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At first I was speechless. Then a pervading numbness settled in as I tried to process the information from my doctor. "I'm sorry to tell you, it is cancer," he said as he reviewed the computer screen in front of him.
Surprisingly, my first thoughts were for him, and the unpleasant task of delivering this type of news. But then I quickly realized his dispatch was well practised, a tender oration of medical terminology with just the right amount of compassion. I am sure it didn't make the news any easier to deliver, but the format established a clear time frame for my immediate grieving before moving on to the task of outlining a treatment schedule. The whole event lasted a few minutes, but felt like an eternity.
What followed was a period of even less clarity as I gathered myself to ask important follow-up questions. Every possible scenario was running through my brain, crammed into a timeline that was suddenly wildly out of control. Minutes before, my world was organized and spatial; now it was filled with fear. And yet, as all of this was happening, I found myself also thinking about how I would eventually deliver my news to family and friends. It wasn't until much later that I realized the delicate dance of "communicating cancer" had begun, and would consume precious amounts of energy over the ensuing months.
The day after I received my diagnosis, I drove to my mother's house, 60 kilometres down the highway. I wanted to tell her in person. At 78, she had always taken great pride in her health, and I knew the news would be hard for her to hear. I was her first-born and, at 52, the only person in our family to develop cancer.
I knew I would have to sound hopeful, because she would need to believe everything was going to be okay. My treatment details would have to be kept vague, and I would need to finish on a positive note – even a touch of humour, promising to update her every step of the way.
As I pulled my car into her driveway, my message was locked in. I also needed my mother to deliver a summarized version to my brothers and sisters, leaving it to me to refine the overall story in follow-up phone calls and e-mails. By the end of that day I was exhausted. My illness had been momentarily sidelined as I worked on my next communications strategy – for friends and colleagues.
As soon as you look into the eyes of the person opposite, you intuitively know how to tell your story. Some want every detail; others want only to hear that everything is going to be okay. A few need to control the storytelling by asking their own questions.
One close friend, someone I routinely talked with on the phone, suddenly preferred updates through text messaging. The communication was compact and manageable, and always finished on a positive note.
Another friend from my office, someone I expected to be less interested in my occasional updates, couldn't get enough detail or information. Every day, I received an e-mail, text or phone call wanting to know the latest news.
Twenty months have passed since my cancer journey started. In January of this year, I made the decision to have an operation that would attempt to put the brakes on a cancer that had proven to be more aggressive than originally thought. The news preceding this had always been mixed, so I wasn't entirely convinced the surgery and the ensuing pathology results would liberate me.
When I arrived at the clinic three weeks later, my doctor asked if I had come alone. A lightning bolt of fear went through me – this was not a good omen. After letting him know I was there by myself (my wife had reluctantly agreed to let me go alone), he went over the results.
They were negative across the board: For the first time in 20 months, I was cancer-free. My doctor smiled, and said the decision to have the surgery had been the right one, and I should look forward to returning to a normal life.
You might think I would have jumped for joy, but instead I felt ambivalent. I could only think of the people I had met in my hospital visits, many of whom would never hear this type of news. After leaving the clinic, I sat alone in the hospital coffee shop watching patients, young and old, walk by pushing IV stands and oxygen tanks. It was a moment I will never forget.
A little while later, I considered how to share my latest news. But this time was different – I wouldn't need to customize the message.
That night, after a busy day of e-mails, phone calls and text messages, my phone rang. It was my friend who had been texting with me throughout my cancer journey. He picked up the conversation as if we'd been phoning each other every day, though it was my first call from him in months. I wanted to ask why he hadn't called, but he seemed so relieved to know things would soon be returning to normal for me. I guessed that he, like others, had probably been afraid to talk about an illness he had little control over.
When I hung up, I realized the "normal" he referred to was long gone. There would be no hiding from the fact I am now a cancer survivor, someone who will always wonder whether the disease is really a thing of the past or just sitting quietly, waiting to reappear another day.
To friends, I am a reminder of something they both fear and accept as a part of life's passage. And while it is tempting to believe that I won't have to "communicate cancer" again, the message is part of my everyday life now, like it or not.