Tag Archives: age

In our time (at our age): Facts & Figures

1. “During 2002-2006, women aged 20-24 had the lowest incidence rate, 1.4 cases per 100,000 women.”

2. “The 5-year relative survival rate is slightly lower among women diagnosed with breast cancer before age 40 (83%) compared to women diagnosed at ages 40 or older (90%). This may be due to tumors diagnosed at younger ages being more aggressive and less responsive to treatment.”

3. “Women with breast cancer also are at risk for developing a second primary cancer. There is a strong relationship between younger age at diagnosis of the primary breast cancer and risk of subsequent cancer. Women diagnosed with early-onset breast cancer (age <40) have almost a 3-fold increased risk of any subsequent cancer, with a 4.5-fold increased risk of subsequent breast cancer.”

Source: American Cancer Society Breast Cancer Facts and Figures, 2009-2010.

The oncologist has spoken to the gynecologist re: me.

Oncologist: the gynecologist thinks you’re depressed. Are you?

Is it any wonder?

She writes me a prescription for an antidepressant that causes headaches and tremors and hands me a radiology requisition for a chest x-ray as I’ve been complaining of chest/rib pain. I walk down to Radiology, then turn and walk out of the hospital. I tucked the x-ray requisition, along with the antidepressant prescription, into a copy of Foucault’s The Birth of the Clinic, where both have remained since.

I’m tired of tests and drugs.

My problem, I told her, is not a seratonin imbalance or a residual, inexplicable melancholy. My problem is cancer.

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Dying Young

I shall live to be old, who feared I should die young
    I shall live to be old.
I shall cling to life as the leaves cling to the creaking oak
    In the rustle of the falling snow and the cold.

The other trees let loose their leaves on the air
    In their russet and red,
I have lived long enough to wonder which is best,
    And to envy sometimes the way of the early dead.

Sara Teasdale

Not all die early, dying young–
Maturity of Fate
Is consummated equally
In Ages, or a Night–

A Hoary Boy, I’ve known to drop
Whole statured — by the side
Of Junior of Fourscore–’twas Act
Not Period–that died.

Emily Dickinson

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7 August 2009: awaiting my own tragedy

Day after biopsy–sitting bandaged in the backyard. An excruciating experience all around–less from the pain of the surgery than the hospital inefficiency, in a corner alone for hours afterward, told I’d see the surgeon–that I must see the surgeon–before leaving. “Before six.” Near seven I’m confronted with a registrar who does nothing, looks at my bandage, asks, “Are you always this pale?” Refuses to answer when I ask how to take care of my stitches, dressings, etc. Says the nurses will explain everything. She goes home. The nurses don’t know. Seven days or one, covered or left exposed? So I am still bandaged, taking painkillers and waiting.

What an absolute mess I must seem–and am, snapping at everyone and crying. Jetlagged still, having managed to sleep half an hour before going to the hospital, my first time under general anesthesia, terrified and alone. And back for the mastectomy, the “real” surgery, in a week. The seemingly impossible process of recovery.

The girl in the next bed was laughing, joking with the hospital staff. She was in to have a fibroid cyst removed. “As long as no one cuts my nipple off,” she says to the nurse, smiling. And I think–this is wrong, a grave mistake, shouldn’t it be me there? Instead the urgency of my situation is amplified. Five months ago, it is now almost, waiting for the diagnosis which was almost certainly, they assured me, fibroadenoma. Then cancer. The giant leap for womankind. Now this radioactive, surgical biopsy, more serious, but somehow less horrible than the first because it wasn’t a surprise, an invasion of that magnitude. Now waiting to find out not whether I have the horrible disease, but how horribly I have it. Grading. I always got good grades. And despite my perpetual pessimism about most things, I have a strange optimism about biopsies. Which is dangerous of course, because look what happened before.

So the doctor I met with in Pittsburgh says he’d be “surprised” if it had spread to the lymph nodes. But then, that’s exactly what they said here, only to find it was cancer. Surprise! After “I’m sure it’s nothing.” Sure. That roomful of people, looking at each other, nodding in unison to confirm how surprised they were. Me, stupid, faint, childish in my polka dot skirt and Mary Janes. What does their surprise mean to me? Should I feel honored? At their optimism, if that’s what it was. Dr. S. saying, “we’re hopeful.” As if hope were a treatment, a cure. As if it were anything.

It was raining then too, the day of my diagnosis. I was clutching my blue raincoat in the hospital hallway. Raining the day I began chemo, when I climbed into the loft bed of my little flat and vomited. And a downpour yesterday; we drove to London, dangerously, in it, and it began again fourteen hours later in time for us to leave. K. ran to the car while I stood outside the hospital, holding nothing and sobbing. “Are you okay?” someone said. And I nodded, because what do you say to a stranger?

