Q: Hey, Althea, remember when you went to the Breast Cancer Issues Conference in Portland last month? Who was your Favorite Speaker?
A: That would be Dr. Gene Hong, hands down! He was the acupuncturist in the panel discussion on treating metastatic disease in break out session #1.
He spoke like a human being talking to other human beings, referred to his power point briefly and as back up (vs treating it like a script as the other two panel members-- a radiologist and an oncologist did). He talked about his own journey from Internist to Acupuncturist (the turning point was pondering the "First, do no harm" part of the Hippocratic Oath) and about the Traditional Chinese Medicine belief in Three Pillars of Health: Eating, Sleeping and Pooping. Dr Hong said "If you come to see me, those are three of the things we will talk about, because if you can't do those three things you are not going to be alive very long."
I nearly stood up and cheered. (Perhaps you know the story of my beloved brother-in-law Roach whose surgery left him unable to do any of the above? His surgeon's response was, and I quote: I saved your life; those are just life-style issues.)
Dr Hong adds two more pillars to these Three Ancient Ones:
Exercise: Not an issue when Chinese Medicine was being formulated four thousand years ago, and most people spent a good chunk their days working in rice paddies in order to eat. The body needs to move to be healthy.
Happiness or Contentment: Dr Hong said, "We have to come to some understanding that most of us are about as happy as we decide to be."
We tend to think that our circumstances determine our level of happiness. This neglects the part our minds, our perceptions and our habitual conditioning plays. It makes happiness or unhappiness something that just befalls us and that we have no influence on. We need to question those assumptions if we want to find a way to make life with cancer worth living.
How wonderful to hear such wisdom and compassion at a conference like this! I wanted to tell Dr Hong that he was my new hero, but after the session he was mobbed with patients asking questions about treatment. I didn't want to interrupt just to throw flowers at his feet.
Q: You brought flowers?
A: No. That was just a way of expressing my admiration.
Q: Oh. Good. What else did you learn?
A: The session on Having Difficult Conversations was interesting. Anytime one is dealing with a terminal diagnosis like metastatic cancer, these "difficult" issues are going to arise as surely as a turd in the punch bowl: We are all going to face loss, and we are all going to die, some of us sooner than others.
This comes as a shock to most Americans. We don't have any living traditions to help us cope with death and dying in this culture. Our prevailing ethos is to act as if it will never happen. Which is why cancer patients can feel like such lonely outcasts, and others (loved ones, doctors, nurses) can feel like such failures when patients die. Most of us are left to figure out a way through these thorny questions of how and why we live and what choices we can make around dying on our own.
When they come up, and how frequently they come up, and how ready one is to deal with them at any particular point in time is a highly individual affair. There is a wide range of normal and no matter where you fall on the spectrum, what happens for you is perfectly normal and probably appropriate for you.
Things get more complicated as you bring others into your ever-shifting circles of thought. Your loved ones are likely to be taking their clues from you. They cannot read your mind. As your thoughts, feelings and moods shift, others will always be one step behind you-- still processing whatever you shared with them the last time you spoke. There is always going to be some lag time. I thought this was a brilliant insight, and one that could be helpful for patients and loved ones alike.
And there are good reasons your loved ones may not be on the same wave length as you. Everyone is going through a major life event -- you are just the lynch pin -- and everyone will process it in their own way. There are no rules, no right and wrong way to go about it.
We each must find our own way and do our best to be respectful of other people's way of coping-- even if we don't understand or agree with them. Being willing to stay in communication with loved ones, finding some way to keep in touch, helps fight the debilitating isolation that can come with a metastatic cancer diagnosis.
The most successful technique, turns out, is usually not The Big Talk. It is the conversation that comes up casually, in the car, over a cup of tea, or after a movie. Life is full of little openings. (As Leonard Cohen says, That's how the light gets in.) Being willing to speak when these openings present themselves is key.
Shakespeare would say, The willingness is all.
Q: You just had to rope Shakespeare into this discussion, didn't you?
A: Well, tradition is important.