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Archive for the ‘life writing’ Category

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

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

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

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

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

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


Am I a peninsula slowly turning into an island?

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

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

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

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

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

Would my desires feel different if I lived forever?

  (In:  Mercy Mercy Me, © 2000)

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

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

Writing Suggestions:

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

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

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

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

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

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

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

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

LOVE AFTER LOVE
by Derek Walcott

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

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

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

(Collected Poems, 1948 – 1984)

Writing Exercise

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

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

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

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

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

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

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

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

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

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

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

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


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

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

don’t have cancer anymore…

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


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


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


Writing Suggestions:

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

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

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I admit it.  The months of waiting, of social isolation, the greyness of winter, and more waiting for the promised vaccines have upended any of my resolve to remain calm, positive, and creative.  I wrote about “the long wait” earlier this month for my “writing the heart” blog, and this morning, searching for inspiration, I perused several of my blog posts for the past year, particularly those concerning the initial fear as COVID-19 became a daily reality for all of us, and life began to be defined by social distancing and “shelter in place.”  The summer months brought a kind of reprieve, although my husband and I, both in the “higher risk” category, remained cautious in our movements and interactions. 

Now, approaching a year later, I feel increasingly like I’m living some version of the Bill Murray film “Groundhog Day,” awakening each morning to a kind of mental sludge, reminding myself of what day it is, and yet attempting to maintain some semblance of normal routines…making the bed, sweeping the floor, planning what to cook for dinner, and even yet, writing every morning in the quiet.  That’s where my real mental and emotional state are expressed.  I can barely fill a page in my notebook some mornings.  Any attempts at creativity are more often futile than not.  Occasionally I manage a silly, rhyming poem that, at the least, can make my husband laugh, but even those efforts have become less frequent.  So I was strangely pleased to discover an article in the British newspaper, THE GUARDIAN, this weekend with the title, “Writer’s blockdown:  after a year inside, novelists are struggling to write.”

Well, I’m no prize-winning novelist, but writing is a significant part of my life, so I read the article immediately, feeling some sense of “oh thank goodness, it’s not just me” as I did.  “Drab days, author William Sutcliffe remarked.  “Last night I had a dream about unloading the dishwasher.”  “I can’t connect with my imagination,” Linda Grant, a prize-winning novelist said  “My whole brain is tied up with processing, processing, processing what’s going on in the world.”  She described “waking up in a fog and not wanting to do anything but watch rubbish TV.”  Well, I will now admit I have all but exhausted every British crime drama on Brit Box over the many months of our COVID pandemic life.  It’s just an example of what another author calls “pandemic fatigue” that is affecting everyone.  “Life,” Grant said, “is just a sea of greyness, of timelessness,” sentiments I often share.  Even my reading list has become populated with “easy” reads, like detective novels, a genre I rarely indulged in before COVID, just pure escapism.  And the creative cooking I did for several months?  Gone.  My motivation for trying new recipes, those once weekly batches of scones or even the occasional cake has completely vanished.  Worse, my morning writing is top heavy with greyness and anxiety before I finally settle into “healthier” prose, sometimes the occasional inspiration for one of my workshops or a silly poem for a friend or family member. 

Of course, it doesn’t help my anxiety that my U.S. friends and family members have cheerfully announced they’ve gotten their vaccinations, unaware, perhaps, of Canada’s vaccination delays.  Where we were hopeful toward the end of 2020 that we’d also have ours by now, it’s less and less likely we’ll feel that needle jab in our arms before April. That only feeds my anxiety as the delay persists, and we read reports of more infectious variants. As a “higher risk” candidate, I find I am driven to compulsively read the national and provincial COVID-19 updates daily, despite the fact I know it rarely helps my mood.  We also worry for those who’ve lost their jobs, their shops and businesses as the pandemic lockdowns continue.  What will life be like when this is over? It’s hard to find much that’s uplifting in all of this, and my daily mantras and meditations aren’t helping much at the moment. 

 It’s cold comfort, perhaps, but I am hardly alone in this–far from it. So many people are suffering far more than we are.  So while I allow my worry to surface or write a rant sometimes to let off steam, I am fully aware how important it is I don’t end up in self-pity for more than the briefest of periods.  I’ve learned to close my notebook and turn to other pursuits when I realize I’m heading down the rabbit hole.

