How to Shut Up and Deal: Part 1

It’s crazy to say, but active treatment for cancer is in some ways the easiest part of the process. Treatment is an exercise in simply enduring, there was nothing to do but put my head down and put one foot in front of the other. I no longer had to do research, make decisions, get second opinions, field all the inquiries, get my ducks in a row. I concentrated on just getting through it: countdown the infusion bags, brace for another injection, prepare for the double mastectomy, finish Herceptin. Each benchmark was another hurdle to clear. Another day, another thing, another month, another symptom. Shut up and deal. Ah, yes, an old mechanism I know well.

I finally felt done with cancer treatment after the clean-up Phase 2 breast surgery: nip and tuck, “dog ear” scar correction, lift, areola tweak and, most importantly, I got the port out after 15 long months. The bump in my chest, positioned just so to allow later surgical access to the breast and to pucker under the pressure of the seat belt. The port interfered with bra straps, made tank tops and open necklines unwearable even in the hottest months, and constantly reminded me of treatment. Getting it out was the last hurdle, more meaningful than my last chemo infusion or Herceptin drip.

One doctor joked about the dark abyss that one encounters after treatment, like falling off a cliff when you thought you had come to the end of a path to safety. Nope, nothing down here but dank coldness and an echo you can’t quite make out.

The dealing part over, I lifted my head up and looked around the dark. Two months after the cleanup surgery, I was crying every day. I had some sort of UTI a few weeks prior and a lingering sense that my system wasn’t right. I had speckles of tiny bruises on my thighs, and wondered if it was skin cancer come back. I had a nasty cold sore. Blue feelings. Thin patience and quick anger. The best-case scenario was that I simply wasn't taking care of myself properly. But I couldn't shake the fear and mistrust. I learned to live with it.

I ran into a friend stomping around in a surgical boot. She was pretty agile with it, having been in it for weeks already and resigned to another month or so. She tore up her foot on her stairs at home, nothing glamorous, but it humbled her nonetheless.“You take your body for granted until it gives out on you,” she marveled, then caught herself. “Of course you know what I mean.”

Of course I do, theoretically. Yet I have no sense memory of a time when I took my body for granted. I must have, running around like any average kid who doesn’t give a second thought to what her body can or can’t do, just throws herself over puddles and splays in the sunshine uncovered. I was in middle school when my mother fell ill, and my cancerous doom loomed over my head from then on. Breast checks were a norm as soon as I got them. My sisters and I all secretly wondered who would get cancer first, each convinced we were at the head of the line. After age 13, I was waiting for my body to betray me.

My mother was in treatment for more than a year it seemed, following me from middle school to high school. She was in the hospital for weeks at a time, while our hard-working, city-commuting, hot-headed father was the one in charge. I remember the scent of lilies in her hospital room. I can see her in a fluffy white robe, crawling her hands up the wall as her Cancer Society buddy had instructed her. How did we get places when she was too fragile? Who cooked dinner? What did we talk about? Did we talk at all?

Early on, my mother called me to the kitchen phone; she had just been diagnosed and was telling her family back in Philadelphia. I took the handset and heard my Great Aunt Loretta’s voice.

“You take care of Mother now,” Aunt Loretta seemed to assume I might be lazy without the proper instruction. I’m not sure why she thought referring to my mom as Mother would bring me to heel; how I wished I could have hung up on her right then. “She’s going to need help. You be good to her.”

Did she say this to everyone in the household, or just the youngest of four children?

I can’t fault Aunt Loretta for looking out for my mom — she was more my mother’s person than mine — but her comment set the Shut Up directive for me. Well, that and the very beginning.

I was the only one around when my mother got her diagnosis. I was watching TV in the family room, at the top of the stairs from the basement garage level. I heard the garage door open and close, heard feet up the stairs, and the opening of the hollow wood door. My mom took a few steps to stand on the edge of the room, I craned my head around to catch her eye.“I have cancer.”She went upstairs to her bedroom and shut the door.

I’m sure we must have talked about it more, at the very least covered the logistics of what treatment would look like. Hospital, surgery, chemo. Did they say they wanted our lives to remain as normal as possible? Did we make plans for who would drive whom where? How things would work when only Dad was home?

I remember no talk of feelings. I don’t recall being asked how I was. Whatever messages were sent from the adults in the house, all I heard was Shut Up and Deal.

Sometimes I tried to talk about my feelings, but without much practice I didn’t have a great sense of time or place. In the later days of her treatment, I fought back tears while talking with a prospective boyfriend by the lockers at school. I watched him walk away and felt the echo for the first time, the deep chasm I fell off the cliff into. Had I shown I was too raw to be the bubbly, fun girlfriend to take to a party? I had to go back to Shutting Up.

Fear and quiet became my shadow. I took up smoking. Cancer sticks. Now I see the obvious metaphor of the effort to shut up and deal: swallow, process, exhale. Blow it all away.

The stink of Marlboro Lights surrounded me, I walked with it everywhere I went through high school. I got busted, I changed tactics, tried new rituals to hide it. I got busted again. I got Topol “The Smoker’s Tooth Polish” in my Christmas stocking the same year I wrapped up a little frame with a hand-drawn no-smoking sign as a gift to my mother. I was lying.

Smoking. Partying. Boys, boys, boys. Oh, I could Shut Up alright, but I had to take along some vices to help me Deal.

Somehow I stumbled my way through high school intact, through some act of kismet, sheer luck or the grace of God. College was a new challenge for my Shut Up and Deal process. I never felt more alone and unsure of myself. I wandered unsteadily through my academics, found lively friendships that hid their more toxic centers, and bounced from boy to boy trying to find acceptance.

I pined especially hard for one boy in particular; our respective best friends were sort of dating so the four of us palled around a lot. He had a girlfriend for a long time; I waited her out. When I finally was allowed into his bed after a long party, I found myself more raw and vulnerable than ever.“What’s the hardest thing you ever went through?” I asked him the next morning. We were half-dressed on his futon, still messy-haired and bleary.

He hesitated. He looked away, he screwed up his face and averted his eyes. I didn’t give up, I ignored his obvious discomfort. I wanted him to get to his point, so I could get to mine. I had to talk about it, why won’t anyone let me talk about it?

“My parents’ divorce, I guess.” Poor guy. I’m so sorry I pushed you here.

Ultimately I was allowed to say mine out loud. My mother had breast cancer when I was 13. But it didn’t go much further than that: Really? Huh. That sucks. Let’s go get breakfast.

Not surprisingly, that wasn’t the start of a beautiful relationship. We messed around a couple more times before our lives were caught up in other drama. What is surprising to me is that I thought that moment could bring some sort of release or comfort. Did I really think this poor cornered boy would offer me emotional refuge? Was he supposed to probe the inner workings of my pain and heal me? I shut back up, hidden in a cloud of quiet smoke. I became a master.