Losing the Tiny Bits of Love

This morning I had “safe coffee” with a friend. 

 Safe coffee is one of our new practices where to be COVID safe we have coffee with a friend—outdoors, masked and six feet apart. Weird? Yes. Awkward? For sure. Better than nothing? Absolutely. This is social life in the time of COVID. 

 What I realized today is that many of us have moved from never leaving our homes, to waving across the street, to establishing safe pods with family, to now venturing further and seeing extended family in the backyard or seeing a good friend for coffee or lunch. It’s a select team. We are careful, and we are making choices. 

 It’s rich and a thrill compared to March, but we are still missing so much. What we talked about today was the realization that while we do see those closest to us now, we are missing acquaintances. Acquaintances are out. People in passing are out. Know what I mean? Think about it. 

 Yes, we are hugging our immediate family, dining with extended family, having coffee with a good friend and looking at them across the table. That’s a lot of goodness and a goodly amount of affection. But in our past lives (before March 2020) that’s not where all of our social life came from. 

Before that big quarantine and COVID scare hit all of us we had an enormous amount of people contact everyday even if we didn’t “do” anything with loved ones. We chatted with neighbors, stood in parking lots and caught up with folks after church, we ran into people we knew in stores and at the post office. 

If pressed we would not have said that any of those people were our friends, but they were in and out of our lives, and we were in and out of theirs. What we got from those hundreds of small encounters were bits of love and affection: handshakes, hugs (back when we hugged the way we shook hands) and we also looked at each other. We had seconds or minutes to really see each other. We affirmed their human presence and they affirmed ours. 

 Yes, we are Zooming. I can see your new haircut and I can complement you. You can see the art in my kitchen and ask about it. But all those mini, daily, tiny bits of love and affirmation are gone. 

And it is not crazy to miss them or grieve them.

Life Changes Fast

Life changes fast. It’s one of those things that we understand intellectually but don’t fully grasp until something big happens. Those of us in CancerLand know this. 

We have at least one memory of a perfectly fine day—until the phone rang, or until the doc came back into the room, or until a nurse said, “The doctor would like you to stay for a few more minutes.”

 

Many years ago, on September 11^th in 2001 we all got it.  Then again in 2005 with the Indonesian Tsunami. Then in 2012 with the shooting at Sandy Creek Elementary School.

 

Those incidents were huge, but now they seem to come faster: a shooter, a bomb, a natural disaster. But the aftereffect doesn’t stay with us as long each time. It’s as if there is a half-life of consciousness after having a couple of these “Life is short” experiences.

 

That is true in CancerLand as well—now we brace ourselves for the next news, the next scan, the next colonoscopy or mammogram. We have quiet, whispered conversations with ourselves that go like this, “OK, if this is bad news I’m going to go to Paris first.” Or “If this is bad news I won’t tell anyone for a week—I have to sort it out myself.”

We know that bad things happen in the greater world too. 

We keep reading about how life makes these sudden shifts for other people.

 

We know it happens more frequently in other countries—and in places where people don’t look and sound like us. But when it happens in Colorado, Connecticut, Arizona or Ohio-- places where the skin tones and consonants are more like ours, we get it again, and fast. 

 

As much as we believe that life follows rules like, “What you put in is what you’ll get out,” we are shown again and again that planning denies life’s absolute uncertainty.

 

Your life will change in an instant, in a New York minute, in the blink of an eye, and on a dime. 

 

I’ve seen it happen in the lives of people I love. A friend lost her home and everything in it--burned to the ground. All gone: checkbook, toothbrush, computer, family Bible. Not even a pencil left to tally all she lost. Her family was safe, and for that we say, “Thank God”, but really…

 

Another friend was crossing the street. The light was green. She remembers stepping into the intersection, then--days later--regaining consciousness in the ICU badly broken.

 

Another friend was taking a quick bike ride before work, a car turned left, she was in the blind spot. So beautiful, so young, so gone. A family devastated.

