For the Week of March 19, 2018: Learning to Survive…Again

And I grew strong and I learned how to get along… I will survive

(from “I Will Survive,” sung by Gloria Gaynor, lyrics by written by Freddie Perren and Dino Fekaris)

I’ve been learning, once again, to dance.  It hasn’t been as easy.  My body isn’t as willing to move in new ways as it once was.  But I persist because dancing has health benefits, and whether my body balks a bit or not, it’s about giving up or “just” surviving, whether it’s serious illness, injury, or other life challenges we’re dealing with.  Survival,  I’ve come to realize, is synonymous with learning.

As many of you were, my parents enrolled me in a variety of extracurricular activities a child.  Given my mother’s observation that I was destined to be tall, she quickly made certain clumsiness would not accompany my  growth surges.  First, I took ballet classes, outfitted with pink ballet slippers and a leotard and, once a week, pointing my toes and learning the fundamentals of the classical dance form.  That was followed by acrobatics, tap and ballroom dance as I began to grow taller.  Despite all that, around 7th grade my awkwardness surfaced.  It was less about the dance steps and more about the fact I towered over most of the boys in my classes.  (Try dancing a box step with your knees bent the entire time.)  Nevertheless, I persisted, enrolling in square dance,  folk and ballroom classes in college, but my height was bothersome once again. There were never enough men enrolled in the classes, and that meant I was assigned to dance the part of the male partner.  (To this day, I tend to avoid ballroom style dancing, unable to be led easily by any partner.)

I gave up on dance altogether save for the social dancing we did to seventies rock and roll music at parties until my daughters’ grew into their teenage years.  As my mother had done for me, I enrolled them in jazz and ballet classes.  But I was so enthused by their jazz dance routines, I decided to sign up for an adult class in jazz dance, dancing during the entire time I was completing my doctoral degree, and even performing in the dance show the following year  with my two daughters.  I danced with more enthusiasm, perhaps, than talent, but dance was invigorating, fun and a great way to diminish the stress of graduate school.  Besides, I kept fit, agile and energetic.

Enter the decades of career building, a few half-hearted attempts to take dance classes that never seemed to measure up to the ones I did during graduate school, and the inevitable fact of aging.  I didn’t seem to move as freely as I once had.  Was it the class or the pupil?  The latter wasn’t something I wanted to consider, so gradually, dance fell by the wayside.  My daughters were married, having children, and I was nose-deep in a stressful career.  Instead, I tried exercising at the gym, taking T’ai Chi and Pilates classes.  Each had benefits but none were as fun as dance had been for me.  I lost interest and didn’t sustain any of those activities for more than a year or two.

Fast forward to this past year.  I was completely sidelined by an injured knee and Achilles tendonitis, and it made me cranky, mildly depressed and discouraged.  Stiffness, pain and embarrassment about moving like an old woman were  constant companions.  I hated that my body hurt and how uncomfortable it was to move, much less easily or quickly, abilities I’d long taken for granted. Worse, I am a heart failure patient, and a regimen of regular physical activity is necessary for improved heart functioning.  But it hurt to walk or climb stairs.  I felt trapped by my bodily ailments..  Weeks of pain turned into two, then three months, until, after a frank discussion with my cardiologist,  I’d had to act.  I got a referral to a sports medicine physician, physiotherapist and Pilates instructor, donned ankle braces and used up numerous rolls of athletic tape and began walking as much as I could stand.  Then in February, when a friend invited me to join a group called “The Vintage Dancers”, I jumped, well actually, I limped, at the chance.

“Vintage,” as you might expect, meant the dancers were of my age group and older, but it did not mean the class moved at a slower pace.  At the first class I attended, I was left in the dust by an energetic and enthusiastic group of women dancers, some of whom had recently recovered from hip replacement surgery or other bodily ailments.  Yet despite the dancing I’d once done well, I kept beginning on the wrong foot or chasséing in the opposite direction as everyone else.  More than once, I stepped to the sidelines to catch my breath!

The whole experience was not just comic, it was humbling.  I’ve never been a patient beginner—I have a perfectionist streak that inevitably invades any new learning—but my clumsy first attempts at dancing again it got me to thinking about how age, serious illness, or any major life transition requires we learn—even relearn—different ways of being, including skills we once took for granted.  We’re resilient beings, yes, but coming to terms with altered bodies and imperfect selves demands we re-evaluate who we are now vs. who we might have been at an earlier time. The image we once held of our younger, healthier selves) is challenged.  We’re forced to recognize that we may have limitations–physical pain, issues of stamina, agility or even memory–ones we naively believed would never belong to us.  Those complaints and ailments belonged to other people, right?  Wrong.

Does anything in nature despair except man? An animal with a foot caught in a trap does not seem to despair. It is too busy trying to survive. It is all closed in, to a kind of still, intense waiting. Is this a key? Keep busy with survival. Imitate the trees. Learn to lose in order to recover, and remember that nothing stays the same for long, not even pain, psychic pain. Sit it out. Let it all pass. Let it go. ― (May Sarton, Journal of a Solitude)

What is surviving about, really?  It’s about learning to deal with and overcome–to the best of our ability–the impact of aging, injuries, surgeries or treatment regimens and the negative impact on our bodies and minds.  It’s acceptance our lives have changed, and we must continue to learn new ways of being and living.   The ground beneath our feet might seem uncertain, or we’re aware that the steps we used to take with assurance now feel clumsy and tentative,but surviving doesn’t mean giving up.   It means learning other ways of being,  remaining as active and engaged with living as we can–even if, sometimes, the new learning isn’t always easy or pleasant.  It’s a bit like standing in the front row  of a dance class, as I did,  as the only newcomer in the group, trying to understand and mimic the movements everyone else seems to know by heart. We feel like beginners, and we feel awkward and uncertain.  I know that’s how I’ve felt–but after that discussion with my cardiologist several weeks ago , and I shook myself out of the doldrums and got busy living.

