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Archive for the ‘writing as a way of healing’ Category

The attempt to develop a sense of humor and to see things in a humorous light is some kind of a trick learned while mastering the art of living. –Victor Frankl (Man’s Search for Meaning)

It was the first time I’d met them:  first workshop on the first morning of a three day YACC retreat (Young Adults with Cancer, Canada). They dove into writing with candor and openness, a tall order for a group of young adults living with cancer at a weekend retreat.  Given our time constraints, there was little time to discuss writing’s healing benefits or provide a warm-up exercise.  We dove directly into writing about their cancer experience:  that first terrible moment of diagnosis, the life they’d had before cancer, the fears and also the sorrows before, taking a sharp turn in the final half hour of the second day.  “Tell me a funny story,” I said, asking them to describe a humorous moment during their cancer experience that made them laugh. I gave them only a short time to write, they all began writing, some quickly, others smiling or chuckling to themselves as their pens moved across the page.

Wait.  Was I nuts?  You might be asking, “What’s so funny about cancer?”  It turns out that there is a lot that happens during cancer that can make us laugh. I recall one woman at Stanford Cancer Center years ago who, when she lost her hair during chemotherapy, would arrive for her treatment with a variety of funny stickers applied to her bald head.  She wasn’t the only one smiling.  It is a known fact that laughter has beneficial effects on health and well-being.  Do you recall the remarkable story of writer and editor, Norman Cousins, author of Anatomy of an Illness (1979)? Diagnosed in 1964 with ankylosing spondylitis, a rare disease of the connective tissues, his doctor told him he had a 1 in 500 chance of survival and should ”get his affairs in order.”

Cousins refused to accept a death sentence, fired his doctor and found another who agreed to partner with him in his treatment and recovery.  He began researching his disease, looking for a possible cure.  Laughter became a critical aspect of his treatment.  As part of an experimental treatment, he began a steady diet of watching old comic films like the Marx Brothers and the “Candid Camera” television shows.  The humor in them made him laugh, sometimes so hard his stomach hurt.  Cousins ultimately recovered and lived another twenty-six years.

A few years ago, I was experiencing swelling and pain in the left side of my forehead where my steel plate had been inserted during my teenage years after surgery for osteomyelitis of the skull and an abscess against the membrane of the brain.  The plate replaced the area where infected bone was removed and held in place with 23 screws into the surrounding bone.

My family doctor referred me to a specialist. After several tests and bone scans, I returned to hear the results and his diagnosis.  I tried masking my worry and nervousness with a smile and sat across from the physician.        “Sharon,” he began, “we can only discern that the problem is… (here he paused a bit before continuing) a loose screw.”

I felt my mouth twitching as I tried to suppress a nervous giggle.  “You’re joking, right?” I asked.

No, he said, he was not joking.  The only plausible explanation for what I was experiencing was that simple.  I returned home, worried that as I aged and lost bone density, there might be a bit of slippage of my left forehead down my face.  My brother was visiting that evening and as I walked into the house, he greeted me with a worried expression.

“So what did the doctor say?”

“He said it’s because of a loose screw in my forehead.”

My brother’s mouth twitched.  He thought I was joking.  “Well, we all know that, he said, laughing, “so now, what’s the real diagnosis?”

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

The funniest part of it all was that the more I allowed myself to laugh, the more therapeutic my tears became. Jim Higley,  (“Finding Humor in the Midst of Cancer,” Coping with Cancer Magazine, March/April 2012)

To think about humor and laughter in the midst of cancer treatment seems, at first, to be counterintuitive, almost an affront.  But it’s not.  In the writing groups I have led for cancer patients and survivors over the years, laughter is as much a part of the responses to shared stories as the tears, anger and frustration.  The YACC participants were no exception.  We broke into smaller groups to read and share their funny stories of the cancer experience, and within moments, laughter filled the room.  It turned out that there were a lot of humorous moments in cancer.  One of the participants had even turned her colo-rectal cancer diagnosis and treatment into a stand-up comedy act, something several former cancer patients have done.

