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October 3, 2021: Haiku: a Way to Express the Experience of Illness

There’s something about the approaching autumn, for me,  that invites more quiet reflection, a daily tumble of memories.  Nature’s seasons are an apt metaphor for aging, something we become more aware of as the years pass or serious illness strikes.  I think of my own life now as synonymous with autumn, reminding me of how human life is so intimately connected to Nature’s seasons–metaphorically and physically.  Seasons, whether nature or the human life cycle, invite reflection and expression in the metaphors of poetry—none quite so elegant as Japanese haiku.

A few years ago,  I was invited to speak about the expressive writing programs I lead with a visiting group of medical students from Dokkyo University in Japan, hosted by the UCSD Moores Cancer Center in San Diego.   Not only was I challenged to explain the research and practice highlights of expressive writing in terms easily translatable to group whose English language skills were not well developed, but I also had to explain the definition and use of expressive writing while bridging the cultural differences between North American and Japanese populations.  To “tell the truth” of one’s painful or traumatic experiences and share it with others as is done in an expressive writing group is not common in Japanese culture. 

Haiku, however, is a poetic form that is part of the Japanese culture, so the medical students and I segued into an interesting discussion in how haiku might be used as a way to encourage Japanese patients to write and express their feelings about living with serious illness. Our discussion naturally migrated expressing the “seasons” of illness similar to the seasons of nature expressed in Haiku, and gave us additional possibilities for exploring haiku as as poetic form for cancer and other illnesses.

There was some precedent.  Shortly after the catastrophic Japanese tsunami of 2011, haiku became a popular form for the Japanese people to capture and express their pain and anguish in the weeks following the devastation and loss of life in the Tōhoku earthquake and tsunami in northeastern Japan. Writing for The Los Angeles Times, reporter Julie Makinen described how it began: “Amid the cacophony of news bulletins and tweets and cellphone  alerts registering yet another aftershock, Yoshikatsu Kurota quietly sent out his brief verse. … Seventeen Japanese syllables, radiating out into the universe, perhaps touching a few other distressed souls adrift in the chaos.”

About the nuclear power plant

too much detail I hear

such unhappiness

You Yasuhara, a Buddhist monk living in Kyoto and a practitioner of haiku,  wrote a haiku ultimately carved into a memorial stone in the city of Kyoto:

Days of disaster

I can never forget

the cold and wet

Creating poetry out of life’s hardships is an acknowledged healing practice and also a way for people to express grief and sorrow in the weeks after the U.S. World Trade Center attacks in 2001.  ‘In times of crisis it’s … always poetry,” former U.S. Poet Laureate Billy Collins remarked in a New York Times article. “What we want to hear is a human voice speaking directly in our ear.” I often use poetry to inspire writing in my groups, and on several occasions, we’ve explored the illness experience through writing haiku.

The essence of the haiku form lies in its brevity and visual intensity.  In seventeen short syllables, it paints a picture in the readers’ mind, calling our attention to an observation and the story hinted at behind the image.  Its most common form is written in three lines, the first line five syllables long, the second, seven, and the third, five, for a total of seventeen syllables, although when translated from Japanese, is not always perfect.  This week I stumbled on the British blog site, authored by https://heartytalescouk.wordpress.com/, authored by Laura Donald, a heart failure patient, which regularly invites its readers to write haiku expressing the experience of heart failure and cardiac disease. 

Stairs like a mountain.

I start to climb – my heart sinks

Like my oxygen.

(https://heartytalescouk.wordpress.com/)

Pulse:  Voices from the Heart of Medicine, www.pulsevoices.org, another great site for patients and medical practitioners, routinely publishes personal essays and patient haiku expressing the medical experience in its weekly issues.  Some of my former writing group members have had their writing published in Pulse.   And, as it turns out, I received a “Call for Submissions” from Pulse for haiku expressing the medical experience just this past week. It’s a great opportunity to try your own hand at creating haiku that express elements of your experiences as either a cancer or a heart patient. The deadline for patients and healthcare professionals alike is October, 31st.  

cancer support group

a circle of sympathy

which leaf will be the next to fall

(By Cynthia Colby, in Pulse)

The essence of the haiku form lies in its brevity and visual intensity.  In seventeen short syllables, it paints a picture in the readers’ mind, calling our attention to an observation and the story hinted at behind the image.  Its most common form is written in three lines, the first line five syllables long, the second, seven, and the third, five, for a total of seventeen syllables, although when translated from Japanese, is not always perfect.  Haiku also teaches us the power of observation, of being present to the here and now.  It can also be a short-hand route to express suffering and pain, as the tsunami haiku shows us, and used to express the medical experience, because it offers an alternative way to express what you are feeling, while finding, perhaps, metaphors in Nature too.

Haiku also offers us more. While the first level of Haiku is always located in Nature, the second is most often a reflection on Nature.  In haiku, a dialogue with Nature is more than just observation; it takes us inside ourselves.  Writing haiku is a kind of meditation,  calming, and quiet.  It takes us beyond the sorrow and pain to notice the fleeting moments and beauty in Nature, and that fosters gratitude.  Perhaps haiku, poetry in its simplest form, offers not only a way to find words to express our suffering, but also encourages to pay attention to Nature and the beauty around it. Perhaps the little three line poetic form is a prescription for a more observant life.

Open House for Butterflies, 1959

Writing Suggestion:  

This week, try using Haiku to express your experience of living with cancer or a serious heart condition in three lines lines, 5, 7, 5, for a total of seventeen syllables.  If you’ve been reluctant to try writing poetry, haiku offers you a very simple, but powerful, way to begin.  You might find inspiration in some of the haiku previously posted in Pulse.

