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Archive for the ‘expressive writing’ Category

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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But [Pooh] couldn’t sleep. The more he tried to sleep the more he couldn’t. He tried counting Sheep, which is sometimes a good way of getting to sleep, and, as that was no good, he tried counting Heffalumps. And that was worse. Because every Heffalump that he counted was making straight for a pot of Pooh’s honey, and eating it all. –A.A. Milne, Winnie the Pooh

Sometimes, when the world is too much with me, my sleep suffers.  Last night was one of those times.  I yawned repeatedly as I read, so I closed my book, turned off the lights and immediately fell asleep.  But barely an hour or so later, I was awake.  A vicious cycle began.  I couldn’t get comfortable, tossed the duvet aside, pulled it back on, lay on one side, then the other.   I tried to meditate, a slow, deep inhale, a long exhale, but my mind was having none of it, and a relentless parade of “to-dos” began clamoring for attention.  I checked the clock:  1:10, 1:20, 1:40, 2 a.m.  I sighed, tossed back the covers, grabbed my novel and glasses, and tip toed out of the bedroom, making my way to the kitchen.  A cup of warm milk and three chapters later, I returned to bed, finally drifting off to a sound sleep for a few hours, but awakening, as I do habitually, at 6 a.m., saw my nearly illegible list on the night table, scrawled during my wakefulness in an effort to quiet my mind.

Busy brain, an important event happening the next day, or minor aches and pains aren’t the only culprits that keep us awake at night.  Life hands us challenges from time to time–difficult or traumatic events job loss, death of a loved one, worries about a child, a parent or spouse, illness. In the days before my husband’s surgery to remove a cancerous kidney, neither he nor I slept well, and I know that before his next scan, his worry will keep him tossing and turning until it’s over.  In times like these, one’s sleep may be disrupted for weeks.

He would lie in the bed and finally, with daylight, he would go to sleep. After all, he said to himself, it is probably only insomnia. Many must have it.― Ernest Hemingway, A  Clean, Well Lighted Place

Sleepless nights are no trivial matter.  Sleep disruption does more than irritate or make us drowsy the following afternoon. It alters the hormonal balance in our bodies.  An inability to fall asleep and stay asleep can result in anxiety, depression, breathing problems, fatigue, or headaches—to name a few. It is well known that lack of deep, restorative sleep negatively affects mental performance and in particular, memory.  There is even some newer evidence that individuals who showed signs of pre-clinical Alzheimer’s disease had poorer sleep efficiency than those without Alzheimer’s markers.

Sleep disorders are also a common and sometimes chronic problem for patients with cancer as well as cancer survivors. They can be caused by anxiety or depression, or the side effects of various treatments.  Chemotherapy drugs, for example, can cause nausea, vomiting, night sweats or fatigue.  The medications that may be prescribed to help combat the side effects of chemotherapy can also create sleep problems, causing drowsiness, or, in some cases, leave a patient feeling energized.  A common remedy is to try to sleep during the day.  But daytime naps can aggravate one’s ability to fall or stay asleep during the night.

It is 5 a.m. All the worse things come stalking in
and stand icily about the bed looking worse and worse and worse.

― Fleur Adcock, poet

According to a 2007 study published in The Oncologist, researchers discovered that the cancer itself, its related symptoms, and treatments may also create sleep problems. Even years after treatment, chronic sleep disturbances are common among many cancer survivors.  In fact, there is some evidence that disruption of our circadian rhythm may also affect an individual’s cancer prognosis.

According to Dr. David Spiegel and his Stanford University colleagues, a good night’s sleep is an important weapon for fighting cancer.  When the hormonal cortisol cycle is thrown off by troubled sleep, the cancer-fighting branches of our immune systems are suppressed.  The Stanford team’s findings also suggested that breast cancer patients who suffered disrupted sleep cycles may die earlier from the disease.

The bottom line?  A good night’s sleep is not only an important weapon in the arsenal for fighting cancer but for overall health. What can you do if you’re having trouble sleeping?  A good first step is to talk to your health care team about your sleep difficulties, but there are some basic steps, recommended by organizations like the American and Canadian Cancer Societies, that might help you get a little more shut-eye.