No matter how old you are,
it helps to be young
when you’re coming to life,

(Joy Ladin, “Survival Guide,” in:  The Future Is Trying to Tell Us Something: New and Selected Poems 2017)

Life is more than just  surviving.  It’s thriving, enjoying, contributing, and living as fully as we possibly can.  Whether cancer, the effects of aging, major surgeries, or unexpected life transitions, we have to remind ourselves  that we’ve  proven, again and again, that we can adjust to life’s challenges and move on.  Our lives change in subtle and not so subtle ways year after year, but we learn the new movements, necessary strategies and behaviors, and little by little, we again embrace the life before us–new, different, and ours.

But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,

and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,

determined to do
the only thing you could do–
determined to save
the only life you could save. 

(From:  “The Journey,” by Mary Oliver)

Writing Suggestion:

  • Thinking about your own life, how would you define “survival?”
  • Describe a time when life knocked you down.  What kept you going?  What helped you survive?
  •  Write about what it was like was to find your footing on uncertain ground and not only to survive but thrive and embrace the new life before you.
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For the Week of March 12, 2018: Writing the Experience of the Body

When we see our suffering as story, we are saved.–Anais Nin

As happens with every “Writing Through Cancer” program I lead at various cancer centers and support organizations, the weeks fly by and before I know it, I’m preparing for the final writing session, as I have again these past few days.  It’s a time of reflection and gratitude for me to remember where people began and where their writing has taken them in the past eight weeks.  So much happens during our meetings. My notebook is filled with snatches of the phrases and descriptions from participants’ writing shared aloud, writing that has touched, surprised or left me breathless, so honest and beautiful are their words.

Whenever I get somewhere, a poet has been there first.  –Sigmund Freud

“The call to write,” “is a call that’s received in the body first. John Lee wrote in his book, Writing From the Body(1994).  I recall what one cancer survivor wrote in a creative writing course I was teaching several years ago:   Even when I was in the midst of a five day in-patient ‘chemo’,” she wrote,” I took notes. Some are frightening and some are funny – and I’m still writing. I think this …has shoved me into being a writer and admitting it, whether anyone ever reads it or not.

What she describes is not unlike how many poets and writers have described the creative process.  It’s a physical urgency and it’s insistent.  It calls us to feel with every part of our bodies.   In her memoir, A Match to the Heart (1994), Gretel Erhlich describes the moment she realizes she has been struck by lightning.

“Deep in an ocean, I am suspended motionless.  The water is gray.  That’s all there is, and before that?  My arms are held out straight, cruciate, my head and legs hang limp.  Nothing moves.  Brown kelp lies flat in mud and fish are buried in liquid clouds of dust.  There are no shadows or sounds.  Should there be?  I don’t know if I am alive, but if not, how do I know I am dead?  My body is leaden, heavier than gravity.  … A single heartbeat stirs gray water.  Blue trickles in, just a tiny stream.  Then a long silence. Another heartbeat.  This one is louder, as if amplified…. I can’t tell if I am moving…Another heartbeat drives through dead water, and another, until I am surrounded by blue…. I have been struck by lightning and I am alive.”

Erhlich is not only writing from the memory or remnants of a near death experience, she is writing from the experience of her body, a vivid, visceral account of the physical sensations felt in the aftermath of being struck by lightning.  She portrays the lived experience of the human body, drawing us into her story through our senses. As readers, we feel an almost physical awareness of what she experienced in those terrifying moments.

One of the most healing aspects of writing is that it helps us make sense of the chaos of emotions we feel when our lives are turned upside down by illness, tragedy or loss.  We stumble into insights and meaning as we release feelings on the page.  Time and time again in my writing groups, I’ll hear people react with surprise, saying “I had no idea I wrote that!”  as they read their writing aloud.  Tears may come without warning, laughter too, as they “hear” what they have actually written in the timed writing exercises.

Long before there were words…

long before this haze of lies this

swirl of stupid things said and done

the body knew… (Seibles, in Lee, p. 5-6)

John Lee writes of ancient wisdom that lies dormant in our bodies, of knowing deep inside, “how to get through the high grass without being devoured by lions.”  When we begin to release the memories and images we have stored in our bodies, powerful writing often results.  Brenda Ueland, in her wise little book, If You Want to Write (1938), counsels the would-be writer:

You must feel when you write…. You must disentangle all thought.  You must disconnect all shackles….  You can write as badly as you want to.  You can write anything you want to…just so you write it with honesty and gusto and try not to make somebody believe that you are smarter than you are.”

To write, we need to learn allow ourselves to open up. The experiences held within our bodies can take us into new ideas and fresh ways of writing.  It doesn’t happen easily at first, because in the aftermath of a cancer diagnosis, the sudden loss of a loved one, or other expected tragedy, the nerve endings of pain and suffering are numbed.  Sooner or later the emotional pain we feel becomes insistent, needing release.   Releasing our emotions through writing not only clarifies our thinking, it releases energy.  Writing requires we free up that energy and give it voice.  To do so, to write well, we must let ourselves be vulnerable, to feel deep within our bodies.

“What is important, “Audre Lorde wrote in The Cancer Journals (1980), “must be spoken, made verbal and shared, even at the risk of having it bruised or misunderstood.”  “Writing is a courageous act,” prize winning author of The Alchemist, Paul Coelho wrote.   We put ourselves, our lives, on paper.  Others interpret what we’ve written from their own experience.  Yet to write honestly and authentically requires we have the willingness to go deep and tell the truth of our experience.  Writing helps us reclaim and express the difficult feelings that are part of our humanness.  We begin to heal, but much more happens:  We embark on a process of unmistakable growth as writers.

These past eight weeks with the men and women who’ve attended my expressive writing program has, once again, reinforced my belief not only of writing’s healing power, but of the emergent power and beauty to be found by individuals who remarked, at our first meeting, “I’m not a writer, but…”  “In every patient,” Anatole Broyard wrote in his memoir, Intoxicated by My Illness, “is a poet trying to get out.”  How can you give your poet, the writer inside you, permission to be released?