Interested in submitting your haiku?  Pulse:  Voices from the Heart of Medicine is seeking haiku submissions on the medical experience.  Here’s where to find their haiku guide:  https://pulsevoices.org/index.php/haiku-rules-of-the-road. You can submit up to three haiku for consideration.  Deadline is October 31st.   https://pulsevoices.org/index.php/category/haiku

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September 22, 2021: Our Stories: Our Legacies

“Death steals everything but our stories.” – Jim Harrison (“Larson’s Holstein Bull”)

She was first diagnosed with metastatic cancer in 2014, but N., one of my former writing group members recently died after a valiant struggle less than two months ago.   Her struggle was a valiant one amidst considerable odds, but she began, in the months after her diagnosis, collecting poems and quotations that, as she put it, “uplifted me.”  A year or so later, N. joined one of my “Writing through Cancer” workshops.  She. embraced the expressive writing approach and continued to explore and deepen her writing, studying with author Natalie Goldberg and poetry with haiku masters.  She also a two year study of teacher training in mindfulness meditation training with Jack Kornfield, even as she was weakening and hospitalized for infections.  In short, N. was a person a who inspired not only me, but many of the people who knew her.

I believe the greatest teachers in my life have been the men and women in my writing groups, like Nan, who have shared their experiences of living with metastatic cancer over the years.   While I have mourned their deaths, even years later, their memories are vivid in my mind.  The writing they shared was as powerful as any found in published memoirs and poetry collections—even more so for me, for they are the living legacies of who they were, what they experienced and what they endured.

“I will tell you something about stories.  They aren’t just entertainment.  They are all we have to fight off illness and death.  You don’t have anything if you don’t have stories.  (Leslie Silko, Ceremony)

N. was such an inspiration.  She was, I knew, intent on writing a book before she died.  We had exchanged emails about the possibilities—and challenges—a year before her death.  Her plans crystallized in Spring of this year:  it would be a book to give to her partner, family, close friends, and teachers before she passed.  And, at the end of July, I was delighted to receive her gift of the book in the mail.  Entitled Legacy of Love:  Gifts I Received on the Path of Life, it is a beautiful book:  professionally bound, illustrated with her partner’s nature photographs, and filled with the reminiscences, stories and learnings from her life and cancer experience.  Quotations, meditations, prayers, and poetry that she found meaningful are interspersed among the stories of her life’s journey.  Writing prompts she’d experienced in the writing groups and other workshops are followed with her written reflections and haiku. 

It was a deeply moving experience for me to read N.’s book; I lingered over the pages, remembering her presence, the enduring love and support of her partner she’d often written about, and her deeply moving prose.  I immediately wrote to her, expressing my gratitude for such an intimate gift of her life.  In the weeks that followed, I returned to it again and again—and a week or so ago, I was moved to write her again to express my gratitude.  But unlike before, I heard nothing in return from N.  I contacted her partner and learned she had died, apparently within a day or two just after I had received her book.  My sorrow was softened because I felt Nan’s presence so vividly between its pages.

My story is myself: and I am my story. This is all you will know of me; it is all I will know of you. This is all that will survive us: the stories of who we are. — Christina Baldwin, Story Catcher

Her death saddened me, yes, as the deaths of others have who have been part of my writing groups.  Yet I was reminded again of how fortunate I am to witness and experience the many gifts of poetry and stories written and shared in the workshops I have led for so many years.  I still hear their voices and remember their faces as I read and re-read some of their stories or poems—ones that frequently took my breath away with its power and depth, ones that still bring tears to my eyes with its honesty and poignancy, writing that was lyrical, poetic, profound—the stories of their illness experiences, of their lives.  Writing I have wished more than once could have been shared with their doctors to illuminate the patients’medical experiences:  the good, the difficult, and the sometimes cold and impersonal.

Their stories, yours, mine—it’s what we carry with us on this trip we take…we owe it to each other to respect our stories and learn from them.

Advice to a medical student by William Carlos Williams, physician and poet

Patient stories have begun to be recognized as important to the medical experience, thanks to the work of Rita Charon, who created the term, “narrative medicine,” a medical practice that uses patient stories in clinical practice, research, and education as a way to promote healing.  Storytelling, as several researchers suggest, is a powerful tool for patients and healthcare providers alike.  It provides the patients with a way to give voice to the experience of illness and, in turn, to begin to confront their illness, questions of care and mortality. 

Stories offer insight, understanding, and new perspectives. They educate us and they feed our imaginations. They help us see other ways of doing things that might free us from self-reproach or shame. Hearing and telling stories is comforting and bonds people together….Being able to narrate a coherent story is a healing experience.2,3… stories keep us connected to each other; they reassure us that we are not alone.Miriam Divinsky, MD, Can Fam Physician. 2007 Feb; 53(2): 203–205.

Illness, unexpected tragedy or hardship may be the triggering event in our lives that ignites the desire to write, but what I experience with every writing group in the weeks together, is that other stories begin to be written — stories of love, loss, family, childhood, life’s joys and sorrows.  These are the stories of the experiences that make us unique, that make us human.  Writing and telling our stories offer a way to understand and make sense our lives.  In sharing them, our lives are affirmed, our legacies articulated.   Our stories say: “This is my life.  This is what I have experienced.  This is important to me.  It is what has shaped me into the person I am.” 

But in order to make you understand, to give you my life, I must tell you a story—and there are so many, and so many—stories of childhood, stories of school, love, marriage, and death. — Virginia Woolf

As I write now, I instinctively reach out and touch N.’s book—her stories and poetry; her life captured in its pages, her willingness to look death in the face, to ask herself the hard questions, to give us glimpses of what she suffered, feared, learned and loved and ultimately how she prepared herself for death, just as others faced with the prospect of mortality have written and expressed, sharing their lives, their fears and courage, so honestly and poignantly.  It is an extraordinary gift, a way to remember, a gift from the heart.

Poetry, stories:  it’s what I carry with me…and, I hope, what I can leave behind to say, “This was my life.  This is what mattered to me.”  (N., 2021)

Writing Suggestions:

  • What are the stories you want to tell?  The ones about you, your life, what matters most?
  • Has your illness broken you open?  Offered new insights or ways of seeing your situation?
  • What has had the most impact on your life?  Try this three part exploration:
    • Who were you?  (Look to your past)
    • Who are you now?
    • Who are you becoming? (What are you learning about yourself now?)
  • Use a line from a poem, essay or story that you love.  Begin with that line and then keep writing—wherever it takes you.  Here are a few you might try:
    • “Starting here, what do you want to remember?”
    • “Before you know what kindness is, you must lose things…”
    • “It is in the small things we see it.”
    • “Let the hard things in life break you.”
    • “I am falling in love with my imperfections.”
    • “But my heart is always propped up in a field on its tripod…”

August 31, 2021: I Guess That’s Why I Called It the Greys

Everywhere in North America, children are heading back to school…only it’s not with quite the same unabated enthusiasm for many youngsters and their parents.  COVID, despite the many months of lockdowns, social isolation and available vaccinations, hasn’t finished with us, as the Delta variant and climbing case numbers demonstrate.   Since my three grandchildren are beginning another school year, I can’t help but wonder about the spread of the virus among schoolchildren who have not, as yet, been eligible for vaccinations. 