“This too shall pass,” my mother would say at any time we had an upset in our childhood…we grew tired of her pat phrase, but now, I can hear her voice in my mind, those same four words repeated again and again.  While I never found them very helpful in relieving whatever angst or youthful heartbreak I was feeling, I now find variations of that same theme in the words of poets I have long admired.  I guess there’s some truth in my mother’s mantra.

Wait for now.

Distrust everything if you have to.

But trust the hours.  Haven’t they

Carried you everywhere, up to now?

Personal events will become interesting again.

Hair will become interesting.

Pain will become interesting

Buds that open out of season will become

     interesting…

(From “Wait,” by Galway Kinnell, in Mortal Acts; Mortal Words, 1980)

Writing Suggestions

–Fed up with waiting?  Set the timer for 15 minutes.  Try writing a rant, just “dumping” all your worry and frustration on the page.  When time is up, stop.

–Re-read what you’ve written.  What stands out? Now, start with the one thing that seems most important and, setting the timer again for another 15 minutes, explore what’s beneath the frustration.

–How are you coping with the extended period of social isolation and lockdown?  What helps?  What doesn’t?  Write a humorous “prescription” for coping with this extended wait.

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I’ve been thinking about loss and losing things as I and my long-time friends grow older, although it seems to on my mind more often in this long year of living with the COVID-19 pandemic.  There are many months ahead before we might be able to declare an “end” to it, but a return to something called “normal” life is likely to take even longer.  What will we have lost?  What will we have learned?  What will “normal” be like?

I think of the losses—not just the deaths suffered—but all the other losses suffered by so many:  large and small businesses going bust; jobs lost by so many people; the loss of freedoms during these necessary lockdowns that we took for granted…and so much more.

In the coming week, I’m beginning another expressive writing workshop for Gilda’s Club here in Toronto, and as I think about the sessions and the men and women who will attend, I think of the losses of cancer brings with it and how COVID-19 may add to the stress of living with a cancer diagnosis and the fear of loss.

What do you lose when you’re diagnosed and treated for cancer?  There are physical loses and emotional ones.  Some permanent; some temporary.  I thought back to one of my earlier writing groups a few years ago. A dozen people, all living with cancer, seated around the table with their notebooks open as I offered a short “warm-up” writing prompt at the beginning of the session..    

“What’s on your mind this morning?  What thoughts or concerns have accompanied you to our group?”  Within seconds, only the rustle of paper and pens could be heard, as everyone bowed their heads and wrote.   A few minutes later, I sounded the chime and asked, “Who wants to read what you’ve written?”  One woman, her head covered by a brightly colored scarf, quickly raised her hand. 

 “I’m angry about losing my hair,” she began.  “It was always long and full, and it’s was my signature.”  She looked up from her notebook, eyes red and teary.  Several of women nodded sympathetically.  I recalled my own embarrassment when, as a teenager, I sported a bald head twice after two neurosurgeries.  I had no choice but to cover my bare head and the ear-to-ear scar with brightly colored scarves as I returned to school after surgery.   I remember how vulnerable I felt without my hair, how embarrassed, and how I prayed no one would make fun of me.  

It grew back, of course, just as the young women’s hair did, becoming full and long again over time.  She was one of the lucky ones, just as I was; her hair loss was temporary.  She recovered and regained a full head of hair and an active life—in contrast to other group members, who’d lost far more than their hair. 

When I invite the participants to write about loss, temporary hair or diminished energy during treatment aren’t at the top of the list.  Bodies are altered by surgeries and scars.  Dreams are lost. Friends are lost.  Loved ones are lost—whether by death or by the dynamics of families unable to come together in crisis.  Although many may return to a so-called “normal” life, their lives are rarely the same as they were before cancer.  

Being human demands that we come to terms with different losses at different times in our lives, small or large. We all experience them.   Life requires our continual adjustment to the changing seasons of being alive and learning to let go of old ways of being that no longer serve us or are possible. It’s not easy, this business of loss and losing.  Yet, it is the thing we all are challenged to master—and learn from.

Then we couldn’t help expressing grief

So many things descended without warning:

labor wasted, loves lost, houses gone,

marriages broken, friends estranged,

ambitions worn away by immediate needs.

