to an increasing elderly population.” What’s more, waiting can have more negative impact that simple frustration.  An extended interval from diagnosis to treatment, the researchers concluded, adds to patient anxiety, leads to gaps in care, and perhaps affects disease progression.

Participants in my expressive writing groups often express frustration in the amount of waiting involved to be tested and then receive the results of those tests.  If you’ve been faced with the anxious period between any test for cancer and its results, Muriel Fish’s poem, “In Cold Dreams Before Dawn,” captures the  how waiting can escalate fear and worry:

…The radiologist

Enters, snaps the x-ray film into a wall unit lit with

brisk efficiency…

…the bite of the biopsy needle reminds me

most lumps are benign…

…I wait, remembering long

Bittersweet days sitting with my mother and sister,

each with their own small malignancy and dead within three years.

(In:  The Cancer Poetry Project, V. 1, 2001)

Robert Carroll, MD,  a UCLA psychiatrist, utilizes poetry to help patients cope with illness and struggle.  In a 2005 paper, “Finding the Words to Say It:  The Healing Power of Poetry,” he explored how poetry can help us find the words to express trauma, illness, death and dying.  “What Waiting Is,” one of the featured poems, captures, for me, the emotions that often accompany the waiting room experience of parents, spouses, and family members.

We sit on the bench in the hospital corridor
next to the cafeteria, and we wait.
You know what waiting is.
If you know anything, you know what waiting is.
It’s not about you.
This is about
illness and hospitals and life and death…

In matters of death and dying, we may be forced to do little but wait while our emotions run rampant.  Finding ways to express pain and emotion by writing or discovering meaning in others’ poetry and prose can have therapeutic benefits.  Certainly, it has for me.  Poetry has helped me put words around tumultuous emotions more than once, but this poem, “What Waiting Is,” captures the emotions I felt in the hours preceding the death of my parents, one from lung cancer and the other from Alzheimer’s.

In the bathroom you look in the mirror.
What do you see?
Your father’s sad face?
Your mother’s eyes?
You catch the water cupped
in your thickened hands, splash it on your face,
and hope against hope you can wash it away—
the aging brown spots, the bags,
the swelling truth of waiting—…

you get home to see the light
flash on your answering machine…

you push the button,
and it’s your sister’s voice,
but it’s choked,
and she can’t speak.

 Waiting never seems to get easier, although you may, as I have, become more “seasoned” at doing it as your time in waiting rooms increases.  But there are inevitable times, particularly in the midst of any serious illness, trauma or suffering, that the waiting we must do seems endless.  Perhaps learning to wait, like it or not, is a life lesson we are forced to endure–and to master.

I recall the words of T. S. Eliot in The Four Quartets, “I said to my soul, be still and wait without hope, for hope would be hope for the wrong thing; wait without love, for love would be love of the wrong thing; there is yet faith, but the faith and the love are all in the waiting…”  (East Coker, The Four Quartets, 1940)

The faith and the love and the hope are … in the waiting.  These words make me reconsider why life makes us wait.  I am still learning, even after all these years, to accept what I cannot control, to let things unfold as they will.  “This is life.  You learn to wait.”

Writing Suggestions:

Like you, I’ve sat in many waiting rooms, worried and anxious, as a child or spouse underwent surgery, or waited for the call I dreaded but knew would come as my parents were dying, and waited for the results of echocardiograms or a biopsy.

• What has been your experience of waiting?
• Think about all the times you’ve waited for something or someone, whether in a medical waiting room or at another time in life, whether worrisome, painful or even humorous (once, of course,  the waiting ended!)
• Write about what it’s like to be caught in the “helplessness” of waiting.