That low level anxiety lingers–all too frequent a visitor in my life during the past year and a half. While my husband and I enjoyed some of the gradual opening up of restaurants, galleries, and stores during the summer months, we also remained cautious.  Then the dog days of August descended with haze, heat and oppressive humidity. That, coupled with the daily reports of drought and wild fires around the world, put the reality of advancing climate change into sharper focus, and coupled with the rise in COVID cases, my anxiety rose.  The blistering heat forced me back indoors, which was all too reminiscent of the months of lockdown.  Days dragged, headlines screamed disaster, and my spirits took a nose dive.

Mornings, which are my quiet time for writing, offered little relief.  For many days, my notebook pages contained more white space than words.  I couldn’t seem to get inspired, unable write through my monumental case of sagging spirits.  The days seemed cast in muted, colorless tones. And worse, when I looked at myself in the mirror, my image reflected back seemed dull and grey, just like my mood. I remarked to a friend, “In these times, grey has become a primary color.”

That one spontaneous sentence, and the next day, my associations with “grey” came out of hiding.  I recalled Mordecai Richler’s wonderful children’s book, Jacob Two-Two Meets the Hooded Fang, published in 1975, read and re-read to my young daughters.   Jacob, is a  young boy in a large family who has to repeat everything twice just to be heard, which results in his nickname, Jacob Two-Two. His habit is also the reason he is misunderstood and considered rude. All of it results in his being punished and sent to the children’s prison,  “Slimer’s Isle,” which is run by the Hooded Fang.  Slimer’s Isle is a place where captive children like Jacob never see the sun.  The image of that sun-less place seemed a perfect description for the grey mood that had lingered in my psyche for months. 

Yet Remembering Jacob Two-Two and Slimer’s Isle was also an inspirational nudge.  It was enough to inspire me to a fruitful morning writing, and this time, the words came.  I had fun tinkering with the song lyrics of  “I guess that’s why they call it the blues,” substituting the color grey and adding a few lines about COVID in my version. While it’s hardy ready for public consumption, my husband and I had a laugh over my attempt at song lyrics.   A day or two later, time spent with my granddaughter led me to the old memory of the Crayola Box of 64 colors—an item which accompanied every “back to school” bag during my childhood.   Grey was my most unused color in the box, but thinking of it transported me to the memory of  a delightful poem about color written by a medical student in a writing workshop I led for faculty and students of Stanford Medical School in 2015.

I used color as a writing prompt.  To get people inspired, I spread out a handful of paint color chips on a table.  Not only are a full range of colors represented in the interior paint chips , but they have somewhat exotic—one might even say “silly”—names, such as “first light,” “little princess,” “dinner party,” “head over heels,” “windmill wings”…  Whether using the color or the names associated with them, participants had great fun working them into poems and stories.  But one med school writer’s poem stood out above all the others.  She had chosen the least popular color of the lot:  grey, labeled “hickory smoke.”  When she volunteered to read aloud, we were in awe of how she’d brought that mundane color to life.   Here is an excerpt of her poem, simply titled “Grey”:

…“Air with dirt,” they say.

Floating soot clamoring cold and unwanted

against a clean white wall…

…Grey is the color of “yes, life has been here,”

and “don’t you know I have a story to tell?”

Grey is the sidewalk that’s been walked,

the white house that’s been lived in…

White is before, but give me the after

Give me the ninety-year-old under her old grey comforter.

Has she lived? Well, tell me the color of her soul.

Show me the spots of grey, and tell me how you’ve lived,

the story printed dark and true in the deepest, most imperfect,

ugliest and sweetest shade.

–Workshop Participant, 2015

It’s probably no surprise that after re-reading her poem again, my grey mood had begun to dissipate.  Since then, I’ve pulled my ancient and well-worn copy of Jacob Two-Two from the shelf to recall his experiences on Slimer’s Isle, how he won over the Hooded Fang and returned to his family a hero.  I suppose that all the little memories of grey served as a reminder that while life has been difficult, and despite Zoom, lonely at times, it’s within my control to find ways to navigate this rather strange “new normal”  with a more positive outlook.  Even in the greyest of times, it seems we can find new insights, ideas, perspectives.  School is starting for my grandchildren, my teaching daughters, and even for me, beginning new series of writing workshops for cancer and heart patients.  This is activity I truly look forward to, and I am particularly grateful that despite these months of lockdown and isolation, I can be engaged in meaningful ways.  While my mirror doesn’t lie—I am getting grayer–but that would have happened even without COVID! So grey hair or not, I’m engaged in ways that matter to me.  And that’s  how I want to live.

 “Show me the spots of grey, and tell me how you’ve lived…”

WRITING SUGGESTIONS

.  How have you navigated the long months of COVID isolation?  What kept you going?

.  Did you experience “the greys?”  or “the blues?”  What helped you through those less positive moods?

.  Pull up a color wheel on the web—or open a box of 64 colored crayons.  Choose a color, any color. Make a list of what comes to mind for just 3 minutes.  Read it over, then choose one thing from your list and write for 15 minutes.  Try playing with a narrative or a poem that uses that color in it.

.  Did COVID help you gain clarity about what matters most in your life?  Write about the lessons from lockdown.

.  Back to school.  What memories do you have from your childhood about a new school year beginning?

August 13, 2021: Returning to the Page

Even as we inoculate our bodies and seemingly move out of the pandemic, psychologically we are still moving through it to make space for this individual land collective trauma. – Deborah Siegel-Acevedo, Harvard Business Review, July 1, 2021

Two  months ago, I took a  break from the many workshops I’d facilitated in the past academic year.  The virtual experiences, which while offering a way to continue to our cancer and cardiac patient writing groups, seemed to take much more energy to lead without the in-person interactions among the group members.  Still, I was grateful we could offer them via Zoom. 