 

What about the to-do lists in their handbags? Their responsibilities at work? And the library books they always returned on time?

 

Twice I had to suddenly look at my life in a new way. Both times doctors holding clipboards were my wake-up call.

 

I’d always measured myself by my work, but that changed quickly. Someone asked me, “What about your career?” and I answered, meaning to be flip but surprising myself with the truth, “I don’t have a career, I have a life.”

 

That insight had incubated over time by too many funerals and too many days in Intensive Care waiting rooms watching family members die.  That was an incredible wisdom school—and in many ways a gift—but that’s a school with a very steep tuition.

 

So, in the midst of the shootings and terrorism, and this COVID-19 virus gobbling human lives like Pac Man, there may be a bit of buried treasure. 

While we can’t control everything that happens to us, we do get to make choices. We can love others, we can allow ourselves to be loved, and we can say Yes much more than we say No.

 

One day it might be that lone package on the train, or a screech of tires, or a fever and a cough that won’t quit. Or that call-back from the doc. Knowing we might die can paralyze us or it can liberate us.

 

Life changes fast. So, what do we do about that?

 

I vote for living it. Starting right now.

 

 

Happy Canada Day!

We were on vacation in Northern Ontario. It was midnight in the little village and no cars had moved for hours. 

At the crosswalk I step into the intersection and feel a sudden tug on my arm. 

My ex-husband, Peter, pulled me back to the curb, I look up to see that the signal says, “Don’t Walk”.  

Smiling I stand on the silent sidewalk and wait. When the traffic signal glows its approval to cross we step out carefully and correctly; I laugh. This is the kind of thing that happens in a mixed marriage.

I married a Canadian.

Hockey, beer, donuts, moose –these stereotypes, all rooted in Canadian reality are funny to Americans. 

We especially like the accent, the lilting up and down of Canadian speech. In just a few hours in Ontario I am imitating my in-laws, “Will ya go to the lake, eh?” But I also know that the final “eh” on Canadian sentences and obeying traffic signals are related.

The Canadian “eh” is not just a conversational tic. That uplifting extra syllable is an invitation to consensus, to agreement, and to keeping the order.

Keeping order is one of the greater aspects of Canada that we Americans-- so nearby-- miss when we think “Canadian”. Canadians –motivated by a concern for a “common good” are more orderly, law abiding and considerate than we. It’s not because they are nicer, but consideration of one’s impact on others is a strong cultural value. 

Speech patterns give more than a clue to this difference. The histories of our nations are echoed in how we use our common language. There are very few declarations in Canadian dialect. Declarations invite challenge. This makes sense when you remember that Canada did not have to struggle for independence as Americans did. 

Britain approved Canada’s confederation in 1867.  So, you can hear how the inflection, that final “eh” leaves the conversational door open with space for another’s thought.

For example, while visiting we met a young man who was dating a niece. He was not as bright as the family might have liked. 

But as I was about to blurt, in my American declarative, “He’s an idiot”, my sister-in-law said in her Canadian lilt, “Ya say hello to him and he’s stuck for an answer, eh?” Message delivered; door left ajar.

Americans however are poised for a fight. You can hear it in our speech with its tone of certainty and downward inflection; we are always staking a conversational claim. Even the most pacifist of us hold our opinions –and our right to them—like guns.  This also comes from our past. We arrived here fighting.

This is also why the gun control issue seems easier to Canadians. Friends in Ontario shake their heads at our debates and say, “Such a big fuss, eh?”  For us the gun question is emotionally charged because at a deep level we remember fighting for our land and freedom.

It may be around the idea of freedom that our look-alike cultures diverge. My husband and I have a regular debate about freedom. I say Americans have more freedom: We can be and do and say whatever we like. It’s freedom TO.

But, says Peter, in Canada freedom is seen as freedom FROM. The Canadian consideration for the common good allows Canadians relative freedom from violence, from crime, and from poverty.

