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Cancer, “Graduating” to the Next Level

Last week I had my first follow-up appointment with my oncologist. A weird way to look at it is if I’m really lucky, it will be the first of many.

While I did experience familiar nervous moments of apprehension and anxiety before entering the now all too familiar hospital/clinic, I was struck by how calm I actually was once I arrived on the fifth floor, the cancer floor. I realized my perception about the entire hospital atmosphere had evolved in the months since my diagnosis, but yet had not. I had moved on, yet I had not. I felt “comfortable” there on the fifth floor, yet I did not. I was like the towering Christmas tree in the lobby, somehow out of place. You can decorate a tree and make it look quite lovely, but the fact remains, it’s still a tree in a hospital. Just like me, it doesn’t seem to really belong there.  

In the past, standing in line waiting for my turn to check in made me feel as if I was being sized up and scrutinized. I felt like everyone could tell I had cancer. I felt like I stuck out. Now I realize how ridiculous that feeling really was. First of all, no one else was ever focused on me; everyone had problems of their own. Secondly, even if everyone knew I had cancer, in that particular waiting room, such a fact did not make me stand out anyway, sad but true. There were too many of us in the same room, most with serious health issues, many with cancer or a history of cancer. It was, after all, the oncology department.

I proceeded to check in with the familiar face at the appointment registration desk. Unlike at numerous previous check ins, I no longer felt awkward or intimidated by my impending appointment. She asked me the same questions she always asks, and I robotically answered them like I always do.

Sitting in my waiting room chair and observing the number of patients coming and going, caused me to stop and wonder at what point each of them was in their diagnosis or treatment. I observed some obviously new patients busily filling out forms with worried expressions on their faces, uncertain of their futures. Others sat patiently with their scarves, wigs or hats camouflaging their bare heads while waiting for their next chemo infusion. One or two sat surrounded by uncomfortable looking family members reminding me of the many appointments I accompanied my mother on. One paced around the room, unable to wait quietly in his seat, much like a fidgety student in one of my classrooms.

Familiar looking nurses appeared every few minutes to collect the next patient on their list. One or two of them acknowledged me with a smile or nod, recognizing my face as someone who had gone through the “cancer program” and graduated to the “next level.” Clearly, they were busily occupied with their newest “class.” Sadly, it was pretty obvious the stream of patients “walking through cancer’s revolving door” was continuing on, despite my less frequent appearance.

When it was my turn and my name was called, the old familiar feeling of disbelief kicked in. Even after all these months I thought to myself, I can’t believe I need an oncologist. I can’t believe I was diagnosed with breast cancer. I can’t believe I received a positive gene mutation test outcome, endured a bilateral, completed a huge chunk of reconstruction and finished chemotherapy.

While these unpleasant memories are permanently etched into my memory, I still can’t believe these memories belong to me. In some ways I still feel nearly as disconnected to cancer as I did on the day of my diagnosis. It still feels unreal. To this day I can’t believe it all happened to me.

“I still can’t believe I actually need an oncologist,” I mentioned out loud to David.

“Well, you do,” was his honest reply.

At times it continues to feel as if I’m observing someone else’s life.

Are such thoughts some sort of self-protective denial or mysterious coping mechanism? Am I still too close to it all with not enough time elapsed yet? Is it some kind of strange mind game? Am I not progressing properly, unable to grasp my “new normal?” Am I a slow learner? Does anyone else feel similarly at this point in their journey?

I don’t know the answers to these questions. Perhaps there are none.

David and I made it through the first follow-up appointment successfully. We limited our list of questions to only a page, so as not to overwhelm any of us. I graduated to the next level and don’t come back for three months. This felt like tremendous progress, until the doctor gently reminded us that the first two years are when the greatest risk of recurrence will be.

Even a simple follow-up appointment is a balancing act between recognizing the tremendous progress we have made along this path while also remaining mindful of still ever-present potential “land mines” that lie ahead. I guess you never completely graduate from the “cancer program.”