Yet so much of my daily life had become virtual:  meetings, doctor appointments, grocery shopping, chats with friends and family.   Spending so much of one’s life in virtual interactions produced a different kind of fatigue, felt deeply, and with it, a pervasive kind of  spiritual malaise.   What strange new world was I living in?  What would “normal” life look like once the pandemic ended?    I began to shun the daily news headlines and reports.  Reading them was anxiety-producing and depressing–even confusing much–of the time.

I turned to my morning writing practice as a way of relieving my feelings of sadness and worry, hoping to find a little bit of solace in the midst of the pandemic storm—but as the lockdowns continued,  my pages were becoming filled with the musings of a woman who was anxious and slightly depressed—feelings which  I’ve since discovered were common among many of my friends.   There were days I wrote little more  than a paragraph or two, and more than a few pages dominated by the mood of the isolated existence of lockdowns and waiting for a second dose of vaccine. 

Cold comfort perhaps, but my experience wasn’t unusual.    “Depression among adults,” Siegel-Acevedo wrote, “has increased three-fold since the pandemic began.”  When I read the statistics of rising case counts, vaccine shortages and losses of life, I was chastened.  My situation was relatively safe and comfortable compared to the losses of so many others.  I got tired of myself.  “Pull up your big girl pants, Bray,” I murmured one morning after a particularly fruitless writing time.   I needed a cognitive overhaul. 

I took a break to shift gears, break the cycle of “the blues,” and return to my writing  with the goal of making sense of these past many months,  not to ignore or suppress what I was feeling, but to express it, detail it, and in doing so, move through this strange chapter with some greater understanding of what impact this pandemic has had on me, my life, the way I think about the future now.  What had I learned about myself that could be used to positive effect—even if ZOOM workshops are going to be in my life yet for some time to come.   After all, the good news is that many more people, coast to coast, had access to the online writing workshops.  And writing, Siegel-Acevedo’s article remind me, has always help me—and many others—navigate the painful and difficult times in my life, invariably leading to discoveries of possibilities for my life to be even  more fulfilling or meaningful.

“Writing expressively,” she stated, “can also lead us toward hope…writing our pandemic stories to remember…and to envision ourselves whole again…to sit with and determine the meaning of our …human experience and existence.”  And in a world with so many people in need and suffering, with climate change undeniably critical, how might this experience inform the actions we take, the ways we live.

Siegel-Acevedo quotes the 13th century Sufi poet Rumi, near the conclusion of her article. “The wound is the place where the Light enters you,” he wrote, something that expressive writing can also help us discover.  Writing honestly and deeply about our own pain and trauma can help make our fears, scars and traumas visible, where we can begin to understand them, make sense and learn from them.  We being to  realize we can change the way we are living and responding to people and events in our lives,  and that’s when healing begins.  Centuries later, Canadian songwriter Leonard Cohen echoed Rumi’s word in his now famous song, ‘Anthem’ written in 1992, his lyrics described by many during this most recent pandemic experience as “a beam of light,”  the words still relevant as we wait for this chapter of our lives to be behind us. 

The birds they sang
At the break of day
Start again
I heard them say
Don’t dwell on what has passed away
Or what is yet to be…

Ring the bells that still can ring
Forget your perfect offering
There is a crack, a crack in everything
That’s how the light gets in…

–Leonard Cohen, from his 1992 hymn, Anthem

Writing Suggestions:

  • Pandemics are historical events that have occurred throughout civilization.  Yet, when it began, it seemed unbelievable, almost surreal, most of us.  What do you remember most vividly?  Write about your experience of the pandemic:  the isolation, lockdowns, anxiety, concerns, losses, coping strategies, lessons. 
  • Where did you find relief from the anxiety and constant barrage of fear-arousing news?  What gave you solace?  Hope?
  • How did the light find its way in for you?
  • How has your sense of what’s possible in the future changed?
  • What books, songs, poetry or other music gave you respite and comfort?  Why?
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June 22, 2021: A Time for Quiet

Best of any song
is bird song
in the quiet
but first you must have the quiet.

Wendell Berry, A Timbered Choir: The Sabbath Poems, 1979-1997

It’s been an especially busy last few months, heightened the socially restricted way of life demanded by the COVID-19 pandemic.   Interactions with family,  friends, and my expressive writing workshops have all been relegated to the disembodied realm of ZOOM.

Happily, we have begun the gradual opening up of a more normal life as vaccinations have progressed. ZOOM will remain a vehicle for my writing workshops, allowing much greater reach for those living with cardiac conditions and with cancer, but I am welcoming a summer’s respite from the virtual setting, a chance to be outdoors and re-acquainting myself with family and friends:  in person.

“What are you going to do now that you have no workshops for awhile,” my husband asked last week. 

“Be quiet,” I said.  “And putter.”  I have since decided that there is much to be said for the value of puttering about our apartment:  rearranging bookshelves, drawers and closets, changing artwork hung on the walls, tending to the potted plants on the balcony, settling into a book without any concern for a schedule of “must be done by” tasks, and not imposing any deadlines on my days.  Being quiet and puttering about are my ways of re-fueling and revitalizing.  Given the almost surreal existence of the past year or so, we all need that kind of time, whatever form it takes.

I am taking a brief hiatus from my blogs (www.writingtheheart.ca and www.writingthroughcancer.ca) for a few weeks    —  but if you’re looking for a little writing “inspiration,” the archives of each are chock-a-block full of old posts and writing suggestions.  In the meantime, enjoy the summer, the re-entry into a more normal daily life, and if you’re inclined, as I am, to putter about a bit—have at it! 

Thanks to those of you who either follow one of these blogs or occasionally dip into the content.  Happy Summer—May you all have the time and space to replenish your spirits. I’ll return to these blog posts later in August.

Sharon

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May 25, 2021: Who Were You Then? Advice for the Younger You

Why should we travel back, who’ve come so far— 

We know who we are. 