“How old are you?” the nurse asked yesterday. “Twenty-four? You’re a baby.”

Of course I am. I have never felt younger or more helpless, never. And my body has never felt older, more decrepit and disgusting.

The bandage is not so bad, it’s everything else. My hair of course, getting patchy, falling out steadily, the pathetic covering I regrew over the past few months littering the pillows. Lost hair, gained weight. They made me strip off my nail polish yesterday and I got a look at my cracked yellowed nails. All to complement the fake, nippleless, Franken-stitched breast they’ll make me. I feel sorry for K. I wonder how he can stand it. Maybe he can’t.

At home, I flipped through my high school journals, and was not as embarrassed at that self as I imagined, but amazed at my intensity. Perspicacious pessimism–and actually prophetic in it, or at least realistic. I wrote at seventeen: “I am awaiting my own tragedy.”

Everyone has one, surely, coming up, sooner or later, I supposed. To varying degrees, maybe. But I’ve always been waiting for it. Or maybe  pessimism causes cancer, that holed-up negative energy. Maybe. Either way–awaiting my tragedy? Here it be. Continue reading

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15 July 2009: the Lord preserves the young ones

The sick cloud of the final chemo—I can hardly write or fathom the date. Barely able to function in this sick, spinning state. Unable to speak coherently to my mother—having caught me in the library, demanding a date to book my return—a suggestion I mooted yesterday as an alternative to my father’s coming here for my surgery, but now I’m unsure as to whether it is an entirely coherent idea and cannot be asked to consider it now. Everything is overwhelming.

Last night: sitting by an open window with lotioned feet, alone, reading de Beauvoir’s Memoirs of a Dutiful Daughter. A brown-red leaf had blown in through the window—made me feel alive and sad.

Yesterday I stumbled across Toru Dutt’s The Diary of Mademoiselle d’Arvers in the Wantage Public Library. Strange and fascinating, this young and sadly fated Indian woman writing French, her character’s deep and desperate fear of death, the clinging to conjectured concepts of marital and maternal love—and the author herself dead of consumption at twenty-one. Everything in the book clings to youth as salvation, yet admits the futility of such thinking.

“I have great faith in youth,” the doctor says—

but Marguerite’s frightful prophetic dreams; the recurring song, the buried bride—all that Ophelia-like sad youth and chastity—and her pathetic question: “The Lord preserves the young ones: he will preserve me, won’t he, my friend?”

All the time having known, from her dream of her husband with “the face of Death,” that “When the trees will flower again, I will no longer be there; I will be lying under the cold grass.”

The Epilogue sadly woven with Psalm CXVI:

I love the Lord, because he has heard
my voice and my supplications.
Because he inclined his ear to me,
therefore I will call on him as long as I live.
The snares of death encompass me;
The pangs of Sheol laid hold on me;
I suffered disress and anguish.
Then I called on the name of the Lord:
‘O Lord, I beseech thee, save my life!’

Gracious is the Lord, and righteous;
our God is merciful.
The Lord preserves the simple;
When I was brought low, he saved me.
Return, O my Soul, to your rest;
for the Lord has dealt bountifully with you.
For thou hast delivered my soul from death,
my eyes from tears,
my feet from stumbling;
I walk before the Lord
in the land of the living…

—& how cruel to have this, a supplication against her own fate. And for me to read it, somehow still believing in the sanctity of youth and its preservation, that beseeching for lifesaving is so tempting—

I walk before the Lord
in the land of the living

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9 July 2009: Why is there not a discovery in life?

Another bout of this, a day wasted, hours and hours in bed, wet pillowcase. Pain in my armpit. The inability to do anything–and those horrible lines from Love Story, a movie I haven’t even seen, but which has somehow pervaded our culture like cancer itself: “What can you say about a twenty-five year old girl who died?”

What can you say? Nothing. Nobody’s wife or mother, mother of no ill-formed offspring of feeble brain. And yet you can say a hell of a lot more about the twenty-five year old girl who died than the twenty-five year old girl who lived, surely. Because death is infinitely more interesting, published in the pack of lies that accompany it. It makes me sick.

K. is embarrassed by how I snapped at him in the meeting with the surgeon. I snap beause no one listens–talk and talk and nothing happens; no one listens.

I feel imprisoned here (West Hendred’s a prison; then is the world one). It’s of my own making. It would be a wonderful place to write, were I not losing my mind. Holing up here by myself in bed. The hours, the emptiness, the dust and clutter. Wanting to be left alone, and yet terribly afraid of that condition at the same time.

