Fighting Breast Cancer and Confronting Death Gracefully

PJ Hamel Health Guide
  • I was walking through my quiet neighborhood early one recent morning. The sun had just risen; everything was crystal clear in the chilly first light of day, and perfectly still. No wind, no sound save a far-off flock of crows. As I walked, I noticed leaves falling from the brown winter oaks. Not a blizzard of leaves, swirling and tumbling along the ground in a gusty wind. No, these leaves were drifting straight down, one by one, and settling gently on the ground. I thought to myself, why is THIS the moment those leaves fall? They’ve clung to their branches all winter, through snow and ice and wind, without loosening their hold. And now, as spring dawns, they’re simply letting go. Because it’s their time.
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    Since having cancer, I’ve become all too familiar with the end of life. More than once, I’ve witnessed the long walk towards death. Some people go calmly, almost gladly. They’re satisfied with what they’ve done, where they’ve been, WHO they’ve been. They’re ready to move on to whatever comes next. Sure, they’re apprehensive; but they’re not fighting. They believe it’s their time to let go.

    Other people fight death every step of the way. They’re furious they’re leaving life a life they feel they haven’t yet fully lived. They still have places to visit, responsibilities to fulfill, children or grandchildren to watch over. They’re agitated, searching relentlessly for one more treatment to try: a last-ditch clinical trial, a European drug not yet approved in this country. They go down fighting, often moving restlessly in bed even as their final moments approach.

    What is it in us, I wonder, that determines how ready we are for death–how willing we are to let go of life? Several months ago, I was privileged to hear a speech by Dr. Ira Byock, a nationally known authority on end-of-life issues. Past president of the American Academy of Hospice and Palliative Medicine; co-founder, Reclaiming the End of Life initiative; and director of palliative medicine and survivorship at Dartmouth-Hitchcock Medical Center here in New Hampshire, Dr. Byock has written two critically acclaimed books: “Dying Well,” and “The Four Things That Matter Most.”

    Byock, speaking to an audience of breast cancer survivors, said, “Mortality can teach us a lot about life–if we let it. Where one would expect only suffering and misery, tragedy and sorrow, we also find moments of joy, moments of celebration and laughter. It doesn’t seem expected or seemly; but they’re there. When pretense falls away, the things that matter most come to the surface… Awareness of mortality can inform our life, and need not lead to lifelong depression. When cancer strikes, death is there; it becomes the phone that won’t stop ringing. The phone call from someone you really don’t want to talk to. It’s only by answering the call that you can make the ringing stop.”

    And how do you “answer the call” when death’s on the other end? Byock noted that one stumbling block so many of us face is the feeling that we’ve left relationships “unrepaired.” And this feeling of incompletion prevents us from letting go easily.

  • “The relationship in our lives that most urgently needs to be repaired is the relationship with ourselves,” Byock added. “We’re awfully hard on ourselves. Many carry wounds that are based on internalized expectations. I was never good enough… My lifelong dream remains out of reach.”
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    Byock suggests four strategies–“lessons”–for repairing the relationships in our lives, including the all-important relationship with ourselves:

    “Lesson 1: Human beings are imperfect. We strive for perfection, but even the best people tend to die imperfect. We’re just human. Get over it. Being human is good enough. Many of us are raised as human DOINGS, rather than human beings. Then when we get sick, and we can’t DO, we start to feel bad about ourselves. Have some mercy on yourself.

    “Lesson 2: Mortality teaches us a lot about life; it teaches us about what matters most. The answer will always include names of the people [we] love most. It’s a constant across the human continuum. The things that matter most aren’t things at all. Our human connections are the things that matter most. Our relationships are the potential source of enormous gratification… as well as the source of emotional pain and suffering.

    “Lesson 3: Relationships aren’t perfect. We all carry traumas and wounds, and they can open all too quickly. If it weren’t for mortality, there would be no urgency, no pressure, to deal with this stuff in our lives. But the fact is, on any give day, all of us live just a heartbeat from infinity.

    “Lesson 4: Healing is possible. The unwanted fact of death often encourages or forces people to face the fact that what matters most is other people. Barriers that used to look insurmountable look approachable, perhaps for the first time in many years… For most of us, it’s not about the other person; it’s about us. It’s a sophisticated strategy for letting go of the emotional baggage that we’re carrying around… The person making the good faith effort is always better off emotionally for having tried. Show up and have good intentions–that’s about as much anyone can do.”

    These wise words boil down to a simple truth we all understand, deep inside: love is the answer. If we forgive and love ourselves as much as we do our families and friends, we might just find it easier to let go when death comes knocking.

Published On: March 18, 2008