Because Canada is a non-litigious culture Canadians are especially free of the kinds of legal hassles that cost Americans so much time and money.

These differences run deep but they’re obvious when you lay the historic values side by side. We salute “Life, Liberty and the Pursuit of Happiness.” There is a win-the-west, win-the-war feel to it.

Then picture Canada’s: “Peace, Order and Good Government”. Can’t you just see people cueing up and taking turns, and leaving room in the conversation for the other guy?

Canada is not a land of Boy Scout, do-gooders of course. The very contradictions make you love ‘em, eh? Theirs is a mostly non-violent culture whose national pastime—hockey-- knocks the teeth out of every male over nine years of age. And while living surrounded by natural beauty and wilderness air Canadians smoke themselves to death. We joke that Canadian restaurants offer two seating choices: Smoking and Chain-Smoking.

I learned a lot in that marriage. I learned to care more about the rest of the world as Canadians do and to not run from the room when the world news comes on.

I learned that waiting for the walk signal is not passive submission to rules and regs; rather it’s an active expression of community and being part of the common good.

Racial Discrimination & Disparity in CancerLand

So, this week we are each looking at ourselves and asking about our own participation in the culture of racism, and asking ourselves (I hope you are) “What can I do to be an anti-racist?”

But, for goodness sake Diane, this is CancerLand, could there be a place more inclusive, and more, “we are all in this together?”

Well, I get that. 

Colon cancer, breast cancer, lung cancer—when we suffer, we suffer. Our caregivers are stressed and anxious in similar ways. Yes, but. But. There are differences related to race and class and income and poverty and disproportionate care and access to care.

Years ago, working with a cancer support group I was dismayed that when there was an opportunity to locate that luscious care center in our County it was built in a very suburban area, with very little access to public transportation. Yes, busses do go there a couple times a day, but no sick or tired cancer patient was going to take two or three buses with a 30-minute wait in-between. But the place was so pretty and the staff so truly loving, that reality slipped by.

The other way that cancer and cancer care discriminates is in its relationship to poverty. When many of us—let’s say middle-class—are diagnosed, our friends rally: here come the casseroles (Oh, dam the lasagna), and the offers of childcare and rides, and “I’ll go to the doctor with you to take notes.”

But if we live in poverty the odds are pretty good that our friends do too. They care just as much but maybe they can’t cook for two families or take time from a no-benefits job to accompany us to appointments, or spend hours at chemo with us, or offer rides if public transport is their ride. 

So, patients in poverty miss more appointments, leave chemo earlier, don’t have a pal advocating fiercely for that second opinion or that NYC or Boston trip. Do those things affect cancer’s outcome? Add to that--their family caregiver likely can’t take as much time off  from work.

And, we haven’t even touched the subtle racism (let’s say unconscious) by some docs and other medical personnel. 

It’s a very different part of CancerLand.

Let’s learn about that, and use our Cancer Power for advocacy in our shared territory.

And let’s read a bit, and ask more questions, now or as soon as you are feeling better.

Want to learn more?
Here are two articles that explain this discrimination and disparity in CancerLand:

This article is from Rush University Medical Center
https://www.eurekalert.org/pub_releases/2019-04/rumc-owc042219.php

This article is by Brian Rivers, PhD for Cancer Today Magazine

https://www.cancertodaymag.org/Pages/Spring2020/Taking-Steps-to-Address-Cancer-Health-Disparities.aspx

The Tools in CancerLand That Help Right Now

Those of us who have lived in CancerLand, have a tool kit that we can open in this time of COVID-19.   These may not be tools we wished for years ago, but nevertheless, we have them. And maybe now we can lean into those tools to help ourselves and others.

Here's an article from Kate Bowler who is a cancer survivor and a scholar at Duke Divinity School: 

https://www.nytimes.com/2020/04/05/us/kate-bowler-cancer-coronavirus.html?smid=em-share

Maybe take some time today to inventory your tool kit.

