Cancer, a battle or a journey?

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War, what is it good for?  Well, for overcoming cancer apparently.  From the moment I shared my cancer diagnosis I was surrounded by war metaphors.  I was told I was battling cancer, I was a warrior, I could win my battle, and I would beat cancer.  I was told I was waging war and if I fought hard enough I would emerge victorious.  Defining an experience with cancer using battle language seems to be the societal norm.  For many, the notion that you “go to war” with your cancer defines the journey with this disease.

The idea that you can conquer cancer, that with heroic fighting you will win the battle, works well for some people.  I understand that it may help to adopt a war mindset as someone deals with this disease.  Of course, I want to be a hero too. At least sometimes I do. Mostly though, I just want to nap, just want the pain to go away, and just want to feel better.  I often don’t feel like soldiering on and I am seldom up to being in a battle.

I get the need to find a way to articulate the fear, the pain, the suffering, and the uncertainty, and it is only natural to turn to metaphor to both help to understand and to communicate the cancer experience.  The science is complex, the treatment options varied and how each person responds to the disease differs widely, making coming to terms with cancer difficult.  It is easier to use a simple war metaphor to explain what is happening than to try to explain the details.  “I am battling cancer” is easier to articulate than a long explanation of your specific cancer, treatment regimes, side-effects and likely outcomes.

While “battling cancer” seems to be the prevailing metaphor for dealing with this disease, it has not resonated with me.  I know that it works very well for some and I have no argument with all of the cancer warriors, warrior princesses and superheroes for whom this helps with their struggle, but I wonder if there is a downside.  Does the idea of winning a war with cancer imply that those who don’t are losers?  John Diamond, the British journalist and author who died of throat cancer in 2001 seems to have thought so.  In his book C – Because Cowards Get Cancer Too…, he says “My antipathy to the language of battles and fights has nothing to do with pacifism and everything to do with a hatred for the sort of morality which says that only those who fight hard against their cancer survive it or deserve to survive it – the corollary being that those who lose the fight deserved to do so.”

Early in my diagnosis I was inspired by a blog written by Dr. Kate Granger, a physician with a terminal cancer diagnosis.  She knows that she is not going to “win” her battle, so does the use of this metaphor impact her ability to “fight it”?  In an article in the Guardian she writes “As a cancer patient who will die in the relatively near future, I believe rather that instead of reaching for the traditional battle language, [life] is about living as well as possible, coping, acceptance, gentle positivity, setting short-term, achievable goals, and drawing on support from those closest to you.”

Aria Jones in a letter on McSweeney is much more emphatic that this language can be harmful.  She says that describing cancer as a war implies that “either adversary can win – not the case with some cancers  Are you truly comfortable telling a cancer patient that, if his cancer doesn’t GTFO stat, it’s because he didn’t try hard enough?”

“I hope you are no longer inclined to compound the challenges facing those of us with cancer by calling us losers.”

For those of us for whom the battle metaphor doesn’t work, what is another way of looking at this?  We still need a way to contextualize and communicate our experience.  How do I describe living with cancer, working with a team of professionals and a community of care givers to become healthy again or to manage the disease as it progresses?  I am in no way implying that you should enjoy having cancer; cancer sucks, but it doesn’t have to be a war with winners, losers, battles and constant fighting.  I struggle enough and many days I don’t want to wage war, I just want to find some calm and peace in my day.  To me the war metaphor implies that taking a nap, seeking comfort, making new friendships and finding humour are out of place, that I should be fighting ceaselessly rather than laughing and finding peace.

For me, the idea of this being a journey works better than it being a war.  When I started my blog, after being diagnosed with chordoma, a rare bone cancer, I used language like “battle with cancer” but quickly changed to “journey with cancer” as it fit more with the meandering, sometimes bewildering, sometimes frustrating, and confusing path that I was on, a path that was more often waiting and recovering than battling or fighting.  Writing on kevinmd.com, Rob Ruff writes of the journey metaphor:  “With this image, having an illness takes us on a trip, a journey that will be marked by twists and turns, ups and downs, unexpected detours, smooth stretches of roadway, seemingly impassable rocky paths, enemies that threaten us as well as loved ones who support us.  One is often changed even transformed by a journey.  We learn lessons along the way, lessons we may never have learned if we hadn’t been set on this challenging path. We weigh what we need to take and what is better left behind.  Sometimes, we have to abandon items we thought we would need but don’t, traveling lighter as we go.  Storms may arise which blow us far off course, off the map we’d been using to guide us, leaving us lost in an unknown land.”

“Yet we can, with effort and assistance, chart a new course and regain our bearings.  A journey provides us (and our loved ones) with lasting memories (rather than the regrets of a “battle” that was “lost”).  On a journey, we can appreciate the beauty we encounter and have deep conversations with those who travel alongside us (instead of the chaos and conflict that characterize a battlefield, strewn as it so often is with the destruction and detritus of war.) Long and difficult journeys wear us out, and sometimes we don’t know if we have it in us to keep on going.  The journey may end well, bringing us to our desired destination.  Or it may end before we expect it to; long before we reach the hoped for goal.  Either way, one doesn’t win or lose a journey but rather takes it a step at a time, trying to keep on going as best we can, watching for where the road takes us, hoping that in the end it leads us home.”

