"Picking up the pieces and putting yourself back together is difficult."
Author Dan McNamee shares his cancer diagnosis story and his internal reflections about life and death.
This month I’d like to introduce you to Dan McNamee, author of the memoir, Everything That Makes Me Happy Makes Me Sad. You can find him on Substack, too, and I’d love it if you’d check out his writing, support his work, and offer a supportive and encouraging affirmation for his brave and vulnerable sharing today about his cancer diagnosis and the constellation of emotions and thoughts that followed it.
How can a person pull themselves together after a cancer diagnosis?
Towards the end of June 2020, I was living in Paris with my wife and two young sons when I had a random, deep, throbbing pain in my right leg that persisted for a week or so. I was only forty years old, juggling a wife and kids and work, so I didn't have the time or, frankly, the inclination to take a random leg pain too seriously.
But when that pain subsided, only to pop up in the other leg, my wife convinced me to go to the doctor. One doctor led to another, which led to an ultrasound. The ultrasound discovered a blood clot in my leg, leading to a CT scan of my upper body so the docs could confirm that there wasn't another blood clot floating around that might get stuck in my lungs and kill me as I walked down the street or made dinner at home.
As I lay on the table, waiting for the CT machine to come to life, my mind wandered to the stories you hear of those poor unlucky souls who start out feeling broadly normal one day, only to be told later in the day by some doctor that they have cancer and are probably going to die soon. I casually considered how terrible that must be. I felt very bad for those people, and wondered how they could pull themselves together after that kind of blow.
About twenty minutes later, a doctor pulled me into a room, pointed at a computer screen, and told me that I had tumors on my pancreas and liver.
I stumbled out of that small, dark room into the brightly lit and crowded waiting room, terrified but mostly confused. Confused as to what had just happened. Confused as to what to do next or, more accurately, what would happen to me next. I knew I needed to call someone, but I couldn't figure out who. But first, I needed to pay for the ultrasound and the CT scan.
It all felt surreal to me.
I stood in line for ten minutes, then—broken by emotion, confusion, and lack of medical-related vocabulary—muddled through the capitalist end of a death sentence. In French. There isn't a Rosetta stone module for that.
And so I was forty years old when I was told that I would die soon. I was forty years old when the self that I knew was destroyed. Nine months of chemo followed, which wasn't much fun. Then two medical trials in New York, the second of which was very early stage—I was only the third patient—and it broke any parts of me that had survived the diagnosis.
Yet I did survive, and four years after my diagnosis, twenty months off treatment and still free of disease, my oncologist used the words "complete remission" during one of our meetings. Pancreatic cancer kills about 90% of patients within five years, although most die much more quickly. Nearly no one escapes to live cancer free. "Complete remission" was not a future I considered as I stumbled around the streets of New York during my second medical trial, weak and bald and broken.
Most of us are ignorant and naive until late in life, often very late in life. At least until we are twenty-five, when our brains are fully formed, but in my case, it was much later. I never considered the idea that I would die. I am not sure I ever really considered the idea that I could die.
Now, if you had asked me if I was immortal, I would have had the good sense to say "no," but that is a long way away from thinking through the truth—the reality—of mortality. And so the terrifying gap widened from the heights of "I am still young and have most of my hair and it's maybe not impossible that I will live for 115 years" to the rock bottom of "it is very possible I will die before my youngest child starts speaking in full sentences."
Essential truth: “We are not in control of our own lives.”
I have been trying to pull myself back up ever since, but as I crawled along the dark, rock bottom of my life, I learned a number of life's essential truths.
Here is an important one: we are not in control.
We are not in control of the people around us. Our spouses and moms. Our dads and children. We can't control our neighbors, and we are certainly not in control of the country in which we live. We aren't in control of the culture, and we aren't in control of how history will judge us.
We are not in control of our own lives.
But this truth feels useless now that I am trying simply to live. Because I have learned another truth as I have been busy trying to put the pieces of my life back together: I learned that people do not want to know.
We are all terrified of the prospect of death.
People still ask me the questions, maybe because they feel obligated. People ask me different versions of, "What did you see down there at the bottom, in the dark?" When I try to answer, I know they don't really want to know—or maybe it's just that they can't possibly understand—because true understanding would require that they stare into the truth of mortality and shatter their illusions of control. So they nod their head, or maybe say, "Definitely" or somehow have the temerity to consider that maybe my enlightenment was worth the pain and destruction.
