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"Fighting" Cancer

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I've worked on a Medical-Oncology floor for 9 months now...long enough to have developed a very deep and sincere pet peeve. To me, it is worse than nails on a chalkboard, squeaky glass, or the voice of Gilbert Gottfried...

I cannot stand to hear someone utter the words "fighting cancer."

I know that this may sound calloused, but really, I hope I am speaking out of a true heart of compassion. Compassion not just for those who are suffering and struggling through the disease, but for the memory of those who were lost to it.

Cancer is not a game, a contest, a marathon, or even a physical opponent. You cannot ball up your fist and knock it out, you cannot will it away, or will yourself into remission. It strikes some who haven't touched a drop of alcohol, smoked a single cigarette, and who religiously used sunblock. It passes over some who have lived lives of drunken debauchery, surrounded by the haze of tobacco smoke. Sometimes, the dirt poor on welfare stand no greater chance of survival or demise than those who can afford all forms of chemotherapy, surgical excision, and radiation therapy. In the end, there is only one of two outcomes left: survival or death.

To have survived cancer, to me, is not to have fought hard and beat out some insurmountable obstacle. Please don't misunderstand me, I am not belittling those who have struggled through and survived cancer. I can only barely begin to empathize with those who make the decision to allow cytotoxic chemicals to course through their veins, so caustic that they have to be infused through a very large blood vessel, very close to the heart. I cannot begin to imagine the horror of not being able to recognize your own reflection in the mirror as the flesh melts away and the hair falls out...sunken eyes and hollow cheeks staring back at you. Cancer is not a pretty disease. It is horrific. It is the betrayal of the vessel against the spirit that inhabits it. Not some foreign invader, such as a virus, parasite, or bacteria, but a "friendly" gone bad...your own cells, turned rogue, proliferating rampantly throughout your body. The thought is enough to keep one awake at night...and it does.

I have rejoiced with patients who have heard the word "remission," and wept with those who have received terminal diagnoses at 31. It is for those who have been lost, and their grieving families that I must object to the terminology. You see, to say one is "fighting cancer" implies that when the fight is over, the dust has settled, and the victor is the Reaper, the victim has lost. As if there was a failure on the part of the deceased to fight hard enough. They just didn't want to live badly enough. Weren't tough enough. Didn't have the will to live.

I will never forget coming to work one day and not seeing that name on the assignment board. It had been erased. The family was gone, the room was emptied. The sheets were pulled back from the bed as if she had just gotten up to go to the bathroom...but she wasn't going to return this time. It had just been two days before that we had been together. She hugged me as she told me that I was one of her favorite nurses. She smiled at me, weakly, as I performed my duties: assessments, draining collection bottles, administering pain medication...we chatted about kids, moms, life. And two days later, she was gone.

About a week afterward, I saw her passing through the hall as I was charting at the nurses station. Glancing up from the computer, my face broke into a smile as I prepared to warmly and cheerfully wish her a good morning. In the same moment, my heart sank as I realized my mistake. A coworker from another department, who bore her a very uncanny resemblance, was just passing through. I felt grief flooding into every part of my being all over again, as fresh as the morning when we all learned that she was gone. When I think of her, I remember her bravery. She was courageous not because she received treatment for cancer. Not because she decided to try to live rather than seek hospice. She was courageous for opening her eyes in the morning. For breathing. For smiling. For planning the future of her daughter when she knew she wouldn't see the day that she would start school, learn to drive, get married, or cradle her first child. She did not lose a fight. Cancer did not beat her. She did not fail at wanting to live badly enough. She succeeded at leaving an impression. On her family, friends, daughter, and all of the nurses who took care of her.

You can't fight death anymore than you can will yourself to be born. Death happens, whether we are ready or not, deserving, or saintly. It is hard to understand sometimes, but I accept it. Not one moment of preparation, worry, or "willpower" can ward it off if it is your time. Or my time. For me, I will always turn to the Bible for my source of hope, wisdom, and understanding:

"This is why I tell you: Don't worry about your life, what you will eat or what you will drink; or about your body, what you will wear. Isn't life more than food and the body more than clothing? Look at the birds of the sky: they don't sow or reap or gather into barns, yet your heavenly Father feeds them. Aren't you worth more than they? Can any of you add a single cubit to his height by worrying? And why do you worry about clothes? Learn how the wildflowers of the field grow: they don't labor or spin thread. Yet I tell you that not even Solomon in all his splendor was adorned like one of these! If that's how God clothes the grass of the field, which is here today and thrown into the furnace tomorrow, won't He do much more for you--you of little faith? So don't worry, saying, 'What will we eat?' or 'What will we drink?' or 'What will we wear?' For the idolaters eagerly seek all these things, and your heavenly Father knows that you need them. But seek first the kingdom of God and His righteousness, and all these things will be provided for you. Therefore don't worry about tomorrow, because tomorrow will worry about itself. Each day has enough trouble of its own."