How can we be the same 

As those quaint ancestors we have left behind, who share our name— 

( by A. E. Stallings, “Written on the eve of my 20th high school reunion, which I was not able to attend”, In: Poetry, 2008)

It begins with a photograph, one of the few from my childhood I have, nearly all others destroyed when my parents’ home, the one I grew up in, went up in flames many years ago.  In it, we are in his mother’s living room, a drawing of the famous “End of the Trail” sculpture by James Earle Fraser, hangs on the wall behind.   I stand by my father, now seeing the resemblance between us—his high forehead, the set of his mouth and narrow face.  I was four, not yet in kindergarten.  My toddler sister stands in front of me, wide-eyed and inquisitive, a mop of curly dark hair framing her face, but   I stand back, close to my father, shy and somber. My hair is neatly braided, tied with large bows, and I’m wearing my favorite Mary Jane shoes with white socks, the straps buckled around my ankles.  I stare at the camera, unsmiling. My discomfort with the camera will last all my life, as will the shyness, which I will work hard to overcome in my adult years.  If I could, now speak to that four year old girl, what wisdom might I have to offer to her?  What care?  What encouragement?

One of the recent exercises I offered in my writing groups these past weeks was the task of looking back at their younger selves, imagining who they were then—what dreams, fears, and hopes they might have had at a much younger age.  I ask the group members to imagine themselves at a younger age, remembering an old photograph of themselves, or, if writing alone, to choose a photo of one’s self at a much younger age.  Then I introduce the prompt by saying something like, “Study the photograph or take time with that image of the younger you in your mind, noticing all the details:  stance, facial expression, eyes, age, clothing, setting, all the details you can take in.   Now, think about who you are now, what you’ve experienced in your life thus far, and knowing what you have experienced and lived as of now,, what would you say to that younger self? What advice would you give the younger you?”

Interestingly, a similar question was at the heart of two studies reported in The Scientific American in 2019, Robin Kowalski and Annie McCord, of Clemson University, asked more than 400 individuals about the advice they’d offer to their younger selves.  They also asked if there had been a pivotal event in the respondents’ lives that influenced their responses.  The majority of answers people gave fell within the categories of relationships, education, and advice do with the self, for example, “believe in yourself.”  Other categories reported included money, health, goals, and addiction.  Not surprisingly, peoples’ advice often reflected missed opportunities and situations that they could not now change.  But some other responses included reflection on circumstances where “corrective action” could still be taken if one was motivated to change, for example, “finish school,” or “drink less and run more.”

For many, their advice to their younger selves related to a positive or negative pivotal event in their lives, most often occurring in the teens, early 20s or 30s. For some, there were regrets expressed in the reminiscing, but the authors wisely remarked that although advice may offer advice to your younger self, it doesn’t mean you must live with regret.  Some of that advice may well be useful to your present self.  Besides, the practice of occasionally reflecting on your past and your experiences may also inform your present and the ways in which you want to change or live your life going forward. 

I return to study the photograph of my four year old self again.  I still remember the events of that day; I feel tenderness toward that serious little girl in the photograph because she’d accidentally witnessed an argument between her mother and her beloved grandmother in the kitchen. There was a kind of anger between them I hadn’t seen before, and I was confused.  Why were they shouting at one another? How had my petite grandmother had the strength to shove my sturdy mother backwards?  What had made them so very angry at one another?  How could I love them both at the same time?  There is much I would say now, these many years later, to that confused little four-year-old girl.

Looking back may bring up old unresolved feelings or emotions, but there is a plus side too. In doing so, we can learn from the past and how it can inform our present, even our future intentions. Looking back can give us an opportunity to take stock of past experiences and life choices and learn from them. It also reminds us and helps us see of how far we’ve come, and appreciate the life we have.    As Derek Walcott expressed so beautifully in his poem, “Love after Love,”

The time will come
when, with elation,
you will greet yourself arriving
at your own door, in your own mirror
and each will smile at the other’s welcome

Take down the love letters from the bookshelf,
the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.

(In:   Collected Poems, 1948-1984)

Writing Suggestion:

Try writing to that younger self.  Begin with a photograph of yourself at a younger age.  Examine the younger self who looks back at you.   Study it, noticing not only the features, look in the eyes, the facial expression, your stance.  Take time to remember who you were then, your hopes, dreams, fears, sorrows, and questions.

  • How would you describe the person you’ve become from the one you were then?
  • What was it like to be you then? 
  • What hopes and dreams did you have? 
  • What desires?  What worries? 
  • What advice, what words do you want to offer to that younger self.
  • What, in your life now, do you want to change?

Remember, looking back at your past, your younger self, can be more than a passing reminiscence.  Reflecting on who you were then, who you’ve become, can help you feel gratitude for your life but also clarify how the way you want to live going forward and things you want to achieve or change as your life continues.

May 11, 2021: Living the Questions

Like you, there have been many times in my life that questions seemed to dominate my thoughts far more frequently than answers.  In my youth, my burning questions were often about whether or not some high school “love” interest “liked” me or not.  I was terribly shy around the opposite sex, and at the time, as tall or taller than many of the boys in my class, which only increased my insecurities in the arena of teen-age romance.  Then there were questions about college:  Which one?  Where?  Would I do well?  What if I didn’t? 

Some years later and newly married, my first husband and I contemplated his choice of graduate schools.  Questions dominated our conversations for months. In the end, we opted for adventure (it was the time of youthful idealism and protests) and ended up in Ottawa, where he began his doctoral studies.  We were wholly unprepared for Canadian winters or the loneliness we felt at the time, but gradually, Canada began to be “home” to us, especially in the years after his death.    Decades later, after returning to California for several years with my new husband, he announced his decision to retire from academic life.  We had our own questions, but family, friends and acquaintances peppered us with their questions.   “What are you two planning to do now?”  “You’re returning to Canada? Why?”  Their questions prompted our questions of one another: “But what would we do there?”  “What about our friends?”  “Will we sell our house?”  “What if we spent six months there and six months here?” 

Our transition revealed not only questions, but the realization that we didn’t always share the same wishes and wants for our “What’s Next?” chapter.  Nights were often punctuated by restlessness, the questions invading my dreams.  My notebook was filled with questions, a continuous loop of repetition, and I wasn’t finding any answers in what I wrote.  I don’t quite remember how long it took or when, but we stumbled into a joint decision, downsized our lives, sold our home, and watched as the movers loaded up the van with our worldly belongings and set out, as we did, for Toronto. 

