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Birthdays and anniversaries…a time to look back and to cast your gaze forward.  We celebrated mine just yesterday.  There were cards, calls, a dinner out with my family, (where my husband had tied two giant numeral balloons to our table, announcing in shiny silver numerals, my age–a gesture that I had some mixed feelings about, truth be known).  Who wants to announce one’s age as we inevitably turn older?  Yet one of my most cherished moments during the day came when I went to Gilda’s Club to lead my current “Writing Through Cancer” workshop session.

I knew something was afoot.  The group members asked for ten minutes of time at the end of our session.  I agreed, quickly shifting my plan to allow for their time.  Yet I had no idea what was in store, and when they each read notes or poems of appreciation, then joined in singing “Happy Birthday” (accompanied by two of the members, one on ukulele, the other playing the guitar, my laughter was also accompanied by tears welling in my eyes.  I went home filled with my heart full, and later in the evening, when I shared their notes and pictures with my husband, his eyes got a little misty too.  They had given me a great gift, a surprise “Happy Birthday” moment that will be recalled more than a few times as other birthdays come and go.

Birthdays have gotten quieter as my husband and I have aged.  The big celebrations are reserved for our grandchildren’s birthdays and their excitement.  Flora, my Toronto granddaughter has been counting down the weeks until she turns eight in July, just as her cousin Emily reminded us multiple times that she would be turning eight in May, a month after we had returned to Canada from Japan.  Their excitement is infectious, yet at the same time, I can’t help but remember being a little girl just as excited for my birthdays.  There’s a faded photograph of the year I turned three that I sometimes look at, trying to remember that little girl, blonde hair in Shirley Temple style ringlets, topped with a giant hair ribbon.  My aunt’s picnic table nearby is piled with gaily wrapped gifts and a chocolate cake has been placed in front of me for the photo opportunity.  I look, frankly, a little stunned.

It wouldn’t be until I neared five that my birthday excitement began to bloom.  Turning five meant school, and there, my kindergarten teacher had a big wooden cake with 6 candles on it–always lit on the day of a student’s birthday, and “Happy Birthday” sung by the entire class.  Oh, how I wanted those candles lit for me too!  I sport an ear-to-ear grin on my face.  Those were the long ago years I eagerly counted the days until my next birthday, becoming a “big” girl with each year promising many more possibilities than the one before.  I was ready then, even impatient, to claim older age.  Not so much anymore.

Are we ever ready for the changes life presents to us?  It’s never either/or.  Each stage of life has its challenges, but there are rewards too. These days, I’m quite content to embrace the title, “Gramma,” but on the other hand, I am less enthusiastic about some of the inevitable growing older that is mine now:  the relentless pull of gravity, loss of muscle tone, and the silvering of my hair, regular visits with my cardiologist,  eyeglasses for reading and computer work, the stiffness in my joints on cold mornings.  It all reminds me of a condition I thought belonged only to others like my grandparents.  Ready or not, none of us escapes aging.

Yet no matter how old I get, every birthday reminds me of others past.  Memories come alive:  the scent of chocolate as my mother baked my birthday cake, the candle flames dancing while everyone sang to me, shutting my eyes, wishing as hard as I could for something I wanted to happen.  And each time my grandchildren sing “Happy Birthday “enthusiastically serenade me over the telephone, my mind races back to birthdays of long ago.  Whether good memories or sad, birthdays and anniversaries are full of story.  And just singing–or having sung to you– “Happy Birthday to you…”can ignite memories of events, people and places in your past.

I credit Roger Rosenblatt’s wise little book, Unless It Moves the Human Heart (Harper Collins, 2011), with the inspiration to try out a birthday prompt with my writing groups. As Rosenblatt described it, he would begin by asking if anyone in his class had recently celebrated—or was about to–a birthday.  Then he began singing, surprising his students:

I…then burst into song:  “Happy Birthday to You.”  They [his students] give me the he’s-gone-nuts look I’ve come to cherish over the years.  I sing it again.  “Happy Birthday to You.  Anyone had a birthday recently?  Anyone about to have one?” …just sit back and see what comes of listening to this irritating, celebratory song you’ve heard all your lives” (pp.39-40).

When I first tried the exercise, my students also looked at me with curiosity as I began singing before laughing a little and joining in.“Now let’s write,” I said as our singing ended.  “What memories do you have when you hear “Happy Birthday to you?”  I wrote with the group, curious to see where the prompt would take me.  I couldn’t write fast enough it seemed, as I recalled the blue bicycle waiting for me the morning of my seventh birthday, a surprise party my husband and daughters managed to pull off few years ago, the long-ago headline in my small town newspaper’s society page:  “Sharon Ann Bray turns six today,” (my aunt Verna was the society editor), even a rather dismal birthday in junior high school, when I’d been bullied. one memory spilled out after another.

Each time I have used this same prompt with different writing groups, the responses are similar, filled with many memories written and shared.  Yet as inspirational as his exercise is,  Rosenblatt isn’t the only writer who has used birthdays as inspiration for poetry and prose.  If you explore the offerings of The Academy of American Poets,or The Poetry Foundation, for example,  you’ll discover William Blake, Sylvia Plath, Christina Rossetti and many others poets were inspired by birthdays.  I’m especially fond of Ted Kooser’s “A Happy Birthday,” a short poem that captures how a birthday triggers retrospection.

This evening, I sat by an open window

and read till the light was gone and the book

was no more than a part of the darkness.

I could easily have switched on a lamp,

but I wanted to ride this day down into night,

to sit alone and smooth the unreadable page

with the pale gray ghost of my hand.

