Birthday Wishes

I haven’t always paid attention to birthdays. I remember when I turned 7 and my friends and I pretended to be ballerinas before eating cake. And I remember when I had a sleepover birthday party and we did everything but sleep, but mostly they have been a blur of cupcakes and cards and maybe a special dinner or flowers.

Until the birthday I went shopping for a wig. That one will always stand out.

And then there was the one when I didn’t wear a wig, but probably should have. The daughter of a dear friend was getting married at a gala beach affair, and the idea of a hot and itchy wig was too much to bear. My hair had been growing back for a few months and while I would no longer be accused of imitating Sinéad O’Connor, my halo of tight black and gray curls hardly disguised my recent graduation from the chemo suite.

My hair has finally grown back to its normal loose curls in enough gray tones to compete with a best-selling novel, but I haven’t stopped paying attention to my birthdays. One just passed, and I am profoundly grateful to have celebrated another year of health surrounded by loving family and dear friends on a busy day in a meaningful life.

Some people who have recovered from cancer talk about it as being a gift, a wake-up call that allowed them to see life differently, to focus on the joys and to let the daily stresses go. Others talk about it as being the gift that keeps on giving, because the side effects of the disease and its treatment have a way of taking on a life of their own. Your organs shift after surgery and you get digestive issues, or chemo causes neuropathy that makes it hard to get back to your daily routine, maybe your reconstruction goes awry and you need additional surgery or your skin becomes like crepe paper from radiation making even the lightest touch a source of pain and bleeding.

While not the kind of birthday present I ever wanted to receive, or would want to give, in its demand for attention and sudden imposition of a new a priority, cancer gave me an opportunity to take a fresh look at how I lived my life, to test my resilience.

To a physicist, resilience is the ability to bounce back, for a material to quickly resume its normal shape. But to a psychologist, resilience is about being knocked down in life and coming back even stronger. It’s about finding strengths you never knew you had, about getting through somehow and getting on with life. Or, as Kelly Clarkson sings, “What doesn’t kill you makes you stronger.”

I’ve always been determined, driven, even stubborn. But, I gave up on horseback riding after being thrown from a horse 10 times my weight. Was that being smart or giving in? I quit a number of jobs along the way because I didn’t like having a boss. Was that being resilient? With each round of chemo I felt a little less sure I could get through the next one. Would I have the chops to get through my cancer treatment? When my blood tests trended in the wrong direction, I felt a level of despair that I hadn’t anticipated—not fear that I might die from the cancer, but that I might have to go through more treatment. Could I handle it if I had to go back for a second round? Or worse, had a recurrence or second cancer?

Talking to patients who have had more advanced cancer, gone through more involved treatment, suffered more indignities from the disease, I know that I got off easy. But even cancer-lite is an opportunity to put things into perspective. Three years after my diagnosis, I know I have the strength to get through whatever life dishes out. I’m grateful I have more time to spend and clearer about how, and with whom, I want to spend it. That doesn’t mean I won’t honk with impatience at a foolish driver in stalled traffic, but I am more likely to laugh it off moments later.

But even if I have learned a little more about myself and how to persevere through challenges, I still have a hard time calling cancer a gift. Next time, would it be too much to ask for flowers instead?

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