I imagined of course that coming back from France everything would be “different.” That I would feel energized and inspired and finally feel the impetus to make something of all of the time. Instead, lying across the bed watching Woody Allen films and crying.


Why is there not a discovery in life? Something one can lay hands on and say ‘This is it’? My depression is a harassed feeling. I’m looking: but that’s not it—that’s not it. What is it? And shall I die before I find it?

-Virginia Woolf, Diary, Saturday 27 February 1926 

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30 May 2009: the Disease

Tired of The Disease’s distasteful interruption to my life. A coping mechanism, I suppose, to view it as a nuisance. Trying to quell the terror of the possibility of this new drug’s being just as ineffective as the last was. Nothing to do but wait–for that date, the next appointment, 17 June. I’m restless, uneasy; I don’t know how to approach the time til then. Yet I don’t have to “approach” it at all, I suppose–it will approach me, overtake me, as swiftly as the rest of it has.

I’m desperate to stay in the warmth of this moment, this memory, and without all the underlying anxiety–a still, hot Saturday with my bare feet in the garden grass–how could something like surgery, like death, be as real as this?

Mostly it’s the wistfulness of wishing this were ‘really’ my home, my life, that I could be cemented into it somehow without the feeling of wandering wraith-like through other people’s lives, the ghostly uncomfortableness knowing none of this belongs to me, nor do I deserve it.

My father has boked a ticket–four days I’ll see him, after an absence of years. His voice on the phone is tinged with desperation and worry. Both of us helpless, not knowing what to say to one another. The strange, enduring, inarticulate & inexplicable love.

I continue to exist with my imagined life of the mind while my real world recedes, its borders drawn in. I imagine expansion, and how wonderful it would be to have the money and ability to travel, as if, should I go far enough–or far enough away from my daily reality–I might be able to escape it.

How disgusting that news of more chemo would be a blessing. God, I am terrified of going into that room in two and a half weeks and being met with that assortment of chalk-eyed people.

I’ve become accustomed–appointments, pill-taking, exhaustion. The latest nurse who prodded my arms after asked, “How was the cannulation?”

“Great,”I said, and meant it. A relief not to have needed multiple needle pricks, to the point at which it was almost a pleasure. I’m at the point of becoming another one of those doe-eyed women in the ward, bored but unfazed by it all, allowing it to happen because there’s not other choice–realizing your own powerlessness, your insignificance in the system.

And I’d be happy with that, too, truly–all of the hospital bullshit–could I be assured this treatment were treating the disease. I wish I could perceive a difference, not constantly feel it, hard as a peach pit, cruel and unmoving.

If there is no just reason for having gotten cancer in the first place, is there any just reason I should recover without pain or even inconvenience? Most of me refutes entirely the possibility of a mastectomy at twenty-four–but what force will prevent it, not having protected me in the first place? (I cringe at my blasphemy–but it isn’t exactly a doubt of God, but rather the realization that any sort of Calvinistic predestination is not under my direction or at my discretion).

I get embittered by old women. Walking to East Hendred this morning I momentarily hated her, a grey-haired stranger in an overcoat, hands clasping Cadbury’s chocoaltes in their purple metallic wrappers. An overcoat! What right had she, I wondered, to live so long? And of course I was immediately ashamed of myself; God knows what she’s been through. What kind of discretion dictates existence? What sort of sick insistent logic might I apply?

Apocolyptic dreams last night, blood-red streets and starvation. Something about a cult concerning Jade Goody. And Anne Frank preparing to hide in an attic.

Waking knowing what the end would be; feeling cheated.

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6 May 2009: some infinite thing

Told, at the hospital, as expected but still shocked into despair, that there’s been no response to the chemotherapy. All these months for nothing–the cancer in there, ‘no response,’ like an obstinant child. Ineffective drugs–the equivalent of having done nothing at all. It hurts all the time now, a dull strong ache, heavy and poisonous, this albatross organ of sex and life I’m forced to carry around, this growing embodiment of hate & pain & evil inside me. And I’m full of hate as it poisons me–looking vengefully at everyone on the street, wondering why they don’t have cancer. Willing it on them, even. Perfect strangers. At the beginning of the illness I felt instilled in me an awkward, cautious respect for strangers–thinking that if I could be living this awful painful dream of a life beneath my subway-face, what could their lives hold, their faces hide–what were their realities?

And now I feel my own death pressing on me from the inside and I want to drag down the scenery-people with me as I go.