Six years ago, I was a speaker at an Omega Institute program titled “Living Well with Cancer.” Acknowledging that for some, cancer had become a chronic disease, “the program focused on optimizing resiliency at every life stage,” and included presentations and workshops on meditation, expressive writing, yoga, mindfulness walking and a keynote address by Dr. Jeremy Geffen, MD, author of The Seven Levels of Healing.  On the final evening, however, the program took a decidedly lighter tone as former CURE Magazine editor Kathy LaTour and comedian Skip Backus entertained us with comedy acts of their cancer experiences, resulting in loud and infectious laughter from everyone in the room.  Laughing, it turned out, was just as much about resiliency as all the other topics discussed during the weekend.

What does laughter do for us, whether combating a disease or simply navigating through our busy, stressful lives?  It breaks the ice; relaxes people and builds community.  Even in the midst of something as soul shattering as a cancer diagnosis, we still find things that make us smile.  When you laugh, your outlook is brightened, and that has positive effects on your health.  Research has shown that laughter relieves stress and pain, boosts the immune system and reduces blood pressure.  No wonder laughter is good medicine.  Besides, ten to fifteen minutes of laughing burns about 50 calories!

The human race has only one really effective weapon and that’s laughter.  The moment it arises, all our hardnesses yield, all our irritations and resentments slip away, and a sunny spirit takes their place.–Mark Twain

 Oh, about that loose screw diagnosis I received…  It turns out that simply taking amoxicillin before dental treatment resolved the issue.  My forehead hasn’t slipped a bit.

Let’s face it:  smiling and laughter are contagious.  Whether during cancer treatment or simply living in a world be constantly dominated by crises, hardship and struggle, it’s good to find something—even a small thing—to smile or laugh about together.

Writing Suggestions:

  • Take a break from writing about the cancer experience, the more serious topics of life. Instead, dig back into your memories.
  • Write about a time, describing in as much detail as you can,a time something made you laugh, perhaps hard enough to make tears run down your cheeks, a humorous event that makes you smile, even as you begin to recall the memory of it.
  • Read it and perhaps share your story with a friend or family member. Let a little “ha, ha” brighten your day.

 

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She is alive.  Although her doctors said

there was nothing to be done, she is home,

planting her summer garden, is not dead,

and plans to eat everything she has grown…

She will live

beyond the harvest and what will not grow

is her tumor…

this is her time

to cultivate and seed.  She is alive.

(From:  “Seed,” by Floyd Skloot, in The Cancer Poetry Project, 2001)

You’ve finished your treatment.  The doctor’s words are something like “cancer free” or “no evidence of disease.”  You’ve beaten the odds.  You’re a survivor.  You celebrate.  But little by little, you find you’re riding on an emotional roller coaster some days, and you can’t seem to get yourself going and doing all you promised you’d do if you survived cancer.  “Why,” you ask a friend or a partner, “do I feel so bad?”

The good news about cancer, according to a 2011 article by Ann McDonald appearing in Harvard Health, is that “nearly 12 million Americans—4% of the population—are still alive after a cancer diagnosis.  While that’s encouraging news and “a testament to improved diagnosis and treatment…survivorship comes at a psychological price.”

McDonald describes three major and common reactions to survivorship:  1)  becoming emotionally paralyzed by the specter of cancer and unable to re-engage with normal life activities, 2) fears of recurrence, when follow-up medical visits and tests or unexplained pain or other symptoms produce worry and anxiety, and 3) feeling guilty when other friends or acquaintances have not survived.  It’s no wonder really.  As Alice Hoffman, novelist and cancer survivor, described it,

These are the chapters of your life that wallop you and teach you and bring you to tears, that invite you to step to the other side of the curtain, the one that divides those of us who must face our destiny sooner rather than later.– NYT Times, August 2000.

Yet, what other choice to do you have but to learn how to survive the crises life sometimes presents to you, whether cancer or some other hardship?   When you are undergoing treatment, surgeries and chemotherapy, the prospect of survival dominates your life.  You want to be a survivor, one, as the Oxford American Dictionary defines as “a person remaining alive after an event in which others have died,” such as those 9/11 survivors or those who survived the sinking of the Titanic.  It is also a term the Oxford defines as “a person who copes well with difficulties in… life,” something that seems virtually synonymous with being human.