  • Try to keep a normal bedtime routine. Go to sleep in a quiet setting.
  • Exercise a little each day.
  • If you nap, keep your naps short and do it at least 2 to 3 hours before your bedtime.
  • Avoid caffeine for 6 to 8 hours before bedtime.
  • Drink warm, non-caffeinated drinks like warm milk or herbal tea before going to sleep.
  • Try relaxation exercises, listening to soothing music, darkening the room or massage before bed.
  • Keep sheets clean and tucked in, and have extra covers handy in case you get cold.
  • It may also be helpful to talk to someone you trust about any fears and concerns you have.

A good laugh and a long sleep are the two best cures for anything.- Irish Proverb

Sleep.  We all need it.  From time to time, many of us sometimes have trouble getting enough of it.  Work, worries, fears, upsetting events, illness–these very human experiences can disrupt us of our sleep.  The vast majority of us will experience sleep difficulties at some time on our lives, and those will be like the one I experienced last night, when the hours tick by slowly, you toss and turn and feel as if sleep will never come. As for me, I’m taking a long walk in the sunshine rather than succumbing to the desire for an afternoon nap, closing my computer screen at dinnertime, and maybe even put the disturbing novel I’m reading aside and opt for something with less tension and suspense in the plot.  Add a cup of herbal tea or glass of warm milk, the cool feel of sheets and warming cocoon of my duvet, and I just may succumb to darkness’s embrace and restorative power of sleep. As the great poet William Blake advised, “”Think in the morning. Act in the noon. Eat in the evening. Sleep in the night.”

Writing Suggestions:

Did you fear the darkness as a child?  What helped you go to sleep?

Write about sleep–or the lack of it.  What impact does it have on you the following day?  What helps you get to sleep now?

Write, in as much detail as you can, about a time when your worries or fears overtook you and kept you restless and unable to sleep.  Try to re-capture the feelings and thoughts you had.

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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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In a few days, my husband and I will board an Air Canada jet, crossing the Pacific, international borders and time zones as we travel to Okinawa, Japan, where my younger daughter and her family live. Thanks to my adventuresome daughters, I’ve visited many more foreign countries than I might have otherwise. Despite this, living with heart failure makes me a little more anxious about the long flight than I once was.   I seem to vacillate between excitement and nervousness with wild abandon.

I’m reminded of other border crossings we traverse in our lifetimes. Some of them are physical, like the border between countries, others are metaphorical, like crossing from youth into adulthood, graduate to professional, single to married, employed to retired.  The list of transitions, of borders real and symbolic, is endless.  Some crossings are welcomed; others, in the moments when the landscape of your life shifts without warning from familiar to unfamiliar, are not.  In those instances, you land in an unknown territory where what you took for granted, what you thought of as normal, are forever altered.  Not only is it disorienting, the experience can be frightening and lonely.

It’s the same strangeness, the unreality you experience after an unexpected and sudden death of a loved one, or hear your doctor say the word, “cancer,” or just days after unexpectedly collapsing on a walk, you lie in a hospital bed listening to a cardiologist’s use words like “heart failure, atrial fibrillation, ejection fraction, ventricular tachycardia, ICD” and struggle to make sense of them.  It’s those moments, when your life abruptly changes in ways you never imagined, that are burned into memory.

Looking back, perhaps there were warning signs, but ones you ignored or passed off as trivial.  Maybe you were sent for more tests, further consultation, or hospitalized for observation, but even then, you try to push aside the niggling worries.  “It’s probably nothing,” you tell yourself, but then all that changes as you watch your doctor’s face and hear, in those unreal, slow motion moments, “I’m sorry, but…”  And your heart already knows what the brain is trying to process as you’re thrust across the border into what writer Susan Sontag once named “The Kingdom of the Ill.”

Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place. (Susan Sontag, “Illness as Metaphor,” in The New York Times, Jan. 26, 1978)

Being diagnosed with any serious medical condition casts you into unfamiliar and treacherous terrain.  You feel disoriented, as if your body has betrayed you.  Maybe you’ve been given a roadmap upon entry, an informational pamphlet that defines your path of treatment,  but it can seem like a maze of different choices, ones that branch into multiple—and equally confusing—pathways.  Worse, your diagnosis is accompanied by strange sounding terminology, difficult to decipher and understand, leaving you feeling even more overwhelmed and confused.  Your life is suddenly turned upside down, and you confront a new reality you feel ill prepared to navigate.  This is the foreign territory of the body’s betrayal. Nothing seems quite real, and you feel lost and alone.

