A great deal happens when a friend tells me they have cancer. At first, the moment freezes, stops completely and a chill settles over the conversation. Cancer, after all, is the great insoluble conundrum. Everyone I ever knew who had cancer died of it. Lung. Liver. Brain. Colon. The people line up in memory as a phalanx of friendly, pained faces. They are smiling but their eyes reveal a resignation to the deadly forces of genes gone mad.
So, when a good friend told me his doctors diagnosed him with two kinds of cancer, brain and prostate, I felt my insides melted. Another one, I thought. Another friend on his way to the grave. I have lost many friends over the years. Not just to cancer but also to alcoholism, heart attack, car wreck, old age, and cardio-pulmonary disease. All these things are deadly, but none as heartbreaking and difficult as cancer.
The problem with cancer is there’s always hope. Sudden deaths are, by their nature, surprises. A person wasting away from COPD knows the end is coming and play a waiting game. But as frightening as it is, cancer leaves one with hope. Hope that through treatments that have worked for other people will work for them. They labor with the idea that they can beat this thing. Medical science eggs them on. They go through treatment after treatment, sometimes with hopeful results. At times there is a remission. In my experience, which I realize is flawed and limited, the remission ceases and the cancer returns.
It all ends in a box.
I think about cancer all the time. I use snuff and have for decades. Every time I put a pinch between cheek and gum, I wonder if this will be the dose (and it is a dose) that will wake up the oncogenes and turn my lower lip into a series of radiation and chemo treatments to expunge a lifetime of iniquity.
I was a drinker of the worst kind. Even today, 34 years after my last drink, my annual blood analysis reveals my liver function is off a fraction. A future liver cancer diagnosis? I am a man over 60 and the doctor sticks his finger up my anus to feel my prostate. The humiliation of that procedure has me worried, even resigned to the worst, until the doctor comes up with a smile and says, “It feels like everything is all right.”
My friend is a little older than me. I’ve known him for many years. For decades now, we spend a couple of hours together weekly. When it comes to friends, I have many close friends, more than most people. Each of them is irreplaceable, an indelible part of my soul. I take friendship seriously and have my whole life.
When one of them comes to me with a diagnosis of cancer, my catastrophic thinking takes over. This, too, I think, will end in a box. I will go through the inevitable feeling of wishing I never met them, that if I had never known them, I would never know the pain I will feel at their death.
I remember when my friend Andy died. I took the news on the phone at work. When I heard, I wondered why the world had not stopped moving, Why life went on. When my friend Joachim died in 2011, it was as if my world ended. I fell into a depression that lead to the end of a rope. There are others, more than are relevant to this discussion.
As I just said, I take these things seriously.
My friend is in treatment now. Every week he goes in for radiation for his prostate cancer. The doctors are very hopeful, as is he. The five-year survival rate for prostate cancer is nearly 100 percent, as long as it’s diagnosed early enough. The survival rate depends on the health of the patient, and my friend is very healthy. I should share his optimism. But, inside, and from all the other experiences I have with friends and cancer, I can’t help but have the feeling that this thing is not going to go my way.
He also has a brain tumor. From what doctors know now, it is not cancerous. But it may be. Joachim died of brain cancer. When my friend tells me he’s got a tumor that may or may not be cancerous, Joachim’s cancer comes to mind. He was hopeful. He sought every treatment for the glioblastoma growing in his gray matter. He was optimistic all the way up to the time he was bedridden and on the edge of death.
Maybe this is a human thing, this optimism, this pursuit of life even in the face of the inevitable. Certainly, one should attempt everything possible to preserve their life. If not for themselves, then for all the people who’s lives are entangled with theirs.
I’m not saying my friend should lie down and refuse treatment. It’s that the catastrophes of my past put me on guard. It’s as if I have to convince myself that the worst will happen so that I’m not terribly disappointed when they do. When they don’t, I feel the elation of relief. A bullet dodged. A bridge abutment avoided.
No. He should try everything. He needs to follow the doctors’ recommendations and go through all the treatments. Since I am, in the end, a selfish person, he should do these things not just for him, but for me. After all, when it comes to my friends’ lives, I’m the one that matters most. My feelings. My life. My well-being, which includes my mental state.
More than this, however, is that I see in my friends’ deaths my own. Mortality knows no controls. It depends on the entire history of a person’s actions, thoughts, and feelings, as well as environmental inputs and genetics. If we could rewind a life, we might be able to see all the things that contribute to a friend’s early demise or longevity. But we can’t. There are too many variables.
When I see my friend tonight, I will give him a hug. Each of these contacts, with anyone, may be the last. Who knows what will happen? Death comes. It’s best for me to act as if it’s waiting just outside the door. Then, when I go to sleep tonight, I know I will have done everything I can to have meaningful contact with the people who mean are so important to me.
In other words, when a friend tells me they have cancer, I have to act as if it’s fatal. It’s a matter of survival.
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