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How would you react to a cancer diagnosis?

Posted by Dr. Suzanne Koven  April 3, 2013 09:20 AM

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HannahAndSis1.jpgThere's this weird feeling I get when I hear bad news, or even not that bad news, or even the possibility of bad news: a tingling that spreads across my forehead, down my face, into my jaw, and then to my chest, where it settles like, not a lump...a void. I get the feeling every time I go for my annual mammogram or any other medical test, I wonder how I would react to a bad outcome. Would I be brave and noble, as so many of my patients are? Or would I be like Woody Allen in this classic scene from Hannah and Her Sisters--yes, the actress is Julie Kavner, the voice of Marge Simpson--one of the "weaker ones," panicked, swallowed up in the void of my own fear?

At our Literature and Medicine discussion group, I had a chance to reconsider this question. Once a month, nurses, nurse practitioners, administrators and doctors meet to discuss literature related to a particular medical theme. This month, the theme was cancer, and two of the works we read detailed very different reactions to devastating cancer diagnoses.

Christopher Hitchens, essayist and contrarian, died of esophageal cancer in 2011 at age 62. In 2010, he wrote in Vanity Fair about his reaction to the diagnosis (his essays about this illness appear in a book, Mortality, published shortly before his death). Hitchens, a heavy smoker and drinker of alcohol, wrote with characteristic dry wit of learning that he had the same cancer that had killed his father:

...I can't see myself smiting my brow with shock or hear myself whining about how it's all so unfair: I have been taunting the Reaper into taking a free scythe in my direction and have now succumbed to something so predictable and banal that it bores even me.

We also read Susan Gubar's Memoir of a Debulked Woman. Gubar, a distinguished literary scholar, was diagnosed with ovarian cancer in 2008. She now blogs about cancer for the New York Times. In her memoir, Gubar describes a strange euphoria that overcame her as she lay on a gurney in a hall, having just been told by a radiologist that the vague digestive symptoms she'd had for months were likely caused by advanced ovarian cancer. Some of this euphoria--which, of course, gave way to despair, anger, and myriad other emotions later-- was the scholar's satisfaction in learning the truth:

Knowledge clinched or confirmed always feels like a coin falling into the right slot, a ball landing in a basket, a peg knocked into its proper hole. I recognized, I believed, what would kill me. That there is pleasure even in such painful knowledge may seem perverse; however, the mind and spirit are subtle and mobile faculties.

I suppose the point is that there are as many ways to react to a cancer diagnosis as there are people. I certainly have seen a wide range among my own patients: renewed religious faith and loss of faith; determination to get out and do as much as possible and resignation to being an invalid; grace, rage, nonchalance, denial, depression, bitterness, and gratitude...and often many of these, at different times, in the same person.

Roughly one in four of us who will face a cancer diagnosis at some point. We'll bring ourselves to meet that diagnosis. I'm hoping I'll bring my better, braver self--not my Woody Allen-ish self. Meanwhile, I look to my patients to show me the way.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »


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