Gratitude and the Unknown

Don and I are off to a 7-day silent meditation retreat near Baltimore, with Tara Brach, Jonathan Foust, James Baraz, and La Sarmiento as teachers. We’ve been to a few retreats led by Tara Brach and her colleagues before, and they are wonderful. I am so grateful to be healthy enough and to have the time and money to be able to go to it. It’s also particularly good timing, an opportunity to slow way down and reflect, and practice appreciating each moment.

Since my last post I have been occasionally remembering to practice gratitude. This morning as I was preparing some food for the trip, I was feeling the seemingly inevitable grumpiness that accompanies packing in our household. It’s hard to say “who started it,” (though I always think it’s Don), but however it starts it is hard for us not to bicker in this situation. We were doing reasonably well this morning though, and I suddenly realized that I was chopping fresh cucumbers and tomatoes from the farmers’ market, and that I enjoy that sort of task, and reminded myself to feel grateful for it. It was an instant mood-shifter.

I have also felt gratitude, over the past week, for good friends near and far, who have spent time with me walking and talking (and bird- and crane-watching) and supporting my research and decision-making process, or sent fabulously thoughtful gifts and warm wishes, or phoned me or sent me poems or posted on my blog with news from afar. I am grateful for family, who have helped me do research on medical options, listened to me as I processed the information, distracted me with their news and activities, and (in some cases) delightfully trivial requests.

I am grateful for colleagues, who remind me of the value of my work in the world, and who provide stimulating companionship in the process. Tabling for CORE at Madison Nonprofit Day earlier this week, I was grateful to be healthy enough to attend, and for the reminders and stories of how our work is making a difference. (I also got to attend a mini-workshop with Mike Rohde on “Sketchnotes,” a visual note-taking method slightly different from the visual recording and graphic facilitation methods I’ve studied before at The Grove. I enjoyed it and learned a few good tricks). I am also grateful for neighbors who watch over our house while we are away, and for its beauty, shelter, and safety when we are home.

I have also been noticing my appreciation for the scientific process, which leads to better and better treatment for cancer and other diseases. I realized this during meditation one day this week, in the midst of trying to process the various treatment possibilities. I found a part of me that would like to enter the clinical trial in order to help others, even if it doesn’t end up helping me (and I would realistically probably never know whether or not it did help me). For the first time I began to contemplate saying yes to it for this reason. Not out of a desperate hope it will reduce my chances of relapse, but because I do, when it comes down to it, believe in science. Now, science isn’t the only thing I believe in, and I don’t believe in it blindly (having studied sociological and feminist critiques of it years ago). But I do believe that rigorous attention to what we know, how sure we are, and why, is important and powerful.

That belief is also why I am, reluctantly, letting go of the idea of pursuing genetic testing and genomically-directed treatment of my tumors independent of a clinical trial. The heroic, cowboy, go-it-alone idea of using private companies to replicate the tests described in the medical literature and then getting my doctor to prescribe the chemo that’s being tested non-randomly had an appeal to me for a while, and far from going it alone, I had significant amounts of help from very smart members of my family in researching these kinds of options. (I mentioned my sister-in-law the professor of medicine; for this project my Nobel Prize-winning brother-in-law also weighed in. Yes, my siblings have married well; smart, accomplished, and also kind people!) However, we are coming to the conclusion, I think, that not enough is known – by anyone, not just by me & mine – to do that well. A doctor whom we consulted with at MD Anderson in Houston, one of the “biggest” names in treatment of TNBC, told my oncologist that “It is too early in my opinion to be assigning treatment based on…TNBC [genetic] signatures.” Science, like most other human endeavors, is a collective enterprise, and I just have to accept that we are where we are with it.

My mastectomy mantra, “I am sacrificing my breasts for the sake of my life, and I surrender to the unknowable,” comes back to mind. Surrendering to the unknowable – or at least, to what is not yet known – is part of my current practice, I guess. We don’t know whether any cancer cells escaped my breasts before the treatment and surgery; we don’t know whether I will develop metastatic disease; and we don’t know whether there will be significant advances in treatment of metastatic TNBC by the time that happens, if it does. Of course, none of us knows how and when we will die. So, all the more reason to practice gratitude for as many of our moments as possible. I am grateful to have you all accompanying me in this dance.