This past weekend, I presented a workshop for Young Adult Cancer Canada (YACC) on the subject of writing for health and specifically, writing alone.  The willingness to “live the questions,” to find yourself groping in the darkness, are part of what writing honestly demands. The answers, in life or in fiction, are revealed as you write, gradually writing yourself into knowing, but not without making your way through the dark before stumbling on a new insight..  E.L. Doctorow, author of the award novels Ragtime and Billy Bathgate, famously remarked that when one sits down to write a novel, “You can only see as far as your headlights but you can make the whole trip that way.”  

Life doesn’t come with a set of answers, but it is riddled with questions.  It’s like making our journey in that darkness of the unknown at times.  We navigate through it as best as we can, deal with unexpected events, difficult chapters, the illnesses and losses we experience.  Cancer is one of those unwelcome chapters in your life, and the journey through it is not unlike what Doctorow describes.  You survive the shock of diagnosis, the worry and after-effects of surgery and chemotherapy, roller coaster of recovery, but despite all that, you can’t see very far ahead.  There are no certainties.  Your life is punctuated by more questions than answers. “Has the treatment worked? How likely is my cancer to recur?  What if it has metastasized and is lurking somewhere else in my body? Stage four?  Then how long do I have?”  No one can offer you certainty.  You navigate through it all in the same way Doctorow described of writing, able to see only a short distance along the path, but gradually finding your way into the answers.

 “Questions in the Mind of the Poet While She Washes Her Floors, “a poem by” Elena Georgiou, poses several questions, ones that play in in the poet’s mind, and like life, don’t come with answers.  Here is an excerpt:


Am I a peninsula slowly turning into an island?

If I grew up gazing at the ocean would I think
life came in waves?

If I were a nomad would I measure time
by the length of a footstep?

If I can see a cup drop to the floor and shatter
why can’t I see it gather itself back together?

If a surgeon cut out my mistakes
would the scar be under my heart?

How much time will I spend protecting myself
from what the people I love call love?

Would my desires feel different if I lived forever?

  (In:  Mercy Mercy Me, © 2000)

Georgiou offers no answers to the reader.  Nor did Austrian novelist and poet, Maria Rainer Rilke (1875-1926) when he offered advice to a youthful protégé, published in his wise little book, Letters to a Young Poet.   “Don’t search for the answers,” he wrote, “which could not be given to you now, because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps then, someday far in the future, you will gradually, without even noticing it, live your way into the answer.”

Live everything.  Live the questions…  Live the questions nowLive your way into the answer.   I have often quoted Rilke to the men and women who attend my writing workshops.  His words are as insightful now as they were over a century ago.  Whether cancer or embarking on a significant change, living through the questions is not easy, yet it is all you can do. Your task is to be present, to pay attention and live life fully.  Not surprisingly, when you do, you often stumble upon the answers you seek. 

Writing Suggestions:

  • Whether you’re wrestling with the aftermath of a cancer diagnosis or some other unexpected life challenge, make a list of the questions that keep replaying in your mind.  Choose one and for 15 minutes, explore it as you write.
  • Recall an earlier time in life when you faced the unknown.  What questions did you have then, and how did you find your way into the answers?  Are there insights that may pertain to your current challenges?  Write about that time, the questions and how they were resolved.
  • You might use one or two of the poet Elena Georgiou’s questions as your prompt.  Choose it and again, writing nonstop for 15 minutes.  Then read over what you’ve written, underline those words or phrases that stand out.  In a day or two, you might begin with one of those phrases you underlined and explore it more deeply.  You just might discover some wisdom that leads you to some of the answers you’ve been searching for.

April 27, 2021: Once I was…But Now?

Six o’clock in the morning is never a good time to encounter one’s image in the mirror.  Certainly not for me.  My eyes still heavy from sleep, hair askew, and face washed clean of make-up the night before, I see a face that looks more and more like my father’s in his older years, and less and less like the image of myself I carry in my head, the one when I was somewhere around thirty-five, the barest hint of lines forming around my eyes, my hair thicker, longer and a shiny chestnut brown.  Some mornings, more frequent in these long, mind-numbing weeks of the continuing pandemic, I stare in disbelief at the reflection that looks back at me.  “What happened?” I mutter to my reflection.  “When did I become this older, grayer self? “

In the 1991 award winning Irish film, The Commitments, a mirror figures into the storyline as an ambitious Jimmy Rabbitte cobbles together a group of misfits into an almost-famous American style soul band.  The group briefly succeeds then falls short of stardom, due, in large part to their inter-band bickering. But Jimmy imagines fame, and in several charming sequences converses with himself in the mirror, pretending he is the interviewer and the interviewee,.  By the film’s end, the band has failed, and Jimmy is once again back at the mirror, reflecting on their demise and what he has learned from the experience.

We all have hopes and dreams, and some of them are tied to the fantasy that our bodies will never age or at least, not betray us.   We learn to deal with aging, that gentle nudge of reality as our joints stiffen or our hair thins or turns grey.  But when our dreams and desires are thwarted and we’re confronted with unexpected obstacles or events, we’re forced to reconsider and reflect, just as Jimmy Rabbitte, on what happened and why.

Cancer is only one of the life events that throws our lives into turmoil.  When that happens, we’re forced to re-evaluate and change, and that’s not a task for the faint-hearted, confronting the self we imagined ourselves to be and the thwarted dreams and hopes we once envisioned.  Even though they can be challenging, those necessary re-evaluations of our lives can be enlightening.

I recently read Between Two Kingdoms, the inspiring memoir by Suelika Jaouad (2021).  At 22, Jaouad was diagnosed with acute myeloid leukemia and given a 35% chance of survival.  Her hopes and dreams dashed, much of her life was spent in and out of hospital for the next five years until a successful bone marrow transplant put her cancer in remission.  While Jaouad had waged a heroic struggle during her illness and emerged cancer-free, she realized that though she’d survived cancer, she no longer knew how to live.  She embarked on a 100-day journey, accompanied only by her dog, travelling across the United States to visit people who had written her letters of support during her illness. Her journey also gave her the needed time to reflect on her five-year cancer ordeal and how it had altered her life and shattered the dreams she once had.  How would she re-define her life now that she was finally cancer-free?  In an NPR interview, Jaouad remarked, “The truth is that, for me, the hardest part of my cancer experience began once the cancer was gone…But being cured is not where the work of healing ends. It’s where it begins.”