What did cancer or caregiving teach you?

Sending you lots of love.


Be well. Be safe. Stay home.

When Chemo Doubles the Impact of Quarantine

Yes, those of us in CancerLand--whether patients or caregivers--have extra challenges and protocols right now. The pressure can feel more intense, and the restrictions on family are greater too.

Thought you'd like to read this story by Larry Rulison, a reporter for the Albany Times Union--who is working--at home of course because he also being treated for Stage 4 appendix cancer. Here is what it's like at his house in Albany, New York.

https://www.timesunion.com/news/article/Times-Union-reporter-undergoing-chemo-learns-what-15140810.php

What is it like at your house?

What modifications are you, and your docs, making for your care?

Meditation and Mindfullness for Caregivers

It would seem impossible to add one more thing to the caregiver’s to-do list. But, adding meditation or a mindfulness practice may be the very thing that makes that too long list a little more manageable.

No, doing meditation or yoga or Qigong or another mindful practice is not a total remedy to the stress and business of caregiving, but is absolutely a positive aid and help.

Now documented in many years longitudinal research, it’s been shown that caregivers—of people with serious illness, dementia or a child with a developmental delay—cope better, report more ease, and have fewer physical symptoms of their own when they are engaged in a mindfulness practice.

And mindful meditation, breathing practice or yoga becomes more than just a way to cope with the stress; it’s a way to fully embrace one’s life as caregiver.  

Trying to attend a weekly class may be over the top, but there are many online resources, and podcasts that give basic instruction in Pranayama (Yoga breathing), restorative yoga, mindful awareness, and meditation. 

And if you are part of a caregiver support group, ask if some meditation or yoga instruction can be added to the meeting once a month.

The Carry-on Bag for the Caregiver

When you become a caregiver for someone with cancer you need to prepare yourself for the role. 

You have logistical work to do, of course: calendars, credit, insurance, benefits, appointments and medication reconciliation. 

And you have emotional work to do: Fear, worry, love, and the biggie: boundaries. If you are the caregiver for an adult patient you don’t want to be parental, but you will likely need to be responsible. 

You’ll need to separate your feelings from theirs and have your own support team when you cannot turn to your partner to be your support while you are caring for them.  You may have depended on your partner to help you through hard times in the past, but when you enter CancerLand, your partner’s illness becomes the hard time. 

Your partner may have been the one who managed the logistics of your life: cars, money, credit etc. And your loved one may be very competent in these areas but once chemo begins or the impact of other meds like pain killers you will—temporarily—lose that competent partner. And the distraction factor is huge: “Am I going to die?” can undo the most fastidious financial manager.

So, caregiver—you are now in charge:

Get every account number and password in one place. 

Get copies of the medical power of attorney and have two copies with you at all times. You’ll need to hand it over again and again. Just because you put it in the medical record last month doesn’t mean it’s still there.

Get a limited Power of Attorney for all things non-medical as well. There may be things you need to transact on behalf of your partner, or documents you need to see—medical and non-medical and you’ll need that Power of Attorney to graciously make your point.

Start your caregiver notebook immediately—if the diagnosis was slow to arrive you may not have written down every little thing—so back date a few pages and fill in all you can remember: dates, ER visits, doc appointments. Then keep this notebook in your caregiver tote bag (below) and always return it there. Don’t keep it on your desk or at work---you may need to rush to a hospital or jump into an ambulance and that tote bag is all you need to grab because it will have:

Your caregiver tote bag is your home away from home. Buy extra of everything mentioned here so you are not running around or borrowing from the bag. This bag is sacred. In the bag you have:

*Your caregiver notebook—not too big—spiral is great, but no three-ring binders—too cumbersome

* Pens and sharpies and a highlighter

*A written (paper) list of everyone’s phone number: family, friends, doctors, hospitals.

