I read Goodbye Without Leaving, a novel by the late Laurie Colwin, almost twenty years ago. The book is funny and moving and very representative of its time, but what has stayed with me all these years is its epigraph:
Americans leave without saying goodbye,
Refugees say goodbye without leaving.
Refugees say goodbye without leaving. In that sense, living with metastatic breast cancer is like being a refugee from life. It feels like I’ve been saying goodbye to friends, to places, to activities, to life itself for years now. Unlike the refugee who carries home in her mind and heart even though she is physically elsewhere, I am still physically in the country called life but in my mind and heart I am in a continuous process of leaving it.
This is not to say that I am depressed. I am not. (I even have a psychiatrist’s opinion to that effect.) But I am living in the constant knowledge that I will die sooner rather than later, that I am on “borrowed time”. (I don’t care for that phrase “borrowed time” because it contradicts my worldview, but it is convenient shorthand.)
It is now almost nine years since my initial diagnosis, which was at Stage III. The metastasis was diagnosed fairly quickly thereafter, but it was confined to my spine and was stable for a very long time. Since it has begun to spread, though it remains in the skeletal system, I have become more aware of the very real death sentence that is metastatic breast cancer. This has been brought home to me even more by the apparently permanent blow to my immune system (neutropenia) since my most recent round of chemotherapy, over a year ago. I have had to make major modifications to my life style.
The thing is, I am not ready to die. I love being alive, even with all the restrictions that are now my lot. I don’t know how to deal with this and it often makes me cry.
Most people by now are familiar with the Kubler-Ross “five stages” model: denial, anger, bargaining, depression, acceptance. Although Kubler-Ross said that people do not necessarily go through the stages in this order and that not everyone experiences all five of them, people generally relate to them as a kind of preparation course that everyone completes in good order.
Even though I know better, I have fallen into the trap of thinking that way, but again and again I have proved to myself that not only is this not a linear progression, but it also is not a one time passage. It is not as though I have to start with denial and progress steadily through to acceptance and if I don’t, them I’m doing it wrong. (Question: is there a wrong way to die?) I find that I skip around and repeat these “stages” so much that I no longer think of them as “stages” (the word itself implies a progression) but as “states”, states of being, that expand and contract in importance and that change from time to time.
I think I have accepted that I have terminal cancer and that I am going to die much sooner than I otherwise would have. But I don’t want to.
I’ve written elsewhere and in another context about how I feel about acceptance.
Next to humor (and I make some pretty awful jokes), acceptance is the coping technique I do my best to cultivate. Accepting an unpleasant or bad situation – war or abuse or cancer, for instance – doesn’t mean that I endorse it or like it. It just means that I have looked at reality and noticed that it is real. Not accepting reality is fairly insane. I can’t even work to change something until I have noticed and accepted that it is real.
I don’t like that I am going to die, and I am not ready to die, but I know that I am going to die. I can only hope and pray that as my death approaches and becomes more immediate (unmediated by time) that I will be able to live each day with faith and courage, grace and humor to the last.