 

(In Delights & Shadows, 2004)

It’s no wonder birthdays inspire poetry:  birthdays also reflect the passage of time, aging and change, for example, here’s an excerpt from Joyce Sutphen’s “Crossroads:”

The second half of my life will be black
to the white rind of the old and fading moon.
The second half of my life will be water
over the cracked floor of these desert years.

(In:  Straight out of View, 2001)

Or, as Billy Collins muses in his poem, “Cheerios,” the discovery one is growing older may not just be about one’s actual birthday:

    One bright morning in a restaurant in Chicago

    as I waited for my eggs and toast,

    I opened the Tribune only to discover

    that I was the same age as Cheerios.

(In:  Poetry, September 2012)

Well, I’m in no hurry, unlike my grandchildren, to celebrate another birthday. Yesterday’s celebrations will hold me for a good long while, but in the meantime, I have a few memories that surfaced last night as my husband and I talked about this birthday and others before;  I have some writing to do.

Writing Suggestions:

This week, Even though your birthday or an anniversary is not yet here, let birthdays be the trigger that gets you writing.

  •             Hum the birthday tune, or if you’re feeling brave, sing it:  “Happy Birthday to you…”
  •             Or begin with a sentence such as “On the day I turned ___, and keep writing.
  •             Take stock of the memories, good or bad, a birthday ditty evokes.  Whether you will soon be celebrating a birthday or anniversary or have recently joined in birthday celebrations for family and friends, explore your remembrances of past birthdays or anniversaries.  In those memories, remember a story or poem might be lurking.  Why not write one?

 

 

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Springtime has been slow to arrive in Toronto.  The cherry blossoms were late in their annual bloom and trees seemed almost reluctant to bud, but gentler temperatures and more sunny days have been a welcome respite from the gray months of winter.  Despite its considerable growth in recent years, it is a city with many trees, parks, and walking trails and flowers.  Our apartment complex looks out over a canopy of trees and in the distance, a cityscape of tall buildings, and we’re fortunate to live within walking distance to more than one park and walking trails that criss-cross the city.  There is something revitalizing and crucial to the human spirit about springtime and its new life. It’s little surprise then that the most recent posting from author Maria Popova, of Brain Pickings, on the healing power of gardens captured my interest.  She wrote:

There is something deeply humanizing in listening to the rustle of a newly leaved tree, in watching a bumblebee romance a blossom, in kneeling onto the carpet of soil to make a hole for a sapling….  —Maria Popova, Brain Pickings, June 2, 2019

Just over a week ago, my husband and I joined the throngs who were buying plants, soil and pots as soon as it was warm enough to plant.  I spent an entire day filling pots with soil and planting flowers and even a tomato plant, to line our balcony for the summer.  My back may have ached afterward, but I sat and stared at the plants long afterward, with quiet pleasure.  A few blocks away, my daughter and her friend were preparing the soil for the small, but prolific, vegetable garden that will soon provide vegetables to all the residents of their small apartment building.  “The garden is my happy place,” she has often said.

A garden, a walk in the forest or along a city walking trail–these are restorative experiences for the soul and psyche.  I recall how, several years ago, one woman arrived late for a writing workshop I was leading at a San Diego cancer center.  Breathless and smiling, she was wearing a wide brimmed straw hat as she entered the room.   She apologized, saying, “I had to go out in the garden today,” before telling us how it had helped her suspend her worry about an upcoming treatment.   Oliver Sacks, in his essay, “Why We Need Gardens,” wrote, “I take my patients to gardens whenever possible…  I have seen …the restorative and healing power of nature and gardens…in many cases…more powerful than any medication (From:  Everything in Its Place, (2019) quoted in Brain Pickings, June 2, 2019).

The simple act of reconnecting with the earth can be healing. Shinrin-yoku, a Japanese term meaning “taking in the forest atmosphere” or “forest bathing” encourages people to spend time walking in nature to experience its rejuvenating and restorative benefits.  Shinrin-yoku has become an important part of preventive health care and healing in Japanese medicine.

Again, I think of Ann, a former member of one of the writing groups, who outlived her terminal prognosis by several years before her death in from a rare leukemia, in part, perhaps, by choosing to spend her final years in a little cabin in the California redwoods.  There, she took solace and inspiration from the beauty of nature and quiet surrounding her, much of which she expressed in her poetry.

Studies have shown that a walk through a garden or even seeing one from the window can lower blood pressure, reduce stress and ease pain.  In one study, cardiac rehabilitation patients who visited gardens and worked with plants experienced an elevated mood and lower heart rate than those who attended a standard patient education class (USA Today, April 15, 2007).

Healing gardens are now a part of many medical centers, as hospitals and cancer centers have begun to create environments that heal not only the body, but also nurture the spirit.  Such gardens are not new; they originated, believe it or not, in the hospices of medieval Europe.

“Nature heals the heart and soul, and those are things the doctors can’t help,” Topher Delaney, landscape architect, stated in a 2002 American Cancer Society article about healing gardens.  Delaney, a breast cancer survivor, had a mastectomy in 1989.  She was only 39, and after surgery, went into menopause and lost her sense of smell.  The grim surroundings of her hospitalization inspired a change in her work.

“I had my pact with God,” she said.  “Oh, God, if I get through this, then I’ll do healing gardens. You keep me alive, I’ll keep doing gardens.”  She wanted to give others the kind of retreat she wished she’d had during treatment.  “That’s what this [healing] garden is all about — healing the parts of yourself that the doctors can’t.  The garden really gives hope because people see flowers bloom and others enjoying life,” she said. “It’s a garden full of change and metaphor”  (July 24, 2002, American Cancer Society).

The poet Mary Oliver, a keen observer of the natural world, described how Nature and its beauty can open our hearts in essay, “Upstream.”

