Last week I sat in the home of a very wise woman; okay so she is my therapist but I prefer to think of her as a wise sage, like Grandmother Willow in Pocahontas. This woman has seen me through a rather nasty and painful divorce and breast cancer, job loss and creating a new life…several times. She has held my hand through oodles of cases of the willies and frequent niggles of self doubt. I have grieved openly and rawly in her presence. And last week, after I informed her that in December I had crossed into year five of of breast cancer survival she said for the gazillionth time, “You know you have a book in you, it’s time.” “I can’t,” I whined, “I just don’t know how to tie all these things together in a meaningful way,” and she said, “Blog.”

Anne Lamott offers in her book Bird by Bird, that while growing up, her brother was once faced with the overwhelming task of writing an entire paper about birds. She writes, “…he was at the kitchen table close to tears, surrounded by binder paper and pencils and unopened books on birds, immobilized by the hugeness of the task ahead. Then my father sat down beside him, put his arm around my brother’s shoulder, and said, ‘Bird by bird, buddy. Just take it bird by bird.'” So, here standing bird in hand at the place where many of us are “immobilized by the hugeness of the task” that is breast cancer, I will begin this blog. Launching a bird at a time from my cupped and loving hands, setting them free to carry the lessons and hope and insights I have learned navigating breast cancer…after five years.

Let’s go back to the beginning. December 2005. Diagnosed with a pretty darn aggressive type of breast cancer which thank you very much, had been missed by doctors for months. I had chemo, big gun hair loss knock your socks off chemo for 20 weeks, and then Herceptin, the silver bullet infused for yet another 40 weeks after that (well, actually 38 cause it almost killed me.) Fifteen months of chemo, a port put in and taken out, a big chunka lumpectomy after that and then six weeks of radiation. It sucked. I’m alive…five years later.

As a psychologist who specializes in grief and trauma, I was overwhelmed with the sheer volume of losses and traumatic experiences both large and tiny that there were within cancer to grieve as a patient. A literal bombardment of losses, of emotions to sort through and to turn over and over in my hands before I could safely put them in a drawer, shut it and say. “Stay.” Being a survivor continues to carry these tasks, albeit at a slower more thoughtful rate. Survivorship from day one delivers the lessons. Lessons sometimes reluctantly emerging after a deep and long and exhausting coaxing search. Lessons simply placed on my pillow at night, like a mint from hotel service. Lessons which sprouted by doing nothing other than allowing time to quietly pass and leave as its evidence the insight that is hindsight. Lessons arriving with a friend in tow to explain it to me. And sometimes the lessons simply found me, like a toddler in a game of hide and seek suddenly peeking out at me from behind a couch gleefully announcing, “Here I am!” when I walked into the room. However found, I had indeed lived myself into the answers.

In cancer, it is hard work to identify the nebulous and mostly intangible losses that overwhelm you from the day you are diagnosed. It is a task to grieve each and every one and get to acceptance and gratitude for the experience and lesson. It is exhausting to grieve each and every day. And to do this important emotional work at times with your head in the toilet or while you’ve stopped to rest on the landing of the stairs; geez louise. Being a psychologist really made it no easier, because as I love to say, “Girlfriend, ya can’t see the picture when you’re hanging in the frame.”

The last five years have been busy busy busy emotionally for me. It’s a big job to keep the inside of my little head moving right along with my body in the healing process. It has been hard not to get stuck and harder yet to recognize the difference between being stuck and a simple comma. There is just so much of that “out of sync discomfort” when your body healing doesn’t match up with your mind healing. The doctor says, “Treatment is over get back to life,” yet I’m still sitting there immoblized in the deep paralyzing throes of angerdenialdepressionsadnessshock depending on which day you catch me and which issue is the gnawing rodent of the day. Sometimes a well meaning person would say, “You survived, you should be happy,” and not only did I not feel happy, but wanted to cry and kick them in the groin. I just didn’t feel so happy and didn’t know why. I should have been thrilled that I finally had the physical energy to get back to life, but I just did not have the emotional energy to get back to life. I didn’t have the emotional energy to feel happy yet. I hadn’t finished emotionally what my body had finished physically. The evidence said I survived but mentally I wasn’t so sure. The evidence said I was alive, but my brain felt numb.

Chemo was a piece of cake compared to the emotional journey that is cancer, compared to the grief that is cancer, compared to the trauma that is cancer, compared to the knee deep muck that is cancer.