Words lined up in our throats

for a good whining.

Grief seemed like an endless river—

the only immortal flow of life.

After losing a land and then giving up a tongue,

we stopped talking of grief

Smiles began to brighten our faces.

We laugh a lot, at our own mess.

Things become beautiful,

even hailstones in the strawberry fields.

(From: “Ways of Talking, “by Ha Jin, in Facing Shadows,  1996)

Writing Suggestion:

Write about loss this week, about losing something—small or large—whether from cancer, life changes, unexpected tragedies or challenges.    Write what you felt.  Describe how you came to accept and move forward from the losses you suffered. 

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He opens the door

               and walks in,

his face and white coat

stiff with starch,

holds my hand, and

he says,

“I’m afraid.

I am afraid

you have cancer…”

From: “Diagnosis,” by Majid Mohiuddin, in The Cancer Poetry Project)

“Write about the moment when the doctor said, “Cancer.”  It’s usually the very first prompt I offer in a new series of my “writing through cancer” workshops.  That moment of confirmation, the seconds in which a physician delivers the words that, in that one instant, will change your life forever, is something everyone in the group shares, an event that evokes strong emotions as it gets written about and described. 

Writing that is most healing has some particular characteristics, as psychologist James Pennebaker and his colleagues have noted, among them, writing that is concrete, vivid, and gives detailed descriptions of trauma, distress and emotion.  When I ask group members to return to that first moment they hear the word, “cancer.” No one ever responds to this prompt with generalities.  And when they read what they’ve written aloud, it’s often emotional, as they remember their doctor’s words, “I’m sorry; you have cancer.” 

Shifting your perspective, from the immediate and first person (“I”) perspective, can sometimes reveal other aspects of your experience.  At the least, it’s interesting to try writing about that same moment of hearing your diagnosis, but instead of “I”, try using third person, “he or she” to refer to yourself.  It forces your perspective to shift a bit, as it you are looking at yourself in that moment and doing so can reveal other insights into what you experienced or how you reacted in that moment.

But consider the other’s point of view:  while those words, “you have cancer,” are unfamiliar and terrifying to us, to the doctor, they are words delivered many times, to many different people.  How difficult must it be to be the physician who delivers those words to a patient?  Not once, but so many times throughout one’s medical career? 

The door seems impenetrable.

Today is arduous.

I have seen patients with cancers of pancreas,

Gastric, cervix, colon—all unresectable…

Why is it so difficult to enter this room?

(From: “The Door,” by David H. Huffman, MD, in The Cancer Poetry Project, v. 1, 2001)

 “The Before,” written by Jennifer Frank, MD and published in the Journal of the American Medical Association, offers the reader a rare—and poignant–glimpse into the doctor’s mind as she prepares to call a patient with a cancer diagnosis, the words no one wants to hear.

This is the before.  A moment suspended like a bubble floating on a warm summer breeze gently but inevitably toward the ground.  I feel the pop coming, an implosion of the very center of your life.  Anticipating what this moment would hold, I nevertheless hoped for something different.  To be able to eagerly dial your number and shout out the good news to you in a breathless rush.  “It’s not what we thought.  It’s not cancer.”

Instead I take a deep breath, pressing each number slowly, cautiously, drawing out the moment before the burst.  The burst of your plans and your dreams and your future.  I stall for time, asking if this is a good time, are you alone, do you have a pen and paper? …

I want to be straightforward but not blunt.  I want to be compassionate but remain professional.  I slow myself down, remind myself that the words I’m about to say are ones that I’ve said before, many times, but that the words I’m about to say are also ones you’ve never heard before… (In: “A Piece of My Mind,” JAMA, March 7, 2012, v.307. no.9).

It’s difficult, when we are the patients, the ones receiving the diagnosis, to understand what is felt by the person delivering the bad news.  We may never completely understand what is behind the doctor’s mask, yet we need the practiced and steadfast hand of a professional to guide us through the upheaval, and help us find our way through a regimen of treatments.  “All I can offer is my hand,” Frank concludes, “…to hold you up, prevent you from going under until the sea calms and the path clears.” 