I walked, all one spring day, upstream, sometimes in the midst of the ripples, sometimes along the shore. My company were violets, Dutchman’s breeches, spring beauties, trilliums, bloodroot, ferns rising so curled one could feel the upward push of the delicate hairs on their bodies. … The beech leaves were just slipping their copper coats. Pale green and quivering they arrived into the year. My heart opened, and opened again. The water pushed against my effort, then its glassy permission to step ahead touched my ankles. (From “Upstream,” in Blue Iris, 2004).

My heart opened, and opened again…Why not experience the healing or renewing effect of a garden this week?  Go outside to your own or take a walk through a garden.  Find a bench and sit without talking among the flowers and trees, taking in as much of the detail as you can.  Pay attention to what you see, hear and feel.  Perhaps you may discover a poem or essay of your own waiting there.

Writing Suggestions:

  • How has Nature been healing for you?  Describe it.
  • Try walking along a trail, sitting in a park, beside a stream or lake, or in your back yard and simply being quiet for 15 minutes or more.  What do you feel after you have allowed yourself the quiet time in nature?  What thoughts or feelings came up for you?  Write about them.
  • Nature can also be the inspiration for writing.  Take your notebook  with you.  Walk along a path, sit quietly, and notice what captures your attention.   Make a few brief notes about what you see.  Once you return home, try writing another 20 minutes, exploring where your observations may lead you.

 

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When I began writing this newspaper column about cancer, I wondered how long it could last.  After all, how many story ideas about cancer could there be?  Seven years later, the ideas keep coming and I’m still writing.  I’ve decided that writing about cancer is writing about life.  Cancer is a lens that makes life appear in greater focus with added intensity.  (From:  “Writing About Cancer,” by Bob Riter, Ithaca Journal, Sept. 6, 2014)

In the coming week,  I’ll begin a new eight-week series of the “Writing Through Cancer” workshops I’ve been leading for many years in the U.S. and Canada.  I’m preparing for the first session, when a group of men and women will come together to write and share their stories of cancer.  Some of them may have written long before their illness began; others might offer an apologetic, “I’m not a writer but I thought this looked interesting,”  and I’ll gently remind them of poet William Stafford’s definition of a writer:  “A writer is someone who writes.”   We’ll begin at the beginning, the moment that they first heard the words, “I’m sorry, but …you have cancer.”

By the second meeting, any prompt or suggestion I offer to the group will result in writing that is powerful, descriptive, even beautiful.  Some in the group will be surprised at how moved their listeners are when they share what they have written.  By the third week, any prompt will result in the sound of pens racing across the page or the rapid click of a laptop keyboard, as if each person has more to write about their cancer experience than time will allow.  A diagnosis of cancer often triggers intense and abundant writing.

 “The knowledge you’re ill is one of the momentous experiences of life” (Anatole Broyard, Intoxicated by My Illness, 1993).

Like any unexpected hardship, a life-threatening illness thrusts you into new and unfamiliar territory, into a different chapter of life than the one you thought you were living.  So momentous, in fact, it sometimes overshadows everything that came before it.  Yet one thing is certain:  cancer changes you.  Arthur Frank, sociologist and cancer survivor, put it this way:  “Being ill is just another way of living…but by the time we have lived through it, we are living differently.” (At the Will of the Body, 2002).  At the end of the writing series, I encourage the group to look back over what they have written.  As they do, they discover that their words, their stories and poems are testament to their changes.   Each person is clearer about the things that truly matter; they appreciate life in ways they never did before, and no one wants to take life for granted again.

That’s the way writing often starts, a disaster or a catastrophe…by writing I rescue myself under all sorts of conditions…it relieves the feeling of distress.  –William Carlos Williams

During those periods of life when you experience hardship, serious illness or suffering, writing can be an important way to express and make sense of difficult emotions.  It’s a way to make sense of your life.  Often, that’s where writing begins.  While you may begin by writing for yourself in a period of upheaval, one that often leads to something greater.   As Louise DeSalvo noted in her book, Writing as a Way of Healing:  How Telling Our Stories Transforms Our Lives (2000), crisis, suffering and are the inspiration behind many of our greatest cultural creations, including art, poetry and literature.  Novelists and poets alike have described their writing as a form of therapy, helping them to heal and articulate traumatic events in their lives.  Writers such as Paul Theroux referred to his writing as something like digging a deep hole and not knowing  what he would find.  Famous novelists like Graham Greene wrote of his manic depression A Sort of Life; F. Scott Fitzgerald described his battle with alcohol in The Crackup, and William Styron examined his suicidal depression in Darkness Visible.  Creativity, as many great writers have shown us, is often fueled by life crises, trauma and suffering, and there is no shortage of contemporary poets and writers’ whose personal struggles have inspired fiction, nonfiction or poetry.  Literature is, after all, about the human experience, and in reading the work of others, we often discover insights, even ways to articulate own experiences.

An insightful, experienced oncologist told me that cancer need not be a person’s whole book, only a chapter. (Alice Hoffman, New York Times, August 14, 2000).

Cancer may be where you begin when you first start writing after a diagnosis, but it is rare that cancer is the only thing expressed when you begin writing.  Old wounds, memories of earlier times, and the experience cancer all make up the landscape of “writing through cancer.”  In my workshops, a gradual shift in what is written and shared in the group occurs over the eight weeks we write together.  The first weeks are usually focused on one’s cancer experience, but as the weeks pass, everyone’s writing begins to shift.  Other life stories surface and are written; themes of gratitude and hope begin to emerge.  And the writing doesn’t stop at the end of the workshop series.  More than a few people continue to write after the group experience ends, but not only about cancer.  Other memories, stories from their lives, themes of gratitude and hope emerge.  Several of my former workshop writers have gone on continue writing in groups or enroll in writing classes.  Some have published poetry, memoir and narratives originally birthed in the writing workshops.