Matthew 6:25-34

~ Jess :twocents: :smokin:

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Jess, you cannot let your own grief and struggle with the horrors of cancer to cloud your perception of what cancer victims are experiencing.

As a cancer survivor I can tell you that much of the experience is like a battle. We fight to remain positive even when we feel like crap. We fight to have the energy to go to our 8 year olds birthday party, to go to the high school play for our daughters, and to give our parents, siblings, spouses hope when we feel that our only hope may be for the healing power of heaven. We fight the nausea and the pain and the sleeplessness. We fight the depression and the fear.

And many of us survive...not enough, but many.

As for winning...it would be unfair to narrow the success to only survival...there is the concept of fighting for a normalized, fulfilled life while dealing with cancer. Thus, there will be winners of that fight even though they do not survive the disease.

Good luck.

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I've worked on a Medical-Oncology floor for 9 months now...long enough to have developed a very deep and sincere pet peeve. To me, it is worse than nails on a chalkboard, squeaky glass, or the voice of Gilbert Gottfried...

I cannot stand to hear someone utter the words "fighting cancer."

I know that this may sound calloused, but really, I hope I am speaking out of a true heart of compassion. Compassion not just for those who are suffering and struggling through the disease, but for the memory of those who were lost to it.

Cancer is not a game, a contest, a marathon, or even a physical opponent. You cannot ball up your fist and knock it out, you cannot will it away, or will yourself into remission. It strikes some who haven't touched a drop of alcohol, smoked a single cigarette, and who religiously used sunblock. It passes over some who have lived lives of drunken debauchery, surrounded by the haze of tobacco smoke. Sometimes, the dirt poor on welfare stand no greater chance of survival or demise than those who can afford all forms of chemotherapy, surgical excision, and radiation therapy. In the end, there is only one of two outcomes left: survival or death.

To have survived cancer, to me, is not to have fought hard and beat out some insurmountable obstacle. Please don't misunderstand me, I am not belittling those who have struggled through and survived cancer. I can only barely begin to empathize with those who make the decision to allow cytotoxic chemicals to course through their veins, so caustic that they have to be infused through a very large blood vessel, very close to the heart. I cannot begin to imagine the horror of not being able to recognize your own reflection in the mirror as the flesh melts away and the hair falls out...sunken eyes and hollow cheeks staring back at you. Cancer is not a pretty disease. It is horrific. It is the betrayal of the vessel against the spirit that inhabits it. Not some foreign invader, such as a virus, parasite, or bacteria, but a "friendly" gone bad...your own cells, turned rogue, proliferating rampantly throughout your body. The thought is enough to keep one awake at night...and it does.

I have rejoiced with patients who have heard the word "remission," and wept with those who have received terminal diagnoses at 31. It is for those who have been lost, and their grieving families that I must object to the terminology. You see, to say one is "fighting cancer" implies that when the fight is over, the dust has settled, and the victor is the Reaper, the victim has lost. As if there was a failure on the part of the deceased to fight hard enough. They just didn't want to live badly enough. Weren't tough enough. Didn't have the will to live.

I will never forget coming to work one day and not seeing that name on the assignment board. It had been erased. The family was gone, the room was emptied. The sheets were pulled back from the bed as if she had just gotten up to go to the bathroom...but she wasn't going to return this time. It had just been two days before that we had been together. She hugged me as she told me that I was one of her favorite nurses. She smiled at me, weakly, as I performed my duties: assessments, draining collection bottles, administering pain medication...we chatted about kids, moms, life. And two days later, she was gone.

About a week afterward, I saw her passing through the hall as I was charting at the nurses station. Glancing up from the computer, my face broke into a smile as I prepared to warmly and cheerfully wish her a good morning. In the same moment, my heart sank as I realized my mistake. A coworker from another department, who bore her a very uncanny resemblance, was just passing through. I felt grief flooding into every part of my being all over again, as fresh as the morning when we all learned that she was gone. When I think of her, I remember her bravery. She was courageous not because she received treatment for cancer. Not because she decided to try to live rather than seek hospice. She was courageous for opening her eyes in the morning. For breathing. For smiling. For planning the future of her daughter when she knew she wouldn't see the day that she would start school, learn to drive, get married, or cradle her first child. She did not lose a fight. Cancer did not beat her. She did not fail at wanting to live badly enough. She succeeded at leaving an impression. On her family, friends, daughter, and all of the nurses who took care of her.