Several years ago, when I was leading writing workshops for the “Writers’ Workshop at Stanford Medical School,” I invited a group of medical students and physicians to “write about the moments just before you had to deliver bad news to a patient or someone close to you.”  What they wrote and read aloud were achingly honest and no less powerful than those written by the people living with cancer.   Their stories and poems offered a glimpse behind the medical mask, a reminder of what it is to be human, to care and to feel, whether patient or physician.  As Huffman expresses in his poem,

…I can only be forthright and compassionate.

Why is it so difficult to enter this room?

Maybe someday I will be in that bed.

I hope that if that time comes

My doctor will be as truthful and considerate.

But if she hesitates at the door…

I will understand.

Writing Suggestions–Changing Point of View:

This week, write about that moment, the one just before you hear the words “you have cancer.”  Remember, if you can, write in as much detail as you can:  what you were feeling, where you were sitting or standing, what you remember about your doctor’s voice, eyes, face.  Write in the first person, “I.”

Then, as options to try a different point of view, write about that same moment again, but instead of “I,” write in the third person, as if you’re watching yourself from a distance, using “he or she” or she to write about that same moment.  

Now, as an even more intriguing perspective, try putting yourself in your doctor’s shoes and write from her or his perspective.  Imagine you are the one who must deliver the bad news, this diagnosis, to you.  What the doctor might have seen as she or he looked at you or heard when you came to the telephone?  What might she or he have felt?  Write in as much detail as you can. 

When you finish writing in either the third person to refer to yourself OR writing from the imagined doctor’s perspective, compare the versions.  Did anything change in the way you think about that moment? Did you discover any new insights or understanding?  What was it like to write from the doctor’s point of view? 

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The new year always brings us what we want
Simply by bringing us along—to see
A calendar with every day uncrossed,
A field of snow without a single footprint.


(From: “New Year’s” by Dana Goia, from Interrogations at Noon, 2001)

For several days now, I have been reflecting on the year gone by, 2020, the year of a pandemic, of social isolation, masks and lockdowns…a year unlike any I’ve experienced before, challenging my assumptions about life and living, daily reports of escalating cases of COVID and of deaths.  An undercurrent of caution, of worry seeping into my daily life…hope, much of the year, seemed elusive, and I struggled, some days, to dig myself out of a persistent case of the blues.

Rewinding the mental tape of the year just passed, I recalled my intention, the choice of my guiding word, for 2020. “Calm.”   It has been impossible to miss, this word, displayed, as I do each year, in a small frame on the bookshelf in my office.  A word that confronted me every single day of the past year, but a one, given the landscape of 2020, that fell by the wayside within weeks of the first COVID case in Canada.  Calm was all but absent in the context of this past year for me.  I fall into the category of “higher risk” where COVID is concerned, and given the political tension and upheaval in the US too difficult to ignore, my days were nagged by a persistent undercurrent of worry and low-level anxiety.  I tried, for a time, to live with “calm” daily, but despite frequent self-admonitions, attempts at meditation and extended periods of deep breathing, it didn’t work.  Tension and anxiety were my regular visitors.  Any pretense of calm was just that, utter and complete pretense.

With the daily onslaught of reporting—which I tried not to read and failed miserably—whether about new numbers of COVID cases and deaths or the nearly unbelievable reports of the circus surrounding the US presidential campaign and election, hope was nearly nonexistent, at best, a slender thread that seemed to be growing fainter each day.  My notebook attests to the dark cloud that grew and hovered overhead.  I wrote, as is my daily habit, but increasingly, I found myself going down the rabbit hole more than a few times.  Gradually, I found a reprieve in the daily practice of making explicit my gratitude for those on the front lines, unexpected kindnesses, shared laughter, and little surprises or inspiration from others. 

Articulating gratitude became the most important habit in my daily life, the one that balanced out the tension, complaints, worry or depression.  It served to remind me of the gifts I have in my life vs. what I didn’t.  Making gratitude explicit in a daily list, halted those self-defeating thoughts and forced me to be quiet, observe, and remember all that enriches my life.  It’s what I want to carry into this new year, a spirit of gratitude.

2021.  Hope, where the pandemic is concerned, is within reach, even though there is still much healing ahead of us in the coming months.  Yet as I say good-bye to this tumultuous and difficult year, I do not want to forget all that has happened around the world and there is yet much work to do for the good of all people:  eliminating disease, hunger, poverty, violence, racism, and wanton disregard for this fragile planet.