Cancer can wallop you and brings you to tears, but it also can help you see life more clearly and with greater appreciation.   Ultimately, it’s important to remember that cancer is not your only story.  It may be one that drives you to write, but as you do, you begin to remember r and appreciate the life you’ve lived , the one you are living now, and how many stories or poems are contained in your life that are waiting to be expressed.

You don’t need a “big” event or big idea to write.  Cancer might get you writing, but inspiration doesn’t need a crisis to keep you writing.  Rather, it awakens you, makes you more observant to life, and grateful for it.  Inspiration does not arrive with a big “aha!”  It is quieter, waiting, because it comes from living, noticing, and paying attention.

Remember the commonplace, the wooden chair on the white planked deck,
trees kneeling in the rain and deer prints
leading into elegant rushes. A kinder place
cannot be found…

(From:  “Directive,” by Ann E., former writing group member, personal communication)

I recall listening to poet Billy Collins several years ago, as he described how he found the inspiration to write volume after volume of poetry.  His inspiration, he told the audience,  came simply from looking out the window and noticing the world around him.  The most ordinary thing, he reminded us, may contain the seed of a poem (or for that matter, any kind of writing).

…Cancer need not be a person’s whole book, only a chapter.  You each have many more stories to write than cancer.  All that’s required is the desire to write and learning to pay attention and notice what’s just outside your window, waiting to be discovered.

…poems hide. In the bottoms of our shoes,

they are sleeping. They are the shadows

drifting across our ceilings the moment 

before we wake up. What we have to do

is live in a way that lets us find them…

Maybe if we re-invent whatever our lives give us

we find poems. 

(“Valentine for Ernest Mann,’ By Naomi Shihab-Nye, in: Red Suitcase, 1994)

Writing Suggestions:

  • Just starting to write?  Begin remembering the moment you first heard you had cancer.  Before you write, take a moment to close your eyes and visualize that day, that moment–where you were, the quality of light in the room, the facial expression of the doctor or nurse, what you were feeling seconds before he/she spoke and then afterward.  Then setting the timer for no more than 15 minutes, write, describing in as much detail as you can, the moment you first heard the word “cancer.”
  • Tess Gallagher, poet, described the telling of an act of by her husband, washing his dying mother in the poem, “Each Bird Walking.”  Her poem includes the narrator’s words to her husband:  “Tell me,” I said, “something I can’t forget.” Use Gallagher’s words, “tell me something I can’t forget” as your prompt, and begin writing.  Again, set your timer for 15 minutes and keep the pen moving.
  • Find a quiet time and place near a window–or, if your weather allows, find a similarly quiet place to sit outdoors.  Spend a few minutes simply noticing what is around you:  sights, sounds, colors, objects, life.  Take one thing you observe and let it become the trigger for your writing.  Write for 15 minutes.

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Life changes fast. Life changes in the instant. You sit down to dinner and life as you know it ends.–Joan Didion, A Year of Magical Thinking

The sky was overcast yesterday morning, typical March weather, but yet, a somber sky that seemed to reflect the heaviness felt by so many around the world in the aftermath of tragedy–lives lost; others permanently changed, and all in an instant.  The first was the crash of the Boeing 737 Max in Ethiopia that killed everyone aboard, and the second, and, perhaps, more difficult to comprehend, the fifty victims of mass shootings at the two mosques in Christchurch, New Zealand, until now, a country spared the kind of violence experienced in so many other countries.

The scale of the two tragedies was nearly incomprehensible, but the outpouring of shock, condemnation around the world in the aftermath of the New Zealand mosque shootings was immediate.  Such events are at odds with our fundamental beliefs, including “that we live in a just world, and that if we make good decisions, we’ll be safe,” according to Laura Wilson, PhD, co-author and editor of The Wiley Handbook of the Psychology of Mass Shootings. We may stand in solidarity with New Zealand and the victims, but the question remains:  how has our world become so dominated by hatred and violence?

When people experience life-threatening or other traumatic experiences, their focus is on survival and self-protection,  according to Bessel van der Kolk, MD, discussing the nature of trauma in Dialogues in Clinical Neuroscience (2000 Mar; 2(1): 7–22) The traumatic experience triggers a mixture of numbness, withdrawal, confusion, shock, and speechless terror. The National Center for PTSD estimates that 28 percent of people who witness a mass shooting develop post-traumatic stress disorder (PTSD) and might be at greater risk for mental health difficulties compared with people who experience other types of trauma, such as natural disasters. The memory of the traumatic event may be replayed repeatedly, dominating victims’ consciousness. Abdul Aziz, a survivor of the mosque shootings, who’d also ran after the shooter and chased him away from the mosque, described how the event has traumatized  the survivors, “Each time we close our eyes,” he said, “we see all of the dead bodies around us.”

As I read different accounts of the shootings, I came across a poignant comment offered by an Australian news anchor, Waleed Aly,  also a Muslim.  He reflected on those who were in prayer at the mosques, moments before the first shots were heard:

“I was in the mosque today. I do that every Friday just like the people in those mosques in Christchurch today,” he said. “I know exactly what those moments before the shooting began would have been like. I know how quiet, how still, how introspective those people would have been before they were suddenly gunned down. How separated from the world they would have felt before the world came in and tore their lives apart.”