You can't fight death anymore than you can will yourself to be born. Death happens, whether we are ready or not, deserving, or saintly. It is hard to understand sometimes, but I accept it. Not one moment of preparation, worry, or "willpower" can ward it off if it is your time. Or my time. For me, I will always turn to the Bible for my source of hope, wisdom, and understanding:

"This is why I tell you: Don't worry about your life, what you will eat or what you will drink; or about your body, what you will wear. Isn't life more than food and the body more than clothing? Look at the birds of the sky: they don't sow or reap or gather into barns, yet your heavenly Father feeds them. Aren't you worth more than they? Can any of you add a single cubit to his height by worrying? And why do you worry about clothes? Learn how the wildflowers of the field grow: they don't labor or spin thread. Yet I tell you that not even Solomon in all his splendor was adorned like one of these! If that's how God clothes the grass of the field, which is here today and thrown into the furnace tomorrow, won't He do much more for you--you of little faith? So don't worry, saying, 'What will we eat?' or 'What will we drink?' or 'What will we wear?' For the idolaters eagerly seek all these things, and your heavenly Father knows that you need them. But seek first the kingdom of God and His righteousness, and all these things will be provided for you. Therefore don't worry about tomorrow, because tomorrow will worry about itself. Each day has enough trouble of its own."

Matthew 6:25-34

~ Jess :twocents: :smokin:

It seems oncology was not the specialty for you.I hopw you find the one that you're meant for. Although going back and reading what you have written perhaps the health care profession is not for you. People come to, and are admitted to the hospital for medical or surgical treatment. if someone comes in for trauma following a car accident do you let them bleed out because the accident was God's will, and therefore the ER should take a wait and see approach? Do you withold albuterol to a child having an asthmatic attack with the belief that this too shall pass if God deems it so? I guess I'm more of a" God helps those that help themselves" kind of gal. Oncology happens to be my speciality... and although you disagree I do believe the patients fight.. tooth and nail sometimes and with grace and dignity all the time. Yes, it's ultimately in the Lords hands, but the Lord also gave humans the intelligence to find new medicines and treatments to help His children. Cancer patients have taught me more than I could ever dream of teaching them. They teach me to live everyday, to not complain about silly things, to forgive, to love, to laugh..to stop rushing around for a minute and look at the beautiful cherry trees blooming outside. I am humbled by their courage. I am honored to be their nurse. And yes we pray...there are no atheists on an oncology unit. Fighting cancer is a battle every step of the way. If you're a patient you come out the other side weary, wiser and thanking God every day for his mercy and many blessings. As a nurse I see miracles happen all the time. What was once considered impossible, now is not only possible, but is thought of as the expected outcome. If you actually worked on an oncology unit you would have witnessed the war that is waged on cancer. The fight, the spirit and the sheer mind over matter attitude that cancer patients exhibit during a traumatic time in their life is to be applauded. Your lack of empathy and compassion sad. Your underestimation of the human spirit is even sadder...but to think especially as a nurse that every patient does not deserve the right to make their own health care choices is wrong. The young woman you spoke of made her own decision not to under go treatment. That was her choice. We are here to give people all the information we can so they can make the best choice for themselves...and to always act in a respectful way. Shame on you for passing judgement on other peoples personal healthcare choices. I advise you find a therapist to help you get through your anger and resentment issues.

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Firstly, I am surprised that you do not understand the tone of my posting. There is no anger, no resentment, no lack of empathy, and I am currently in the running for a hospital-wide compassion award. As I said, that was my $0.02. You don't have to agree. It was not written for those who are living and "fighting," if you will, but in memory of those who have died. In fact, I am currently preparing to go to a memorial service for a patient who recently succumbed to lung cancer to not only remember her, as I worked for her for many years, but to love and support her family. Her husband, also a patient at my hospital, is being released to attend and affectionately refers to me as "his girl."

Perhaps you should go back and reread. Not once did I mention withholding treatment, merely the fact (and it is a FACT) that treatment works for some and not others and there is nothing we, as nurses, can do about it except pray for our patients.