 (Yes, I know they are in your phone but if your phone doesn’t work, dies, isn’t permitted—you have the numbers) And people who might not be in your phone—your partners employer, doctor, best friends.

*A phone charger—a separate charger that only lives in this bag.

*A book to read in waiting rooms—like Goldilocks—not too hard and not too easy. A good book

*Magazines—there will be times you are too fraught to read a book and the magazines in waiting rooms are awful and old.

*Some spiritual or inspirational literature. Something to lean into that inspires and uplifts you. There are lots of nonreligious ones—a daily meditation book etc. There are several just for caregivers.

*Envelopes—for when you want to leave a note for a doc or nurse

*Nonperishable snacks—protein bars, packs of nuts, candy bars that cannot melt, bring more than sugar—a 30-minute appointment can become a six hour wait in a flash.

*Cash—yes, paper money and coins for just in case for phones, tips for the valet, coffee machine etc.

*A sweater or shawl that you keep in this bag. (Do not “borrow” to wear to work.) Waiting rooms and ICU rooms are cold—on purpose. And fear has a way of lowering your body temperature.

*The Healthcare Proxy (multiple copies) Have this conversation with family early—include his/her parents, siblings, ex-spouse, step kids. Be sure its legal and official and notarized. 

When your partner is sedated or unconscious or in the recovery room you don’t want the additional pain of  a family fight over, “He wanted…she wouldn’t want…I’m the husband…Well, I’m his mother.” One spokesperson. One proxy plus a backup.

*The Powers of Attorney—keep copies in the tote bag.

*Tooth brush and mini tube of toothpaste (in a ziplock)—Just in case you need to stay longer or just to refresh yourself mid-day

*Extra glasses and bring a case for your contacts.

*Have a copy of your partners driver’s license, birth certificate—copies only—you don’t want to lose the original documents, but copies can come in handy.

One Hundred Autobiographies, by David Lehman

There are many personal stories of cancer. Many self-help stories and many memoirs. And yes, there are even cancer poems.

But now we have a book that is both a cancer story and a work of literature that happens to be a memoir by a poet. We would not wish cancer on anyone, not even—as we say—our worst enemy, but now some gratitude because cancer has given us a gift in the new book:

“One Hundred Autobiographies” by poet and scholar, David Lehman.

It is true that for a writer everything is material, and that for a writer everything is examined through the lens of language, so of course from his first suspicions Lehman began to craft a story—the real and awful story --of his bladder cancer.

The “One Hundred Autobiographies” is one hundred short vignettes detailing and documenting diagnosis, treatment and into the start of recovery. 

While we, here is CancerLand,  may know some things about cancer, and some things about bladder cancer, Lehman takes us to new places only a poet can take us.

He brings popular culture into the rooms, (look there--Keith Richards and Patti Hanson--who knew?) and he also allows intellectual folk like Edward Said and Lionel Trilling to join in. 

But how else would a poet and scholar do cancer?

Lehman shows us his pain and fear, and he shows us his love, and his loving wife, Stacey who documents what Lehman cannot see or sense when he is under the spell of anesthesia and the recovery room.

But here’s the thing about this cancer book: You are also going to laugh when you least expect it, and you are going to scribble in the margins (hence, buy your own copy) all the quotes you want to save and the books you’ll want to put on your library list (“The End of the Affair” by Graham Greene was first on mine.)

Lehman’s book is smart and sharp, with a touch of literary celebrity, and beautiful language. And something else: You don’t even have to have cancer to be enthralled by this book.


***
David Lehman is the author of: Poems in the Manner of...and Sinatra's Century: One Hundred Notes on the Man and His World. Lehman is the editor of The Oxford Book of American  Poetry and series editor of The Best American Poetry. He teaches in the graduate writing program of the New School in New York City.

Caregiving and Memoir at SUNY Book Festival Next Week

We talk a lot about the Literature of Caregiving here. Caregivers need books about caregiving. Yes, we need the how-to books—absolutely. But we also need books by caregivers, and we especially need beautiful, well-written books by caregivers.