See. I’m a gal who likes to gather experiences up in her hands and feel their heft and dimension; to stick my nose into them and breath in deeply to understand their essence. I sometimes (well ok lots of times,) can be quite annoying to those around me with this process. Just like the game of 20 questions I will persistently and sometimes with a quite frantic demand, ask and seek out more and more information about this “thing” I’m holding until I get it just right. I will shamelessly solicit people’s opinions, and will stalk and cannibalize the subject online. I will grind away at it, along with my teeth as I pretend to sleep. And like a kid asking “Why?” over and over again, I’ll annoyingly ask friends the same questions again and again, convinced that if the answer varies by even a single word it will give me more information, convinced they can see something I can’t, convinced that hearing the answer for the 20th time will make a light bulb go on in my head. During cancer I often sent out blanket emails asking what people thought about something, asking them to help me process giant issues, as no one is wise enough alone. I can be quite neurotic and obsessive about defining the intangible, wanting to see and know the invisible edges. I insist on having a yardstick to dip into the un-measurable depths of an emotional experience to size it up. Perhaps this gives me a sense of control where I had none, perhaps it helps me to talk it down to size; I prefer to think of it as know thy enemy.

Perhaps being a psychologist, it helps me to understand something intellectually before I can incorporate it emotionally. I think that’s what Freud would say.

But cancer has no edges, no identifying smell and it is indeed the deepest pool I’ve known.

Still after five years, I came away with deep insights and lessons about the emotional journey that is breast cancer, some on my own, some solely from others, and some with the whole village pecking away at it. And still it is a daily work, five years later.

In my professional work I often caution people that dealing with trauma is a lifetime process. Not that therapy takes a lifetime, but that trauma demands a grief process over and over again in our lifetimes. That is, if say you were abused as a kid, it means something different to be 7 and have been abused than it does to be 14 and have been abused, then it does when you marry and then it does when you have kids of your own. At each developmental stage (and yes we go through them till death,) there is an essential necessity to take the trauma out of its drawer, take another look at it and figure out how it fits in your life now. And to identify what you need to grieve at that moment, and grieve it. A jigsaw puzzle that is worked over and over again in our lifetime, with this essential piece being reworked into it each time. Ignore it, and you can be darn tootin’ that it will keep pestering you from that drawer, tapping you on the shoulder at night insisting, “Wake up damnit and look at me!” until you give it the respect and attention it deserves. Then and only then will it agree to be quietly slid into the drawer again till another day.

People fight this process. They will back up against the drawer, putting every piece of furniture in the house up against it to hold it shut. You don’t have to fight it. I don’t know that you have to embrace it either. You just say to it, “I see you; do we need to chat again?” Cancer likes to visit you and chat again and again, even after five years. Trauma and it’s sidekick grief, unfortunately (or fortunately depending how you come to view it) are not something you get done with and move on. They often lag behind like the annoying last guests at the party who don’t know when it’s time to leave, long after your healed body has gone back to work. Often, I hear people lament, “Ugghh! Why is this bugging me again; why can’t I move on?” and the answer is, “Well cause it supposed to, it means you are growing.” And that is a good thing. That is where the lessons and gratitude are found, again and again. That my dear, is what catapults you to the next level of play.

Cancer is big gun trauma, with a million very very complicated, overlapping and intraconnected losses to grieve. There is anticipatory grief, garden variety grief, post traumatic grief and the projected into the future grief of “what if?” Some days, especially early on in diagnosis, you come across something new to grieve while you are still working on the bomb that was dropped the previous day. It’s piled on. Grief involves a trajectory of shock, denial, anger, sadness and depression, and acceptance. What is so freaking crazy making in cancer treatment is that in one given day, you can be depressed about one loss, in denial and shock on another, and blazing hot angry about another. Some losses take some sleuthing to figure out why you feel sad, and other issues are blatantly in your face, like losing hair or a breast or two. Some losses are minuscule and others are enormous. Some are concrete yet others float around us like a thick fog blurring our vision, making us feel wet and icky. Some can be examined and grieved in a day and some take years. Some require the safety and security of five years later to have the guts to face, and some simply will emerge only after five years has passed.

With breast cancer there is grief, there is trauma and there are lessons.

After five years, I have had time to sort. After five years, a bird at a time, from my nest lined deeply with the gatherings of the last years, I will launch the lessons and insights.

After five years… I am.