What ignites your will to survive and helps you cope and keep going?  It’s different for all of us and yet, so much the same.  Hope is surely one of those things that keeps us going.  The support and love of friends and loved ones are also important to our will to survive–even, at times, those who have yet to be born.

A., a beloved writing group member who died from metastatic breast cancer, demonstrated extraordinary determination to live fully for as long as she could, filling her days with family, friends, travel, and joy. Her oldest daughter was pregnant, and she was determined to survive to be present for her first grandchild’s birth, even though the odds were very much against her.  She died a month after he was born, but she lived to be present at his birth and hold him in her arms for the short time she had left.  I have no doubt that his impending arrival strengthened her will to live and experience the joy of his arrival.

J., another of my former writers, given a terminal diagnosis of acute lymphoblastic leukemia, evidenced a strong will to survive from the moment I met him.  Not surprisingly, he underwent a bone marrow transplant and intent on living as long as he possibly could, lived for another  five years before dying.  He engaged fully with living during that time, and he wrote poignantly, humorously, and honestly about his cancer struggle in the group and later, on his personal blog. Shortly before he died, he sent me a copy of an essay, entitled “What I’ve Learned,” summarizing the lessons of  his cancer experience.  Among the many bits of wisdom he expressed, he reminded us all that survival, no matter how brief or lengthy, is about living fully, for as long as we have.  Among  J.’s survival tips were:

  • Work at what you love…
  • Travel light.
  • Do what the doctors tell you.
  • Offer support when you can and it will come back to you when you need it.·
  • Cherish the ones you cherish.
  • In the end, all your physical beauty and prowess will leave you. You must still love that person in the mirror
  • We all will die eventually, so find a way to face death without fear. Don’t dwell on death, but enjoy each day as best you can.

He gave us good advice, because in life, we are all survivors of something.  Life is sometimes challenging, and you may face tough chapters to navigate through. Surviving–and surviving well– is something we all have to learn–and relearn–multiple times in our lives.  As your life continues to change, another challenge or difficulty can make you feel uncertain, clumsy or tentative.  But surviving isn’t about giving up.  It requires you learn new ways of being–and that is not always easy or pleasant.

Whether cancer, the effects of aging, unexpected life transitions, from time to time you have to remind yourselves that you’ve  proven, again and again, that you can adjust and move on.  As your life continues to change–in subtle and not so subtle ways–you learn the new movements, necessary strategies and behaviors.  Even better, you may learn how to move beyond “just” surviving and rather, fully embracing the life before you–changed and different perhaps, but yours.  After all, it is the only life you have, and you need to care for it.

…and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,

determined to do
the only thing you could do–
determined to save
the only life you could save. 

(From:  “The Journey,” by Mary Oliver, in Dreamwork, 1986)

Writing Suggestions:

  • How do you think of or define “survival?”
  • As a cancer survivor, what advice would you offer others newly diagnosed?
  • Describe a different time, cancer excluded, when life knocked you down.  What got you back on your feet?  What helped you survive?
  • After you were designated “cancer-free,” did you experience any difficulty in learning to live fully again?  What helped you re-engage?

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A few years ago, I received a note from Sister Anne Higgins, author of the blog, “Scattered Showers in a Clear Sky” a blend of narrative, photographs and poetry. 2011, when   Her blog posts continue, more oriented today to current issues, but in 2011, when she first wrote me,  she was going through cancer treatment, and a line from one of her poems, “At the Gettysburg Cancer Center,” still lingers in my mind:   “Here is the club you never want to join…”

Sister Anne’s words reminded me of a phone call I once received from a cancer survivor several years ago soon after she learned I had been diagnosed with early stage breast cancer.  “You’ll find you belong to a private sorority,” she said, “one you never knew existed until now.”  I appreciated her call, but even during my university years, I was never one to join clubs or sororities, and I rang off certain I didn’t want to belong to any “private” cancer sorority or club.  However, I was in denial, a state of numbness and disbelief that would last more than a few days.