Shock and sadness will linger for a very long time among New Zealanders and many others around the globe, coupled with a sense of helplessness in the senseless, incomprehensible acts of hatred and violence that have become too frequent in our world.  Sadly, these events have become much too numerous to list in full, but for example, school shootings in the U.S., terrorist attacks of 9/11, the 2015 Paris and Beirut bombings, a resurgence of anti-Semitism, the ethnic cleansing of the Rohingya in Myanmar, the 2011 Norway attacks by a lone gunman, on and on.  Yet while we may first experience shock and disbelief,  do we also become numbed by the magnitude of events like these, ones reported in the news with ever greater frequency, yet ones we do not experience personally?

As I often do, I  have turned to poetry as a way to find the words that might express what I feel in the  wake of these deeply sad and disturbing events.   I recalled that after the tragedy of 9/11, poems about it were difficult to find.  At the time, I copied down a quote from the American Academy of Poets website, which said, “There seemed to be pressure on well-known poets to produce a poem, or refuse the opportunity, as former US poet laureate, Billy Collins ,did, saying  “the occasion was “too stupendous” for a single poem to handle.” He said that the terrorists had done something “beyond language.”  Again, years later and many more acts of unbelievable violence later, perhaps we still struggle to find the words “big” enough to help us comprehend these horrible events.  I know I do.

When we live with cancer or another chronic and progressive condition like heart failure, we come closer to the fact of our mortality.  From time to time, I admit the little shadow of fear of a shortened life sneaks up on me, but the events of this past week have again put things in a different light.  As I think about the victims of the shootings and the airplane crash, of the grief and suffering of loved ones and survivors, I am reminded to live with gratitude for the life I have.   I have to find hope, as we all do , that we can find ways and take actions to help lessen the suffering of those who have experienced these horrible, incomprehensible events.  Even though the elusive state we call peace seems ever more out of reach, I remember the words of St. Francis of Assisi:

…That where there is hatred, I may bring love.
That where there is wrong, I may bring the spirit of forgiveness.
That where there is discord, I may bring harmony.
That where there is error, I may bring truth.
That where there is doubt, I may bring faith.
That where there is despair, I may bring hope.
That where there are shadows, I may bring light.
That where there is sadness, I may bring joy.

(From: The Peace Prayer of St. Francis of Assisi)

Writing Suggestions:

This week, I invite you to reflect on the events of these past many days.

  • Write about losses you have experienced and how they changed your life.
  • Write about your own reactions to a tragedy like a mass shooting.  Did anything change in your thinking or actions?
  • Write about any other traumatic event you or a loved one has experienced and what helped you  heal.

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“Why is loneliness so toxic?”  It’s the question posed in a 2018 headline from  an article by Wendy Leung in the Health section of The Globe & Mail, Canada’s national newspaper.  Loneliness, according to Leung, in the context of cancer or any debilitating illness, is common. She describes a 2107 research study conducted  by a team at Rice University, which studied loneliness among ill people.  The findings suggested that “loneliness puts people at risk for premature mortality and all kinds of other physical illnesses.”  Why?  It’s a source of stress, but perhaps even more importantly, “a sense of being cared for and loved is a crucial factor in our well being.”

Loneliness often accompanies  cancer diagnosis and treatment.  Lisa Masters, living with metastatic breast cancer, offered a poignant description of the kind of loneliness she experienced in a 2014 Huffington Post article:

I am by nature an optimist. I am strong. I usually keep the sadness of myself to myself. I tell you that I’m not terminal and that I believe a cure will be found in time. I so want that to be true. I have Stage IV Metastatic Breast Cancer.

Today I write about a subject that I don’t often speak of, nor even give into its darkness very often.  Today I am lonely.  I wonder how many of you who also have Stage IV cancer are lonely.  I can’t be alone. I know I have my friends and my family who love me. They would do anything I needed them to do. All I need to do is ask. But, they really do not understand how alone someone with cancer can often be…

Today… it’s dark, it’s raining and I feel the loneliness of my cancer.  

So why is loneliness so toxic?  According to Ruth Livingston, PhD, founder and direction of Living with Medical Conditions, writing in a 2011 Psychology Today article, “Curing the Loneliness of Illness:

Being lonely can itself be dangerous to one’s health. Loneliness can double a person’s chances of catching a cold and, worse, lonely people are four times more likely to have a heart attack and, once they do, four times more likely to die from it…Further,… loneliness has an effect on the immune system: …it reduces antibody production and antiviral responses, protective against health risks. Loneliness, then —all alone — is a hazard. 

Summarizing the analysis of 70 studies on loneliness conducted at Brigham Young University,  Dr. Veronique Desaulniers reported that feelings of loneliness can increase an individual’s chance of dying by 26%.  Why?  Loneliness creates is stressful, and overtime, may lead to long-term stress, the “fight or flight” reactions that can have negative impact on our immune system functioning.

 

MacMillan Cancer Support, based in the UK, estimated loneliness put cancer patients’ recovery at risk, finding that cancer patients who are lonely are three times more likely to struggle with treatment plans than those who aren’t lonely,  skipping treatment appointments, not taking medications as prescribed, refusing certain types of treatment or skipping it altogether.   Commenting on the research, Ciaran Devane, CEO at MacMillan Cancer Support said, “We already know loneliness may be as harmful as smoking, but this research shows…it is particularly toxic to cancer patients.” https://www.macmillan.org.uk/aboutus/news/latest_news/lonelycancerpatientsthreetimesmorelikelytostrugglewithtreatment.aspx

Themes of loneliness often make their way into the writing shared by tcancer patients who attend my expressive writing workshops.  These are similar to those described by the National Cancer Institute:

  • Friends may have a hard time dealing with your diagnosis and not call or visit as they once did.
  • You feel sick post-treatments and aren’t able to participate in activities or social events as you once did.
  • It’s common to feel as if those around you—friends and loved ones—don’t understand what you are going through.
  • And even when treatment is over, you may suffer from loneliness, missing the support and understanding you received from your medical team and feeling vulnerable as your “safety net” of regular appointments is taken away from you.

