The Man Who Would Be Healed
"How much more of this do you think I can stand?" the patient demanded. He slumped in his chair, and his face darkened. "Six months ago all I could think about was staying alive. I listened to anyone who held out hope for a cure. They're all scared to come out and use the word 'cure/ of course, but I've been promised every kind of rose garden you can grow. It all sounds pretty funny now, doesn't it?"
"No," I said quietly, "I know how hard you have worked to get well." I put my hand on his shoulder, but the man stiffened and drew back. "Let's drop it," he muttered. "Only a fool would keep on like this."
"A condition like yours is going to have its ups and downs. That's only to be expected," I said gingerly, "but instead of being so disappointed about your white counts - "
"No," he interrupted bitterly, "no more white counts. I don't want that anymore."
"What do you want?" I asked.
"A way out."
"Believe me, if I knew that - " There was a long, tense silence. The man kept staring at the floor, his face set in a hard mask. We both waited to hear what I would say next.
My patient's name was Robert Amis. He was thirty-seven and had worked for a small computer firm on the outskirts of Boston. A year earlier his company had urged all employees to undergo a complete blood screening as part of a stepped-up emphasis on health. Robert complied without qualms. He was surprised when the test results came back showing a suspicious rise in his white blood cell count. Follow-up tests were run, and a few weeks later an oncologist somberly informed him that he had an incurable form of leukemia. Robert was deeply shaken. The average life expectancy for his particular disorder, called chronic myelocytic leukemia, or CML, was uncertain, but it could be as short as two to four years. With so little time left, he knew he had to act.
"The minute I left the doctor's office, it was as if a switch clicked," he told me at our first meeting. "I knew that my priorities had to change." He proposed to his live-in girlfriend and very quickly got married. Next he gave up his job in Boston and bought a condo in Miami. But the main thing that happened was that Robert threw himself with abandon into the project of curing himself. "I kept reading that there's an inner healer," he said, "and I was determined to find it."
He discovered no lack of channels for reaching his goal: self-hypnosis, visualization, psychotherapy, deep massage, and progressive relaxation were just the beginning. He started attending support group meetings with other leukemia patients and weekend seminars on self-healing, at which he heard inspiring stories from patients who had recovered from incurable illnesses. When I met him, he brandished the latest in a series of audiotapes he mailed out every month to update friends and family on developments in his life - meaning his disease, for that had become so nearly all-consuming that there was very little of Robert's life outside it.
After six months, when he was at the height of his new existence, Robert felt more emotionally secure than he ever had. He confidently went in for his next blood test, only to find that, far from coming under control, his white cell count had skyrocketed. His disorder seemed to be accelerating dangerously, and his oncologist took a stern tone, advising him either to start intensive chemotherapy or to take the more drastic step of having a bone marrow transplant. Neither course of action was likely to lead to a permanent cure, but conventional medicine had little else to offer.
Robert tried to remain resolute and refused both options. Soon afterward, however, he began to tailspin into a deep depression. He lost his appetite and found it increasingly difficult to sleep. By the time he was referred to me, he was bitter, lonely, and all but cut off from other people by his desperation.
He sat slumped in his chair in front of me, and I pondered what to tell him. Although everything he had pursued was "right" - his search for an inner healer, his attempt to break old, unfulfilling habits, his decision to avoid stressful situations - he had not really changed himself in any profound way.
"Let me make clear that what I want isn't for you to 'think' yourself into getting well," I said. "It's not a question of hoping hard enough that this disease will go away - every patient in your position desperately wants to get better. Why do some people have it happen?"
He shrugged his shoulders. "A stronger body, good genes, luck. Maybe God loves them more than other people."
"I'm not discounting any of these factors, and we can go into them one by one. But what I hear you asking for," I said, "is not just a cure but a reason why this has happened to you." Robert's expression remained frozen, but his eyes seemed to soften a little. I continued, "It would be easy for me to claim that your sickness is meaningless, that it is just the result of some random disruption in your body. That is more or less what medical training drums into us.
"It would also be easy to tell you exactly the opposite, that your disease has a simplistic emotional cause, that you don't love yourself enough or that some form of repressed psychic pain is making you sick. But that, too, is a half-truth. Both are prepackaged answers."
"What else is there?" he asked bitterly. In that question, which hung in the air between us with so much reproach and hopelessness, we both came to a turning point. He was at the limit of what he could ask for. I was at the limit of what medicine said I could offer. Yet it was absolutely clear, in human rather than medical terms, what was being demanded. The old questions - "What does life mean? Why can't I have what I want?" - had come back up to the surface of Robert's mind, triggered by the crisis of his disease.