It’s no surprise that the guiding word I have chosen for 2021 is simply “gratitude.”  It’s not only a way of remembering what is good in my life, but hopefully, makes me more aware and intentional in responding to others with kindness, generosity, and forgiveness.  This is the only life I’ve got—gratitude also ensures I am intentional in how I live it, and the kind of footprint I leave in each day of the year ahead.

Starting here, what do you want to remember?
How sunlight creeps along a shining floor?
What scent of old wood hovers, what softened
sound from outside fills the air?

Will you ever bring a better gift for the world
than the breathing respect that you carry
wherever you go right now? Are you waiting
for time to show you some better thoughts?

When you turn around, starting here, lift this 
new glimpse that you found; carry into evening
all that you want from this day. This interval you spent
reading or hearing this, keep it for life –

What can anyone give you greater than now,
starting here, right in this room, when you turn around?

(“You Reading This, Be Ready,” by William Stafford, from The Way It Is, 1992)

Writing Suggestions:

.  What is the word or intention you have for this new year?  Write it down, exploring the reasons you have chosen this one word to frame your intention.

.  I’m not one for resolutions, since I rarely followed through on the vast majority of them, despite my good intentions!  But if resolutions for the new year are your preference, then write them out—and also spend some time exploring the reasons for each one you’ve chosen.

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I’ve been trying to summon up something that resembles the “Christmas spirit,” muted by this time of social isolation and continuing lockdowns.  For years, our holidays were filled with family traditions, memories, and the excitement of Santa’s arrival during the night of December 24th— all re-experienced years in the wide-eyed excitement of our grandchildren.  Now they are old enough to know that Santa Claus isn’t “real,” but their joy and excitement are as fresh as ever, and sharing the holidays with them, re-kindles our own memories of our childhood Christmases.

Yet this year, with COVID cases rising again at a disturbing rate, we will, like so many others, be spending our Christmas alone. Isolated from my daughters by distance or the pandemic, the usual magic of Christmas tree trimming, colored lights everywhere, holiday carols, and the remembrance of Santa Claus seem like distant memories.   At times we struggle to quell our anxiety and cling to hope—as so many others in a time time that has unended our sense of well-being, community, and hope.  The vaccine can’t come soon enough—but even as it begins to arrive, then what will “normal” life look like?  What losses are yet to be fully realized?  There are challenges yet we will all face.

I’ve been thinking a lot about Christmases past—those that were joyful; others that were accompanied by losses and difficulties.  I’ve remembered childhood, when Christmas was a magical time, and I, like all the children my age, believed in Santa Claus.  Those memories also reminded me of the time I discovered Santa really didn’t exist…

Third grade. I was eight years old, and it was early December, shortly before our Christmas break. I arrived at school morning and was hanging up my winter coat in the cloakroom when my two best friends came in and pulled me aside.  “Guess what,” they whispered, “There is no Santa Claus!” I stood stock still, trying to take in what they were telling me.   Santa, they said, was made up.  He was something for little children, not for 8 year old girls like us.  “It’s your mom and dad,” they whispered conspiratorially. They buy all the presents and put them under the tree.  Santa Claus isn’t real. He’s just for little kids!”  They smiled smugly, watching to see my reaction.

 “I know,” I said quietly. I didn’t want to appear stupid, but I was embarrassed, because the truth of the matter was this: I still believed in Santa Claus, even in third grade.  Besides, I had a younger sister and brother, so Santa Claus was very much alive in our home.  I returned home after school that day with the weight of an awful secret on my shoulders. Should I should tell my parents I knew there really was no Santa after all?  In the end, I said nothing and a day or two later, my sister and I came down with the chicken pox, just days before the Christmas break.  There would be no visit to sit on Santa’s lap that year.

Shortly after dinner, Christmas eve, a loud knock sounded at the front door and we heard a deep voice saying, “ho, ho, ho.”

“I wonder who that might be,” my father said, winking at my mother as he went to open the door.  Santa Claus, somewhat slenderer than I had imagined, stepped into the front room.   “Ho, ho, ho,” he said again, then took his big bag of presents from his shoulder and sat in the chair my father offered, telling us to come close to Santa. I could only stare, the secret told to me by my friends burning in my brain. Was this really Santa or just someone pretending?