Writing Suggestion:

Begin slowly.  Start with a simple phrase, “I remember _____and describe that memory in detail.  Then, borrowing from Natalie Goldberg, continue for three minutes, writing as many single sentences as you can all beginning with “I remember…..”, for example, “I remember the day my grandmother died.”   Or “I remember seeing the pavement rushing up to meet me.”  Or “I remember the moment the doctor said_____”

Once you’ve filled a page with “I remember,” turn it over.  Begin again, only this time, start with “I don’t remember…” and again, write as many as you can in three minutes.  These memories may be more difficult to recall, but they yield much to explore in writing, for example, “I don’t remember why my mother and father stopped speaking; I don’t remember passing out on the sidewalk…  I don’t remember what it was about that morning that first upset me… 

When you’ve written as many of “I don’t remember” as you can in three minutes, choose one sentence from either side of your paper and explore it.  You have many memories that can result in a longer narrative or perhaps even a poem.  But focus on one and tell the story of that single memory, describing not only the event or setting, but what you were feeling in as much detail as possible.  Write from the “lived” experience of the body.

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For the Week of March 5, 2018: Sleepless Nights

But it’s really fear you want to talk about

and cannot find the words

so you jeer at yourself 

you call yourself a coward

you wake at 2 a.m. thinking failure,

fool, unable to sleep, unable to sleep…

(From: “Insomnia,” by Alicia Ostriker, in: The Book of Seventy, 2009)

“Unable to sleep…”  It happens to me periodically, and I’ve written about it before, since it is one of those persistent afflictions that comes with life’s worries and aging.  It’s triggered by a distraction like my husband’s snoring or finding my dog has quietly leapt up and curled her body next to mine–taking up the better part of my side of the bed.  More often, there’s worry, whether for my loved ones or myself.  It happened just a couple of weeks ago, after a round of cardiac testing and a frank discussion with my cardiologist.  “We’re in this together,” she said, as I digested the results.  Later that night, however, the emotions I’d held at bay during the day kept me tossing and turning until the wee hours.

Paul Kennedy, in December 2017 CBC broadcast entitled “Have Insomnia?  Blame the Romantic Poets,” described a “culture of insomnia” as typical for this century, the Information Age we now live in. He quoted the work of Robert Vaughn, author of Bright Eyed:  Insomnia and its Cultures (2015), who wrote:  “We’ve naturalized insomnia and … valorized insomnia.  People boast about it, connecting to late capitalism’s idea that we are in a total state of productivity… We’ve created a dialogue in our heads that sleep is a kind of luxury. We’re expected to be on call 24/7.”

Whether a 24/7 work culture or the anxieties and worries of life, sleeplessness or restless nights are something most of us experience at some time or another.  Whether it’s the result of a tough day at work, deadlines, finances, worry about a loved one or just eating a late dinner–sleep may be, for a time, elusive.  Worse, however, are the times during emotional upset, personal crises, or serious illness, when sleep disruption can last for weeks.

You’re lying in bed trying to sleep, but you find yourself tossing and turning, unable to get comfortable…”  Ironically, it a message in this morning’s email that sparked this week’s prompt, leading me to the ad from the makers of “Privacy Pop,” a pop-up bed tent designed to promote  a solution for better sleep and “alone time” or simply, fun for children. I went to the site to unsubscribe and instead, ended up reading their blog, which offered  several practical tips on improving sleep, including, of course, the pop up tent, stating it “is a perfect method to develop and maintain the darkness necessary to promote the best possible sleep for your body.” (I bought one in December intended for the fun of my grandchildren’s sleepovers, but I now wondered if, during a restless night, I should try it!)

Sleeplessness, according to the New York Times’ Health Guide, involves “difficulty falling asleep…waking up too early in the morning, or waking up often during the night…or combinations of these patterns.”  …as many as 25% of Americans report occasional sleeping problems. Chronic sleeping problems, however, affect about 10% of people. The lack of restful sleep can affect your ability to carry out daily responsibilities because you are too tired or have trouble concentrating. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning.”

Sleep difficulties are common to most of us at some time or another, as evidenced in countless stories, essays or poems from literature.   “Sleep now, O sleep now,” James Joyce wrote in his poem by the same name, “A voice crying “Sleep now”/is heard in my heart…”  Charles Dickens, in an essay titled, “Lying Awake,” wrote:

But, it happened to me the other night to be lying: not with my eyes half closed, but with my eyes wide open… my hair pitchforked and touzled all over the pillow; …glaringly, persistently, and obstinately, broad awake. Perhaps, with no scientific intention or invention, I was illustrating the theory of the Duality of the Brain; perhaps one part of my brain, being wakeful, sat up to watch the other part which was sleepy. Be that as it may, something in me was as desirous to go to sleep as it possibly could be, but something else in me WOULD NOT go to sleep, and was as obstinate as George the Third.

Even the beloved children’s character,Winnie the Pooh, had sleep problems:

But [Pooh] couldn’t sleep. The more he tried to sleep the more he couldn’t. He tried counting Sheep, which is sometimes a good way of getting to sleep, and, as that was no good, he tried counting Heffalumps. And that was worse. Because every Heffalump that he counted was making straight for a pot of Pooh’s honey, and eating it all… Pooh could bear it no longer.
― A.A. Milne, Winnie the Pooh, 1926

Among cancer patients, sleep disorders are common.  A few years ago, unable to sleep, I tiptoed to my desk in the pre-dawn hours and turned on my computer.  I was not alone.  An email arrived in my inbox moments later from a member of one of my cancer writing groups.  She was beginning a new treatment for metastatic breast cancer and unable to sleep, had been writing in an attempt to capture the myriad thoughts about her illness and life, ones making her sleep elusive.  Several recent studies show 30 to 50% of cancer patients have trouble sleeping, compared to 15% in the general population. Even 2 to 5 years post-treatment, symptoms of insomnia were present in 23 to 44% of study participants. Several factors contributed to patients’ sleeping difficulties:  physical pain, side effects of treatment, emotional stress, surgery and hospitalization.

The inability to go to sleep and stay asleep has negative effects on us all, including anxiety, depression, fatigue, headaches or disruption in the body’s hormonal balance, but perhaps more than we anticipate. In an earlier study, David Spiegel and his colleagues found that those who suffer from troubled sleep are also more cancer prone.  When one’s circadian rhythm is disrupted, a person’s cancer prognosis can be affected.  As a result, the researchers concluded “A good night’s sleep may be one weapon in the fight against cancer.” (Science Daily, October 1, 2003).

What can you do if you are one of those who suffer from sleepless nights or insomnia?  MD Anderson Cancer Center offers suggestions to help you achieve a better night’s sleep.