It’s a different spin on healing, isn’t it?  Healing involves not only looking back, but the hard work of re-defining dreams and goals that are no longer relevant to who we have become.  Life teaches us, through unexpected disruptions, hardships, and disappointments that we can take nothing for granted.  And more, it means we have to take a tough look at ourselves in our own mirrors and come to terms with how our lives have changed—something Jimmy Rabitte and Suelika Jaouad also experienced.

It’s a process of slowing down, making the time to reflect and revise the way we want to live our lives.  It’s not unlike the hero’s journey we read in a good memoir: a vulnerable, searching narrator tries to make sense of his or her life in the wake of tragedy, upheaval or hardship.  Each is slowly transformed by their experience, and their lives changed.   This isn’t a struggle confined to memoir or fiction: our lives demand the same journey of us in the aftermath of any upheaval, tragedy, or life-threatening illness.  We too must hold up our metaphorical mirrors, remember who we were, but accept and honor who we have become; who we are now.   

LOVE AFTER LOVE
by Derek Walcott

The time will come
when, with elation,
you will greet yourself arriving
at your own door, in your own mirror,
and each will smile at the other’s welcome,
and say, sit here. Eat.
You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart
to itself, to the stranger who has loved you

all your life, whom you ignored
for another, who knows you by heart.
Take down the love letters from the bookshelf,

the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.

(Collected Poems, 1948 – 1984)

Writing Exercise

Begin with a photograph of your younger self—before cancer.    Reflect: What was important to you then?  What hopes and dreams did you have?

Then, compare that younger self to the person you are now, after the experience of cancer, of life having left its mark, visible or not. Reflect on how your life has changed.   What dreams, hopes or goals do you have for yourself now?

(If you’re having trouble getting started, use a simple “brainstorming” exercise, making a list of “I used to be ________________ but now I’m________________.  Then choose one or two of the points and expand them in your writing.)

April 11, 2021: Put a little Ha-Ha in Your Life

 Cancer is no laughing matter.  And as we’ve discovered, neither is the continuing presence of COVID-19.

Yet if you happened to pass by a meeting room in a cancer center or overhear the Zoom sessions where I lead writing programs those living with cancer, laughter is something you’ll hear.  Even though we’re writing about the emotional impact accompanying a cancer diagnosis, laughter is always part of our sessions.  Counterintuitive perhaps, but there’s plenty of evidence to suggest that laughter is good medicine, just as Norman Cousins described in his 1979 book, Anatomy of an Illness.  Cousins wasn’t the first to advocate for the healing power of laughter.  Mark Twain had already done so, writing, “The human race has only one really effective weapon and that’s laughter,” he said.  “The moment it arises, all our hardnesses yield, all our irritations and resentments slip away, and a sunny spirit takes their place.” 

I grew up in an extended family who loved telling humorous stories and sharing laughter together.  Losses were mourned, yes, but soon afterward, the funny stories that were associated with the relative were told regularly at our family holiday gatherings.  And more than anything, I remember the fun of sitting among my aunts and uncles and sharing the memories and the laughter.  Life became brighter; there was no time for a bad mood, and somehow, the humor seemed to bind us more closely together. 

The power of laughter to help us heal is so great that some time ago, reading a 2015 issue of CURE Today Magazine, it didn’t entirely surprise me that, according to author Jeannette Moninger, many hospitals across America offer laughter programs for cancer patients, no doubt inspired by Norman Cousin’s experience and the research on laughter’s benefits. Moninger described a few: 

At North Kansas City Hospital, patients can watch funny movies…Duke Medicine offers a Laugh Mobile, a rolling cart from which adult patients in oncology wards can check out humorous books and silly items like whoopee cushions and rubber chickens.  And the Big Apple Circus Clown Care Program sends…clowns to 16 children’s hospitals nationwide to help put smiles on the faces of ill children… 

Even as far back as the 13th century, surgeons used humor to distract patients from the agony of painful medical procedures.  (Given the absence of anesthesia, laughter had to be good medicine!)  Those early surgeons were on to something, borne out since by many research studies since.   Laugh, and not only the world laughs with you: your body releases endorphins, the “feel good hormones that function as the body’s natural painkillers,” Moninger states, “the same hormones that create the “runner’s high.”  Endorphins also decrease the body’s levels of cortisol, the hormone associated with chronic stress.  In fact, cortisol has a number of negative effects on our bodies, compromising our immune system, tensing up our muscles, elevating blood pressure—all of which laughter helps to counteract. 

We all need a little laughter in our lives, no matter if we’re dealing with cancer or in this extended time of COVID—whether in person or, as many of us are now, on Zoom with friends and family.  Laughter helps to overcome loneliness and the mild depression that many of us are combatting in these extended lockdowns.  We need to laugh just as much as sometimes, we need to cry.  As cancer survivor Jim Higley wrote in a 2012 issue of the magazine, Coping with Cancer, laughter became invaluable during his treatment and recovery:

when you are raised with the gift of laughter, as I was, it can’t stay suppressed forever. It’s too powerful. Thank goodness for that. I eventually could see bits of “ha-ha” in my own life. Certainly not in the cancer, but in the mind-blowing circumstances that suddenly consumed my life. And laughing at parts of those experiences made me feel a little more alive.

The funniest part of it all was that the more I allowed myself to laugh, the more therapeutic my tears became.

(“Finding Humor in the Midst of Cancer,” Coping with Cancer, March/April 2012)

Try it. It’s good to find something—even a small thing—to smile or laugh about.  Yesterday, my husband and I recalled the humorous story of my first—and last—blind date.  My grandson, age 12, has decided he can cheer up his grandparents by sending us emails from Japan, filled with various memes and online games, ones I have tried and failed to win, which amuses him and, of course, me.  Just the fact he has written with so many “resources” for humor counteracts the greyness of our COVID lockdown life.  It’s an email full of smiles.