A Cry for Meaning
Over the past ten or twenty years, medicine has had to open itself to issues that it never felt comfortable facing in the past. Patients want to know why they hurt, which is certainly not new, but as they aim the question, its deeper implications refuse to remain buried. They are not content just to be told why the stomach, the intestines, or the breast hurts. "Why do / hurt?" is their dilemma, and even after you salve the ulcer, unblock the intestine, or cut out the breast tumor, the patient returns with trouble in his eyes.
Pushed to the edge of my so-called expertise, I have thought about this hurt and tried to observe as closely as possible the people who are honest enough to confront me with it. I have made some surprising discoveries. There seems to be a hole in the middle of everyday life, as if a rock had been thrown through a plate-glass window. But instead of being a physical hole, one could call this a "meaning hole," an absence that cannot be defined except to say that it hurts. Even if they cannot analyze the effect that lack of meaning is having on their lives, people feel it, and as a result a sick sadness hangs over things, even the best things. How many people experience love, freedom, faith, or devotion as deeply as they really want to? How many cannot feel these things at all and are left with guilt and blame instead?
On the surface, all my patients are seeking help because they are ill, sometimes gravely ill. But what often shocks me is that many seem, in some barely concealed way, relieved. In the midst of all his struggle, Robert showed an undercurrent of this feeling. He hated his disease, but it had also opened up opportunities denied to him by ordinary life. "I didn't believe in God until I got this cancer," one woman in her sixties said, "but now He feels very close." I cannot judge her experience; certainly I am glad that she has found solace near the end of her life rather than being shattered by bitterness. But her words also seem to say, "My life didn't mean much until I was forced out of it."
One of the strangest phenomena of postmodern culture is this optimism over death: doctors and therapists are urging us to make death, not just a positive experience, but the positive experience of a lifetime. Sickness has always had an element of escapism in it. As children we were coddled by our mothers whenever, we ran a fever, and seriously ill adults are still given "intensive care." But if a terminal illness is seen as escapism carried to its ultimate, one cannot help but ask, "Is this life so terrible that escape is its greatest reward?" A patient of mine with multiple metastatic colon cancer attended a seminar on "the will to live," which is said to help people recover from incurable illness. She opened her program book and was horrified to see that the main sponsors for the event were six funeral homes. No one else seemed to notice, or at least comment upon, this savage irony.
I do not want to parody this issue, having strong beliefs of my own that the fear of death is very crippling and needs to be overcome at the deepest level. But it is disturbing to think that our culture provides us with so little opportunity to confront the basic meaning of life that sickness and death have filled the void by becoming conversion experiences. Robert was desperate to have such an experience and furious that it was denied to him. Other patients of mine, however, have found their conversion and embraced it with disquieting results.
One of these patients was Barbara. The minute she walked into my office, it was hard not to be bewitched. Even though I knew she was consulting me about a serious illness, she looked radiant, with sparkling eyes and a perfect complexion. A native Californian, she had flown to the East Coast for our appointment, and when she saw me staring as we shook hands, she laughed and told me a story:
"I tried to fly to Boston to see you last week, but a family emergency made me miss my flight. I asked my doctor in San Diego to write a medical excuse so I could get a refund on my ticket. On the phone I simply told his secretary to ask for a note stating that I had the flu.
"When I got to the airport and handed over the note, the counter attendant turned white. My doctor had written, 'This unfortunate woman is being extensively treated for a terminal case of metastatic breast cancer.'"
I was as taken aback as the ticket agent. It was hard to credit that this woman, so young and alive, had been undergoing surgery, radiation, and chemotherapy for over a year to combat a malignancy that had spread beyond her breasts and invaded many areas of her bones. As I probed deeper into her medical history, Barbara began to reveal in bits and pieces her present frame of mind, which was extraordinarily peaceful.
"You see, I have been spending twenty years in a drive toward success. As a young woman I set up certain totally artificial goals for myself. I wanted it all: a beautiful house, adoring husband and children, and financial independence by age forty so that I could quit working and enjoy my family. These goals were set in my mind before I was out of college, and I never lost sight of them.
"I finished law school and launched myself twenty-five hours a day into achieving what I wanted. By last year, it was all within my grasp. I do have the house, husband, and children, and at my legal practice I have risen to full partner. Then I was diagnosed with breast cancer. Mentally, I knew that I had been told something terrible, but within a few days I found that I was falling into an extremely strange mood. I began to feel very happy and contented."
I agreed that this was quite an unpredictable reaction.
"I have always believed that you get what you wish for in life," she explained. "And I asked myself why I had gotten breast cancer. Was there a secret wish at work? For many people that is a scary question, full of guilt and denial, but for me it was quite reasonable to ask. And you know what the answer was?"
I told her I was very curious to find out.
"Cancer allowed me to achieve my final goal," she said with a note of triumph in her voice. "I had wanted to retire at forty, and now here I am, on a full disability pension. I am a woman of leisure at last."
Tags: Personal Growth