On Death

I was asked the other day if being diagnosed with cancer had changed how I felt about death. And the answer is no. I do wonder what life will be like for my family and friends, but those thoughts have been with me for longer than I knew I had cancer. I can’t answer for everyone, but death is something I think about rarely. I’m comfortable with believing that death isn’t an ending but a beginning, and I know I have lots of living to do yet.  So I’m not ready to leave this world any time soon. Of course, I probably won’t have any control over when I die.

When I was first diagnosed, I was told that lung cancer isn’t curable just manageable. At that point I was certain this cancer would kill me, and I thought Stage 4 lung cancer was always fatal; the question is just when and how long I could keep it under control. I have since learned that it is possible to have no evidence of disease (NED) after treatment. And I know of some who have been NED for years. But there are also those whose treatment doesn’t work and who die early on with the disease. Part of the problem with lung cancer is it often isn’t diagnosed until the late stages when it has already metastasized. And the traditional treatments don’t always work, or they work for a little while then the cancer becomes resistant. There are some exciting new treatments out there that harness the  power of the body’s own immune system and others that target a particular DNA mutation switch – all fascinating. And options for clinical trials that may not have been available when I was diagnosed, which was just in October of last year.

I remember reading “On Death and Dying” by Elisabeth Kubler-Ross as an assigned book for one of my nursing school classes. Of course back then I had no sense of my own mortality. I saw patients die and I saw patients get well and leave the hospital. I cried with the bereaved families and rejoiced with new parents and the families of those who went home. And the five stages of grief stayed with me from all those years ago. Now I find myself going through those same stages – because those stages don’t just occur after someone dies; they can also be a response to a diagnosis such as cancer.

The five stages are denial, anger, bargaining, depression and acceptance. They do not happen in a linear fashion, so people don’t necessarily go from denial to anger then bargaining etc. The stages can occur in any order, and people can even sometimes skip a stage altogether. Some never reach acceptance. I seem to vacillate between anger and depression with a little acceptance thrown in there every once in a while. But mostly I’m fighting and convinced I can beat this, at least for a while, and determined to live my life the way I want to live it – not the life this cancer wants me to live. I never did just ‘go with the flow’; I was always the one fighting the status quo – and I still am.

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