In Albany, next week, we have two of the most beautiful writers on caregiving coming to the SUNY Albany Book Festival—on Saturday September 14^th. In a day that includes more than a dozen keynotes and several dozen authors signing, we’ll have two featured writers whose stories might scare us—bad things happened--but who ultimately inspire and encourage us.

Allison Pataki will be here discussing her memoir, “Beauty in the Broken Places—a memoir of love, faith, and resilience.” When she was five-months pregnant, and they were heading off on their babymoon,  her 30-year old husband suffered a massive stroke. Pataki became caregiver to a newborn and an impaired husband. 

Presenting with Pataki will be Abigail Thomas, author of the memoir, “Three Dog Life”—the story of her stunningly disrupted marriage when her husband suffered a severe brain injury, and how she faced the terrible decisions that followed and how she made a different, and fulfilling life.

At their presentation (11:30am to 12:15) we’ll have a chance to hear about structuring memoir and structuring one’s life after such huge disruptions to relationships and careers, and how one makes art—these books are truly works of art--out of shock, pain and crisis.

For some of us caregiving comes on fast—as it happened for these women and writers—with a call, a fall, a break. For others, we move in more slowly into it —no less tragically—with dementia, cancers, neurological illnesses. But for all of us who are caregivers we face this disruption and the challenge to make new lives—and maybe art. And all of us can learn from these writers who let us see the pain, the grief and especially the joy that is there as well.

Join us in Albany next Saturday or get these books for yourself or for a friend.

The Dutiful Daughter's Guide to Caregiving

It’s true that we don’t laugh a lot as caregivers. That means we are extra grateful when someone makes us laugh in the midst of this challenging life. And it always turns out to be a fellow caregiver—often who went thru a horrendous time before us, and who has enough perspective on the caregiving scene to look back and find the humor. 

Judith Henry’s book has that. Her book is subtitled “A Practical Memoir” and it is that.

 It’s her own story, and from that experience of caring for two ill and aging parents she extracts practical and helpful info that benefit the rest of us. 

And we readers can trust her cause she tells the whole truth—the hard parts, the crazy parts, the “I’m losing my mind” parts and the loving parts. 

Here are a couple of chapter titles just to give you the flavor:

Chapter One: I’m OK and You’re Going to Be Ok

Chapter Ten: My Dad Was a Lousy Tipper

Chapter Fourteen: In My Father’s House There Are Many Boxes

Chapter Twenty: The Facts of Life (A different perspective)

Her chapters also include beautiful short essays on love and literature and learning about sex as a 13-year-old reading Lady Chatterley’s lover, so yes, crazy as it may seem “The Dutiful Daughter’s Guide to Caregiving could make a great gift for someone—all of us—of a certain age.

Caregiving and Your Career--Cancer and Work

One of the worries--and pressures-on caregivers is  what to do about work. Of course we often fear to admit we are worrying about our job when a loved one has a terrible diagnosis, but our jobs and careers are a reality.

For our sanity and peace of mind we need our work, and the financial realities of cancer are such that most caregivers can't afford to quit a job or lose one.

This week I wrote about caregivers and work for Cancer Today Magazine.

Here's the link:

https://www.cancertodaymag.org/Pages/Summer2019/Caregiving-and-Work.aspx

A Beauty Guide for Women with Cancer

Ok, so you might think, “Beauty tips, really? That’s the least of my worries right now.” And that might be true at the start of diagnosis and treatment. But as we progress—or our loved one progresses—through CancerLand, issues around appearance will come up.

You know this. We know about hair loss and hair thinning, and skin changes and dryness everywhere. But just as I had to learn the hard way about cancer and sex, I’m learning too about cancer and appearance.

We also know that while the big stuff is on the inside (Courage, Wisdom, Will to Live, and Beauty) our outsides play a big role in how we feel and how we fight for our lives.

