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Darkness to light

In 1999, I was diagnosed with breast cancer. I could hardly believe this was true, for as far as I knew, no female relative in my family had ever had this disease. But once the unthinkable became reality, I felt I had to deal with what happened to me-in my own terms. For me, part of this ' coming to terms' with cancer lay in internalising the experience and then trying to write about it objectively. 

The article that follows is a result of that endeavour.

Cancer, today, is the modern equivalent of leprosy. Everyone talks about it in hushed terms, and the victims are made to feel that the doom of unmitigated suffering and pain hangs over them. At first, this is what I too tended to believe. But today, thanks to the grace of God, the love and support of my family, my friends and colleagues, and the kindness and professionalism of my doctors, I am back at work and as busy as ever. 

I, therefore, offer this article to all women who have to face the same predicament as I did, in the hope that it would help someone, somewhere.

In my mini-library of books on cancer, there is a telling chapter which says "No one ever forgets the moment they learnt they had cancer." That sun-drenched afternoon when I read the Pathology report will remain etched in my mind forever. I remember being surprised by how calm I was. I re-read the chilling sentences over again - the word 'malignant' foregrounded in bold letters. Some other being seemed to take over- "you'd better get to the doctor fast". Then began the strange, frightening and bewildering process of coping with a disease for which there is yet no cure.

I climb into the car and all too soon we arrive at the doctor's clinic. We walk in and he greets us. Silently I hand the report over to him and watch him as he impassively scans the piece of paper. I can see him reading and re-reading it, as though like me, wishing to deny what he reads. He has seen me through many 'crises', and this one, I know, he is wishing that he could have spared me. At last he looks up and reaches for his pen.. " Right, you'd better go and see my good friend..."

As he writes the note to the surgeon he tells me, 'You are the fourth person who has come to me with this same problem in the past three weeks." Breast cancer, it seems, is all too common. In the US, it strikes one out of seven women. In Sri Lanka, the statistics are not that accurate but still this form of cancer has been recognised as one of the more common prevalent in the island.

Like most women who have never experienced cancer within their families, I had never thought that I would ever be stricken by this disease-that the odd thickening I had noticed was, in fact, something that had to be taken seriously. Moreover, this thickening tended to hurt whenever my arm brushed against it. I had always thought that if it hurt, it cannot be cancer- that cancer was a painless lump.

I learn that I now belong to a new sisterhood - women whose lives have been inexorably changed. Life taken so much for granted has now become infinitely precious. I thought ruefully back to a week ago, when for the first time I had actually prioritised my work and set out the tasks I meant to do week by week, and had thought- "This year, I will complete all of this."

I think I moved through the encounter with the surgeon with almost the same clinical detachment that suddenly seemed part of my mental processes. Returning home from the doctor's clinic, I, knowing the surgeon recommended was an extremely busy man, had sat down at the telephone business-like to see which of my friends could help locate him for me. The friend who eventually did was incredulous when I told her the news. She even impatiently asked me - "Are you sure.." and I heard the hushed silence when I told her "Yes, I got a biopsy done yesterday and have the report". Within minutes she called me back to say the surgeon would see me that evening. At the surgeon's clinic, the options were carefully explained to me, and even when I said "I'd rather have it all out," it still seemed as though all this was happening to someone else, not to me - who only that morning had been quite busily involved in academic decision making. 

Then suddenly the slow tempo of the discovery changed into hustle and bustle. Phone calls had to be made to family and friends and decisions to be acted upon swiftly. Within three days I was installed in hospital awaiting surgery and the welcome appearance of family from abroad generously willing to share whatever ordeal was in store for me and to see me through it. There was time now to consider what had happened to me. No one in the family - mother, aunts, sisters, cousins - ever had had breast cancer. What was it in my make-up that had made my cells go haywire? However there does not seem to be time to dwell on questions such as these. 

What seems to loom larger is the grave question mark hanging over the future - will there , in fact, be a future. I had just been through a major operation in May 1998, and now six months later had to face another one which seemed more terrifying. Perhaps what made it so frightening was the memory of two dear colleagues who had died of cancer. Both had told me that they could not think of a fate worse than that of cancer. 

I tried however to bolster myself with thoughts of others- colleagues, teachers, friends —who had survived cancer , and were busily leading active lives. Such thoughts - and nightly prayers when I realised more than ever- how very much in God's hands we were- somehow helped fill the days. With all the decisions to face upto, it was a relief each night to place the day in God's care and mercy, and seek comfort from His protection.