There’s a moment, not necessarily when you hear your diagnosis, maybe weeks later, when you cross that border and know in your heart and soul that this is really serious… The hardest thing is to leave yourself, the innocent, healthy you that never had to face her own mortality, at the border.  That old relationship with your body, careless but friendly, taken for granted, suddenly ends.  Your body becomes enemy territory …The sudden crossing over into illness or disability, becoming a patient, can feel like you’re landing on another planet, or entering another country… (Barbara Abercrombie, Writing Out the Storm, 2002).

As a heart failure patient, an unexpected outcome from my radiation treatment for breast cancer several years earlier,  I’ve been surprised by a lack of support programs and resources like those available in the cancer community, where I’ve been leading therapeutic writing groups for cancer patients for nearly twenty years, beginning years before I was diagnosed with heart failure.  The writing groups offer a safe and supportive environment in which people can write from the personal experience of cancer.  Illness or tragedy cracks us open.  Over the weeks together, patients’ stories become progressively deeper and more powerful as they explore the impact of cancer on their lives.  They are often surprised by the power of their words to touch others in the group as they are read aloud.  A strong sense of community is created in the sharing of one another’s stories.  People feel less alone as they go through surgery and treatment, even as they face death in a terminal diagnosis.  Writing is powerful medicine and part of the motivation for me to begin this blog–hoping it might encourage heart failure patients to also write and share their stories.

Somewhere out there in that darkness are hundreds of thousands … like myself …new citizens of this other country… In one moment of discovery, these lives have been transformed, just as mine has been, as surely as if they had been  plucked from their native land and forced to survive in a hostile new landscape, fraught with dangers, real and imagined.(Musa Mayer, Examining Myself:  One Woman’s Story of Breast Cancer Treatment and Recovery, 1994.).      

I have become more aware of how loneliness sometimes accompanies those who are living with heart failure, something I wrote about in my February post.  I am not immune to those same feelings, so when I was invited by a cardiac nurse to become a patient partner for Toronto’s UHN hospital community, I quickly agreed.  The Patient Partner program at UHN “recruits, selects, orients, and provides skill-building for UHN patients and caregivers, in order to contribute to important hospital planning and decision-making activities.”

I attended my orientation to the program in February, and afterward, I was eager for an engagement opportunity.  The planned “get acquainted” “evening with other patient partners was postponed due to a late February snowstorm, and my active involvement was put on hold until after my trip.  Nevertheless, I felt my motivation slipping.   The “get-together” was finally last week, but as the date arrived, I considered cancelling my attendance.  I’d had a full day of appointments and meetings, and my energy was waning.  Being an introvert by nature, making small talk with strangers is not something I enjoy, but I forced myself to go.  And frankly, I’m glad I did.

To my surprise, I experienced instant camaraderie with others in the room.  The program team facilitated a relaxed and friendly environment, ensuring we had time to have fun and get acquainted before breaking into small groups to discuss the pros and cons of the patient partner experience.  As we introduced ourselves, telling, in a few words, our different medical diagnoses and conditions, I was again humbled to hear others’ stories of illness, many enduring far more debilitating and serious conditions than I ever will.  Yet they’ve overcome extraordinary odds, are resilient and now actively participating in various hospital initiatives aimed at improving patient care, something I found truly inspiring.  I even had a surprise encounter with another patient partner.  We hadn’t recognized one another at first, but as we were talking, I realized he had been one of the managing partners at a former Toronto consulting firm where I worked right after graduate school.  In fact, he had hired me 33 years ago!  We laughed and marveled at the unexpected coincidence.  No longer “senior consultant” and “managing partner,” we are simply former colleagues who are now patients and volunteering at UHN.