Most of the information on what to do is passed woman to woman (rarely man to man) and in that way we gather the scoop on wigs, skin care, eyebrows, oral care etc. But now I discovered a book that pulls it all together. It’s not a new book, but it’s new to me, and

maybe new to you.

The book is, “Pretty Sick: The Beauty Guide for Women with Cancer” by Caitlin M Kiernan. It was published in 2017, but recently Googled its way to me, and I’m loving this resource.

Let me say right off that Kiernan’s tone in the book is one woman to another. She was a beauty and fashion writer, so you’ll recognize the voice.

If you always loved woman’s magazines as I do, you’ll like this approach.

She’s a friend and a cancer sister telling the truth. 

But here’s a fellow cancer sister with the most amazing Rolodex of experts and resources, and friends in the beauty business. 

But let me add this too: While it says “women with cancer” in the title, this is also helpful for men. Yeah, you don’t have to be a “metrosexual” to want to save your hair, or deal with skin or mouth problems. 

On the other hand, Kiernan speaks directly and frankly and honestly about what happens to our sex lives and our sexual parts as a result of cancer treatments. I bless her for that. 

You know, if you’ve been reading this blog for a while, that I came to this fight because NO ONE would talk to me about sex and cancer, sex and chemo, or sex and marriage for that matter. So, I came to this keyboard to do battle with fear, shyness and shame. 

If you have any of those questions go directly to Chapter Nine. No one has to lose their love life or relationship along with their hair. 

Caregivers and friends of friends with cancer: your job is to buy this book and hand it over. You can add a note that says, “When you’re ready to talk about this, I’m here.”

“Pretty Sick” turns out to be a pretty cool way of supporting a friend with cancer.

Marriage Can Be Hard..But...

I’m always thinking about relationships and marriage. It’s one of my favorite reading topics, because, of course, I love learning about what makes people tick, and intimate relationships are the perfect crucible. I find that sometimes the best learning comes from reading about relationships that don’t work, …until they do.

I know it’s a book that divides the field, but I loved Elizabeth Gilbert’s memoir, “Eat. Pray.

Love”

 I’ve read it and listened to it. I especially love what she has to say about God and pleasure and faith and how she learned to overcome her fear.

Yes, it did help that she had a big house to sell and a huge book advance. But, for me, none of that discounts her humor and the good grace of her book. 

I especially loved when she asked –by name-- everyone in the universe co-sign her prayer to have her divorce end peaceably. And I also loved the water tower scene in India, when finally turning that ex over to God—and seeing their higher selves meeting and releasing. 

But the book that followed “Eat, Pray, Love” was Gilbert’s second memoir, and the continuation of the story.  “Committed” is about marriage and how Gilbert reluctantly married the man she fell in love with at the end of “Eat, Pray, Love.”

One of my favorite lines from Committed is this: “There is good reason to end such stories with weddings, and buoyant celebrations of love. Because what follows a wedding is a marriage. And marriage is an institution, not a party.”

That’s a great line, and quite borrowable for toasts, I think.

What Gilbert also says is this: “Marriage is hard when you invest all of your expectations for happiness in one other person. A man can be part of a good life, but not the life.”

Now that’s a great poster or a mantra for young women.

So how do you get to a great marriage from the reality of “Marriage is hard”? The recipe is this: Invest in all parts of your life and in many relationships. You have to make (intentionally create) your own good and full life, and then a partner can become a great accessory.

Indeed.

*****

I write a lot about relationships and marriage in my book, “Out of the Woods”—available at bookstores and, of course, on Amazon.

We Measure Our Age in Tubes

It was T. S. Eliot who famously said “I have measured out my life with coffee spoons.” What a lovely image for and from a great poet. But this week I glimpsed another way I can measure my aging life: I can count the tubes.

Yes, you might remember going to Grandma’s house, or maybe to your Mother’s and her medicine cabinet had a million squashed tubes of this and that. Some were shiny, some rusty, and some gooey with missing caps, and you thought, “How does that happen?”