Like Ruff, the journey metaphor fits much better for me.  It allows me to make some sense of my cancer and gives me permission to enjoy my recovery and find humour where I can.  If my cancer comes back, if it gets the upper hand, it will be another phase of my journey.  I hope it won’t mean that I am a loser or didn’t fight hard enough.

What do you think?  Are you comfortable with the war metaphor?  Has it helped you or a loved one to be stronger in their challenges?  Does it work for you?

I highly recommend John Diamond’s book C – Because Cowards Get Cancer Too…  Vermilion Press, 1998

Dr Kate Granger’s writing can be found at:

http://theothersidestory.co.uk/

http://www.theguardian.com/society/2014/apr/25/having-cancer-not-fight-or-battle

Aria Jones’ open letter on McSweeney is at:  http://www.mcsweeneys.net/articles/an-open-letter-to-people-who-use-the-battle-metaphor-for-other-people-who-have-the-distinct-displeasure-of-cancer

Rob Ruff’s blog post is at:

http://www.kevinmd.com/blog/2013/04/change-warfare-metaphors-illness.html

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15 thoughts on “Cancer, a battle or a journey?

  1. I am truly sorry you have to deal with this situation at all. I am praying for you. But, not that you are healed necessarily,as, though I’m not overly religious, I do believe in God and His Word. I do hope that it is His will to heal you of course, but, I also know, and firmly believe the words from:

    Romans 8:28> For we now that all things work together for the good to those who love God and care called according to His purpose.

    I have on many occasions taken comfort in the fact that this promise emphasizes ( All Things) and not just the ( Good ) things…

    Although I know nothing about your worldview, or beliefs…( and am not here to try and proselytize anyone) I am comforted in seeing you are neither wildly wielding a sword, and making battle claims, and cries against this terrible thing, Nor are you taking it lying down. You seem to be on a level plateau of dealing with it daily. Your blog, and writings are awesome.

    Kind of reminds me of an interview question I heard Mr. T respond to once:

    They asked him if it were true that he had cancer, as unconfirmed reports had circulated. He said;

    “You know I’ve got cancer… but, did you know I’ve got God?”
    Peace be with you brother.

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  2. Paul – I am a ten-year, almost 11-year survivor of a sacral chordoma. Last radiation treatment – March, 17, 2004 at Massachusetts General Hospital in Boston. where they have a protocol treatment plan for chordomas. I likened my Cancer journey to a roller coaster — one day you’re up, the next day you’re down. I found the Cancer Survivors Network and made new friends who understood what I was going through. People from coast to coast were praying for me. My sense of humor was invaluable. – RockinRobin

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  3. I have never had cancer but I have lost two loved ones to it. I am fascinated by cancer as I am by all illnesses and how and why they come into our lives. Is it totally random? I have heard and been inspired by many personal methods of dealing with cancer. One such story sticks with me where a lady visualized her cancer is a black bin bag and used to mentally ‘kick the shit’ out of it. She believed that helped her. I remember a philosophy class where it was presented that cancer is a visitor into our lives and what do we usually do with visitors? Well we welcome them in, give them a cup of tea and get to know them better. It is very interesting Paul to hear your thoughts on the whole ‘warring’ aspects of it. II love the discussion.

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  4. Like the previous commenter, I also don’t have any personal experience with cancer, but I really enjoyed reading your thoughts in this post. It’s true that the concept of war/battle and cancer have become so closely linked in our society – it’s just the wording that people have come to naturally use when describing someone’s experience with the disease. Although I can see the battle metaphor being a motivator for some, something about it has never really sat right with me. I much prefer your idea of a journey and the thought of travelling along a road with your disease, instead of struggling against it.

    This was a great read today . . . as always. Thanks for sharing 🙂

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  5. I have always thought war was a negative metaphor and I find the journey metaphor much more positive and life affirming. Congratulations on your attitude, Paul, and thanks for sharing with us. Karen k

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  6. Paul I like the metaphor of journey as opposed to fighting a battle. This is just another turn in your journey in life. Keep up the positive thinking and continue to grab life in both hands and continue on your journey inspiring many of us. Love positive thoughts and love from ‘down under’ !

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  7. Paul, I have been thinking about this post all day. I am totally with you on the journey metaphor; I found myself resisting the battle imagery during treatment, snd even now it does not feel like I am “victorious”. One of the big things that my cancer forced me to face was fear. . .fear of the unknown, fear of death, fear of pretty much everything I can’t control! I can’t pretend that I have overcome fear, either, but I do know that if I “fight” it, I will never understand it or learn how it can actually enrich my life. I don’t have to like cancer to learn from it, but if I battle against it, I likely won’t be open to what it has to teach me.

