I thought of the teenager who had a car, yet lacked the fuel to drive it.
I speculated as to whether or not I would witness the spring-time again, and could not help but question absently if my 20th birthday would prove to be my last. I was unable to release myself from the thought of my impending death; I wasn't simply Lauren Isaacson. I was "Lauren Isaacson, victim of cancer." I identified myself with the disease and found my thoughts encompassing various subjects with cancer continually in the back of my mind. I never denied the presence of the disease, nor did I wish it on someone else, and perhaps this is what allowed me to bridge a period of gray disillusionment so common in the acceptance of solemn news; I would much rather face a heart-rending truth than to live amid a cloud of fantasy derived of the mind. Tumors have no conscience, and no amount of wishing, cursing, or bribery will cause the disease to disappear. These mind-games will one day come to an abrupt, emotionally wrenching halt or lead to personality disturbances if not corrected; such reactions only injure the individual or those with whom he must associate.
In coping with a weighty truth of such magnitude, the family as well as the patient, will experience various and ever-changing emotions, and I believe it is quite important that these feelings are ventilated. Simply because the family is not afflicted with the illness does not mean that the individuals are immune to its emotional nuances. In fact, the family is sometimes the worse off; they essentially feel helpless, unable to ease physical pain or shield their loved one from his frightful pursuer.
When the family is able to openly converse on the topic of the patient's illness and imminent death, the entire affair seems less formidable, rather like a beam which is directed upon the unlit recesses of a room, thereby dispelling the uncertainties which lay dormant in the darkness. Because there are manifold reactions to adversity, related conversation will evolve at varying rates. While some people would be ready to speak candidly after a brief time, others need to ingest the situation gradually and should not be pressed into heavy conversation directly following a shock. Moreover, there exists in most humans the great need to face life's circumstances with dignity and composure and would not, therefore, relish a serious discussion until they could do so without losing control of their emotions and causing a tearful scene.
Although it is unhealthy to continually dwell on the plight of the family, silence is debilitating. . . especially if it evolves through avoidance of the problem, rather than simply the inability to verbalize one's thoughts. True coping deals with self-expression, not the clever avoidance thereof. One should never attempt to stifle grief, for to do so will create unendurable stress; and what, I might add, is so terrible about venting one's sorrow in the form of tears, when the situation certainly merits that behavior?
Anger is an understandable reaction to the discovery that one harbors a debilitating disease, for since everyone must eventually die, surely there are more pleasant routes toward that destination if given the right to choose. Moreover, anger is thought to be a less degrading form of expressing depression. No one wants to suffer or restrict himself in a manner unnatural to his lifestyle, nor lose his sense of control, no matter how much or little he actually has.
If anger is a prevalent emotion, its release is necessary; yet projecting that anger on undeserving family members or hospital personnel is unfair. Anger is counter-productive when wrongly displaced; fanatical rage and irate demands are increasingly ignored and replaced by the unfortunate avoidance of the enraged individual. No one can benefit from this chain reaction.
An alternative which could be used by the patient having the objectivity to discover his outward rage is anger expressed through writing or intelligent conversations rather than transforming the anger into unfounded complaints. The problem is not the unsmiling intern, or the wife who arrived ten minutes later than planned. The problem is health, and if not dealt with, attitude as well.
A reasonable exception is when the patient's anger is derived of pain; it is virtually impossible to be civil if each breath heralds another moment of severe physical anguish. This belligerence should not be taken personally by either relatives or hospital staff, nor should the unfounded anger described above be ingested as relating to their presence or prescribed duties.
If it is attention the patient needs, it is more likely to be given if he behaves in a manner deserving of amenity. It is a pleasure to be near a person who, despite his personal problems, can retain humor and conduct himself in a respectable manner. If my experience is any indication of the quality of the residency in hospitals, I found the staff to be most personable if treated likewise. On the rare occasion that a patient is forced to abide a hostile nurse, or one who refuses to believe that he is suffering to the degree that he claims, a complaint is well within reason. One case in particular concerned an incontinent elderly woman who, after an accident over which she had no control, was chastised by a hostile nurse, resulting in tears which should never have been provoked. A patient is not paying for abuse; moreover, a hospital without patients is just a stone building, and its personnel is up for hire. Inflicting emotional anguish has no place in the medical profession.