There’s an old black and white photograph from that long ago Christmas eve:  my little brother sits on Santa’s knee, my wide-eyed sister next to him, while I am seated farthest from him, doubt clearly etched on my face.   I still remember how much I wanted to believe it was really Santa Claus sitting with us, but I couldn’t. I was now old enough to know better.

Early the next morning, , I tiptoed to the living room before the rest of the family awakened, eager to see the presents which had appeared under the tree during the night.  Our colored tree lights had been left on and the were drapes open to make them visible to passers-by.  I knelt at the big picture window and looked out:  snow had fallen during the night, frosting streets and sidewalks a sparkly white.  That’s when I saw him—Santa Claus. He was opening the gate to a neighbor’s house just three doors down from ours and walking inside.   For an almost magical moment, the possibility of Santa Claus’s existence lingered that Christmas morning, snow glistening in the morning sunlight, as I watched a bearded man in a red Santa suit disappearing inside, an empty burlap bag slung over his shoulder.

I stopped believing in Santa for good after that year, but the memory of that last glimpse of him, remained for a time–the faint hope he might exist. It was about what it meant to grow older and be conflicted: not wanting cling to childish beliefs, and yet, reluctant to let go of the magic of Santa Claus for just a bit longer.  There would be similar life lessons repeated many times in my life—broken dreams, discovered truths that were hard but necessary to accept, losses of people and beliefs I thought never could happen.  But that’s life, isn’t it?  We all come to terms with the difficult parts as well as the good, and somehow, we still find hope, good, and love in the midst of life’s most challenging moments–maybe even magic or miracles… just like that earnest eight year-old gazing out the window on a Christmas morning, the first snow glistening, while a man in a Santa suit disappeared into a house and rekindled a hope that maybe, just maybe, Santa existed.

It is probably why I still love the famous letter written by Francis Church, then a writer for the New York Sun, responding to eight year-old Virginia O’Hanlon’s letter asking, “Please tell me the truth.  Is there a Santa Claus?” Church was given the task of responding to her.  He wrote:

     Yes, Virginia, there is a Santa Claus. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy. Alas! how dreary would be the world if there were no Santa Claus! It would be as dreary as if there were no Virginias. There would be no childlike faith then, no poetry, no romance to make tolerable this existence.

     We should have no enjoyment, except in sense and sight. The external light with which childhood fills the world would be extinguished.  (From: “Is There a Santa Claus?”The New York Sun,September 21, 1897)

I don’t know about you, but I’m not going to give up on the spirt of Santa Claus, of the generosity, kindness, courage and gratitude I have for the gifts of life I have experienced during my lifetime. It’s those memories and qualities that keep me going and give me courage and hope.

To all those reading this blog, I wish you a holiday season that includes the warmth of friends and family, however far apart we must be this year, and for year ahead, hope and healing.

Happy Holidays.

Writing Suggestions

The December holidays are full of memories. Whatever your traditions, write about some of the most “alive” memories you have of this time of year–what stands out for you?

Did you believe in Santa Clause when you were a child? When did you stop? Was it any specific event that changed your belief? Write about it.

What, in this year’s holiday season, will be different for you? How are you making it–or not–a time of celebration, even without the usual activities,family or friends as part of it?

What’s most important for you to remember this holiday season? Why?

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Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude. ― A.A. Milne, Winnie the Pooh

It’s been nearly two weeks since I awakened in the middle of the night with a horrible sore throat, one that quickly turned into bronchitis.  I was quick to baby myself, staying in bed, drinking fluids, resting and crossing my fingers that the deepening cough which had followed was nothing to worry about.  Several days later, I began to feel better, but that was short-lived.  The next night I began coughing so hard and often I could not lie down, and spent the weekend propped up in a sitting position in hopes I could get at least an hour or two of sleep.  That didn’t work, and this past Monday, at the advice of my family doctor, I ended up in the Acute Ambulatory Care Unit at a downtown hospital for bloodwork, chest x-rays, a second COVID test (both negative) and\ doctor’s examination.  Four and a half hours, I returned home, exhausted, grumpy, and with a prescription to help relieve the congestion in my left lung.