  • Power down. The blue light from cell phones, tablets, TV and computer screens suppresses melatonin, which directly interferes with sleep.
  • Rituals.  Make sure you keep a bedtime and wake up ritual, even on the weekends.
  • Cool it down. Check the temperature of your bedroom. The optimum bedroom temperature should be between 65 to 72 degrees for sound sleep.
  • Leave the room. If you cannot sleep within 5 to 10 minutes of lying down, get out of bed and read a magazine or book that is soothing or boring. Spend time in prayer or meditation to calm the mind.
  • Limit your food and drink intake. Avoid heavy meals, alcohol, chocolate or caffeine products, such as soda, coffee or tea, three to four hours before bedtime.
  • Avoid naps. Keep your daytime naps to 30 minutes or less. And, don’t take a nap within several hours of bedtime.
  • Exercise.  The American Cancer Society recommends that cancer patients and survivors do at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week.
  • Pull down the shades. Your bedroom more like a cave, dark, cool and quiet.  Cover clocks or other electronic devices that emit light in your bedroom.
  • Write it out. Keep a pen and paper by your bed if you are prone to wake up and worry about the next day’s events.

It appears that every man’s insomnia is as different from his neighbor’s as are their daytime hopes and aspirations. —F. Scott Fitzgerald

Writing Suggestions:

  • Write about sleepless nights. What keeps you awake at night? Explore it.
  • What do you remember most about a particular sleepless night? Describe it in as much detail as you can.
  • What fears or other emotions often resurface and keep you tossing and turning?
  • Have you ever “birthed” an idea for a poem or story in the darkness of the night?  Write it.
  • What’s helps you coax yourself back to sleep? Write about your rituals or calming practices that help you overcome the agony of a sleepless night.
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For the Week of February 26, 2018: What’s So Funny About Cancer?

What’s so funny about cancer?  A lot, it turns out.  At least, more than a few comedians and others have taught us that there’s laughter to be found in the face of cancer.  One of the most famous was Gilda Radner, former comedienne of Saturday Night Live fame, diagnosed with ovarian cancer in 1986 and after a brief period of remission in 1988, dying  in 1989.  She described her cancer struggle in her memoir, It’s Always Something, a phrase often used by her comedic character, “Roseanne Roseannadanna.”  While she wrote honestly of her experience with disease, she  peppered her prose with moments of levity and humor, such as descriptions of the joys of farting after dealing with stomach problems or appearing after her chemotherapy and hair loss as someone “resembling a newborn Easter chick.”  In  an appearance on the Gary Shandling comedy show in 1998, she announced she’d been away because she had cancer.  Then she asked her host,  “What’d you have?”  He smiled and said, “a very bad case of career moves, which…there’s no cure for whatsoever.”  After her death, Gilda’s Club, a nonprofit community organization with locations in the US and Canada, was founded in her name.  It’s where, in Toronto, I now  lead a series of expressive writing programs for people living with cancer.

If you don’t laugh, you’re going to cry your eyes outIt just makes things less awful… As someone who will live with disease for the rest of my life, to never laugh again would be horrific. The jokes make me feel better. To some extent, I get to decide how I’m going to cope and I tell jokes.”  — Beth Caldwell, a 38-year-old metastatic breast cancer (MBC) patient and Seattle blogger.

For many of us, when we are going through periods of hardship, laughter helps to lighten the load.  As  Susan Gubar,  writer and cancer survivor explains, “Cracking up may be a better option than breaking down.”  In a recent New York Times column, she offers examples like Nina Rigg’s memoir, The Bright Hour, where Riggs commiserates with a friend also dealing with triple negative breast cancer. They imagine starting “Damaged Goods,” a business selling a line of morbid thank-you cards  from cancer patients with sentiments such as:

“Thank you for the taco casserole. It worked even better than my stool softeners.”

“Thoughts and prayers are great, but Ativan and pot are better.”

“Thank you for the flowers. I hope they die before I do.”

“All your phone messages about how not knowing exactly what’s going on with me has stressed you out really helped me put things in perspective.”

It doesn’t take much searching, whether online or in bookstores, to find a wealth of cancer cartoonists, comedies, like The Bucket List (2007) or 50/50 (2011), musicals, funny greeting cards and  humorous memoirs and guides like “God Said, Ha!,” “Does This Outfit Make Me Look Bald?” , “Cancer Made me a Shallower Person,” and “Cancer on Five Dollars a Day (Chemo Not Included).” Online, the list of funny cancer feeds are endless, from Welcome to the Hotel Melanoma,  Cancer Slayer, Dancing the Cancer Down to Dust, or Cancer is not a Gift/Laughing in the face of cancer.  

But not everyone finds anything funny about cancer nor  humor a useful coping mechanism, according to Dr. Bonnie McGregor, psychologist and public health researcher at Fred Hutchinson Cancer Research Center. “Not everybody finds it helpful,” she cautions.  “It can be hurtful if the timing isn’t right or the situation isn’t right. So you have to be careful with it.”  It’s important to remember that humor is not one size fits all, nevertheless as McGregor agrees, there’s plenty of research that supports that overall, laughter can be very good medicine.

If you happened to stand outside the door of conference room where I lead my expressive writing workshops, you’ll often hear laughter.  It comes naturally in the group setting.  I love to laugh too,  raised with the gift of shared laughter thanks to my father.  It’s helped me through more than one serious illness, I couldn’t ever help but find humorous moments in each, and a grin or chuckle always helped me feel a little better.

In my writing groups, even though we’re writing about the roller coaster of emotion that comes with a cancer diagnosis, tears occur–but so does laughter.  Perhaps that seems counterintuitive, but there’s plenty of evidence confirming that laughter is good medicine.  Saturday Review editor Norman Cousins was one of the first to ignite the “laughter therapy” movement when he wrote about the analgesic properties of laughter in his 1979 memoir, Anatomy of an Illness.  But well before Cousins’ insights, Mark Twain,whose stories of Tom Sawyer and Huckleberry Finn I eagerly read in my childhood, stated,  “The human race has only one really effective weapon and that’s laughter. “The moment it arises, all our hardnesses yield, all our irritations and resentments slip away, and a sunny spirit takes their place.”

