This Week

Today is not my ninth wedding anniversary, and I've been thinking about cancer.

Cancer is so hard to treat because it is fundamentally an excess of healthy cell processes: growth, replication, angiogenesis (blood vessel formation), and migration from one tissue to another. One genetic gas pedal may get stuck in the ON position while another genetic brake line gets cut while still another genetic gateway gets disabled, all accelerating the cancer cell's growth out of control.

The dynamics that ultimately ended my marriage came not from outside forces but from overexpression and underregulation of normal human needs.

Desire for connection became desperate, clinging anxiety about the relationship.

My instinct to help became overfunctioning, which enabled underfunctioning in the rest of the family, which led to more overfunctioning in an endless loop, and eventually, resentment.

A heightened sensitivity to others' needs became a numbing of my own wishes.

Making space for others became making myself smaller, until I realized I could never be small enough to stay married to this person.

There is nothing wrong with my wish for connection and to see those around me happy and healthy. In fact, I love these things about myself, which I have intentionally cultivated despite opposition throughout my life.

But there can be too much of a good thing, and my job now is to relearn--or maybe just learn--to regulate better. (Especially now that I'm no longer in a relationship that constantly triggers my least effective coping mechanisms.)

To kill cancer, you must attack the very basic processes of life. Early surgeons cut out tumors, then the nearest lymph nodes, then more and more of the surrounding tissue, trying to cleanse patients of cancer. The first chemotherapy drugs pushed patients within a millimeter of their lives, in hopes of eradicating the malignancy while leaving just enough healthy survivors to repopulate, an internal Noah and the flood, as it were.

And sometimes, cancers of the blood or bone marrow can prove so treatment-resistant that doctors must leave no survivors at all. In a process called conditioning, chemotherapy, monoclonal antibodies, or radiation scorch the bones to make room for new stem cells. (To make this metaphor even better, sometimes patients can do an autologous transplant, which means they get transplanted with their own stem cells collected before conditioning.)

After the transplant, the stem cells must go through something called engraftment. This is when the cells multiply, filling the space hollowed out by conditioning, hoping the body won't reject the transplant. And then, after blood counts plummet to zero and all seems lost, new healthy cells emerge.

This last year of my life has been a emotional and spiritual oncology ward. At this point, I am in a stage that could be called minimal residual disease (MRD) positive. I've cut out the main mass of overfunctioning and undervaluing myself, and done my best to infuse my life with my values and new skills of distress tolerance and effective communication, but rogue snippets still turn up on more sensitive tests. So I'm mostly fine with day-to-day school and parenting and friendships, but send me out on a date and there's still a chance for relapse lol.

The term "curing cancer" implies that it's gone forever, and that is certainly the hope in medicine. But while the parts of me I love most may also be the most harmful when dysregulated, I wouldn't wish them away. I'll just have to keep living with that risk.

What I'm Reading

​Let's be friends on Storygraph, the non-Amazon version of Goodreads that comes WITH CHARTS ABOUT BOOKS!

I'm sure it will surprise you zero percent that I recently finished The Emperor of All Maladies, Siddhartha Mukherjee's very readable "biography of cancer." You don't have to be a scientist to understand or enjoy it!

I whizzed through The Marvelous Mirza Girls by Sheba Karim and neither liked nor disliked it. It was another YA where the stakes just seemed too low for me to care but the writing and characters were okay enough for me to not stop reading.

I am now reading Remarkable Creatures by Sean Carroll which is a history of the theory of evolution. (This is the most extensive nonfiction kick I've been on in...possibly decades.)

Acknowledgements

I'm drafting the acknowledgements section of my book little by little every week.

Thank you to past and present me. You're doing great.