So much of what I feel as a cancer survivor comes from the feedback I receive from others. Positive, complimentary, flattering characterizations are crucial to my optimistic outlook. Negative descriptions, reactions, etc., are not. Not to discount honesty, but the emotional divide on which a cancer patient’s self-assessment/attitude teeters is delicate indeed and honesty is sometimes (I said "sometimes") not the best policy. If I’m in the right mood, negativity can be deflected, absorbed even; not a problem. If I’m in the wrong mood, however, the negative can push me into a black hole of emotional despair. Regardless of whether the comment/observation is well-intended, accurate or even prudent under the circumstances, its effect can be deeply felt. Getting back to normal is not impossible and mostly within my control, but if it’s all the same to you, I’d rather not have to claw my way out.

In most instances, this kind of cancer-patient feedback is harmless and fairly random; it happens when you least expect it and you’re either up to the emotional punch or not. It’s not as if you can prepare or study for it. It’s certainly not a test; it’s a reality. And there’s really no way to know from whom and from where or even when the comments will come. It’s not exactly hit or miss. It’s more like you wouldn’t miss not getting hit – figuratively speaking, of course. Nevertheless, it is part of the survival process, and the longer you survive, the greater the potential for unintended consequences.

Having experienced a wide range of such innocent commentary over my nearly five years since being diagnosed, there are a few steps I have taken to over-compensate in advance to prevent the inevitably negative consequences: I try to act as positive as possible. Make jokes. Stay strong (after all, I am from Boston). Sound body and mind, so the comments will be positively reinforcing as to how well I look, sound, seem, etc. This tends to elicit the desired positive response. And when the desired response (dare I say, manipulated) is offered, I embrace it with sincere appreciation. You see, the fewer times I have to explain my deficiencies, the fewer times I am likely to invoke the c-word. And the fewer times I hear the c-word come out of my mouth relating to me, the more often I can believe that my cancer is somehow inactive. (Delusions of my life being grander you might say.) And the longer I can think my cancer is inactive, the more normal I think my life will be. Granted, this is all mental gymnastics, but as a terminal patient – with an abbreviated life expectancy, if I don’t find a way to make light of the incredibly heavy burden I am carrying, the weight of it is likely – if the anecdotal evidence is to be trusted, to exacerbate an already unpleasant set of medical facts.

Not to deny my reality – too much, but there’s enough of it present in my life already that I can’t ignore that (A) I don’t need any more of it inadvertently or otherwise and (B) minimizing what there already is of it, however foolish or unrealistic, contributes to a life worth living. However unintentionally – physically and/or emotionally – a cancer diagnosis/terminal prognosis can suck the life right out of you. Finding a way to fight back – on your own terms, has been the operandi of my modus. So far, so good. Besides, it’s too late to change now.