Writing Suggestion:

Find a little laughter in your life this week.  Dig back into your memories this week—the fun times, when you laughed so hard, tears ran down your cheeks.  Take a break from writing about and instead, try writing a little humor.  (Even a medical experience can have humor at times.  I was once diagnosed as having a “loose screw” after suffering swelling and pain in my forehead, where I do have a steel plate.  It wasn’t a loose screw, as it turned out, just a need for taking antibiotics before dental work.  But the diagnosis gave us a good laugh, helped relieve the worry and got me to another specialist for a second opinion—one who provided the solution to my forehead discomfort).

Perhaps you have a few memories of times that made you smile, even laugh aloud whenever you think about them.  Write one, that funny story, and let a little “ha, ha” brighten your day..  After all, as Charlie Chaplin said, “A day without laughter is a day wasted.”

March 28, 2021: There’s Not a Book–or App–on How to do This

Siri, that monotonous virtual voice of iPhone assistance, has proven to an unreliable narrator.  Where I once counted on “her” for directions to my desired destination by her unflappable female voice through streets and freeways of my city and arrive at my destination without getting lost, I have been often been offered directions to places not in Toronto, but a city in Oklahoma or somewhere north of Algonquin Park. I confess that more than a few expletives have sometimes been uttered in Siri’s direction.   

How, I wonder, did I ever get from point A to point B in the years I was consulting with organizations scattered all over greater Toronto or the multitude of new technology firms in Silicon Valley?  But now, it seems we’ve all become seekers of much more than driving directions.  We search for advice and directions for navigating our lives.  Yep, there’s an app for all that.   On countless mornings my husband and I turn to our mobile phones for answers to our questions.  (I have dubbed my iPhone as “the fount of all available knowledge.”)  Sometimes I wonder how we managed to get through adulthood without the abundance of advice and information available in today’s world. 

The internet has no shortage of advice, whether we’re seeking advice on how to prepare food, get directions to places, assemble furniture, fill out required forms, deal with relationships, child-rearing, or emotional and health complaints.   How did we remember directions, facts and other things before the ease of our technology gave us instant answers?  I can’t help but wonder how my grandchildren will grow and learn with ever more sophisticated technologies as part of their lives.

Ask a question about anything, whether your mobile phone or the internet, and you’ll find a preponderance of information, self-help websites, blogs and books.  In 2011, Dr. Jim Taylor, writing for The Huffington Post, commented that whether forced to change due to unexpected illness, hardship or loss, there was likely a book, podcast or DVD offering you a step-by-step explanation on how get through your latest life upheaval.  By 2017 the self-help industry alone was valued at around $9 billion, and in 2019, at $11 billion.  Now it’s estimated to grow to over $13 billion by 2021. “Contrary to the assertions of just about every self-help book that has ever been written,” Dr. Taylor wrote, “change takes incredible commitment, time, energy and effort. Someone might be able to show you the way, but you have to make the journey yourself.”

 And making the journey yourself is something every cancer patient or survivor fully understands. 

Teva Harrison, award-winning cartoonist, who wrote and illustrated In-Between Days (2016), a graphic memoir of her journey with a life-threatening cancer.   “When I was first diagnosed, I made all these frantic lifestyle changes, as if I could turn back time, undo my bad luck.  I think a lot of us do that…I was frantic, driven by panic,” she wrote.   As her cancer progressed and treatment changed, she faced living with an ever-advancing and terminal cancer.  She wrote, “If we manage to stabilize it, it’s only stable for an indeterminate while…it’s only a matter of time before it finds a way around the barricades and begins to grow again…” 

Harrison’s cancer journey required she adapt to and navigate her life through constant change, yet even in the face of a terminal and progressive illness, she sought ways to enjoy what she could. “I mean, the cancer is here, and I have a life to live.  And sometimes living well includes eating something made with sugar or having a glass of wine with dinner,” not something she’d likely find to be advised by the health literature, yet necessary for her.   “I’m not going to be hard on myself,” she said, “I’m going to enjoy every minute I can.” Harrison did her best to enjoy the time she had left, widely mourned in Canada when she died at age 42 in the spring of 2019.  Her humor, honesty and sorrow continue to be cherished for many diagnosed and living with cancer.

Thankfully, there are a wealth of excellent cancer support programs and resources for those living with cancer.  Writing groups, such as I continue to lead, are one example.  The shared experiences of the cancer community can be a source of comfort, making you feel less alone or saying the things you find difficult to articulate yourself.  Again, and again, I witness the power of the group experience to help overcome loneliness, to give voice to feelings and fears, and, even as some face terminal diagnoses, to offer support in multiple acts of kindness—something far more meaningful than self-help books and sites can offer.

In the poem, “There’s Not a Book on How To Do This,” cancer survivor Sharon Doyle reminds us of the challenge of discovering your own way through cancer as she sketches the composition for her fall garden, her celebration of her cancer journey ending. 


There’s not a book on how to do this,
but there is an emphasis on composition.

The trucks that slug by under our window
hold trombones, mirrors, dictionaries.
It’s not my fault they invade
the calm of trees like cancer.  I

don’t have cancer anymore…

…I rarely remember the
uterus I don’t have.  One of my sons said,
“You were done with it right away, right, Mom?”
I guessed so…


(In:  The Cancer Poetry Project, v. 1, 2001, Karin Miller, Ed.)


There’s not a book on how to do this…” Cancer or any major life challenge doesn’t come with the luxury of a GPS or an “app” to help us navigate through our life upheavals, fears, or grief.  Yes, you may find help from others’ advice; you may have the comfort of family, friends and others, but ultimately, the journey is yours to navigate.  It’s a road full of unexpected twists and turns, conundrums and set-backs, yet with each step you take, you begin composing that new life, the one that honors where you’ve been and what you’ve discovered about yourself and the way you want to create your live going forward.  That is, truly, when healing begins.


Writing Suggestions:

As you write, reflect on your own life journeys and life during and after cancer treatment. 

  • What was most helpful for you as you navigated the rough waters of profound and unexpected change? 
  • What internal compass—your beliefs, aspirations, or faith—played a part in helping you rediscover hope and embrace a new life?
  • Based on your experience, what advice or suggestions might you offer someone just beginning the journey through cancer?
  • If you could compose a garden, painting, sculpture or collage to honor your cancer experience, what would it include?