Living with cancer: 'Gravy' days

When I was diagnosed in November 2008, I began counting forward, assuming I would die by November 2013, at the latest. Prognosis for late-stage ovarian cancer is three to five years, even with state-of-the-art treatment. November, which happens to be the month of my birthday, became a memento mori: an annual observance of my projected end. A statistical approximation, the prognosis tolled in my ears like a death sentence.

Years after their diagnosis, many people observe their cancer-versaries: the annual recurrence of the date on which they learned the type and stage of their disease along with an estimate of how long they would likely live with treatment. It’s understandable to want to mark the moment, since this information can arrive like a thudding blow, a lightning bolt, a tornado. Or it can come as an icy chill, the blank numbness of disbelief since not-knowing may seem preferable to believing. Or, oddly, it can arrive, as it did for me, with relief at finally comprehending what is wrong, followed by trepidation about what to do about it.

In any case, the shocking impact of a cancer diagnosis needs to be remembered. The date becomes a threshold: one door closes; another swings open. We wander between two worlds, one extinct and the other frightfully unpredictable. Its anniversary commemorates an end and a beginning — in this case a traumatic beginning.

I figured that my longevity would land squarely within the range of the projected statistical odds, unlike Stephen Jay Gould. In his 1985 landmark essay “The Median Isn’t the Message,” Gould described his response to a diagnosis of abdominal mesothelioma, an incurable disease “with a median mortality of only eight months after discovery.”

An evolutionary biologist, he set out to use his knowledge of statistics to counter the widespread anxiety of cancer patients about their chances of surviving. He based his redefinition of what the median means on an assumption shared by evolutionary biologists, “that variation itself is nature’s only irreducible essence.”

The median isn’t the message because the variation is; it trumps the median in significance. Gould placed himself amid the variations and noted that graphs of the distribution of variations were “right-skewed.” The right-skewed long tail extended out for years beyond the eight-month median. “I saw no reason why I shouldn’t be in that small tail, and I breathed a very long sigh of relief.” He turned out to be right and lived for 17 years after the publication of his essay.

Endowed with an apprehensive temperament, I watched November 2013 approach, arrive and depart with astonished bewilderment that I shared with a colleague also dealing with late-stage cancer. “It feels weird to be living on borrowed time,” I confessed. “You’ll have to come up with a better term,” she said.

Indeed, “borrowed time” does sound parsimonious, if not silly: Borrowed from whom and to be paid back how? I have heard of patients surviving beyond what they call their “expiration date,” but that made it seem as if the life left was spoiled or rancid.

Better term
A better term surfaced when I read a poem by Raymond Carver about a man confronting a dire diagnosis. It reminds him that 11 years earlier he had been given six months to live unless he quit drinking. He had then somehow managed to sober up.

After that it was all gravy, every minuteof it, up to and including when he was told about,
well, some things that were breaking down and building up inside his head. “Don’t weep for me,”he said to his friends. “I’m a lucky man. I’ve had ten years longer than I or anyone expected. Pure Gravy. And don’t forget it.”

Like Carver’s dying surrogate, I have no illusions about a cure. The death sentence has not been commuted but temporarily stayed – deferred not by any efforts on my part but by the sheer luck of an unpredictably effective experimental drug.

Yet this November I am a lucky woman, reveling in the unearned bounty of more time and a thicker earthly existence than I had ever expected. Counting backward from right now to the predicted death date, I picture myself as a lurching 1-year-old, savouring pure gravy, every minute of it.
INYT

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