Even as far back as the 13th century, humor  had a role in medicine.  Surgeons used it to distract patients from the agony of painful medical procedures.  They were onto something, since many research studies have since confirmed that the effects of laughter are very good medicine.  Laugh, and not only the world laughs with you; laughter causes your body to release endorphins, the feel good hormones that function as the body’s natural painkillers, the same hormones responsible for what’s known as the “runner’s high.”  Jeannette Moninger, in a 2015 CureTodaarticle on hospital laughter programs, refers to findings from a 2011 study conducted at the University of Oxford in England that found  watching 15 minutes of a comedy program with others increases one’s pain threshold by as much as 10 percent. At the same time, these endorphins decrease levels of cortisol, the hormone that floods the body during periods of chronic stress.Endorphins also decrease the body’s levels of cortisol, a hormone associated with chronic stress that compromises our immune systems, tenses muscles, and elevates blood pressure.  Laughter helps to counteract those negative effects and can help cancer patients to talk more openly about their concerns and fears. And it’s fast-acting. A randomized controlled trial of a “therapeutic laughter program” found that breast cancer patients’ anxiety, depression and stress were reduced after just one session of laughing.  

Charlie Chaplin once said, “A day without laughter is a day wasted.”  Whether during treatment for cancer or other serious illness, or simply living a world constantly dominated by hardship and struggle, it’s good to find something—even a small thing—to smile or laugh about.  I still giggle when I recall how, after a lengthy and confusing explanation of potential issues with the battery life of my ICD (implanted cardiac device) I mistook the beeping at the end of our clothes’ dryer’s cycle a few days later as the signal my defibrillator had run out of juice.  It hadn’t, but I had a good laugh after the initial wave of anxiety.  I’m smiling now as I finish this post,  hearing that gravelly voice of Louis Armstrong playing in my head, and I’m smiling.

Oh when you smilin’, when you smilin’
The whole world smiles with you
Yes when you laughin’, when you laughin’
Yes the sun come shinin’ through…

Writing Suggestions:

  • Have you had moments during your cancer treatment that made you laugh–whether in the moment or as you remembered the incident?
  • What about other times in your life that something unexpected occurred that, even years later, still makes you chuckle?
  • Dig back into your memories—the fun times, times you laughed so hard, tears ran down your cheeks.  Take a break from about the pain or anguish that also comes with cancer.
  • Write one funny story from your life.    If you feel like it, try on a little dose of medicinal humor.
Posted in expressive writing, reflections on life, writing from cancer and serious illness, writing from life, writing humor, writing to heal | Leave a comment

For the Week of February 19, 2018: Making Time for Life

This is not a dress rehearsal…today is the only guarantee that you get… think of life as a terminal illness, because if you do, you will live it with joy and passion, as it ought to be lived.–Anna Quindlen

For much of the past month, I accomplished little, succumbing to a nasty case of bronchitis that left me hacking and wheezing for nearly a full month.  Boredom was my companion after the first several days of my illness.  I didn’t feel well enough to do much except read or nap.  The regimen of new physio-therapy exercises for a case of Achilles tendonitis quickly fell by the wayside, and classes, social events and appointments were all canceled, rescheduled and canceled again as my illness lingered.  Then it changed.  Abruptly.

I finally recovered, and eager to resume a life, I’ve quickly jumped on the treadmill again–but not, unfortunately, the one at the gym.  It’s the other treadmill, the full of appointments, lists of “to dos”, deadlines and making up for the activities lost during a month of illness. Without realizing it, I’ve begun to feel as if I’m running as fast as I can from one thing to another, but there’s little to show for it at the end of the day.

My online calendar has become an annoyance of sorts.  While I’m grateful it issues daily reminders of whatever I’ve planned, committed to, or have to complete, it seems as if it’s gone from being a benign virtual presence in my life to a relentless taskmaster.  But it’s no one’s fault but my own.  The truth is, I’m over optimistic about my time, and routinely pack too much into my days.  When this happens, I veer into negligence:  not noticing, not being present and enjoying the little moments in my daily life.

It’s nothing, of course, for the time taken up by a cancer diagnosis and the way in which it dominates every waking moment–even one’s dreams.  Time seems interminable as you wait for test results; there’s the time it takes for doctors’ appointments, getting referrals to the necessary specialists, preparing for and recovering from surgeries, chemotherapy, and a host of other demands on your time and energy that extends well beyond one’s initial treatment.  Life, as you once knew it, disappears, and your time, it seems, is dominated by the demands of living with cancer.  Months pass by; you barely notice anything around you for weeks at a time, until, as Barbara Crooker describes, “in the middle/of a life that’s…complicated…/struggling for balance, juggling time…”

One day you look out the window,
green summer, the next, and the leaves have already fallen,
and a grey sky lowers the horizon…

Each day, we must learn
again how to love, between morning’s quick coffee

and evening’s slow return. Steam from a pot of soup rises,
mixing with the yeasty smell of baking bread.

From:  “In the Middle,” In:  Radiance, 2005)

Each day we must learn…there’s more to that phrase than we think.  Whether we’re choosing to fill our lives with busy-ness or forced to fill it with the details of cancer treatment and recovery, we slip into habits, feelings that we’re constantly “running out of time,” and forgetting to pay more attention to how we use the time we have each day.    To step off the treadmill suddenly might send us flying;  the landing would be abrupt and hard.  If we can learn to slow the speed gradually, however, take a few deep breaths and pay attention to the world around us, the rewards are great.  The re-learning, though, takes time and attention.

We are what we repeatedly do, Aristotle once proclaimed.  I came across this quote in a 2014 post from Brain Pickings Weekly that explored how long it takes for us to form new habits.  If Aristotle is right, and I continue to constantly overbook my life, building internal pressure and stress, do I become that harried, rush-rush, stressed person?  Apparently so.  William James, one of our first psychologists, agreed, stating:  Could the young but realize how soon they will become mere walking bundles of habits, they would give more heed to here conduct while in the plastic state.  For most of us, our “plasticity” isn’t as great as it was in our youth, but change is still possible, if we’re serious about slowing down, noticing life around us, and paying attention.  It takes more than just resolving to say “No” to an overscheduled self.

According to the article I read in Brain Pickings Weekly,  it takes more than resolve for  a new habit to take root in a person.  According to a study conducted at University College in London, it takes 66 days of consistent behavior before a habit is formed, and in cases of well entrenched and complex behaviors like my tendency to constantly overbook my time, it could well take much longer!