Feelings of social inclusion and support, however, are an important factor in disease resistance.  Dr. Lisa Jaremka, a member of the Rice University research team, discussed the wealth of research showing that a sense of being cared for and loved is crucial to  well-being.  “The need to belong is a fundamental part of being human.  It’s like the air we breathe.  We need oxygen and we need healthy, thriving relationships equally as much.”

So what can you do to combat or overcome loneliness?  Although it’s a feeling we all may have at different points in our lives, it can be particularly prevalent during during cancer treatment and recovery, but let’s face it, it’s also unique to each person, and one works to alleviate loneliness in one person may be ineffective with another.  Overcoming loneliness requires many different approaches to discovering the emotional support we need to help contend with loneliness and its negative health effects.  When you’re feeling lonely, it can sometimes seem as if it’s just too much effort to reach out to others, so what are your options?

Thanks to The Globe & Mail article, I learned about Marissa Korda’s unique online community, “The Loneliness Project,”  initiated in the fall of 2017.  Korda, a Toronto graphic designer, invited people to share their stories and experiences of loneliness on her site.  It has inspired more than a few stories and grown into something much larger than she originally anticipated.  You can read more about Korda’s site and her inspiration for it here.  Writing, together with sharing their stories with one another, as participants in my writing groups will attest, is one antidote for loneliness.  An online community like Korda’s may be one way to to share your experience while sticking your toe in the water of reaching out and finding those important social connections that help you combat loneliness.

City of Hope, a leading research and treatment center for cancer, diabetes and other life-threatening diseases in Southern California, offers seven practical suggestions for helping to overcome the loneliness of cancer:

  • Ask for practical help, such as transportation, financial support or child care by telling your doctor, nurse or other support staff
  • Reach out to your loved ones and friends. Be honest about your feelings but be understanding of their schedules and limitations.
  • Find a support group. Whether a therapeutic support group or an expressive writing group, online or in person, it is an opportunity to share your experiences, hear those of other cancer patients, and learn from them too.
  • Talk to a therapist or your pastor or rabbi. Open up about your feelings in a safe and confidential place with a trained professional.
  • Join a spiritual or religious group to help relieve the loneliness of your cancer journey.
  • Find activities you can enjoy, staying busy as your energy and time allows. Whether a book club, yoga, meditation, expressive arts, taking an online class, or just having fun with a friend.

Remember, having social connections, particularly during the journey of cancer, is important to our health and well-being.  It’s important to have contact with friends, family and others to help diminish loneliness.   Start small:  even simple activities like taking a walk or sitting in the sunlight in a garden be a start to helping you combat loneliness.  Take it a step at a time, but gradually,  re-engage with the things and people that normally, help you feel better.  Reach out; reconnect with life and people.  It’s good for your health and a powerful way to overcome the debilitating effects of loneliness.  I remember how, during a very difficult period in my life, I turned to music, listening well into the late night after my daughters were in bed.  I had a favorite song and repeatedly listened to (and sang along with) Bette Midler’s “Friends” from her 1972 album, The Divine Miss M.:

...And I am all alone
There is no one here beside me
And my problems have all gone
There is no one to deride me

But you got to have friends
The feeling’s oh so strong
You got to have friends
To make that day last long…

I doubt Midler ever realized how much positive impact that one song had on my spirits–and my resolve to reach out to friends during a time I often felt like simply going to bed and covering my head with a pillow.  My friends helped me get through a tough time.  I’ve never forgotten how important to my healing they were.

Reach out; reconnect with life and people.  It’s good for your health and a powerful way to overcome the debilitating effects of loneliness.

Writing Suggestions:

  • What is your experience of loneliness? How did it feel?  What helped you overcome it?  What it was like to be lonely?  Write about it.
  • What images or metaphors best capture your experience or feelings of loneliness. Expand on them and create a poem.
  • Did you experience loneliness even after treatment had ended? Describe what it was like.
  • What has helped you diminish the feelings of loneliness during cancer or another serious illness?
  • How did friends and loved one help you combat loneliness?
  • What advice do you have for the newly diagnosed cancer patient or the cancer survivor completing treatment?

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“I guess I’ve become a cancer survivor,” my husband announced over our morning coffee.  It seemed strange to hear him say it, even though his use of the label is correct.  The National Coalition for Cancer Survivorship (NCCS) originally defined survivor as “any person diagnosed with cancer, from the time of initial diagnosis until his or her death.”  Less than two weeks after his surgery, he’d joined the ranks of those living with cancer, a survivor.

We received his pathologist’s report earlier last week, learning that his chances of recurrence in the next five years were lower than we expected, although he will be participating in a clinical trial at the recommendation of the doctor, which he readily agreed to do.  Minus one of his two kidneys post-surgery, you’d hardly know that a month ago, he was dogged by fear and worry.  Now, his mood is lighter, his humor has returned, and he’s begun to resume normal activity.  But our conversations are different–quieter in tone, deeper in subject matter, with a stronger sense of gratitude for the life we have and a determination to live as fully as we possibly can for as long as we can.

Cancer teaches us, whether we are the patient or the caregiver, about what’s important in our lives–what truly matters.   My husband, who rarely shows emotion, is much more likely to exhibit his softer side, whether he is relating a touching life story heard in his Toastmasters Club or has written notes of gratitude to the several Toronto friends who have offered their help and support to us in the past weeks.   Life, I think, seems much more precious to him in the wake of his cancer experience.

