T is for ‘Tsunami’

tsuːˈnɑːmi/
an arrival or occurrence of something in overwhelming quantities or amounts.

As an English grad I love a good metaphor and, at risk of mixing mine, (remember that one about life’s journey and the cancer sinkhole?), being given a cancer diagnosis is a bit like being hit by a tsunami.

First, when you’re sitting in a doctor’s office and hear the words ‘you have cancer’, you find yourself in a strange void.  It’s like standing on a beach and realizing that the tide has suddenly gone a peculiarly long way out and you’re on this vast expanse of empty sand wondering where everyone else and all the water has gone.  That cliché that you hear only the ‘you have cancer’ and nothing else that follows isn’t a cliché.  It’s true. Your brain freezes and refuses to register or process what is said next.  Your consultant gives you surgical details (mine even drew that lovely sketch of the hole he was going to cut in my boob), the Breast Cancer Nurse gives you tissues and a resource pack but you’re still just stuck on that beach staring out at the sand, where someone’s written ‘cancer’ in big letters, and wondering where the water’s gone.

Then, after a while, on the horizon, maybe when you’re back at home, or on the bus, or in the hospital car park, you see a wall.  It’s getting bigger.  It’s moving fast and it’s coming straight for you.  The water is coming back and there’s no high ground to run to.  That tsunami has your name on it and it’s full of cancer emotions, rushing up to overwhelm you.

Because it’s probably emotions that will hit you first.  Of course everyone’s reaction to a cancer diagnosis is going to be different but for me the first tsunami wave was definitely fear.  Fear of the unknown (because the majority of people will know nothing concrete about cancer until they’re made to face it), fear of the surgery that’s needed, fear of the treatment paths that might be ahead (especially chemotherapy and all it entails, the sickness, the hair loss, the exhaustion), fear that the cancer might already have spread and, of course, the biggie, fear that the malignant lump in my breast was going to kill me way before I was ready to say goodbye (I still want to lick chocolate off a naked Tom Hiddleston goddamit).

And just to make sure this tsunami is a swirling, seething mass of cold, wet,  uncomfortable emotion, you’re probably going to get angry too.  Angry about why you should be so fucking unlucky to be one of those 1 in 8 women who will get breast cancer in their lifetime (1 in 8? Let’s get fucking angry about that); angry about all the things this means you’re not going to be able to do (Want to go on holiday? Nope, you need surgery and then after that travel insurance might be prohibitively expensive.  Want to get a new job? See how that goes when you’re so exhausted you can’t move); angry about … well, anything. And everything.  You’re just very bloody angry.

Don’t forget to add regret (‘what did I do wrong? Did I eat the wrong things? Not do enough exercise? Dye my hair too much? Put my cellphone in my bra one too many times?’) and guilt (‘how is this going to make my family feel? Will they be able to cope with me being ill? How many times can I asked loved ones and friends to help me out before it’s one too many times?’) and probably a good dollop of totally trashed self-confidence (‘who’s going to want me now I’m damaged goods? Not that anyone wanted me before but Benedict Cumberbatch is almost definitely off my list of possible conquests now’).

And if it’s not enough that the tsunami rains down a shitload of unwanted emotions on your head, you are overwhelmed by wave after wave of information too.  Even if you steer clear of the demon Google (the enemy of cancer patients everywhere) you are bombarded with unusual and definitely not user-friendly medical information at every turn.  Everyone uses an alien language, full of acronyms, jargon and data, that you have to very quickly learn and digest if you want to find any kind of purchase on the shifting sands that this tsunami is creating under your feet.  And there’s no Rosetta Stone pack for cancer-speak. DCIS, IDC, ER/PR/HER2, BRCA1, WLE, SNB, MX, OMFG WTF does it all mean?

And no-one can you a straight answer about anything.  As everyone’s cancer is as unique as they are there’s no ‘one size fits all’ treatment plan, no ‘we always do this, then this and we’ll get you to here’ because every next move depends on test results, biopsies, pathology reports, histology reports, scans that no-one can predict and no-one is willing to take a punt on.  It’s like realizing you’re going to have to cross that huge, wide, frothing powerful river in front of you but you’re only ever going to see one stepping stone at a time and they’ll pop up randomly and maybe only for the briefest of moments. (See, I told you I liked mixing my metaphors).

For me, it’s this level of uncertainty that is the hardest thing of all to deal with in the midst of the cancer tsunami.  It washes over your old life, hurling your certainties around like they were flotsam trash and leaving everything in disarray.  Whereas once you knew that today you would be working, tomorrow you would have dinner with friends, next week you were going to the theatre and in the summer you were off on your holidays, now you can’t plan beyond tomorrow because that next test result, that next hospital appointment might mean a shift in those stepping stones and a shift in your treatment plan that will trash your diary for months.  As a control freak, an an organizer by nature, always looking for the next fun thing to plan with friends, the horror of not knowing where the next stepping stone might emerge from the water is the scariest thing of all.

Post-that-initial-tsunami, your new cancer life is also littered with things you didn’t want and shouldn’t be there (just like that classic tsunami photo of a boat in the backyard of someone who lives miles from the coast) but this boat is endless paperwork (appointment letters, test results, forms to fill in), surgical scars, hormone therapy tablets (and their side effects) for the next five years, ever present anxieties about those small aches and pains that every aging body has but now might presage something awful.

And the truth is that while the waves do recede a little as you digest the news and learn to adapt (it’s surprising how quickly cancer becomes the new normal), they never go away completely.  You can often feel them lapping round your feet even at the most mundane of moments, in a supermarket, on the tube, peeling the veg for tonight’s dinner, curled up on the sofa watching crap TV, and they can gather force and overwhelm you at any time. That small annoyance that wouldn’t have phased you pre-cancer suddenly has you sobbing hysterically as if the world has come to an end.  It’s like someone has peeled off your emotional skin and left your nerves exposed, raw and open, set screaming and jangling by even the gentlest of breezes.

For the luckiest of us that survive the cancer tsunami, clinging on to some tree for dear life until the wave passes over us and rushes on (fingers crossed I’ll be in that number), there will always be some devastation left in it’s wake. We might rebuild the house, put that boat back in the sea where it should be, sweep the mud from the garden but please pardon us if sometimes we look and act overwhelmed as I think we’ll always be finding some of the sand in our shoes.