The Battle We Didn't Choose

Jennifer Merendino was diagnosed with breast cancer in 2008, five months after marrying her husband Angelo. In 2010 it recurred, metastasizing to her liver. In an effort to maintain contact with friends and family and to help them understand their struggles, Angelo, a photographer, started taking and sharing photos of their life with breast cancer. The photos can now be found on his website, poignantly titled "The Battle We Didn't Choose".  The images capture the progression of Jennifer's disease, from tender and intimate moments of almost-ordinary life, to the pain and suffering of end-stage cancer, to the almost unbearable emptiness that Angelo clearly felt when she died in 2011. The "Our Story" section of the website tells of their journey together, tragically short, but very sweet.

So much is made in the breast cancer world of surviving, survival, being a survivor. That's understandable - what else could give us hope? But because of that, I think that we sometimes are implicitly or explicitly discouraged from recognizing the heightened sense of mortality that serious illness brings. When I first starting looking at Angelo's photos, I thought that of course the last photos would be of Jennifer after treatment, with her hair growing back, perhaps a little baby in her arms, or wearing a pink tee-shirt while running a marathon. To instead see her in hospice, looking 30 years older, and then to see her empty hospital bed and her headstone - it was a shock. (It turns out that Seth had found these images independently, but hadn't wanted to show them to me, to spare me this shock.) Even the images we see of patients who have died are typically from happier times, pre-cancer or at least when they were still on the winning side of their fight with cancer, smiling, hopeful, and strong. We don't see images of dying, and we don't see images of death.

And it just so happened that I found these photos around the same time that my own mortality had made its way into the forefront of my mind. For the last six months, my focus has been on getting through treatment, first chemo, then surgery. I've never had any illusions that my treatment would guarantee a cure, but it wasn't until the last week or so that I thought about death as a real possibility. Even when I wrote my advance directive, which is entirely about my own death, it still seemed like an abstract concept. I can't explain why it suddenly stopped being abstract to me. Maybe it was my left-brain dominance coming out, that seeing the actual numbers in black and white when Dr. Hurvitz gave me my ten-year odds of distant recurrence made it real to me (distant recurrence is considered to be incurable, so these odds are basically the odds of death). Or maybe it was that once I had recovered from surgery, I no longer had to focus so hard on just getting through the next moment and I could start thinking about what the more distant future might hold.

It wasn't as upsetting as it might sound. I've had a vague sense of death hovering in the back of my mind since my diagnosis, so it is actually a relief to acknowledge it and to put some numbers to it, as approximate as they might be - at worst, 20%, and at best, 7%. Though I decided a while ago that statistics are illusory, my mind still works the way it works, and 7-20% is a framework I can get my mind around. 

Deep down, I don't believe that I'm going to die of this cancer, and it is reassuring that the odds corroborate my feeling. In ten years I think Seth will take a picture of me, looking exactly ten years older, with our ten-year-old son by my side. Maybe all three of us will be in pink tee-shirts, running a marathon (though probably not). In any case, I think I'll look like a survivor. But I'll also know what I now think all survivors know - that we all fight hard, but winning or losing this battle we didn't choose, it's just chance.