I’m not going to think about that part today. At least I’ve advanced to the “next level.”

Have you ever felt like an observer in your own life?



Friday 14th of January 2011



Friday 14th of January 2011

Betty, Thanks for taking time to read several posts! I appreciate your support and comments! Getting to this point does feel odd, but still I must be in some kind of denial or something because the whole thing continues to feel surreal at times. Is that normal? I don't know.

Anna Rachnel

Friday 31st of December 2010

Nancy - I constantly feel like an observer in my own life, especially when I'm at the oncologists office. Sometimes I catch myself when I'm explaining to people what's going on, because I can't believe what is coming out of my mouth. Nor can the person on the other side of that conversation either. I just don't believe in the concept of the "new normal", because you can never really get used to what has happened to you. It's just so much complicated than simply being able to file it away under "traumatic life experiences". Some days you can check it at the door, and some days you can't. I think that's just how it goes. So in summary, what you're feeling is completely normal in my humble opinion.


Friday 31st of December 2010

Anna, Thanks for your reassuring comments that maybe I am normal. Oh wait, there's that word again! ha. I agree you can't file "this stuff" away, not for long anyway. I always look forward to your insightful comments. Thanks for your continuing loyalty as a reader. You know, it's funny, your writing kinda has the opposite effect on me. Your writing's fiestiness gets me riled up. And that's why I like it!

Beth L. Gainer

Thursday 30th of December 2010

This is a beautiful posting. For me, graduating was a mixed bag. At first, I didn't want to go three months without seeing my oncologist because I felt protected medically as long as I had his support. On the other hand, I didn't want to ever return.

On being an observer, what you are experiencing is totally normal. When I was done with chemo, all I could think was, "What just happened? Did this really happen to me?"

I see my oncologist once a year, but each visit prior and present has led to so many observations. I look around the waiting room and feel sorry for myself, noticing that so many in there seem older than me, and I wonder why I had to get cancer so young.

Then I see people who are still undergoing treatment and wonder which ones will live. I often feel survivor's guilt. Then I get scared that I'll get a recurrence.

Once a person has cancer, he/she never really graduates mentally from this disease. Mind games live on, but we can do so much to keep them at bay for as much as possible.


Thursday 30th of December 2010

Beth, Thanks for taking time to comment on three posts! I always like hearing your thoughts as someone on "the other side" for a while now. You know, I felt sorry for myself too sometimes thinking I was too young! And I'm quite a bit older than you are! ha.


Thursday 30th of December 2010

Nancy, I can completely relate to this. Even now, two years out from diagnosis, it still sneaks up on me sometimes. I'll feel that punch in the gut feeling and think... I can't believe I had cancer. I can't believe this is my life.

xoxo, Katie


Thursday 30th of December 2010

Katie, Thanks for sharing. I was wondering if such thoughts continue on down the road. I guess they do. "A punch in the gut feeling" is a perfect description!


Thursday 30th of December 2010

Nancy I had to go back to see where I was at the time just after my being diagnosed. I was alone, I felt like I was living in a sureal nightmare reality show. Only I was looking in and trying to figure out How I ended up here in the first place. this had to be a mistake. But I read my script well. Since I was playing the part I may as well play it well. I was going to be a fist clenched "Cancer Warrior" You know the kind of woman that embodies a resiliance and power that can get her through nearly anything. They forgot to write in the script what happens to your body on the 3rd Chemo. , I felt like I was a lump of flesh curled up in a fetal position. I was so sick. My 16 year old son never left my side for a moment. He helped me get to the toilet to vomit. He caught me not once but twice because I hsd the heaves so badly I fainted. He called 911.. A 16 year old child should not see his mother so broken..... Love Alli xx


Thursday 30th of December 2010

Alli, Thanks for sharing those painful memories. Sorry you were so sick. I agree, our kids shouldn't have to witness such things, but on the other hand, we can't shield them from the ugly or difficult parts of life either. I'm sure your son continues to be a huge support to you, as do my kids.

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