a shift, a palpable shift

By now, I have accrued a large pile of books about cancer. I keep the books with the awful knowledge that someday someone I care about will have a pressing need to read them, and I will offer the pile to that person. Still, sometimes I wonder if I should get rid of the books. I worry that it's that Law of Attraction thing again: if you build the book pile, the cancer will come.

I've read a lot of books about cancer in the past 6 months. About the lifestyle changes cancer asks of you. Dietary recommendations - some simple, some convoluted - for preventing its recurrence. Spiritual transformations that can or should occur. Attitudinal or yogic postures to adopt. Things to do, things not to do. Things to think, things not to think. Miracles to expect, losses to accept.

The cancer books I've read have ranged from annoying to dull to inspiring to informative. But none has been transformative, none has offered an epiphany I haven't already pointed my own bellows at in an effort to strengthen my time-limited spark of a body, to warm myself by the blaze of my soul, to sustain the little flame of the Bic lighter of my mind.

Something shifted, though, while reading "Anti-Cancer: a new way of life," by David Servan-Schreiber. When Gretchen recommended it a couple of days ago, my first, second, and third thoughts were, "Ack. Another cancer book about eating broccoli and omega-3 fatty acids." Still, I read it in its entirety yesterday, finishing it while Laura was on campus late last night dealing with a passel of sophomores who had tried to trip the light fantastic on some vodka. When she got back at 12:30 this morning, I was sitting up in bed, wide-eyed and needing to talk about what was awakening in me.

I don't think it was just Servan-Schreiber's book, though I recommend it to anyone who is healthy or is working toward being so. I didn't actually learn too much I hadn't already known, but I heard it in a different way this time and with this timing. As I read, I could feel myself shifting from paula who is nearing the end of chemo, to paula who needs to stay cancer-free. These offer wholly different vistas and tasks.

Though I am not to blame for getting cancer, there is something about my body that made it possible for it to grow in me. I have to focus on making my body an inhospitable place for cancer.

I am not yet sure what that will look like, precisely, but I do know that I need to place my health at the center of my life.  The cancer cells are likely to be working on gaining a toehold over the next 5 years, especially since I am triple negative (and thus more susceptible to recurrence than those who are receptor positive). I need to be more vigilant and determined than those cells are, to have more stamina than they. I need to see this not as a 6-month ordeal that ends with chemo, but as an ongoing challenge to my internal GPS. It is Serenity Prayer stuff, carved deep.

For one thing, I need to frame my days around getting enough exercise (did you know that cancers vary in the amount of exercise needed to reduce chances of recurrence? "For breast cancer, there seems to be a measurable effect after 3-5 hours a week of walking at normal speed. For cancer of the colon and rectum, twice as much is needed to have a comparable effect"). I'm not bad at getting enough exercise when I am well, but I squeeze it into my schedule instead of putting it up there with eating and sleeping. This is that hackneyed story of putting the big rocks in the jar first.

I absolutely need to get my immune system stronger. That is clear. It has taken a serious beating by chemotherapy, but it had to have been weakened in order for me to get here in the first place. It's distressing to have it noodlier than ever as I near the end of treatment, but this is the kind of situation where my Doing self will stand me in good stead. I can work on this. Maybe if I focus on strengthening my immune system, I won't just kill cancer cells, I'll also be able to fight off the tiny warts that keep appearing on my right nostril and which any healthy immune system would handle without missing a beat. I tell you, I'm thinking big.

This mindshift means my life cannot be constructed around my private practice; it must be the other way around. How will this work? I am not sure. I am just clear that that needs to be the order of things. I'm clear that if I just go back to my full client load, life as it always was, and then have a recurrence, I will know that I hadn't done all I could.

If I design at least the next few years (if the cancer doesn't recur within 5 years, it is extremely unlikely to recur at all) around warding off a recurrence, the cancer might still return, but I will know I've done my job as steward of my body.

Still and all, I do not want my identity to be too wrapped up in she-who-is-fighting-cancer. I don't want my Doing self to overdirect my Being self, which also needs attending to. We all have this challenge, I know. But cancer brings another dimension to it. It is a delicate balance, a dynamic tension, a Whole-Life-Sudoku that I will be solving as I go.

And is there a tension within me that wonders if I really get to do this, if I am allowed to focus on my health while Laura works 80 hours a week? Oh, yes. It's the same part of me that is quietly startled when she says, "Wonderful. Please do whatever you can to stay well." Can this be true?

Tomorrow I hope to have enough of an immune system to tolerate my last Taxol treatment. The doctor worries that the toll of this last treatment may outweigh the benefits. Full steam ahead, we've decided over and over again, tattered flag waving and nose warts proliferating. "Failure is less frightening than regret."

Permission to feel crummy for the next 6 weeks or so (I am optimistic, despite word on Infusion Street that fatigue and bone/joint pain tapers over 6-12 months), and then gradually but decisively shift toward making my body unwelcoming to disease.

All this is easier said than done. Again, I don't yet know what it means to take this on. I just know that I must accept that cancer found me to be an acceptable host, and that I need to do what I can to change that. I am aware that at one point I assumed I would survive this disease. Now I really, really hope I do, but I no longer assume it. Chemotherapy has been nothing if not humbling.

I've said for many years that I could live on nuts, seeds, fruit, and berries, and now I get to put my money where my mouth is. Finally, I get to eat more like a cavewoman. One who, while undergoing treatment for cancer, not quite so strangely as I had thought, has been guided toward acquiring a taste for sushi.