In the preface of her book, Survival Lessons (2015), Alice Hoffman wrote of her cancer journey and becoming a survivor, saying I forgot that our lives are made up of equal parts sorrow and joy, and that it is impossible to have one without the other.  This is what makes us human…I wrote to remind myself that in the darkest hour the roses still bloom, the stars still come out at night.  And to remind myself that, despite everything that was happening to me, there were still choices I could make.

Lynne Eldridge, MD, in her recent article about positive changes in people after a cancer diagnosis, stated “Research tells us that most people experience some degree of “post traumatic growth”…describing these changes with words and phrases such as:

  • Silver linings
  • The benefits of cancer
  • “What cancer has taught me”
  • Meaning making, sense-making, or benefit finding
  • Life transforming changes
  • The blessings of cancer

While she acknowledges not all cancer survivors experience positive personal growth, “one-half to two-thirds of survivors admit to some positive changes,” and find more the longer the time since their diagnoses.   Examples of these positive growth changes include:

A greater appreciation for life, enriched personal relationships, compassion for others, deepening spirituality and the discovery of “benefits”–or silver linings–in one’s cancer journey.  As one person said, “I wouldn’t wish cancer on anyone, but looking back, there are ways that I’m a better person than if I’d never had cancer.”

Dana Jennings, a New York Times editor, who published regular blog posts throughout his diagnosis, surgery and treatment for prostate cancer, reflected on life after cancer, saying, Living in the shadow of cancer has granted me a kind of high-definition gratitude. I’ve found that when you’re grateful, the world turns from funereal gray to incandescent Technicolor…The small moments of gratitude are the most poignant to me because they indicate that I’m still paying close attention to the life I’m living, that I haven’t yet succumbed to numbing obliviousness.

When you have cancer, when you’re being cut open and radiated and who knows what else, it can take a great effort to be thankful for the gift of the one life that we have been blessed with. Believe me, I know.

And sometimes, in the amnesia of sickness, we forget to be grateful. But if we let our cancers consume our spirits in addition to our bodies, then we risk forgetting who we truly are, of contracting a kind of Alzheimer’s of the soul.

And so to our lives. My husband and I are more aware now of our mortality, the reality of being human, growing older, and having survived more than one serious illness.  There’s a sense of peacefulness, perhaps, that has become more present in our day-to-day living than we knew in the years of chasing careers, moving across the country four times, and running as fast as we could.  Serious illness teaches you to slow down, smell those roses, and enjoy, truly enjoy, the simple pleasures found in your daily life.

We’re grateful for the fact that my husband’s cancer surgery was successful and for the fact that his chances of recurrence are slimmer than we thought.  We are focused more on the simple pleasures of living and being together, reminded again of the preciousness of life, family, and friends.  “Cancer is not a gift/but a lesson,” Judy Rohm writes in her poem, “The Lesson, “full of seeing now and living presently.”  (In:  The Cancer Poetry Project, V. 1, 2001).  Living fully, presently, is what we are striving to do in our lives.

This is what life does.  It lets you walk up to
the store to buy breakfast and the paper…

Life lets you take the dog for a walk down to the
pond, where whole generations of biological
processes are boiling beneath the mud…

…And then life lets you go home to think
about all this.  Which you do, for quite a long time.

Later, you wake up beside your old love, the one
who never had any conditions, the one who waited
you out.  This is life’s way of letting you know that you are lucky…

(In:   Our Post Soviet History Unfolds, 2005)

Writing Suggestions:

  • Write about being a survivor of cancer and how having experienced cancer has change you:  your life, your outlook, how you approach each day.
  • Have you become more or less grateful for your life post-cancer?  Why?
  • What matters most to you in life now?  Try capturing your sentiments in a poem or personal essay.
  • A way to begin?  Try making a list of “Before Cancer, I was…” then do the same with “After Cancer, I am…”  Choose one or two and develop those feelings into a narrative.

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The art of reading is in great part that of acquiring a better understanding of life from one’s encounter with it in a book. — André Maurois

It’s taken me the better part of three days to organize my books into some kind of order on my bookshelves.  In part, I have a lot of books, although far fewer than I used to when our move back to Toronto dictated some serious downsizing of our belongings.  Despite my reluctance to let many of them go, a feeling much like saying good-bye to old friends, I did, inviting writing group members to choose from the books tagged for donation, giving a few favorites to friends, and donating several boxes to the local library.  Yet I kept favorites, volumes of poetry, selected works of fiction, books on art and writing, and to my shock, I still had enough to fill three large bookcases.

The process of organizing was a slow one, alphabetizing poetry books, grouping fiction favorites and then nonfiction before several volumes on writing and poetry craft, even several favorite children’s books I have yet to let go of.  But as time-consuming as the basic task was,  I was further slowed in my progress by the constant desire to open a book to a dog-eared page, re-read the underlined passages, someone’s inscription on the title page, or if poetry, more than one of a poet’s collection.  I was often lost in remembering:  where I was, what was going on in my life, why I loved a book or a poem as much as I did.  My books, it turns out, have been as much a source of healing and happiness as they were about learning and growth.

“And death shall have no dominion,” Dylan Thomas wrote in his poem by the same name, his words offering me some measure of solace in the wake of my first husband’s drowning:

And death shall have no dominion.

