What Survives of Us

Pam and me at my book launch party, September 2010

“What will survive of us is love.” -Philip Larkin

Pam broke the news on December 9th, over dinner at our house for an early Christmas celebration. She had stopped all her cancer treatment because her oncologist, who cried breaking the news, told Pam there was nothing more they could do for her. She was calm when she told us how she could feel her body shutting down. My brother-in-law Jeff, his partner Eddie and I cried. Bruce, my husband, did not, but he got a huge lump in his throat.

And then Pam did something I will never forget. She talked about how grateful she was for the life she had and for everything she had been able to do in 40 years. She talked about what a wonderful vacation we had together in Napa in October and about how much fun we were going to have that weekend.

And we did have fun. We went to the Old Market the next day and watched the Dickens carolers. We had lunch in our favorite French bistro. We sipped chocolate martinis in our favorite bar. We toasted being there, in that moment. Our standard toast two years earlier was “Here’s to getting to.” We had started counting toasts in Napa with ridiculous numbers; toast 4,205 or 5,622. We kept that going now.

In the breast cancer Twitter community we talk about being fearless friends. I am so far from fearless. I was scared for Pam all the time, and so was Bruce. We were afraid of what might go wrong when we were traveling together or she was visiting. Jeff was driving her somewhere one day toward the end and she suddenly went “Oh! Oh!” and scared the daylights out of him, but she had seen some fast food drive through she wanted to stop at for iced tea or a shake or something. What allowed us to be there for her was her incredible strength and steadfast refusal to let that thief cancer rob her of her joy in life. If she was tough enough to handle it, so were we.

She never stopped being interested in life. She wanted to know everything about our lives. She wanted to hear about school and work and food and wine. Bruce and I spent the weekend with her in her Kansas City home in early March, a month before she died. She said if you want to come, you should probably come sooner than later. 

She took us shopping and to lunches, to a speakeasy and dinner with her parents. We got pedicures and she brought champagne in her tote bag. She cooked. She drove–like a bat out of hell. She hugged me so hard when we left it was like being hugged by my cowgirl cousin, who throws hay bales. I could feel her spine. When we called to let her know we got back to Omaha, she was at her son’s baseball scrimmage, in spite of pain that had kept her on the couch. None of us will ever know what all that effort cost her. When the hospice nurse started coming to her house, she told Pam she wasn’t taking enough pain medication, but Pam had to do this her way. She put off the shrinking of her world as long as she could.

After she went to hospice, she was talking to my sister-in-law Anita about something Anita had made for dinner and said, “I want that recipe.” She knew she was never leaving the hospice; she was tough enough to make the choice to go there. You need to know this isn’t denial. This is insistence on being alive.

One of my favorite stories about Pam was from the night of my book launch two years ago. She bought a carrot cake at the restaurant where we had dinner because I mentioned I liked it. (She was like that. If you liked something, she remembered it and you ended up getting it as a gift.) We brought it home after the party and she set it on the kitchen counter. Jeff and Bruce and Eddie and I were all dithering–too late, too many calories, blah blah blah. Pam didn’t say a word. She pulled five forks out of the silverware drawer, came back to the cake and stabbed all the forks into it. We mauled that cake.

That was how Pam lived her life, and how she faced death. Straight on, no dithering, no excuses. If I can be half the woman she was when my time comes, it will be because she taught me how to live with joy and light and love, and how to face death with grace.

Here’s to you, Pam. Toast 10,373 and counting. I’ll raise my glass to you for as long as I live.

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The 10 Commandments of Breast Cancer

(Editor’s note: This originally ran in September 2011. I planned to “recycle” it later but I did it now since it showed up on someone else’s blog without citing me. Updated: The other blogger added me as the author after I told her it was me. At no time did she try to claim credit for my work. Some of the comments below were before it was resolved.)

1. Thou shalt give thyself time to think. When you’re diagnosed, you may feel like you have to do something right now. You don’t. Take a deep breath. Give the spinning in your head time to slow down before you make any decisions.

2. Thou shalt not judge thy neighbor’s treatment or reconstruction choices or attitude toward their diagnosis. I honestly have not seen people in the breast cancer community judge each other’s treatment or reconstruction choices, either online or offline. The real armchair quarterbacks are the people who have never been through it.  They need to be mindful of who’s actually on the playing field. Attitude gets a little trickier. No one has the right to tell you how you should feel. Some people would have you think you should be able to overcome your fluffy pink cancer by being all shiny and happy, or that you should be grateful for some life lesson. That’s a BIG fail. But you may be the naturally optimistic type. You may actually be grateful. And we all need to remember that’s okay too. We’re all wired differently. I always say that telling you how you should feel about your diagnosis is kind of like saying you should be six feet tall or have brown eyes.

3. Thou shalt honor thy own feelings, whether shiny and happy or tired or angry or scared. And don’t be surprised to feel all these things within the space of 15 minutes, several times a day.

4. Thou shalt love thyself as thy neighbor. Women are so darn hard on ourselves. Give yourself the same break you would to a loved one going through a big diagnosis.

5. Thou shalt not beat thyself up. You don’t have breast cancer because you ate the wrong things or didn’t breast-feed your kids or exercise enough or the right way. You have breast cancer, because.

6. Thou shalt allow others to help you. This is a tough one for many of us. But your family and friends want to be able to do something for you; let them.

7. Thou shalt not bear false witness against science. You may or may not decide on a certain course of treatment. (See Commandment 2.) You may or may not have a good experience. We can learn so much from each other’s honest recounting of our experiences, but that doesn’t make us medical experts. Celebrities and politicians have a special responsibility here.

8. Thou shalt ask thy doctors questions. Do not be afraid to ask, “What is the risk if I do A or B?” or “What does that word mean?” or “Could you repeat that?” Good doctors welcome your questions and concerns. Not-so-good ones need to be reminded there’s a person attached to the breast.

9. Thou shalt seize the day. There’s no doubt cancer is the elephant in the room. But sometimes you just have to pat its big ugly flank and say, “Excuse me, elephant, but I’m going to the beach, or the movies, or the back yard with my kids. I’ll catch you when I get back. Right now, I’m off to have some fun.”

10. Thou shalt remember you are more than your cancer. Cancer is all about cells run amok in your body. It will do its best to claim your identity as well. You may be a woman with cancer, but you are also a wife, mom, sister, daughter, employed person and friend. Let the extent to which cancer becomes part of your identity be your choice, not its choice.

-Jackie Fox

©Jackie Fox 2011

P.S. Since so many of you have recommended printing and sharing with your family, friends, and doctors, I created a PDF to make it easier to print and share. Thanks to all of you who have shared this and commented. The 10 Commandments of Breast Cancer