I didn’t have a choice, as it turned out; life had forced me into the cancer club.  Many weeks later, during the seven weeks of radiation treatments, I acknowledged my membership when, responding to a writing prompt–one single sentence, “the hospital corridor was dimly lit,” I wrote: “I turn left into the waiting room; a montage of faces greets me:  men, women, a teenage girl, a grade-school boy.  Some with hair; others without.  We are all members of a private club.  We meet each day at 3 p.m., wearing the pale blue hospital gowns, the uniforms of anonymity, as we sit in silence…”

Cancer isn’t the only circumstance or time in your lifes that you may be labeled by hardship, trauma or illness.  In those moments, it’s as if life is dealing from a deck of cards  in game we never even wanted to join, as one former kidney cancer patient described:

Hit me.

Two cards down.  Two more dealt and…the wild card, stark in your hand…the cancer card…you want your discard back; you want to fold…you were so certain you didn’t belong here, in this neighborhood, playing this game, but Oh-Yes-You-Do.

These are the life cards no one wants to be dealt, the memberships and labels you didn’t choose:  cancer survivor, heart patient, war veteran, single parent, homeless, refugee, widows or widowers, living with disability, on and on.  The list is endless, and sometimes, without warning, you suddenly find a new label is thrust upon you. You feel vulnerable, exposed, and even violated, as Molly Redmond describes in her poem, “The Cancer Patient Talks Back,”

It has made me public property, like being largely pregnant.

People invade—an assault of connections—

for reasons fair and foul.

Strangers on elevators. Acquaintances.

The medical cadre too.

Either way,

I am covered with fingerprints, with labels…

(From:  The Cancer Poetry Project, Vol. 1, 2001, Karin Miller, Ed.)

You protest, even try to deny this new reality, as Kathleen Rogers’ poem, “A Woman Argues with the Casting Director,” portrays:

I don’t, don’t want the part.

I really don’t what this part.

I don’t, I don’t believe it will be glamorous.

It won’t be opera, no swooning diva,

No Violetta, no burst of aria…

I told you—didn’t I tell you?—

I don’t, don’t, don’t, don’t want

this part…

(The Cancer Poetry Project, V. 1)

Well, you’ve gotten the part; you’ve drawn the card; you’ve been given the label.  You find you’re in the club you never asked to join.  Now what?

That new label is where you begin. “Cancer patient,” “living with cancer:” these are new identities that introduce new memberships but also strong emotions.  For example, those who attend my expressive writing groups quietly identify themselves as “living with cancer,” and they often express feelings of loneliness and fear as our meetings begin.  As the weeks progress, however, I witness a growing sense of community, support for one another and special understanding that comes from experiences openly shared in their writing.

It is not just face-to-face groups where this happens.  With the growth of online support communities, many newly diagnosed cancer patients turn to the Internet for information and for the social connections formed online.  Social media and online support group opportunities can also be beneficial for those diagnosed and living with cancer.  For example, a randomized controlled trial involving breast cancer patients suggested that “a Web-based support group” could “be useful” in reducing depression, cancer-related trauma and perceived stress.”

While being diagnosed with cancer may introduce you to a private “club” you may be reluctant to join, you may well discover the support of others, similarly diagnosed, helps to diminish your diminish feelings of loneliness, fear and isolation:  that’s a powerful form of medicine that can help you heal.

Writing Suggestions:

This week, think about a time that life circumstances forced you into a category, stuck you with a new identity, or “forced” that unwanted membership upon you.

  • Describe how it felt.  How did you deal with it?
  • Did you find your self-concept challenged?
  • Did it spur you into action or change the way you thought about your illness or situation?
  • Did you join a support group?  Writing group?  Online support group?
  • Did you find a sense of community, of others who understood what you were going through?
  • Write about the experience finding yourself in that club you never asked to join, what you did, and the impact it had on you.