The need for such protection was never more pronounced than on the day of surgery. The early start and preparation only heightened the uncertainty that seemed to hang in the air. The presence of the family— and the prayers that they were engaged in - was comforting but also strengthened my private belief that this was a farewell. Lying there, capped and gowned, it seemed as though the family could not help me. I could only place myself in God's care. The tension was increased by the long wait outside the operating theatre. Murmuring a prayer repeatedly, I gazed at the ceiling in a state of calm acceptance at whatever fate was in store for me. Even inside the theatre, it was as though my 'other' self had taken over. I popped up from the stretcher demanding to be taken to a toilet, and refusing to let the anaesthetist do anything till the surgeon had come in. Once he arrived, it seemed natural to leave it all to him though I did manage to tell him that I was terrified... and that I was in God's hands and his.

Recovery back in my room was far more instantaneous than my previous experience with anaesthesia. I woke to recognise my sisters- not to the grey mist that had shrouded everything during my earlier recovery. Mercifully my recovery was uneventful and painless. Although I dreaded the return home to face all those who would want to know what was wrong with me, having the family with me helped to ease my 'journey' back to normalcy. A welcome interlude was provided by a short break in a resort hotel where I think the real process of healing began.

The operation however was merely the first phase. More fear and uncertainty were to be aroused when the post operation reports came in. Now began the difficult process of realising that more was yet to come - which sounded even more frightening than surgery. I still remember the lurch of fear when the oncologist pronounced his verdict that I would need extensive radiation therapy and chemotherapy. Once again my mind went back to the memory of what my friends had suffered. Chemotherapy to them had been worse than the disease itself. With their suffering in mind, I decided to take myself away. Mercifully the family were there to support this decision and make it a reality.

Life once again seemed to take on the quality of a nightmare from which I would never awake. My mind would not - perhaps it could not - look beyond one day at a time. There was yet again a myriad decisions to be made.. where should the treatment be done, who would be the best doctor, when should I go, who would accompany me......

The healing process however seemed to go on quietly and I had very little post-operative trouble. The day of departure grew nearer and this time I felt I really needed to put my affairs in order. There seemed no way that I would resume the life I led, and so among other settlement of affairs, I decided to write my will. Nothing perhaps seemed more symbolic of death than the recognition that all one had lived for finally comes to nothing.

Possessions, achievements all seemed to pale in the face of the darkness I was facing. This sense of finality was accentuated by the departure at the Colombo airport, which as is normal for flights out West, was in the dead of night. The lateness of the hour, the uncertainty of what lay before me, our collective helplessness ,the suddenness of it all - everything seemed overwhelming and bleak.

The arrival in New York brought with it more helplessness. The cold formality of the renowned cancer centre we had decided to approach was certainly not comforting, and the surgeon's dismal pronouncement that I needed another operation seemed to pose another major setback. 

But as always there were friends willing to advise and help out, and give us the benefit of their expertise. Faxes to and fro helped to settle the question of another operation, and also helped settle the question of whether we were going ahead with this particular hospital. Their uncompromising stance only made it easier to decide to check with another oncologist, who, by chance, happened to be a Sri Lankan and a fellow school mate. Once she took over, somehow everything seemed much easier.

I have now had my first dose of chemotherapy. It was grim and enervating - but I realised that one could come through. The loving support of the family, the care and concern of my oncologist and her staff all seemed to indicate that things are not that bad. .... the problem seemed to lie with me. My fear and negative attitude made the treatment seem worse than what it really was. I needed to remind myself that my healing lay in my own hands, that what I, who had been fortunate enough to be surrounded by kindness concern and love,needed - was not self-pity -but a positive state of mind that life would go on....Inshallah.

Epilogue

I wrote the above article in New York when I was recovering from my first dose of chemotherapy. Since then, I have undergone months of treatment which included chemotherapy as well as radiation treatment. I seem to have been very fortunate for I had no major problems during these months of treatment. I lost my appetite-but it came back; I lost my hair, but it grew back. 

Those of us unfortunate enough to be struck by this disease would do well to remember that cancer treatment today is not what it was in the past. New drugs are available which help alleviate the suffering that once accompanied chemotherapy. Radiation techniques are precise and painless. And even in the West, there are many who advocate natural and more holistic -forms of treatment. Having cancer is admittedly a frightening experience but it certainly is not the end of the world.

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