I haven’t been in the best of moods, weary of being sick and more housebound than ever with the combination of a chest cold and a serious second wave of the Corona virus. Yet I tried to write a much overdue post, deciding to write about the experience of waiting–something we’re all doing as the pandemic continues to take its toll and vaccines have not yet been made available.  Thinking about waiting only made my mood worse, so I stopped writing.   Frankly I’ve found it increasingly difficult to write anything as these many months of COVID-19 life have continued.

Yet, I’ve tried to keep my appointment with my muse despite her disappearance, and again early this morning, I sat staring out the window, notebook and pen in hand, watching the sun rise over Lake Ontario.  “I’ve dumped the attempt of writing about waiting,” I wrote at the top of the page.  “What on earth can I write about?”

I had no answer to the question, so I paused, remembering the long day spent at the hospital. What came to mind wasn’t the long period of waiting, rather, it was the kindness and care the hospital staff– from the health professional who drew my blood to the nurses at the unit desk, to the physician who conducted my physical examination.  As the afternoon wore on, one nurse even brought me a warm meal of chicken cacciatore and vegetables, which I hungrily wolfed down.

Then I recalled the responsiveness of my family doctor during our telephone consultation early Monday morning.  Not only that, but I’d received a call from the cardiac clinic and the nurse who monitors the daily reports of heart patients’ symptoms—recorded and sent virtually by the innovative app, “Medley.”  On Monday, my reported symptoms included shortness of breath and greater fatigue. She made certain my cardiologist was informed, and that, too, was reassuring.  At a time when our healthcare workers are again on the front lines, working hard to provide care and services to the rapidly increasing numbers of people infected with the Corona virus, experiencing such concern, care and kindness was humbling. I remembered then how lucky–and grateful–I am.

Somehow, in the many months of COVID, my daily practice of ending my daily writing time by focusing on gratitude had disappeared. Boredom, the blues, interminable periods of self-isolation and waiting for some sense of normality to resume have taken their toll.  This morning I again began a gratitude list. On it, my doctors, my husband (who has been wonderfully caring), my little dog (following me evrywhere, quietly positioning herself closer to me whenever she can), and my daughters and friends who’ve checked in daily to see how I’m doing.  Rembering each, I felt better—more positive and a lot less cranky.

According to Robert Emmons, PhD, professor of psychology at University of California, Davis, “Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life.”Among its many benefits are lower blood pressure, improved immune function and even better sleep.  But there’s more.  A study conducted at UC San Diego’s School of Medicine found that grateful people actually had better heart health with less inflammation and healthier heart rhythms.  Other university research studies have also found that gratitude boosts our immune systems, reduces stress hormones and may reduce the effects of aging to the brain.  “Gratitude works,” says Dr. Emmons, “because…it recruits other positive emotions that have direct physical benefits.” 

It is gratitude that I want to remember during these difficult and trying times.  Some days it takes more effort to find it amid my crankiness, impatience, boredom in the “sameness” of our days, but the bottom line?  I’m lucky to be feeling better, to be able to do all I do, even if, for the moment, those things are simpler than I sometimes like.  It’s life, and I’m grateful I have mine.


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…

“Starfish,” by Eleanor Lerman, in:  Our Post-Soviet History Unfolds, 2005)

Writing Suggestions:

  • Try developing—or re-igniting a practice of gratitude.   Simply list 3 – 5 things you are grateful for each day.  Do this for a week, faithfully.  Do you notice any changes in yourself?  Continue the practice for another week or two, then reflect on it in more depth.  What changed?  Did it help you be more aware of the life around you?  Did you feel more positive? Calmer? Happier?
  • Practice noticing and appreciating the ordinary.  Find gratitude for the simple joys of living.   Choose one small moment from any day, whether from nature, loved ones, your daily routine—a simple pleasure that sustains, inspires or offers you joy.  Describe it in as much detail as you can; perhaps you’ll find a poem or a story lurking there. 

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When death comes
like the hungry bear in autumn;
when death comes and takes all the bright coins from his purse

to buy me, and snaps the purse shut…
when death comes
like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering:
what is it going to be like, that cottage of darkness?