 

 

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In ordinary life we hardly realize that we receive a great deal more than we give, and that it is only with gratitude that life becomes rich. ― Dietrich Bonhoeffer

Two weeks ago, I was preparing to head to the hospital for the second time in a matter of days. …   It had been a frustrating week before, what began with happiness–my birthday, a family celebration, calls and cards from friends scattered across North America–had plummeted into frustration in a matter of hours.  Sometime after I’d gone to bed after my birthday dinner, I awakened thirsty and made my way to the kitchen for a glass of water.  I stepped onto a damp floor near the kitchen…and moments later, realized our ceiling was leaking water from several large cracks.  It was the result of an elderly neighbor, one floor above, leaving her faucet running with the sink stopper in.  The next hour and a half were spent trying to forestall any major damage to artwork, rugs and furniture.  Worse, I awakened the next morning utterly exhausted.  My surgical procedure–replacing my ICD (implanted cardiac device)–was scheduled for the next morning, and I was tired and stressed already.

It didn’t end there.  My husband and I checked in to the hospital early in the morning as instructed.  Seven hours later, we returned home, my surgery cancelled and rescheduled due to unexpected complications and, thus, a backup in the admissions department.  I was slated to have the procedure done the following Tuesday.  Not surprisingly, I was worried I might be sitting in the waiting room for another marathon of several hours.  Gratitude was far from my thoughts.  I was anxious and tense.

Tuesday arrived, and thanks to the scheduler, who knew of my plight a few days earlier, I was first in line for the cardiac operating room.  The procedure completed, I spent the day in the hospital to ensure everything was working, then returned home, the tension of the preceding days dissipating, and instead, feeling grateful:  first, for the surgical procedure completed successfully, but also, for the kindness of the staff, a well-rested surgeon, and a new ICD.  Awakening the following morning with a spirit of gratitude was far preferable to the irritation, anxiety and stress I’d felt just days before.

An attitude of gratitude is good for us.  Science confirms that it’s beneficial for us in a number of ways, among them:

.  It can make you more patient.

.  It might improve your relationships.

.  It improves self-care.

.  It can help you sleep.

.  It may stop you from overeating.

.  It can help ease depression.

.  It gives you happiness that lasts.

This past week was the final session of my current “Writing through Cancer” workshops at Gilda’s Club, and not surprisingly, gratitude was something mentioned by most of the participants:  gratitude for things like the lessons of cancer, for family and friends, for doctors and nurses, for the things in life that truly matter most.

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

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

I try, daily, to end my morning writing practice with a gratitude list.  I do it because it helps me remember the small gifts, as well as the larger ones, that I have experienced in my lifetime.  I think of the neurosurgeon who saved my life as a teenager, and I think of my cardiologist whom I see now–someone of extraordinary skill and healing;  I remember my father’s stories and sense of humor, grateful some of that was passed to me.  I am grateful for a handful of enduring friendships–people who’ve weathered the good and the challenging times with me; I mumble quiet thanks for sunlit days, grandchildren, having one daughter nearby…and each day, there is no shortage of things to add to my gratitude list.

I feel better as I close my notebook.  In fact, as Robert Emmons, psychologist at the University of California, Davis, states, “Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life.”

A gratitude practice enhances my daily life, but among its other benefits are lower blood pressure, improved immune function and even better sleep.  A study conducted at UC San Diego’s School of Medicine found that grateful people actually had better heart health–less inflammation and healthier heart rhythms, something I’ve paid attention to, and   other university research studies have also shown that gratitude has beneficial effects on  immune systems, reduction of stress hormones and may even reduce the effects of aging to the brain.  “Gratitude works,” says Dr. Emmons, “because…it recruits other positive emotions that have direct physical benefits.”

In recent years, researchers have examined the role of gratitude plays in well-being, whether the impact is psychological, like increasing positive emotion, or physical, such as improving sleep.  Gratitude research has also extended to cancer patients.  Reported by Anne Moyer, PhD, in a 2016 Psychology Today article, one study was conducted among patients with cervical cancer that indicated fostering a mind-set of gratitude increased levels of positive emotion and reduced negative ones.  As a consequence, patients showed increased flexibility in thinking and, thus, improvement in their ability to cope with stress.