It was a reminder of how illness levels the playing field between people, stripping us of the old symbols of status or hierarchy, humbling us and making us more compassionate.   In the kingdom of the sick, struggles, sorrow, and fear are part of the universal human experience.  We become more aware of our mortality.  The act sharing our stories of illness or suffering with one another helps to lessen our loneliness, make us feel less overwhelmed, even less sorry for ourselves.   We need one another as we navigate through the landscape called illness, to realize that even though we may be living with incurable conditions, there much more we are capable of being and of giving.

In the telling of our personal lives, we’re reminded of our basic, human qualities—our vulnerabilities and strengths, foolishness and wisdom, who we are…, through the exchange of stories, we help heal each other’s spirits.

–Patrice Vecchione, Writing and the Spiritual Life

Writing Suggestions:

  • Write about the moment you heard your diagnosis, “I’m sorry, but you have…” Describe that moment in as much detail as you can.
  • What is it like to cross the border into the unknown territory of life threatening illness?  What was it like at first?   What fears did you have?  What fears linger?
  • What old assumptions did you have to leave behind? How has your relationship with your body changed?
  • What has been the most helpful or supportive experience you’ve had as a patient?

 

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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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If this comes creased and creased again and soiled
as if I’d opened it a thousand times
to see if what I’d written here was right,
it’s all because I looked too long for you
to put in your pocket. Midnight says
the little gifts of loneliness come wrapped
by nervous fingers. What I wanted this
to say was that I want to be so close
that when you find it, it is warm from me.

“Pocket Poem,” By Ted Kooser; In:  Valentines: poems, 2008)

This past week, I addressed three brightly colored envelopes, red and pink, to the grandchildren who occupy such a big space in my heart.  I’ve been sending them valentines every February since they were first born, and for good measure, adding cards for their mothers, my daughters to the list.  One more card is hidden in my desk, which I’ll place on my husband’s desk early Thursday morning, a continuing tradition that, despite the many years that we’ve been together, remains intact.

Valentines, however entwined with rampant commercialism that accompanies all  holidays, began as a simple expression of love and gratitude, the first attributed to the Charles, Duke of Orleans, imprisoned in 1415 in the Tower of London after the Battle of Agincourt.  As the story goes, he passed his time writing romantic verses for his wife, who was still living in France.  Today, nearly sixty of the Duke’s poems remain and are considered as the first modern-day valentines.  Yet nearly three hundred years passed by before valentines became popular, their verses created by valentine writers in England in booklets that could be copied on decorative paper.  By the early 1800’s, valentines were constructed from simple black and white illustrations, painted and assembled in factories.  By the mid 1800’s, valentines were adorned with lace and ribbons, included affectionate messages and illustrations of turtle-doves, lovers’ knots in gold or silver, cupids and bleeding hearts.  Even though the valentines on display racks in card shops and drug stores now range from the flowery to the comical, I was surprised to learn that more cards are exchanged on Valentine’s Day than other time of the year except, perhaps, Christmas.

Like many of you, I first experienced the exchange of Valentine’s cards in kindergarten.  My teacher decorated a large hat box with red and white paper hearts, lace and ribbons. This, she explained was our valentine card mailbox, and each student was instructed to bring one valentine for each classmate, to be placed in the “mailbox” and exchanged at our Valentine’s Day party.  The excitement we all felt was palpable, and early on the morning of February 14, I awakened  and slipped out of bed quietly while my parents still slept.  I tiptoed into the living room of our upstairs apartment where a package of valentines lay on a card table, waiting to be addressed.

I was too excited to wait for my mother and went to work, painstakingly printing the one name I knew how to spell in dark blue ink.  By the time my mother walked into the room,  I’d addressed over two-thirds of the packet of 32 and proudly showed her my handiwork.  I didn’t expect her reaction, one of shock and “Oh, no, Sharon…what have you done?”  I’d addressed all the cards to my very best friend, another girl with the same name as mine, carefully printing, “To Sharon H., From Sharon B.” just as we were distinguished in our classroom.  My mother managed to salvage the remaining third for other children in the class, but the memory of that morning lingers.  As my teacher pulled one card after another from the decorated box and called out each recipient’s name, one classmate received many more valentines than anyone else.  “Why, here’s another card for Sharon H.,” she said, casting a knowing smile in my direction.  “I wonder who it’s from?”