But I know it wasn't worth it. Some days, most days, I would trade anything to go back to my blissful ignorance.
Ignorance of the reality of mortality and the absurdity of control, because I have learned another truth: that to live my life again, to put the pieces of myself back together, I must forget or at least be capable of forgetting.
To navigate being a husband and a father and a son and a brother and a friend and a person capable of earning enough money to pay a mortgage, I must find a way to ignore many of the truths I learned while staring into the abyss. Because those truths, scavenged in the pain and darkness, seem to be useless, grotesque even, when brought out into the light.
Gratitude can be a struggle.
Don't get me wrong: I am deeply grateful for the chance to live again. I don't think I could be any more grateful, although I feel like I should find a way to be. I am annoyed with myself for any thought that could seem ungrateful. My gratitude should be unqualified. But it has been a struggle.
I guess I thought I would be further along in putting myself back together, although I don't know why I believed that. Maybe I overestimated my own abilities and underestimated the scale of the undertaking. I have an extensive track record of that.
But it turns out picking up the pieces and putting yourself back together is difficult. When one day you were minding your own business and some unseen drone drops a metaphorical bomb on your house, while everyone who loves you is congregating in your living room. The earth ends up showered with the flaming remains of your house and humanity. People walking around with missing limbs, blind and disoriented, wondering what just happened.
Picking up the pieces and putting yourself back together is difficult.
Maybe I would have been further along in all of this, but another member of my family, not much older than me, well, a bomb was dropped on his house recently too. I was standing around his living room when that bomb fell, and there I was again, with everyone I knew and loved, stumbling around looking for the pieces of what it means to live amongst the wreckage of the announcement of death.
As I watched him live through the process of dying, I realized that I never allowed myself to consider this process for myself. Witnessing a family member walk this path is more painful than I expected. He's finishing the nightmare that I started.
I thought a lot about the fact of being dead. Of not being a part of the lives of my loved ones. But I did not, maybe could not, let myself project forward to the reality of dying.
Just as one can't really consider, in detail, the truth of mortality without being forced to, I did not, maybe could not, consider the process of dying. A process through which bits of myself was taken from me, one after another, and I was expected to sit there, or lie there in one of those retractable hospital beds, one that was brought into my house so I could be "more comfortable". I was supposed to take all of this thievery and horror with dignity and bravery.
I sometimes think I know life is precious, but it's not something that can be known theoretically. To understand the fragility of it, I had to accept the idea that my life will end soon. Much sooner than I had budgeted for. My brain won't allow me to consider this as some thought exercise, and I should thank my brain for this self-defense mechanism, because really knowing how fragile all of this is and accepting it can be paralysing.
And I know this because I was paralysed by this terror and I'm still paralysed by it, although some days I can move around and pretend to be like everyone else.
Maybe soon I will have more good days than bad. Maybe soon I'll have forgotten some of the things I saw down there in the darkness, some of the lessons I learned. Maybe soon I will have used enough duct tape and bailing wire to reassemble myself.
This seems impossible, but it also seems impossible that I will live to see my kids grow up and hug my wife when we're both old and grey. But I might have a shot to do just that. Sometimes now I find myself staring off into space, and I am not thinking about the darkness, but about some other insignificant piece of modern life, and it's comforting because I am not considering death and the capriciousness of life. For me, this means maybe I am making progress in putting myself back together.
I hope I can find enough of the pieces amidst all of this rubble.
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no words
17 year survivor of a stage 1.5 breast cancer ♋️
One of my good friends died of pancreatic after a terrible struggle about five years ago. He was brave, as brave as you are. But I don't think he found the peace you have, and was in more denial. I really applaud your fortitude in fighting this terrible disease. I have had about twenty people in my life die of various kinds of cancer in the last fifteen years. That's too many! It seems that cancer has replaced death from heart problems now--but maybe that's just an illusion. I really don't know. Maybe it's because we live longer and the statistics of dying at this particular age (in our late sixties and early seventies, which is where I am on the time line, tho perhaps not you), have escalated. It's all too much, whenever it comes. Thank you for this fine piece which is eloquent and fearless.