A second study with breast cancer patients utilized a gratitude intervention to address patients’ fear of recurrence and worry about death.  They were invited to spend 10 minutes weekly over a six-week period writing a letter to express their gratitude to someone who’d done something kind for them.  Those who practiced expressing gratitude to another experienced a decline in their worry about death.

If the only prayer you said was thank you, that would be enough.― Meister Eckhart

Our ceiling has now been repaired; the discomfort experienced after my ICD was re-positioned under the muscle has all but disappeared.  This morning, as I sat on our balcony, warmed by the summer sunlight, I was reminded that even the mundane and ordinary can inspire gratitude.  All we have to do is notice.

i thank You God for most this amazing
day: for the leaping greenly spirits of trees
and a blue true dream of sky; and for everything
which is natural which is infinite which is yes…

(From:  “i thank You God for most this amazing” by e.e. cummings, In:  Complete Poems, 1904-1962)

What can you do to incorporate more gratitude into your life each day?   In a 2016 article appearing online in Forbes WomensMedia, Janet Miller, offers eight practical tips:

  1. Don’t be picky. Appreciate everything.  Gratitude doesn’t have to be about the big things.
  2. Find gratitude in your challenges. Difficult or negative experiences can teach us what we’re really thankful for.
  3. Practice mindfulness. Daily, think of five to ten things you are grateful for.  Doing this daily will actually “rewire” your brain to be more grateful, and you’ll feel happier.
  4. Keep a gratitude journal. Several researchers suggest writing the things you are grateful for on a daily basis, at bedtime.
  5. Volunteer. Give back to others in your community.  It increases your own well-being.
  6. Express yourself. Do more than just keep a journal.  Let people you care about know you are grateful for them.
  7. Spend time with loved ones, friends as well as family.
  8. Improve your happiness in other areas of your life

Writing Suggestions:

  • Try developing a habit of practicing gratitude.  Use a journal to document, daily, your gratitude.  It doesn’t have to be a long list or very detailed.  Simply list 3 – 5 things you are grateful for.  Do this for a week, faithfully. Then take stock:  Do you notice any changes in yourself?  Continue the practice for another week or two, and 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 e.e. cummings described in his poem.  Explore your 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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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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The way the dog trots out the front door

every morning

without a hat or an umbrella

without any money

or the keys to her doghouse

never fails to fill the saucer of my heart

with milky admiration…

(From:  “Dharma,” by Billy Collins, in Sailing Around the Room, Random House, 2002

My mornings are incomplete without her.  Somewhere between 4:30 and 5 a.m., as I begin the slow process of waking, our ritual begins.  I hear her rise from her bed on the floor, shake herself awake, then two, perhaps three, seconds past before she springs up from the floor and onto the bed, choosing to nestle her back against mine.  As small as she is, she is like a block of cement then, a guarantee that by six a.m., I will awaken, and my morning will begin.  I’m first to rise; she prefers another ten or fifteen minutes of dozing. But as I grind coffee beans and spoon them into a paper filter, she pads into the kitchen, stretches, and patiently waits for her breakfast.  Coffee ready and kibble consumed, we settle ourselves in the living room, where she curls up in a corner of the sofa, dozing and occasionally casting a watchful eye at me while I write.  She is Maggie, a small border terrier mix, adopted five years ago to become my faithful companion, but more:  comforter, guardian, playmate, nonjudgmental friend.  Whether canine or feline, many of us are very attached to our pets.

…Perdita makes me smile every day. She runs to greet me when I come home, and she flops at my feet in the morning to be petted. She loves boxes and balled-up pages of the Nation. She is afraid of vacuum cleaners and tornado sirens. She lies on her back in squares of sunshine with her paws in the air and looks perfectly ridiculous and content. My friend Kristen tells her cat Mouse each morning that he’s her best friend, which is the sort of behavior that makes non-cat-people roll their eyes. But there’s something to it. Perdita and I don’t discuss novels or anything, but we really are friends.  (From:  “Perdita, Why Cats are Better than People”by Michael Robbins, Poetry Magazine, July 2012).