I’ve often written about paying attention, the act of being fully present to our outer and inner worlds.  It is the writer’s work, yet even though I consciously try to pay attention to life around me, I can get pulled in a dozen different directions before I realize it.  I’ve gotten better about this in the past few years, but I often have to remind myself to quiet my mind, notice and be attentive to the gifts life offers.  It’s harder than we think to slow down and pay attention when we’re so used to the busy-ness in modern day life.

Ted Kooser, former poet laureate and a cancer survivor, knows even a poet can be distracted by life’s demands and by cancer.   Winter Morning Walks:  One Hundred Postcards to Jim Harrison, published in  2001was created from postcards Kooser began writing and sending to his friend as he recovered from cancer surgery and treatment.  He described how the book came to be in the preface:

“In the autumn of 1968, during my recovery from surgery and radiation for cancer, I began taking a two-mile walk each morning…hiking in the isolated country roads near where I live…During the previous summer, depressed by my illness, preoccupied by the routines of my treatment, and feeling miserably sorry for myself, I’d all but given up on reading and writing…  One morning in November, following my walk, I surprised myself by trying my hand at a poem.  Soon I was writing every day…

The poems reveal a touching portrayal of a man recovering from the ravages of illness and treatment, whose spirit and sensibilities were reawakened in his habit of making time for morning walks and once again, noticing the life around him, slowing himself and time down to take pleasure in the beauty of the natural world.  Cancer is mentioned only briefly, for example:

…filling my lungs with hope

on this, my granddaughter’s

birthday, her first, and the day

of my quarterly cancer tests.

Instead, Kooser nourishes his spirit and his poetry by slowing down and paying attention to the small moments of beauty and delight in nature.  The final poem in the book celebrates the healing that has come with his habit of walking, slowing down, and paying attention, capturing those small moments in poetry.  In his final poem in the book, Kooser writes:

How important it must be

to someone

that I am alive, and walking,

and that I have written

these poems.

This morning the sun stood

right at the end of the road

and waited for me.

Kooser’s poetry inspired me to embark on a different habit several years ago.  While my days can still become exercises in racing from one thing to the next, I very seldom miss taking time in the early morning to sit in quiet and write, usually beginning with one observation of a single moment in nature.  It helps to quiet my mind when life feels lopsided and too demanding, and more importantly, it helps me remember gratitude and the importance of paying attention.

Where has the time gone?  It’s a question any of us may find ourselves much too frequently.  Think about what time can offer to us if we truly pay attention, because, as William Stafford reminded us:

Time wants to show you a different country.  It’s the one
that your life conceals, the one waiting outside
when curtains are drawn, the one Grandmother hinted at
in her crochet design, the one almost found
over at the edge of the music, after the sermon…

Time offers this gift in its millions of ways,
turning the world, moving the air, calling,
every morning, “Here, take it, it’s yours.”

(From: “The Gift,” by William Stafford, In:The Way It Is, Graywolf Press, 1999)

Writing Suggestions:

  • Write about time: What are you doing with yours?
  • What demands do you encounter daily on your time?
  • Explore how time seems to run ahead of you, how you may be squandering it–
  • Or how you have learned to slow down and make your time each day more fulfilling or meaningful.
  • What practices do you find helpful to making time for yourself?



Posted in expressive writing, reflections on life, writing and nature, writing from cancer and serious illness, writing from life, writing to heal | Leave a comment

For the Week of February 12, 2018: Matters of the Heart

…Do you note that the world has changed since you began

Your tatoo beneath my chest bone?  I would guess that, if

you do, you don’t care.

“Life is pretty simple,” you say, “and besides, I have my

work to do.”

(“To My Heart As I Go Along,” by Kenneth Koch, Poetry Magazine, 2000)

Wednesday is Valentine’s Day, and the retail world has reminded us of the date for weeks.  As a child, it was the anticipation of choosing a packet of 36 valentines to be addressed to my classmates and placed in the decorated cardboard box at the back of my classroom.  There was chocolate, of course, and those little decorated sugar candy hearts with messages stamped on them and, thanks to our mothers, a party with red and pink cupcakes.  We didn’t understand much beyond those exchanged valentines then, nor did we know much about anatomy and physiology when it came to our hearts.  The history of the symbolic significance of the heart was completely lost on us.  We didn’t know then that the heart, in religious texts, is a metaphor or attributed with the spiritual or divine, or that early philosophers and scientists believed the heart to be the seat of thought, reason or emotion.  Despite today’s scientific and medical knowledge, the heart continues to symbolize what we humans feel.

Take a look at, the website for the Academy of American Poets, enter “heart” in the advanced search, and you’ll get 734+ poems about the heart, whether filled with the joy of love or ache from love lost.  If you Google “heartache,” you’ll find a reference to the top 100 heartache songs,   like “Unbreak my Heart,” “How do You Mend a Broken Heart”, “Heartbreak Hotel”, “Total Eclipse of the Heart”, or “Don’t Go Breaking My Heart,” all confirming the heart is where we feel not only love, but our pain, whether  love gone awry or sorrow for others in our lives.  In fact, the definition for “heartache” is “anguish of mind,” or “sorrow.”

It turns out that a broken heart is more than imagined and more than emotion.  In a June 5, 2010 post on his former blog, All Heart Matters, journalist and heart patient, James Borton, cited a number of research articles on “Broken Heart Syndrome,” a left ventricular dysfunction brought on by acute emotional or physical stress.  “Hearts actually can break,” he wrote, quoting an article in a recent edition of The Wall Street Journal, suggesting there is some emotional connection to our hearts.

