When I started college, during freshman orientation week, I was paired with an “upperclassman” as a mentor. The relationship was only intended for one week. The only thing I remember him telling me, was pointing out I had misspelled my name on my nametag (“Micheal” rather than “Michael.” I’ve mentioned before I suffer from dyslexia, haven’t I?).

In the past few weeks or months, we have had four or five (depending on how you count it) people in our circle of friends and family who have been diagnosed with cancer. Now that I’ve endured this bad diagnosis for five years, I would consider myself an “upperclassman” and feel I have some advice for the newcomers to this infelicitous club. But it is just advice.

1. You must map out your own path of coping with your diagnosis and don’t let anyone, especially those who have never experienced cancer, tell you how to do it. I see only two unhealthy approaches. The first is denial. Denial comes in many forms. One is believing that God has or will heal you. Many great saints have succumbed to cancer and why should you be different? You must still pray and believe, but don’t let that belief interfere with real-world action that must be taken to treat the disease. Do all the alternative care that you want, but don’t have a false confidence that those things will cure you. They won’t. Cancer is a vicious prowler, give it no opportunity via undertreatment or unproven therapties. The second one, almost the opposite, is over-worrying. Some worry is healthy because worry causes us to be proactive, but too much worry can be counterproductive. We cancer patients must come to a place of peace as we await lab tests and imagining studies that will tell us our likely future–life or death–and we do this over and over. Those things could drive a sane person mad. Find a good mental distraction to subplant some of the worry. For me, was writing a book and now building a cottage.
2. Find a specialist if you have a complicated or uncommon cancer. This is true even if you must drive a long distance. A local general oncologist can be helpful for finding treatment close to home, but when big decisions need to be made, a specialist who only treats your kind of cancer is priceless. It is not that the local oncologist isn’t smart or caring, but they must keep up on a long list of profoundly unrelated cancers. Also, the way the American healthcare system is set up, unfortunately, is that the insurance companies reward the local oncologist for spending as little time with the patient as possible. For example, a 20-minute visit might be paid at $40, but a 40-minute visit isn’t paid at $80, but more like $55 or $60. So, a local clinic, to survive, must schedule patients in 15- or 20-minutes slots. Large cancer treatment centers usually have better reimbursement and usually have a pool of financial support from donors, which affords them the luxury to spend more time with the patient. Time can mean life or death. While you can pick a local oncologist based on their compassion, pick the specialist who is smart, regardless of their bed-side manner.
3. Be kind to yourself. Cancer is a bitch, more so than non-cancer people could ever realize. But life is still the same in the rest of the world. People will still want to take advantage of you, hurt you, and criticize you. Don’t let them. Let yourself rest. Eat that desert without guilt. Listen to good music. Look at beautiful art or sunsets. Take long walks, enjoying every leaf, every snail, every bird, and give each cloud a name. Let others help you when needed. With all the help and rest in the world, you are still working harder than 99% of the world by the fact you are in the battle for your life. Let other people judge you without mercy if that’s their MO. Take their criticism with a grain of salt. Pity on them for not knowing better.
4. Don’t let religious people criticize your spirituality simply because you are suffering. It sounds strange, but it is true, they will. The word “cancer” and “God” doesn’t seem compatible to some people so every time you bring up the elephant in the room, your cancer, they will assume you are a God-hater. Pity on them.
5. Cancer and chemo make you tired. Bone weary. Rest! People who love you may get tired of you, your resting and lack of energy, but don’t let that get to you. Your body is at war on the inside.
6. Be aware of the emotional consequences of cancer. Many of your dreams have been stolen. You have been marginalized in a “healthy” society. You may never feel well again, in this world. Cancer destroys your best appearance, moon face, flabby belly, losing hair, scars, on and on. Those are big losses. Cancer is not for the faint-hearted. Realize those losses as substantive. You are a hero . . . by default.
7. Some people, who believe in God, especially those who have never experienced loss, must reconcile their cancer diagnosis with God. Cancer is so awful, that a loving God could not have purposefully given you the disease. If you try to hold those two irreconcilable beliefs, a loving God and God gave you cancer, in the end you will end up hating that God. The fact that bad things happen to good people is the pattern of this world and it must be accepted. Be like Job, who suffered honestly, but never blamed God as the source. While I don’t think God gives cancer to teach us something, still take the opportunity to grow closer to God than ever before. Outsiders will never understand the intimacy that you have found with God during the hard times.
8. Cancer is lonely. I was told this by a cancer mentor at my diagnosis and it made no sense. But many of us lose our jobs, must step down from social commitments, go into isolation for prolonged periods of time, and have time taken by appointments and rest.  But cancer and suffering does something else that is isolating, something I couldn’t get my head around at first. Your cancer makes some people so uncomfortable; they prefer not to be around you anymore. “Oh, what if I say the wrong thing?” I assume they ask themselves. “I don’t like to be reminded of cancer because I fear I may get it myself” is another thought I suspect some people have. I have had close friends who have never communicated with me since my diagnosis five years ago. I’ve been cancer ghosted by them. I still think they are good people but just couldn’t get past their fears. But I’ve had other friends, some long-lost for decades, show up and reach out to me via phone or letter. I had people I barely knew visit me when I was in the hospital. I treasure those brave souls who went out of their way to find me. You must treasure them too. You will also discover saints, other people you barely knew, who become profoundly close, fighters in your corner. Your champions. Yes, they are still saints in this world. Treasure them.
9. Be kind to your caregiver. In a way, they had their lives interrupted by your diagnosis just as much as you have had. Try to do as much for yourself as you can, allowing them to help when they must. Even when you are in pain, talk to them gently.
10. It is rude for someone to tell you how they knew someone who had the “same kind” of cancer as you and either had a horrible outcome or “handled it much better than you.” Avoid those people. They are not helpful.
11. I found a support group of patients with the same diagnosis as me very helpful in the beginning, when my local doctors had only pessimism to share. These strangers gave me hope when the medical professionals could not. However, for me, I must use these support groups gingerly because their stories of suffering worse than me or dying is scary and can get you down. It is also true for those doing much better. Envy. While we are happy for them, it is hard to hear of a co-cancer sufferer running marathons when you can’t make it to the car without running out of breath.
12. For some bizarre reason, maybe the Victorian influence or the nordic stoics, there is a myth of greatness for those who suffer in silence. “Yes, grandma had cancer throughout her body, dwindling down to 50 lbs., but she never once complained once.” I find that to be pious bullshit. Sure, if the most important thing to you is leaving a legacy of stoicism, go for it. But I was a human before I had cancer and I’m still a human. I think it does something good for the soul to speak honestly about your suffering. Of course, I’m not talking about going on and on and on about it. But not being shy about it. If you honestly disappoints someone, well shame on them.
13. Find a way to exercise that you enjoy. For me, it is building a cottage.
14. Lastly, self-pity is inevitable, but it must be measured. The late Christopher Reeve was the ideal man. Tall, handsome, strong, and kind. Then, in a freak accident he went on to be a quadriplegic, bound to a wheelchair and on a constant ventilator. He was asked if he ever felt sorry for himself. He said he allowed self-pity to come into his mind for 5 minutes each morning. Then he stopped it, because if he didn’t—it would have consumed his whole world.
15. With all of this said, I must add the caveat, take everything I’ve said with a grain of salt as each person’s experience is different.

Mike

It is 1:20 AM and I’m too tired to proof-read so please be gracious with the typos.