Pets are often the subject of poetry and essays.  They’ve even served as major characters in novels or heroes in films.  Anthropomorphism aside, we humans have strong emotional connections with our pets, whether canine, feline, equine or other kinds.  As companions or sources of comfort when we’re feeling lonely, blue or under the weather.  They rarely pass up a chance to play, and some pets, like my small dog, protect us as if we are their children.

Pets are healers too.    Pets, as Florence Nightingale, the pioneer of modern nursing, observed over a century ago, are “excellent companion (s) for the sick…” There are countless stories of animals assisting and helping their human companions.  One marine dog’s heroism during wartime, for example,  is documented in the best-selling, Top Dog, by Maria Goodavage (2014).  Lucca, a bomb-sniffing German Shepard whose actions saved many lives, lost one leg in battle and was later awarded a purple heart for her bravery.

Dogs like Lucca are only one example of the potential impact animals can have on human lives .  There are guide dogs, hearing dogs and service dogs, for example, whose assistance to individuals with visual, hearing or other disabilities is invaluable.  Animal-Assisted Therapy (AAT) is a widely practiced approach that is used to achieve therapeutic goals through interactions between patients and trained animals. AAT provides comfort, assistance, and companionship for people suffering from chronic or grave illnesses, grief, depression or disability.  It’s an approach widely used in many settings such as hospitals, prisons, nursing homes, mental institutions and homes. According to the American Humane Society, AAT has helped children who’ve experienced abuse or neglect, patients undergoing chemotherapy and other difficult medical treatments, and veterans and their families struggling with the effects of wartime military service.

When I was in my teens, our family had another dog, a terrier mix, who was my younger brother’s constant companion.  One November night in 1966,  a fire destroyed my family home’s.  Our dog,Tico, was the first to notice, licking the face of my brother to wake him and likely saving his life.  Several years ago, my husband and I had Winston, a West Highland terrier who died in 2008 at age seventeen.  Calm, steady and loyal, his temperament made him an excellent candidate for therapy dog training.  Once trained, he accompanied my husband to visit young hospital patients.  Winston was happy to lie quietly next to a sick child, have his ears rubbed or back stroked, seemingly unaware to the happy smile on a child’s face that his presence produced.  When it was time to move to the next child, he obediently followed my husband to the young patient’s bed, tail erect, and patiently repeated the process again and again.

He puts his cheek against mine

and makes small expressive sounds…

 

he turns upside-down, his four paws

in the air

and his eyes dark and fervent.

 

“Tell me you love me,” he says…

(From:  “Little Dog’s Rhapsody in the Night,” in Dog Songs, Poems by Mary Oliver, 2013)

Is it any wonder we become so attached to our pets?  Or that they offer us solace and comfort in difficult times?  Or that poets and essayists alike have so frequently written about their pets with such affection?  Mary Oliver devoted an entire book of poetry to her dogs.

But I want to extol not the sweetness nor the placidity of the dog, but the wilderness out of which he cannot step entirely, and from which we benefit…  Dog is one of the messengers of that rich and still magical first world…

And we are caught by the old affinity, a joyfulness—his great and seemly pleasure in the physical world.  Because of the dog’s joyfulness, our own is increased.  it is no small gift.  …What would the world be like without music or rivers or the green and tender grass?  What would this world be like without dogs?  –-From Dog Songs: Poems, by Mary Oliver, Penguin Press, 2013.

Writing Suggestions

Have you had a special pet, whether from childhood or more recently, who provided you with comfort, solace or service in a time of need?  Has a pet played a healing role in your life or someone you know?  Write about a pet–dog, cat, horse, or another kind of animal who played an important role in your life at one time.

  • Describe the pet and its unique qualities.  How did it endear itself to you?
  • Tell the story/or write a poem about your pet and of a time he/she helped you heal from hardship, sorrow or even illness.

 

 

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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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