cour·age:  noun

1. the ability to do something that frightens one.
2. strength in the face of pain or grief.

–(Oxford Languages)

It is in the small things we see it.
The child’s first step,
as awesome as an earthquake.
The first time you rode a bike,
wallowing up the sidewalk.
The first spanking when your heart
went on a journey all alone…

I doubt you need to look beyond your neighborhood or community to name more than one cancer survivor, a patient living with a progressive heart condition, or some other debilitating or life threatening illness, whose determination and bravery in the face of considerable odds has inspired you. You may call them courageous, and in fact, I think they are, but it’s not a kind of courage that comes easily or without its familiar sidekick, fear.  In life-threatening, terminal illnesses, fear is never far from consciousness.  Courage won’t cure a terminal diagnosis, so I wonder what we mean when we call someone living with a progressive and life-threatening illness “courageous.”   

Courage, for me, seems to have more to do with putting one foot in front of the other, in not putting on a mask of a brave front for our loved ones, even though we may feel we should.  I think courage has much more to do with honesty, with facing the truth of our situation, the fears and the sorrow, and yet, not letting those emotions overtake us.  Courage is facing up, to the fear of mortality and the progressive reality of the medical condition we have and yet, to find ways to live as fully as possible despite the odds.   And that’s not easy.

It’s one of the reasons I am continually inspired by the men and women who participate in my writing groups.  We mean well, calling someone with a life-threatening illness, “courageous” and ignoring the fact that the very label denies them the freedom to express the truth of what they are experiencing. Expressing the truth of one’s experience is one of the powerful aspects of the writing groups I’ve led for so many years.  Having the freedom to relieve the burden those fears and concerns on the page, that simple act of honesty and release, is freeing, but it is far more than just release: it is the discovery that they are not alone in what they are feeling or fearing.  The honest expression and release, coupled with the support of others similarly diagnosed offers a chance to discover they are not alone in what they feel or fear—and out of that shared experience, a sense of community begins to form. 

That sense of community–of finding others who share similar fears and feelings–is part of what helps many patients feel less alone. I think it also enables them to be more courageous. I remember one particular l one cancer patient who participated in my writing groups several years ago.   Diagnosed with breast cancer, S. first attended an introductory workshop I led at a San Diego cancer center in 2008.  More than a year passed by before our paths crossed again.  When we met a second time, she enrolled in the ten-week writing workshop series I was leading for another cancer center.  Her cancer had, unfortunately, become metastatic, and its spread was rapid. When we began the series, she often volunteered to read aloud. I could hear the shift in her writing as it grew in expressiveness and depth, something I’d witnessed before with terminal patients.  Coming to terms with mortality forces us to go deeper into the unexplored regions of our own darkness and to write honestly and authentically from that place.  Simply put, it is having the courage to “tell the truth,” what writer Maxine Hong Kingston advised the veterans do as they wrote with her about their traumatic experiences of war.

Later,
if you faced the death of bombs and bullets
you did not do it with a banner,
you did it with only a hat to
cover your heart.
You did not fondle the weakness inside you
though it was there.
Your courage was a small coal
that you kept swallowing…

To write the truth of our inner lives, of our experiences, is a courageous act. To write honestly avoids the pretense of being “brave” or “courageous.”  It avoids showy descriptions or flowery language, because living with the reality of a life threatening illness forces us to confront all we taken for granted and define what, in our lives, is truly essential—what matters most. That honesty in the face of dying is probably what I find most courageous among many patients who have participated in my writing groups.

As the writing series progressed, so did S’s cancer.  The toll on her body and spirit was apparent to the group.  When she began struggling to attend the sessions on her own, another group member volunteered to drive her.  She lost the use of one arm, but determined to write, she bought a laptop to the sessions and tapped out her stories with one hand.  One morning, late in the series, S. lost her balance and fell as she tried to take a seat at the table.  Several members jumped up and rushed to her side, but she brushed them away, determined to get on her feet by herself and take her usual place.  But we all knew the progression of her illness was quickly intensifying.   By the final weeks, she had been forced to give up her apartment and move to assisted living, no longer able toc attend the writing group.  We dedicated our booklet, a collection of shared writing, and sent it to her.

Nearly three months later, as another writing workshop series was beginning, S. sent me an email.  Wheelchair bound, she was now receiving full time care in a nursing home, but she still wanted to participate in the writing group.  She asked if there was a way she could do it by email (ZOOM was an unknown in those years). My “Yes!,” was immediate.   I sent her the prompts ahead of each session, and in turn, she emailed her writing to me to share them with the group.  The group members, in turn, offered their positive comments to her writing which I captured in an email and sent to her after each session.  By then her writing was little more than a single, brief paragraph in length, but her tenacity, honesty, and humor were as present as ever.  There was rarely a time that members didn’t have tears in their eyes when I shared her writing aloud. 

S’s courageousness and determination to accept her illness and yet find ways to do what she loved and what kept her connected to others is only one small example of the kind of courage I witness repeatedly among the men and women who participate in my writing groups, whether living with cancer or heart disease.   Courage, as defined in the Oxford American Writer’s Thesaurus (2004), is a quality that endures through difficult times, as so many of these of these men and women have demonstrated.

Courage is what makes someone capable of facing extreme danger and difficulty without retreating…it implies not only bravery and a dauntless spirit but the ability to endure in times of adversity.  (p. 187)

True courage, as S. and so many others have shown me, endures.  It doesn’t retreat despite great difficulty or danger.  S. openly shared her journey with us, and as her life was ending a few months later, she was supported by many who had also been in the writing group, who had experienced cancer but who had been touched by her indomitable spirit.  I have often wondered if I were faced with the same hardship as S. and as many others in my groups over the years, would I be as courageous?

Later,
when you face old age and its natural conclusion
your courage will still be shown in the little ways,
each spring will be a sword you’ll sharpen,
those you love will live in a fever of love,
and you’ll bargain with the calendar
and at the last moment
when death opens the back door
you’ll put on your carpet slippers
and stride out.

(From “Courage,” by Anne Sexton, In:  The Awful Rowing Toward God, 1975)

Writing Suggestion:

• This week, think about courage, what it is, how you define it.
• Have you discovered unexpected courage in yourself you didn’t know you had? 
• Has someone else inspired you with their courage? 
• This week, explore courage:  what it is, and what it looks like, where you find it, or someone who has inspired you with their courage.