    This is just what works for me; other people may learn every bit as much through the war vocabulary, and whatever works for each person is great. I do think we generally fight the idea of death and mortality–and while a desire for life is a very good thing, to think we are going to escape death is not helpful. Dying is not losing, it is inevitable and the final destination on the journey of life. I think that if we stop fighting that idea, even on the level of illness, then we have a better chance of living with joy.

    I love Audrey’s comment about cancer as a visitor. It may not be a visitor we want to invite back again and again, but when it shows up, we might as well get to know it and see what we can learn from it! So I say nap, laugh, heal, write, and enjoy the journey. . .it’s e only one you’ve got! And thank you for writing and giving the citations!

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  8. Paul,
    Your discussion about Journey vs Battle is interesting. “The Battle” was not something I thought much about during my treatments, now that I think about it. Although I do see myself as a “Survivor,” the image of warring with cancer isn’t one to which I relate. Like you, the journey image has much more appeal to me.

    At one of my group meetings, a number of people felt strongly that one can do all the “right” things & still get cancer. A person could war with the cancer but one lady stated simply, that for some reason, one tiny cell in her body went crazy & started her down this path. She also said that “It sucks to have cancer but it’s her journey with it.” Kind of profound…

    Glad to have you back home, Paul. Keep writing. It’s always fun to read your thoughts on things. I continue to send you positive, healing energy to go with your naps!

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  9. I have not had cancer so my opinion doesn’t carry much weight, it is simply, only my opinion. Psychologically, I would think that most people are angry that they have been stricken with cancer. (I would be angry). And I think that the specialists and medical care folks use the “war terms” as a means for those who are angry to get that anger out in a positive and healing way. That would be, “going to war with the cancer.” This would help the cancer patient deal with that anger and use it to further their healing process. Personally, I think the terms “going to war against cancer,” is ingenious. But as you pointed out, it isn’t for everyone. For you, “journey” makes more sense. I have a feeling you were not one to be angry over having it. You have raised a good point and I would be interested in knowing how those who experienced anger feels about the “war” terms.

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  10. I like the image of journey much better than those of battle, war, and fighting. I live with several diagnoses, each of which could end my life at any time: heart failure, adrenal insufficiency, and severe respiratory problems. Like you with your cancer, I often think of my living with these conditions as a journey, not one that I would have chosen but the one I am on, nevertheless. Sometimes it is as my journey is taking me through a dense fog and I cannot see the path ahead. At other times, there is stunning clarity and beauty all around me. When the path is steep or particularly difficult, I pause for breath and sit down, trying to remember to take particular notice of that which is around me that I would not noticed if I focused only on moving forward. There is no winning or losing in this particular journey. As Nelle Morton says, “The journey is our home.”

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  11. Paul, thank-you for sharing your journey. It gives me pause and some (dis!)comfort to read your posts and contemplate the bigger questions vs. worrying about my next self-imposed deadline. I’m guessing that Marnie and I represent the silent majority of folks who read your entire posts but don’t comment. Hope to see you and O this summer (assuming our travel plans materialize). Take care and keep on writing!!

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  12. I think it is innate in any disease that we want to fight it, we want to win. But that’s when we realize we are human and fallible. Sometimes it is hard to beat something we have little or no control over. I like the journey metaphor much better too. I think you just have to take things day by day and live to the fullest. But I have never had cancer but if I do I will consider it a journey, another experience in life, and not waging war. Best of luck to you Paul that you stay healthy and happy.

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  13. I have trouble with the battle language too. I don’t like the implications for someone who dies of cancer to be seen as losing the battle for not trying hard enough to win. I admit I still do use some words like “battling ” or ” fighting ” cancer because it is a lazy shortcut that everyone understands. Journey is better but I think we need a whole new vocabulary, with more subtleties, to describe where we are in relation to cancer. Something that describes active treatment vs the in between time when treatment is over and we are hoping for the best to long term survivorship. Personally, I am mortified being referred to as a warrior. I showed up and had surgery and took my treatments but I didn’t do something superheroic or different than what most other patients do. I have been blessed with longevity but cursed with recurrences, so at times it feels like a battle to get well but I’d like more words to express where cancer and I are at. Sorry for rambling on about this.

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  14. Paul,

    I stumbled across your website today (I search on sacral chordomas every now and then to see how folks like you and me are doing). I like your article and agree that it should be seen as a journey and not a battle. It has now been six years since I had my sacral chordoma resected, I am 55 years old. At first I tried to think of it is a battle as everyone around told me I had to be a warrior and fight. However, as the years have progressed and the pain, discomfort and side effects remain (and have to be dealt with), I have to admit that my eagerness to fight has worn down. it’s not a battle I’m giving up on, it’s just something I have to deal with on my own terms. Other people mean well, but the metaphors to be a good fighter just don’t make me feel better. I may yet live a long life or I may not (I don’t know, but who does). However I don’t want my personal way of living with this condition to be seen by others as giving up when I would rather rest my back and lay down instead of doing something they see as more of their idea of what a fighter should do. Thank you for putting my thoughts about this into such an elegant collection of words.

    Larry

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