Our hearts can break; they also ache.  As she thought about the death of a friend, the constant onslaught of bad news in the world, and challenges being faced by others in her life:  cancer, a brain tumor,  life and health challenges, former Kansas poet laureate, Caryn Mirriam Goldberg wrote,  “When I still myself and just feel what there is to feel, my heart hurts…” (Blog post, February 9, 2011).  One of Caryn’s poems came to mind, written after breast cancer and a double mastectomy, begins with the words:

I am still a woman

even if my heart hurts–

my whole chest aches with emptiness…

(“Reading the Body,” in Reading the Body, Mammoth Publications)

The heart–it knows love, and it knows heartache and so much more.  Our hearts.  The amazing organ pumping life-giving blood throughout our bodies.  I’ve certainly suffered from periods heartache and loss as many of you have, but I hadn’t thought about my physical heart much until a December afternoon in 2008, when I collapsed while walking my dog and ended up in the emergency room a short time later, dazed and confused.  It turned out I was experiencing a very different spin on “heartache.”  A day or two later, my family doctor appeared at my bedside.  “We think you’ve had a heart attack,” she said.  WHAT?  How could that be? I asked.  I’d just had an annual physical two weeks earlier.  She shook her head; she had no answers for me, saying “we don’t really know; it could be any number of things…”  My doctor held my hand as I wept, and told me nothing had been confirmed; a cardiologist was reviewing the battery of tests I’d had when I arrived and would shortly confirm or deny the diagnosis.  Two days later, I had officially become  a heart failure patient, with left ventricular dysfunction and atrial arrhythmia, and I had an ICD (implanted cardiac device) implanted, leaving a rounded lump on the left side of my chest, a constant reminder of how suddenly my life changed.

“It’s always something… “I wanted a perfect ending. Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next.

(It’s Always Something, by Gilda Radner, 1989)

After the shock and heightened fears of mortality settled down, I continued to read and research, looking for answers.  It wasn’t until five years later, when I stumbled on a 2013 study in the New England Journal of Medicine that found exposure of the heart to radiation during radiation therapy could increase the risk of heart disease among breast cancer patients later in life, particularly in women who were irradiated for cancer of the left breast.  I’d been treated aggressively for DCIS (ductal carcinoma in situ) in my left breast in 2000, and seven weeks of daily radiation therapy was a significant part of the prescribed treatment.  Eighteen years later, DCIS is treated somewhat differently; radiation doses have also been reduced and become more precise. Yet I wondered if the radiation I’d received was a possible explanation for why I now suffered from heart failure.

Ironically, it was only late in December 2017 that my new cardiologist raised and discussed the likely probability with me.  Her candor and knowledge of the research was gratifying; I felt as if I was getting some confirmation of all I had come to suspect.  Then, several weeks later, on February 1st, NBC evening news reported that the American Heart Association had just issued a warning about potential harmful effects of certain breast cancer treatments–including radiation.

“Any patient who is going to undergo breast cancer treatment…should be aware of the potential effects of the treatments on their heart,” Dr. Laxmi Mehta stated, director of the Women’s Cardiovascular Health Program at Ohio State University.  “This should not deter or scare patients from …treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”

...allow them to make informed decisions with their doctor...” And there you have it, the importance of asking questions about treatment.   I wish I’d known and asked more questions eighteen years ago, but I didn’t.  The word “cancer” had paralyzed me–I operated in a fog for weeks after the diagnosis and numbly accepted the treatment regimen as “normal.”  Now I live with heart failure, and I am very aware that more older women die of heart disease than of breast cancer.  Thankfully, medicine and treatments continue to advance for both cancer and for heart disease treatments.  And for the continuing research, development, and new treatment available to any of us, whether cancer, heart disease, or other life-threatening illnesses, I am forever grateful.

Gratitude is, as it turns out, what Valentine’s Day has come to symbolize for me–not just for my loved ones and dear friends, but for all those healthcare professionals who have made a difference in my life–the gifted neurosurgeon who saved my life as a teenager, caring family physicians who showed compassion and concern in times of illness or crisis, my cardiologist, who literally breathes life into the examination room when she enters and discusses my condition in clear, direct terms.  Medicine is science, yes, but there’s art in the way in which it’s administered by those men and women who become our physicians and surgeons.

And Wednesday is Valentine’s Day, but I’m well beyond scribbling out “To Jane, From Sharon” on the paper envelopes into which those little dime store valentines were stuffed.  The excitement of exchanging valentines as we did as children disappeared a long time ago, but Valentine’s Day is an opportunity to celebrate with my husband the years of marriage, family and companionship over a dinner out.  We’ll toast together the ever-present matters of our hearts–gratitude for the romance, family, friendship, and life we have.   Happy Valentine’s Day!.

Carefully placed upon the future

it tips from the breeze and skims away,

frail thing of words, this valentine,

so far to sail.  And if you find it

caught in the reeds, its message blurred,

the thought that you are holding it

a moment is enough for me.

(“This Paper Boat,” by Ted Kooser, in Valentines, 2008)

Writing Suggestions:

Expressions of sentiment, captured in small verses or lace-trimmed cards, in letters or postcards, are a way to say “I appreciate you” or “I’m thinking of you,” or “I love you.”  1.  Write a valentine.  In a world full of suffering, war and economic downturns, taking the time to express your sentiments for family, friends, or others whose presence in your life you appreciate is a great gift.  In fact, you can do it anytime.  You don’t have to wait for February 14th!  The simple act of pausing to remember those we care about and those who have cared for us in times of struggle, hardship or illness, reminds us of what matters most in our lives:  people, friendship, love.

  • Write a valentine.  In a world full of suffering, war and economic downturns, taking the time to express your sentiments for family, friends, or others whose presence in your life you appreciate is a great gift.  In fact, you can do it anytime.  You don’t have to wait for February 14th!  The simple act of pausing to remember those we care about and those who have cared for us in times of struggle, hardship or illness, reminds us of what matters most in our lives:  people, friendship, love.
  • Perhaps there’s a poem, song or ode to your heart or some other body part you’d like to write. Why not try, whether serious or humorous, to send a valentine to some part of your body that does all the physical work of keeping you going?
  • “I carry your heart/ I carry it in my heart,” e.e. cummings wrote in his famous love poem. What do you carry in your heart?
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For the Week of February 5, 2018: After the Storm, Then What?

I’ve been thinking about how, in the weeks of our Toronto winter, my mood, dampened by a bad case of bronchitis and nearly three weeks of coughing, doctor’s visits and antibiotics, my writing has mirrored my mood, floundering along with my physical discomfort, state, repetitive themes and forced prose that seems leaden and glum, just as surely as the coughing and overcast skies I’ve suffered through for days on end.  Not only was I bored, whatever I managed to put on the page was uninspired and dull.  Did I need some new life crisis in my life ignite my daily writing practice?  Somehow, that didn’t seem like anything I needed or wanted, lackluster writing or not.