Yes, some patients do exhibit AMAZING strength and grace in the face of a possibly terminal disease. Many others, like the patient I had just the other day, are angry and seem to lack the will to cooperate on any level. I'm not disbelieving those who think they can "fight it," I'm being compassionate towards those who can't. I'm realistic, not and idealist, which can hurt someone very badly. Tell me, which nurse would you prefer, the one who tells you that you can do it, you can fight it, you have the mental ability to overcome what is ravaging your body, while you are rapidly wasting away with pancreatic cancer or the nurse who holds your hand while you receive a terminal diagnosis and asks you how we can do everything you want and need in the days that remain? Be realistic, don't give false hope.

And don't criticize someone you don't know. If you are a child of God, as you claim to be (and not all patients are, dear, if you were a real Christian you would know that...) then perhaps you would be a little bit more hesitant to tell someone else that you have never met what there calling is or isn't. I respect your right to have an opinion, as I shared mine, but not the personal attack. You can keep that.

READ IT AGAIN PEOPLE, it's a memorial to those who have PASSED!!!! Geez...nevermind...

:mad:

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It seems oncology was not the specialty for you.I hopw you find the one that you're meant for. Although going back and reading what you have written perhaps the health care profession is not for you. People come to, and are admitted to the hospital for medical or surgical treatment. if someone comes in for trauma following a car accident do you let them bleed out because the accident was God's will, and therefore the ER should take a wait and see approach? Do you withold albuterol to a child having an asthmatic attack with the belief that this too shall pass if God deems it so? I guess I'm more of a" God helps those that help themselves" kind of gal. Oncology happens to be my speciality... and although you disagree I do believe the patients fight.. tooth and nail sometimes and with grace and dignity all the time. Yes, it's ultimately in the Lords hands, but the Lord also gave humans the intelligence to find new medicines and treatments to help His children. Cancer patients have taught me more than I could ever dream of teaching them. They teach me to live everyday, to not complain about silly things, to forgive, to love, to laugh..to stop rushing around for a minute and look at the beautiful cherry trees blooming outside. I am humbled by their courage. I am honored to be their nurse. And yes we pray...there are no atheists on an oncology unit. Fighting cancer is a battle every step of the way. If you're a patient you come out the other side weary, wiser and thanking God every day for his mercy and many blessings. As a nurse I see miracles happen all the time. What was once considered impossible, now is not only possible, but is thought of as the expected outcome. If you actually worked on an oncology unit you would have witnessed the war that is waged on cancer. The fight, the spirit and the sheer mind over matter attitude that cancer patients exhibit during a traumatic time in their life is to be applauded. Your lack of empathy and compassion sad. Your underestimation of the human spirit is even sadder...but to think especially as a nurse that every patient does not deserve the right to make their own health care choices is wrong. The young woman you spoke of made her own decision not to under go treatment. That was her choice. We are here to give people all the information we can so they can make the best choice for themselves...and to always act in a respectful way. Shame on you for passing judgement on other peoples personal healthcare choices. I advise you find a therapist to help you get through your anger and resentment issues.

Wow, I'm sorry, but I don't think you understood the OP's original post AT ALL.

OP - I can see the compassion behind your post and if I were a cancer pt with no hope of recovery I would want someone such as you at my bedside. Perhaps it's because I lost my own mother to cancer, but I can clearly see how your post was meant to honor those who have passed on.

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A dear friend just died recently from a year 10 year breast cancer "battle".

All I can tell you is that any when she was going through her illness and even when she knew she was losing the battle she very much needed and embraced the "battle" terminology to give both her and her family strength and hope and a feeling that they had some control.

It was not about whether they had any control in reality, but the need mentally to feel that they did.

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i cannot stand to hear someone utter the words "fighting cancer."

perhaps the way you opened your comments was part of the misunderstanding. you don't see it as a fight ("cancer is not a game, a contest, a marathon, or even a physical opponent. you cannot ball up your fist and knock it out, you cannot will it away, or will yourself into remission.") but many of us do see and experience it as a fight. it does seem to be a marathon at times and, although cancer itself is decidely not a game, the victims of cancer are often victims of chance which is an element of games.

yes, some patients do exhibit amazing strength and grace in the face of a possibly terminal disease.

i know that this amazing strength and grace is often the fruit of a significant struggle or contest.

she did not lose a fight. cancer did not beat her. she did not fail at wanting to live badly enough.

so, for the cancer victim...yes the cancer beat her and she did lose that fight. that was what my 38 year old friend told me (in so many words) when she was planning her funeral and trying make arrangements for the futures of her 10 and 13 yr old children. i sat with her as a breast cancer survivor (age 38) and she sat with me as a young woman dying from the same disease. the fights that she didn't lose were perhaps less obvious...the fight to keep positive for her children, to make those recordings for her daughter's graduation and wedding days, to support her husband and mother as they considered how they would ever continue without her.