Maybe you also remember when your medicine cabinet had aspirin, birth control, Vaseline and maybe an antibiotic? 

And then as you got a few years older, there are a few more things and then, suddenly it seems, you (like me last week) look at that basket under the bathroom sink and its full of tubes!

We now have all manner of tubes with creams, ointments and lotions. They are specialized and generalized. We have tubes with goop for every body part and every disturbance. They are oily, creamy, pink, clear or shiny. They range from first aid uses to germ killing to fungus battling to skin soothing.  Some I bought off the shelf and a few were prescribed. 

But this is the new measurement of my life—no longer romantic coffee spoons or lovers past. Now I measure my life—and ours—in tubes.

Cancer and Increased Risk of Suicide

Maybe you’ve had that hypothetical conversation, the one that starts with, “If I ever got diagnosed with…. (fill in the blank) I’d kill myself.” And then someone else says, “No, I could stand that, but if I ever got (fill in blank) I would definitely check out.” 

And on it goes: what we think we could live with, what we think we could not live with: dementia, Lou Gehrig’s Disease, something terribly deforming, or one of 100 kinds of cancer.

Usually when we have those kinds of hypothetical conversations we are in our right minds so we kind of miss the real point: A serious medical diagnosis also has a psychological component or consequence.

In a recent report from the Penn State Cancer Institute, researcher Nicholas Zaorsky (a radiation oncologist) says that a cancer diagnosis can quadruple the risk of suicide among Americans.” 

She says, “there are multiple competing risks for death, and one of them is suicide. Distress and depression can arise from a cancer diagnosis, treatment, financial stress and other causes. Ultimately, distress and depression may lead to suicide. Our goal was to quantify the risk of suicide among cancer patients.” 

What this suggests is that patients, family, caregivers and medical professionals need to

insert care and questions about emotional health in the already crowded conversations and caregiving routines.

With good intentions many of us are tempted to brush past the sadness, distress and grief, “You’ll feel better when chemo/radiation/that side effect is over.” But maybe later is too late.

Nurses and oncologists need to turn around to face the patient and not the laptop, when asking, “How are you?” and maybe pause and ask again, “And how are you really?” And caregivers need to sit with their own anxiety long enough to hear the real distress in the patient’s life and perspective.

Mental and emotional health need attention too.

Valentine's Day in CancerLand

So, you are in CancerLand on Valentine’s Day?

Yep, that sucks. It’s awful. I know; I’ve been there.

But you do not have to surrender to 5FU and all her crazy chemo cousins. 

You can have Valentine’s Day and romance and cancer. Here’s how:

Remember how Valentine’s Day worked before cancer.

Shed one tear remembering that and then laugh. Find something to laugh about. Call up your true love and reminisce together. Make a joke.

Make a Valentine. If you can get out, buy a pretty one. If you can’t get out (friggin’ 5FU) then make one: paper doilies, red Sharpie, tear a story form the newspaper, write on a playing card (yes you can ruin a deck of cards by taking out the King or Queen of hearts).

Drop your expectations. Like a hot potato—drop them. This is Valentine’s Day in a new country: CancerLand.

Think about love, and email love and text that love. There is so much love in CancerLand and with your partner, state it clearly. You have seen and felt love so grand and so different than people who have never visited CancerLand. Claim and celebrate that love. Explicitly.

People around you may be afraid to ask, “What are you guys doing for Valentine’s Day?” like they are asking other couples. Shame on them—announce what you are doing. Stare down their fear.

Things to keep: affection, conversation, chocolate, cards, flowers, bad poetry, good poetry, and romantic comedies (TV listing are crammed with romantic movies tonight.)

Things to lose: expectations and projections

Things to negotiate: a good meal, gifts and sex. (be creative and open-minded with that last one.)

Refuse to surrender: your relationship, your coupledom, your happiness.