Ted Kooser, former poet laureate of the U.S., began a Valentine’s tradition in 1986 that lasted nearly twenty years.  According to NPR, each February, many women around the country and found a postcard in their mailbox bearing a red heart with a poem on it-a valentine from Kooser.  He’d been inspired by a friend  who sent handmade valentines out each year, and in 1986, he sent his first Valentine, a “pocket poem,” to approximately 50 women he knew or had met at his poetry readings.

Over the years, whenever he made a public appearance, and with the blessing of his wife, Kooser invited women to add their names and addresses to his mailing list.  The list quickly grew from 50 in 1986 to 2700 by 2007, and his wife prompted him to “rein it in,” since by then he was spending nearly $1,000 in postage and printing. The enduring result was a collection of the poems he’d sent to the women on his mailing list, simply titled Valentines: poems (U. of Nebraska, 2008).  Valentine’s Day, he reminded his NPR audience in a 2008 All Things Considered broadcast, is a great holiday for a poet or anyone.  “It’s not tied up with anything other than expressions of sentiment,” he said.  Kooser remarked that his wife was very patient with the project, since he always wrote “special valentines” for her.

If  a loved one or friend is going through cancer treatment, showing your support in different ways can be like giving a valentine to them–ways that matter during the roller coaster ride of cancer diagnosis and treatment.  A dinner out or a gift of chocolates are unlikely to appeal to someone going through treatment, but there are, as MD and Oncologist/Hematologist  Cynthia Chua advises, “some wonderful things you can do for your Valentine… sometimes just ‘being there’ is a great gift. Just spend the day with your Valentine and show them how much you care.” She and writer Jennifer Mia offer some suggestions for celebrating Valentine’s Day together with someone who has cancer:

  1. Write a love note or make a card.
  2. Serve them breakfast in bed
  3. Pick up a stuffed animal for them to take to the next chemotherapy session.
  4. Rent a movie to watch together.
  5. Forgot to buy a card to send? Then send an e-card  or make time for a telephone call.
  6. Give the gift of journaling–a notebook of blank pages to write in.
  7. Offer a soft, cozy blanket for time in chemotherapy or a cold hospital room.

But let’s be clear:  You don’t need a Valentine’s Day to express that you care for someone.  You can do this at any time by sending a card, note, email or simply giving him or her a call to show you are thinking about them.  What matters is that you take the time to do it.  You might be surprised at how much it means to someone simply to know that someone cares or is grateful for him or her.  A few weeks ago, I gave my cardiologist a note of gratitude, written in the form of a somewhat humorous poem,  and what I discovered, in doing so, was how very much she appreciated it.

What matters in this world of busy-ness, stress, economic downturns, political drama or the instant and abbreviated communication we’ve succumbed to on the internet, is simply taking the time to express appreciation, concern or gratitude for the people you care about.  It’s a great gift.  You don’t have to wait for February 14th or any other specified holiday.  The simple act of pausing to remember those we care about and those who have cared for us in times of struggle, hardship or illness, reminds us of what matters most in our lives:  people, friendship, love.

“A Perfect Heart”

To make a perfect heart you take a sheet

of red construction paper…fold it once,

and crease it really heard, so it feels

as if your thumb might light up a match

 

then choose your scissors from the box.  I like

those safety scissors with the sticky blades

and the rubber grips that pinch a little skin

as you snip along.  They make you careful,

just as you should be, cutting out a heart

 

for someone you love.  Don’t worry that your curve

won’t make a valentine; it will.  Rely

on chewing on your lip and symmetry

to guide your hand along with special art.

And there it is at last:  a heart, a heart!

(By Ted Kooser, in:  Valentines: poems, 2008)

Writing Suggestions

  • Try writing a valentine this week, a poem, a postcard, even a letter—to someone you appreciate.
  • Why not write yourself a valentine,  saving it for a time when you might need a little self-care.
  • Perhaps you have your own memory of a long-ago Valentine’s Day.  Write it.
  • If writing a card or poem is not something you find easy to do, then pick up your phone and make a call to someone you care about.   Send an email or a Facebook message.  Wish them a happy Valentine’s Day, and let them know you are thinking about them.

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