Back to the hospital tomorrow to start all again. A new drug now: Taxotere. Not stronger, she says, just different. Her responses are all patronizing and evasive–as if she doesn’t know the answers to the questions, or just doesn’t see the use in bothering to give them. The kind of voice that says Oh No It Was Just a Bad Dream, when you can see for yourself how the world is crumbling outside the window. Made to feel crazy and impudent for knowing you are awake. “We’re hopeful.” Hopeful is a word for a greeting card. For the impotent relatives who say they’re praying. For those praying and knowing underneath its utter ineffectiveness, but what else can you say but I’ll pray for you and mumble some slapdash please to Jesus. I want something more than crossed fingers from the people meant to be treating me.

So I look up the drug online once we’re back and read: 30-60% effectiveness.

Multiply that by the chance of not having responded to the FEC, by the chances of getting cancer in your twenties by–

these sick incalculable equations.


Updike:  “Is it just these people I’m outside or is it all America?” Rabbit Angstrom’s runaway query resonates. And for me it transcends America; am I outside all the world? There is not one person in this world yet with whom I feel I have achieved “communication.” At odds with everyone out of jealousy, out of timidity, out of sheer incomprehensibility. Loving K & knowing he loves me and yet the sad fact of his inability to understand me always apparent. And should I settle for that as the apex of human interaction because it just might be possible that no one will ever understand–how adolescent, to say “no one understands me.” Boo, oh boo hoo hoo. But honest I am as baffled by “connection” as I was as an adolescent. Thinking if I could just get out of Erie, the world would open up to me. Well, the world opened but the the people were the same. And all the possibly-important people of my life are those I haven’t spoken to because of the fear of their brilliance. Those shadow-people who will perhaps become characters so I can create fictional dialogue-relationships with them based purely on conjecture and regret.

I am ashamed of myself for my fear of people and my hatred of them, at finding so frighteningly difficult what should come naturally as a member of the species, using language and having empathy, even a hello-how-are-you kind of language and empathy. I operate on, as David Foster Wallace said, “the automatic, unconscious belief that I am the center of the world and that my immediate moods and feelings are what should determine the world’s priorities.”

In this commencement address, published ironically posthumously, he professes life’s “about making it to 30, or maybe 50, without wanting to shoot yourself in the head.” And he was 45 and he was dead. Hung himself at home and sparked that brief literary twitter of ohnowhatashame and so young and possible, so F. Scott Fitzgerald and The Last Tycoon.

Reading this inappropriate manifesto days after his death, I was alarmed in that best-writing way: that someone has articulated something you’d previously believed to be inarticulable, unique to you. Yes, how he feels the same depression and despair that I do–and in supermarkets too–“at how repulsive most of them are and how stupid and cow-like and dead-eyed and nonhuman they seem here in the checkout line.”

It’s that tangible, well-worded depression I identify with too readily. The same adolescent affinity I always felt for Plath’s journals. But the differences between them–DFW & SP et. al.–and me are myriad; why should depression and arrogance and selfishness make us kindred? 1. They were spectacular, and I am not. 2. They sought death, and I do not.

What scares me most is not losing the time to produce, but realizing that no matter how miuch time I had, I never could. Like that joke–“I’m older than I ever intended to be.” Only it’s not just that–it’s that I am more dull and ordinary, more purposeless, less driven, less spectacular and brilliant than I ever intended to be.

That’s what kills me. Not the cancer. Or maybe the cancer is somehow made of it–a symbol, a metaphor, and a bad one. Like how as a child I always imagined my life as a novel, Jane-Eyre-ish, Dear Reader peeping in, interested. Only narrated always in the third person; even I couldn’t communicate with me, my split-self, writing/living and being read. And at some point I stopped because I realized there was no Dear Reader.

Worse is: what if there’s nothing to express in the first place?

DFW: “the constant gnawing sense of having had and lost some infinite thing.”

Or: the constant gnawing sense of having (still) never found some infinite thing?

Every day I feel some touch of that recalcitrant, Hamletesque melancholy: “I do not set my life at a pin’s fee.”

I just wish someone did. That belief in me, that sincere estimation of my goodness & potential. Recognition of my value not as a lover or daughter, automatically and unquestioningly, but seeking someone who disinterestedly believes that I have even a “pin’s fee” in me to contribute to the world. Someone to advocate against my death sentence.

So yes, the desperate project of my life is to make it to “30, perhaps 50”–to do something with the time too.

I feel the tumor pressing painfully inside me. No longer something foreign and separable-seeming, but part of me. No matter what they do some ghost of it, some remembered part, will always be there, hurting me.

And it’s much too close to my heart. My God — my heart.

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