The Cancer Card

I suspect those who have been diagnosed with cancer, or have been close to someone undergoing cancer treatment, understand what I mean when I reference the “cancer card.” Yes, that wonderful hybrid of a gift voucher and a “Get Out of Jail Free” card that is given to most people with a serious cancer diagnosis. I am not talking about a stage IA melanoma that needs a little skin procedure and then it’s back to work, of course. The Cancer Card must be earned the hard way, with the prospect of many weeks, perhaps months, of upheaval, suffering, and a confronting of mortality that is rarely planned.

I’d never say “it’s worth it” to have this card. It is, however, more than just a fringe benefit.

I’ve written in other places how remarkably my community of family, friends, and patients — not to mention acquaintances and complete strangers — supported my family and me from the moment we shared news of my oral cancer. I honestly feel that almost no favor we might have requested would have been turned down. Think about that! I imagine it must be like the experience of being a member of a tightly-knit church when tragedy befalls your family, except this was the far-flung and very loosely-knit community of the people who have filled our lives over the past five decades.

I wrote these lines in an earlier post: “As a people-pleaser, I am more comfortable doing favors than asking for them. Only now am I realizing that, to fully participate in a community, it’s essential to receive support, too.” This realization has changed me. It’s not only okay to ask for help when I need it, it’s the right thing to do. I’m not the only soul who feels better when I am in service. Truly, it can be a gift to someone to ask them for help. I finally get this, in my gut. My family was a fairly self-sufficient unit throughout this ordeal, but we leaned liberally on friends and family for aid, and they always delivered for us.

However, there is an awkward question associated with this cancer card; one that is not discussed in any introductory physician meetings, how-to books, or webinars on handling your cancer diagnosis. Perhaps you can see where I am heading. The question is: “When does my cancer card expire?”

I mean, a major shift is well underway. Some things I pined for a month ago I now can take for granted, like having a ravenous appetite and being able to properly taste, and increasingly eat, savory foods again (yesterday I even registered the faintest sweet flavor of maple syrup, and today’s smoothie actually tasted almost good!). While I often feel in the near vicinity of a nap, I haven’t made a full-on daytime trip to visit the Sandman in two weeks. I’m starting to see patients again in two or three hour blocks a few times a week. All this time at home means I’m more caught up on my practice than I have been since the pandemic started. In short, I am easing back into the business of serving others again. Can I still ask for any favor and expect it to be granted?

I suppose the flip side is that I am still a fairly needy cancer patient. Foods have to be carefully curated, and even then — “WOW this place’s blueberry smoothie must have too much protein powder in it!” — most meals are somewhere between a little painful and “gargling habanero sauce” or “eating ground glass hidden in a slice of toast” intense. I literally swish through about 2 quarts of baking soda and salt solution every day. Nothing eases this pain, not max dose NSAIDs or tylenol nor 10mg of oxycodone, beyond the 20 minutes afforded by a lidocaine gargle, only for it to return in full glory. While I am eating more solid food than I could manage during my treatment, my self-indulgent strike upon returning home against two-a-day smoothies is reflected in my ongoing weight loss, a continued 2 pounds a week! The scale hit 138 yesterday, a number that astounds me to type, much as a 25 pound weight loss should be no shock. The last few mornings, I’ve been able to talk with my family without much pain, a major upgrade that started two weeks ago before regressing again last week; by midday, though, the left side of my tongue literally feels like it’s on fire if I utter a few words. This accords with the warnings we received of an uncomfortable “plateau” of mouth pain that commonly lingers for many, many weeks after treatment stops. Having a full tank of energy, on the other hand, is normally on the timeline of months rather than weeks. Despite ten hours of sleep every night, though I might not be napping, my stamina is so limited that ten minutes of almost any activity has me thinking about a rest.

In a word, recovering from cancer treatment is a process. Feeling so much better than I did in the cold, grey, nausea-tinged days in Seattle has me feeling a bit impatient around the timing of this process. This week, especially, a couple times I’ve been short with my wife, Michelle, who deserves far better from me after so gracefully accepting the task to upend our lives and coordinate an incredibly challenging two months with both love and skill. I’ve snapped at my girls when my mouth is screaming at me loudly enough to make me not want to talk; that’s not the sort of parent I want to be, especially now.

I’ve work to do, to remind myself in as many moments as possible that my aim is to appreciate every minute I have on this earth, sore mouth or not. This cancer diagnosis has made it clear that I don’t get these minutes back, nor do I have any promise of an endless supply in the future. What’s the point of all this suffering if I cannot at least do that?

To that end, I have decided that there is no expiry on my cancer card. True, others might stop seeing it in a short while. The outpouring of offerings of support — which continues on, almost uncomfortably so for me as I feel more and more my old self — will fade with time. This is nothing new. The world responded to Michelle and me a certain way when we held our daughters in their Gerber moments in our arms; that time has passed, and we no longer carry that societal preciousness afforded young couples bringing forth the next generation. After being fully back at work a few months, putting some of those 25 pounds back on, easing into a little running again, and (if the odds hold) getting that negative CT scan in May, no one will be offering a meal, a ride, some money to help us through. That’s only right.

However, I’ll hold onto that cancer card. It will remind me. I don’t need to be ill to ask for help. I can just ask.