Nevertheless, writing out of crisis, pain or suffering, has provided the inspiration for many works of great literature.  Novelists and poets alike have described their writing as a form of therapy, helping them heal from traumatic events in their lives in face, and  Louise DeSalvo states in her book, Writing as a Way of Healing, those traumatic events have inspired many of our greatest cultural creations.  Writer Paul Theroux once described writing like digging a deep hole and not knowing what you will find.  He admitted to feeling a sense of initial shock when reading authors like F. Scott Fitzgerald, Graham Greene or William Styron, discovering powerful—and personal—themes of alienation or suffering in their work.  Fitzgerald described his battle with alcohol in The Crack-Up, Greene wrote of his manic-depression in A Sort of Life, and Styron examined his suicidal depression in Darkness Visible. Creativity, as so many writers have shown us, not infrequently is fueled by life crises, trauma or suffering.  Search for on Amazon’s book listings, and you’ll find dozens and dozens of books written out of personal suffering, illness, loss or other trauma.

Cancer is one of those personal crises that triggers intense and abundant writing and has, for many authors, resulted in books of poetry or memoir.  Writing Out the Storm, the title of Barbara Abercrombie’s memoir of her breast cancer experience,  is a great metaphor for writing out of a personal crisis.   A cancer diagnosis–or many other traumatic life experiences, can make you feel as if you’re in the midst of a storm.  You rage; you weep; you pour your emotions onto the page.  Writing becomes the calm, the eye of a hurricane, a kind of refuge while the storm continues to howl around you.  You may write desperately and furiously, revealing all your anguish on the pages of your notebooks.  The refuge I found in writing during an extended period of personal crisis and loss, and the solace I discovered in it ultimately led me to leading my first workshop for cancer survivors nearly 18 years ago.

Yet the cancer journey changes, just as the weather and seasons across the country.  As you move from the shock and pain of diagnosis, surgeries and chemotherapy toward recovery, winter–although it may not feel like it now–makes its retreat, and Spring arrives.  Your spirits are buoyed by  the promise of calmer and sunnier days emerging from the wreckage left by wild weather.  The first crocus poking through the last of the snow and the buds appearing on the trees, ignite a new sense of hope.  But what happens to your writing as the storm passes and life becomes more bearable?  Does your writing change, or do you stop writing?  Are you predominantly a “crisis writer,” preferring the intensity of a life crisis to fuel your writing or do you discover new inspiration as the sky clears and nature begins to blossom?

For a long time in the aftermath of my loss and grief, I was a crisis writer.  But gradually, I realized I’d begun to ruminate, replaying old questions and sorrow over and over on the pages of my notebook.  Instead of feeling better, I felt worse.  I was mired in the blues.  The monotony of my constant replays on the page weren’t helping me get on with life or writing.  While it’s true that to write, you must be willing to step into your shadows and confront your own darkness, but to remain there defeats the healing benefits writing can have.  It’s why, in my cancer writing workshops, the prompts and exercises I offer to the groups gradually move from the predominant theme of cancer to a person’s whole life.  Cancer isn’t anyone’s complete life story–only a part of it.

A few years ago, I was stuck in a winter’s funk–erroneously called “writer’s block,” something I have since banned from my vocabulary.  Billy Collins, former poet laureate of the U.S. and a favorite of mine, was speaking at a local university; I was determined to hear him speak.  I was glad I did.  Collins’ poetry and wry humor were good medicine for my sagging spirits.  After the reading, he took a few questions from the audience, and one person asked where he found his inspiration.  His answer was brief and to the point.  Collins replied that he finds his inspiration in noticing, by looking out the window.  Read his poetry, and you’ll quickly discover that even the most ordinary thing can contain the seed of a poem or a story.

The following morning, still inspired by Collins’ reading, I opened my notebook, gazed out the windows in our front room and began with a first sentence, “I wish I could write a poem like Billy Collins…”  It was enough.  The words began flowing freely, something to do with being present and paying attention I realized.  I thought of Naomi Shihab Nye’s delightful poem, “Valentine for Ernest Mann,” inspired by a request from a young man to write him a poem and send it to him.  “You can’t order a poem like you order a taco,” Nye began, ” Walk up to the counter, say, “I’ll take two…”  She continued:

…I’ll tell a secret instead:

poems hide. In the bottoms of our shoes,

they are sleeping. They are the shadows

drifting across our ceilings the moment 

before we wake up. What we have to do

is live in a way that lets us find them.

(In:  Red Suitcase, 1994).

What we have to do is live in a way that lets us find them.  In Rita Dove’s wonderful poem, “Dawn Revisited,” she offers an invitation to awaken ourselves to the world around us to inspire the way we live and express our lives.

Imagine you wake up 

with a second chance: The blue jay 

hawks his pretty wares 

and the oak still stands, spreading 

glorious shade. If you don’t look back, 


the future never happens. 

How good to rise in sunlight…

The whole sky is yours 


to write on, blown open 

to a blank page…

 (In:  On the Bus With Rosa Parks, 1999)

The whole sky is yours to write on, blown open to a blank page…  It’s a great image, and it reminds us that the real work of writing is to write under any sky, whether stormy or clear.  It’s is how we capture the intricacy, the poetry, and stories our lives encompass.  It’s the work for every writer—and, perhaps, for healing: to move beyond the crisis, storms, and see the world with new eyes, to awaken, notice and explore.  Perhaps you’ve been writing out of the storm called cancer, but ask yourself this:  as the sky clears, where will you find the inspiration and the motivation to keep writing?

Writing Suggestions:

  • Why not take a look out the window or go outside? Open your eyes and notice how alive the world is with new possibility.
  • Begin with a blank page and write about the sky above you, whether it’s stormy or sunny, gray or blue.
  • Start with the first thing that grabs your attention as you look out the window. Start with a single line, pay attention to what you notice and describe it. Then keep writing for 20 minutes and see where it takes you.
  • Write out of storm, or write about calm.  It doesn’t matter.  The whole sky is yours, the blank page is yours, a space for whatever you want to write. What matters most, is that you write.
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