(excerpt, “When Death Comes,” by Mary Oliver, in New & Selected Poems, 2004)

This morning, the newspaper headlines announced Canada’s COVID-19 death numbers had surpassed 10,000, clear evidence of the continuing second wave of this pandemic in our lives.  I try not to spend too much time reading about the COVID-19 statistics now; to do so only increases my anxiety and more, is a stark reminder that we are far from an end to this current state of social distancing, lockdowns, and face masks as a necessary part of our daily attire.  My husband and I are both high risk—he, a cancer survivor, me, living with heart failure, and both of us older. In these times, that fear of mortality can easily creep into my thoughts, usually late at night, a shadowy presence that is the evitability of life. 

This past weekend, I gave a Zoom session on journaling at the National Symposium for Ovarian Cancer Canada. After introducing a short writing exercise on fear, one attendee offered to read what she’d written:  an emotional admission that the fear of death that is constantly in her thoughts—echoing what many of those attending the session were feeling—and in a time of a pandemic, the prospect of death, of grief, seems to be much nearer. 

We haven’t lost any of our friends or family to COVID-19, but we have lost some people dear to us from cancer recently, which forces the topic of mortality and grieving out in the open.   My husband and I have talked about the grief of a friend’s partner in the past weeks, even though his death was expected as any further treatment options for his cancer had been exhausted.   His death and his wife’s loss reminded me of the death of my husband’s brother-in-law a few years ago, and his sister’s grief.  His death was not unexpected either; he’d endured an agonizing four year battle with bladder cancer, but his wife’s grief had been held in abeyance as treatment after treatment failed, the medical expenses increased, and he clung to life and hoped for a miracle. 

But the dam broke after he died.  I telephoned my sister-in-law the morning my husband boarded the airplane to fly to Seattle for Ed’s funeral.  It rang several times before Joan answered.  She had been crying and quickly apologized.  “I’m sorry,” she said, “I just went into his room and saw how empty it is, and…He’s gone, Sharon,” she said, her voice heavy with sorrow and exhaustion.  “He’s been my life for sixty-four years.” 

It is hard to give up after months of making lists,

phoning doctors, fighting entropy.  But when the end comes,

a bending takes over, empties the blood of opposition

and with a gentle skill, injects a blessed numbness…

(From “Numb,” by Florence Weinberger, in The Cancer Poetry Project, 2001)

There’s a great deal written about dealing with the loss of a loved one from cancer, and while some may think of grief as a single instance or short time of pain or sadness in response to the loss—like the tears shed at a loved one’s funeral—as the American Cancer Society reminds us, the real process of grieving lasts much longer and involves the entire emotional process of coping with the loss.

This morning, I plan on touching base with the friend whose husband died a few weeks ago from prostate cancer.    I check in with her every couple of weeks, remembering too well that emptiness after a spouse’s death, after the calls, sympathy cards, and flowers, and the the reality of living without one’s loved one—the unexpected emptiness in the home, the silences, and diminishment of calls from acquaintances.  The loneliness.   In our last conversation, she described what she’d been doing to keep busy.  She and her husband, like my husband’s sister, had been together for sixty plus years.  “I haven’t cried yet,” she remarked.

 It’s hardly a surprise.  According to the American Cancer Society, studies have identified emotional states that people may go through while grieving. The first feelings usually include shock or numbness. Then, as the person sees how his or her life is affected by the loss, emotions start to surface. The early sense of disbelief is often replaced by emotional upheaval, which can involve anger, loneliness, uncertainty, or denial. These feelings can come and go over a long period of time. The final phase of grief is the one in which people find ways to come to terms with and accept the loss.

Perhaps this surrender foreshadows my own old age

when I have raged to exhaustion and finally have to go.  For now,

the numbness wears off.  I drive to the market, cook my own food,

take scant note of desire

with no one to consider or contradict my choices.

Something in me will never recover.  Something in me will go on.

Life, death—these are the shared human experiences.  I know that, for me, the death of a family member or a close friend stays with me longer now—partly because death seems to be more with us in the time of a pandemic and partly too, because autumn, that final burst of color before winter sets in, is a time of looking back, remembering, being more aware of life—and of death too.   

Writing Suggestion:

This week, consider grief and mourning.  What memories come up?  Have you lost loved ones to cancer, unexpected death or other serious illnesses? Write about the loss of a spouse, family member or friend. Try to articulate the feelings of grief you experienced. What was it like? What helped you work through your grief?

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