They shall have stars at elbow and foot…

Though they sink through the sea they shall rise again;

Those lovers be lost love shall not;

And death shall have no dominion…  

My volume of e.e. cummings Complete Poems 1904-1962 was filled with marked up passages, asterisks, and dog-eared pages, among them one that during my recovery from grief and loss offered me hope and a new way of living:

may my heart always be open to little
birds who are the secrets of living
whatever they sing is better than to know
and if men should not hear them men are old

may my mind stroll about hungry
and fearless and thirsty and supple
and even if it’s sunday may i be wrong
for whenever men are right they are not young…

I pulled Wallace Stegner’s Pulitzer Prize winning novel, The Angle of Repose (1971), sitting down to re-read several pages.  I remembered reading the novel shortly after I  moved my children and myself from Halifax to Toronto two years after my husband’s death to begin my doctoral studies.  I was aching from loss and longing for what I still called “home,” the small Northern Californian town where my father’s family had homesteaded, settled and where, each day of my childhood, I gazed at the beauty of Mt. Shasta, one of the volcanic peaks in the Cascade Range.

Stegner’s book was a powerful read for me, and he became one of my favorite writers.  In Angle of Repose,  the protagonist, Lyman, a writer confined to a wheelchair, had been recently been abandoned by his wife.  He was filled with bitterness and a sense of defeat.  After moving into his grandparents’ house, he decided to chronicle his grandparents’  early days in the western frontier.  As he read through his grandmother’s letters, he discovered much more about their marriage, struggles and difficulties than he anticipated. Through their story, he learned not only of their lives, but his own.

I sampled passages from several of the pages, in awe of Stegner’s command of language, his deep understanding of the challenges of early life in the  West, and the way in which he artfully moved from the struggles of the grandparents to his protagonist’s.  There were lessons in the book had real impact for me at the time,  and I had underlined passage after passage.

  • Home is a notion that only nations of the homeless fully appreciate and only the uprooted comprehend…” 
  • Hope was always out ahead of fact, possibility obscured the outlines of reality…” 
  • We must be reconciled, for what we left behind us can never be ours again…”
  • She saw in his face he had contracted the incurable Western disease. He set his crosshairs on the snowpeaks of a vision.

It’s no surprise, perhaps, but as my shelving slowed and I paused to page through one book after another of the books I’d loved, I was reminded that reading, perhaps as much as writing, was not only an important part of my daily life, but of healing and happiness.

“Medicines and surgery may cure, but only reading and writing poetry can heal.”                    J. Arroyo, author

It’s not a novel concept (no pun intended).  The notion that books can make us emotionally, psychologically and even physically better goes back to the ancient world.  “The Reading Cure,” published in a 2008 issue of The Guardian reminds us that Apollo was not only the Greek god of poetry, but also of healing.  Aristotle believed literature had healing benefits and could be used to treat illness.  Hospitals or health sanctuaries in ancient Greece were typically situated next to theatres, most famously at Epidaurus, where dramatic performances were considered part of the cure.

One sheds one’s sicknesses in books– D. H. Lawrence

A few months ago, a friend sent me a link to a 2015 New Yorker Magazine article “Can Reading Make You Happier?” by Ceridwen Dovey.  Dovey explores the origins of Bibliotherapy, which is defined in the Oxford English Dictionary as “an interaction between the reader and certain literature which is useful in aiding personal adjustment.”  Bibliotherapy is a therapeutic practice, widely used in the U.K., that uses words to soothe the emotions and alter thoughts and to help people deal with psychological, social and emotional problems.   Covey notes that the Ancient Greeks inscribed a library entrance  in Thebes as a “healing place for the soul, noting that Shakespeare, in the play “Titus Andronicus,” encourages the audience to  “Come, and take choice of all my library, And so beguile thy sorrow …”

Bibliotherapy came into its own at the end of the nineteenth century. Sigmund Freud began using literature during psychoanalysis sessions, famously remarking, “Whenever I get somewhere, a poet has been there first.”   Following World War I, as traumatized soldiers returned home from the front, they were often prescribed a course of reading. Later in the century, bibliotherapy was also used in hospitals and libraries, and since, the practice has been utilized by psychologists, social and aged-care workers, and doctors as a viable mode of adjunct therapy.

You may be interested to know that there is scientific research that supports health benefits of reading, for example, Covey cites a 2011 study published in the Annual Review of Psychology that showed when we read about an experience in a novel, we draw on the same brain networks when we’re reading stories and when we’re trying to guess at another person’s feelings.  And other studies suggest that people who read a lot of fiction tend to be better at empathizing with others.  At the very least, reading does boost your brain power, like a good jog exercises your cardiovascular system, and it can help you relate to others feelings, particularly if you read literary fiction.  Reading helps us relax, and reading before bed even helps us sleep.

But perhaps the most important thing reading does for us is in its capacity to open our eyes, minds and hearts to the larger world, to immerse ourselves a world beyond our everyday lives, and to find ourselves among the words another has written on a page–words that speak to what we are experiencing, that remind us of hope and healing.  What good literature can do and does do best, for so many of us, is touch our souls.

From Great Expectations I learned the power the stories we tell ourselves have to do either harm and good, to ourselves and to others; from Death of a Salesman I learned the dangers of a corrupt version of the American Dream; from Madame Bovary, I learned to embrace the real world rather than escaping into flights of fancy; from Gulliver’s Travels I learned the profound limitations of my own finite perspective; and from Jane Eyre I learned how to be myself. These weren’t mere intellectual or moral lessons, although they certainly may have begun as such. Rather, the stories from these books and so many others became part of my life story and then, gradually, part of my very soul. –Karen Swallow Prior, The Atlantic, 2013. 

Writing Suggestions:

  • Consider how reading has played a role in your life.
  • What role does reading play in your life?
  • What kind of books or literature do you most prefer? Why?
  • Has reading helped you during difficult periods in your life? How?
  • What are some of your most memorable or enduring books or poetry you’ve experienced? Why?
  • Describe a difficult time in your life and a book or poem which offered you some solace and insight.

 

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