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Realize What's Important
Darrel Ansbacher

I think time is something man invented, and it really is in some ways one of our greatest inventions. In other ways it's the scariest. It gives you a beginning as well as an end. If there's a chance of that end being premature -- for instance, if you have a potentially fatal disease -- there is no gamble too great to take to get rid of that disease. You don't worry about whether the cure will be worth it.

My point of view is from someone who's on the homestretch, who has a chance of a cure, and I'm speaking as a nineteen-year-old. But my advice to anyone who is considering treatment is that, as long as you have time, as long as you have the gift of a normal life ahead, there is nothing you can do that you can't try to undo later. The cure will be worth it.

After what I've gone through to hold on to life, not to fear death would be a mistake. But I don't think my fear lies in the childish fear of death, in fear of the unknown or darkness or being alone. My fear is more like paying an exorbitant price for a piece of jewelry and then being afraid of not getting the jewel. It's as though I don't deserve death, yet I've paid the price. I've bought time. I deserve life.

Philosophy is not that big of an issue when everything is going OK. Philosophizing about life is something that matters much more in a crisis, so for me to define my philosophy right now and pinpoint how I feel about my body and my vulnerability is difficult.

I'm more aware of every ache and pain. There's a fine line between hypochondria and hypersensitivity, but one of the best ways to describe hypochondria after you've had some sort of cancer is that you live a life in which there are no bumps, only lumps. You jump to the to the conclusion that every little thing that gets raised on your body is not a bruise or simple swelling -- for example, from bumping your knee on the table -- but is some sort of growth.

I still have lots of visual reminders of my treatment. There are scars, but not just the one on my belly from surgery. There are my eyes, which protrude as a result of damage to my thyroid from radiation treatments. There's the balding hair on my temples and the little patches missing here and there in my beard. I still notice these effects and have acclimated myself to them without ever really getting used to them.

But as to whether I have made any decisions differently because of cancer, I'm not sure. I'd like to believe that I think things out a little more carefully than I did when I was younger, but that would partially be a result of just getting older.

The only thing I can really say I have now that I don't think I would otherwise have had is that no one can confront me with a situation and say, "There is no way you are going to make it." I have confidence that any set of circumstances can be dealt with.

All the promises you make to yourself in the last two months of chemotherapy about what your perspective is going to be on the day it's over don't always come to pass. The whole time I was taking chemotherapy, I thought, "Boy, when this is over, those petty little things that used to bother me just aren't going to bother me anymore." That's true to a certain extent, but it's also true that when you get better, you have the same anxieties and problems you did before, and you still have to cope with them.

Disease in many ways is a method of avoiding coping with a lot of your normal problems, inadequacies, and insecurities. As long as you're sick, you can forget about them, because, of course, the reason for your problems is that you're sick. When you're well, they'll be gone. In fact, when you are well, everything is just as burdensome, and there are just as many crises and as many meaningless what-am-I-going-to-do things as there were before.

But I like to think that, in a real pinch, I would feel that as long as I have time, I can straighten things out and that, comparatively, the crisis at hand is not that bad.

I've also changed in another respect. I find I don't worry as much about things that would have made me very nervous before, for example, the rent being overdue or being late for an appointment. I've had something in my life that was really worth worrying about.

I saw my friends during this last quarter at school panic when final exams came around, especially the premed students. I don't say this to their faces, but I wonder what disease they're going to have to get before they realize what's important in life. I find my own grade-point average is higher because of this attitude. I take things much easier.

I don't know what I'm going to do yet, but, unlike my fellow students, if I don't have a job when June rolls around, perhaps that's not the end of the world. I'll just have to keep looking. I don't know whether Hodgkin's disease took the edge off my competitiveness, whether I'm characteristically a less competitive person, or whether I have a better sense now of what is important and what isn't.

I wish I had a chance to talk to prospective employers about Hodgkin's disease during my interviews, because I consider it to be one of my greatest achievements. Some people climb the Matterhorn and afterwards they show slides and want everyone to know about it. I'm sorry there's not a place on my resume to show I had Hodgkin's. After all, I survived that a lot longer than I've held any job.