you see this as well...the legacy, the "impression" that we leave behind which you mentioned. i would encourage you to consider that it is not always easy to leave that positive impression when faced with your own mortality. my friend saw this as a battle and she was magnificent in her warfare...courageous, strong, unwilling to give up, inspite of the odds and opponents. her children benefit today from her fight on that field those years back.

even paul equated the struggles of a faithful christian life to a "fight" and spoke of a "crown of victory".

as for who do i want at my bedside when i am dying...i want the nurse who understands my goals, who is interested in what i need to be comfortable on a physical, emotional, and spiritual level. i want the nurse who allows me to fight or to faint according to my needs. the nurse who on tuesday can be my cheerleader in the game and on wednesday can hold my hand while i cry...then back to the battlefield on thursday. i do not want the nurse who cannot see that cancer is not one battle or fight...it is many and not all of them are lost when and because the patient dies.

i do not doubt that you have compassion for your patients. please be careful with your difficulty with the concept of "fighting cancer"...your patients and families may very well not understand your dislike of that phrase and, frankly, they shouldn't have to.

ps...i am surprised by carrid's comment that "there are no atheists on an oncology unit"...cuz there are plenty in hospice...atheists die from cancer just like muslims, jews, and pagans.

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Jess (and everyone else)---

I appreciate your beautiful words and totally agree...I cried while reading it. Thank you for saying it like it is.

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It seems oncology was not the specialty for you.I hopw you find the one that you're meant for. Although going back and reading what you have written perhaps the health care profession is not for you. People come to, and are admitted to the hospital for medical or surgical treatment. if someone comes in for trauma following a car accident do you let them bleed out because the accident was God's will, and therefore the ER should take a wait and see approach? Do you withold albuterol to a child having an asthmatic attack with the belief that this too shall pass if God deems it so? I guess I'm more of a" God helps those that help themselves" kind of gal. Oncology happens to be my speciality... and although you disagree I do believe the patients fight.. tooth and nail sometimes and with grace and dignity all the time. Yes, it's ultimately in the Lords hands, but the Lord also gave humans the intelligence to find new medicines and treatments to help His children. Cancer patients have taught me more than I could ever dream of teaching them. They teach me to live everyday, to not complain about silly things, to forgive, to love, to laugh..to stop rushing around for a minute and look at the beautiful cherry trees blooming outside. I am humbled by their courage. I am honored to be their nurse. And yes we pray...there are no atheists on an oncology unit. Fighting cancer is a battle every step of the way. If you're a patient you come out the other side weary, wiser and thanking God every day for his mercy and many blessings. As a nurse I see miracles happen all the time. What was once considered impossible, now is not only possible, but is thought of as the expected outcome. If you actually worked on an oncology unit you would have witnessed the war that is waged on cancer. The fight, the spirit and the sheer mind over matter attitude that cancer patients exhibit during a traumatic time in their life is to be applauded. Your lack of empathy and compassion sad. Your underestimation of the human spirit is even sadder...but to think especially as a nurse that every patient does not deserve the right to make their own health care choices is wrong. The young woman you spoke of made her own decision not to under go treatment. That was her choice. We are here to give people all the information we can so they can make the best choice for themselves...and to always act in a respectful way. Shame on you for passing judgement on other peoples personal healthcare choices. I advise you find a therapist to help you get through your anger and resentment issues.

I think this is is just a typical rouse from Christian nurses. You can see that OP said she personally looked at the Bible for wisdom. It was so personal that she bolded that verse. The implication is right there: the rest of us, patients and nurses, need to seek Yahweh for guidance.

Maybe my aunt's late husband died in vain. He had pancreatic cancer. In his last moment, he experienced no pain and gave his family a good smile before he released his last breath. Guess what. He was a Buddhist, not a Christian.

You are absolutely correct. The OP should not work in oncology.

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I just wanted to add that from my experience in hematology, our patients fighting Leukemia, Lymphoma, and Multiple Myloma all fight for various reasons. Some are fighting to get into remission so they can have a bone marrow transplant. Some have highly treatable disease and are fighting for a cure. Some are enrolling in clinical trials, and fighting for new knowledge and treatments. Some are fighting to see their grandchild graduate from high school, or their daughter get married, or some other significant milestone. Often the battle lines change during treatment, but very rarely is the goal a black or white live/die.Atul Gawande touches on how our goals and horizons change in old age and with serious illness in his excellent book Being Mortal: Medicine and What Matters in the End by Atul Gawande.

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