I understand the stigma that's attached to a sick person, however, both in his own eyes and the eyes of an employer. For the prospective employee, it's rather like the person who is embarrassed about seeing a psychiatrist. He hates to show any weakness. Even if he is open about it, other people may think of it as a weakness. A person who's looking for a job doesn't want anyone to know they've faltered because some people in the business community think people are born to success or not. Are you going to be a lucky guy? Are you a guy who lives a charmed life, or are you going to be a loser? If you were just on the operating table for four hours, maybe you're a loser.

I look at it in quite the opposite way. I think the real winner is the guy who was on the table for four hours and lived to get up off it. I view what happened to me as a malfunction and believe the technicians pretty much corrected it. What enabled me to get better as comfortably as I did was having my family around. I had people to feed me, help me walk around, and pick me up at the hospital. I was lucky not to be the guy who showed up for his chemotherapy on the bus then went back to his apartment alone in a cab. That doesn't mean such a person can't get well, but it must be much more difficult.

I think endurance is important. I don't know how to develop it, but all my life I've had methods of getting through unpleasant things. The hot coals are there, but you just look at the other end, close your eyes, and walk over them -- just do it. Like when I wake up in the morning and have to get out of bed, I have a swinging technique so that no matter what my mind and body say, I can get my feet on the ground. You are looking at that spoon that's filled with God knows what and you know you can swallow it.

That kind of endurance takes on uncommon importance when you have to go into one more radiation treatment. While you're taking off your clothes, you focus on being in the dressing room afterwards. You remind yourself of the last three or four times you were there, and you think about getting dressed again. That's all you think about, not about going to the Bahamas when you get well. If you've been successful at everything you've done in life and have that kind of endurance, then maybe you will feel a little better about your chances of fighting cancer. I think the will to live is a crisis mechanism you don't know you have until you need it. Part of the will to live is endurance and part is resourcefulness. But a lot has to do with having the imagination, when things are really bad, to divorce yourself from what's going on. When you really want to live, you'll think of ways to work at it, no matter what the situation.

1998 Update
The past can't be changed. Nevertheless, when offered the opportunity to revise the above passage which I wrote almost twenty-five years ago, I was tempted. But I can't change those thoughts and observations anymore than I can be that age again. Instead, I will add this brief postscript.

Like any nineteen-year-old, nobody could tell me much of anything. My beloved parents blessed me with a solid ego that often led me to state my opinions as if they were the wisdom of the ages, when they were nothing more than the rantings of a teenager. Today I am much less sure of things. I am wary of people who seem too sure of simple answers to complex problems as well as people who are convinced that life's answers have somehow been made clear to them while the rest of us search aimlessly.

Some physical scars are permanent, some transitory. The same seems to be the case with emotional scars.
"I'll never be the same.__________."
"If I survive, I promise I'll never __________."
"If I survive, I promise I'll always _________."
These are conclusions reached in a foxhole in the heat of battle.

Twenty-Five years later I am overwhelmed by the normalcy of everyday life. All such promises and expectations seem to have drifted into oblivion.

Charles Dickens' story of Scrooge is built on the faultiest of premises. It presumes that the experiences of one night can fundamentally change someone from sinner to saint, from schmuck to mensch. No matter how dramatic the events, I would argue that, by definition, the natural state of affairs is normalcy. Scrooge would inevitably fall back into old patterns and come to rest somewhere beyond his old self, but also short of sainthood.

So it must be with those of us who are long-term cancer survivors. Fundamentally changed? Yes. Candidates for sainthood? Give me a break. In any case, no matter how much if any personal growth results from having survived this disease, it would have been far better never to have had it.

I am left with fundamentally the same tools as everyone else with which to confront life's hurdles. But perhaps there is one tool in my arsenal which not everyone can claim. Somewhere deep inside, I suspect I could endure cancer treatment should it, God forbid, ever reappear.

In fact, I did have a recurrence of cancer. Not in me, but in my father, who ten years ago was diagnosed with prostate cancer. When he thought he couldn't face another treatment, he once told me he found strength in remembering how I persevered during my treatment many years earlier. If this eased his suffering by one iota, then there is definitely something of some lasting value in having had cancer myself. His death two years later overlaid my own successful cancer cure with a profound understanding of the tragedy that remains all too common an outcome for many cancer patients and their families.

There is no blessing in disguise here. There is just the chance to live each day, drawing upon the past, hoping for the future, and trying to appreciate the journey which so many years ago almost came to a premature end.

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First appeared April 28, 2008; updated June 12, 2009