ON 27 February 2001, my consultant haematologist gave me the
news that there was no longer any active cancer in my body. The
previously tennis-ball-sized tumour in my chest cavity had shrunk
to scar tissue, and the once protruding lump in my neck had
disappeared.
Over the previous six months, I had sweated in shock after a
bone-marrow aspiration, endured 12 doses of chemotherapy so toxic
that the nurse administering it had to wear protective clothing,
and had watched as my hair and eyebrows fell out.
But, now, I was "in remission". Remission. I chewed the word
over slowly as I left the hospital. I phoned my parents. They were
delighted. Without knowing where to go, I wandered into Starbucks,
alone, and sat silently, nursing a coffee. I texted a few friends,
and was disappointed with their replies, which were along the lines
of: "Great news. Now you can get on with your life."
Since my first confusing hospital appointment, and the
terrifying internet searches for information on "Hodgkin's
lymphoma", I had wished for this moment. And that morning's
appointment with my consultant meant that I could now call myself a
"survivor"; I had won my "battle", aged 21.
Instead, I sat looking out of a window on a drab February day,
feeling defeated, because it was only then that I realised that
being "in remission" did not mean that my experience of having
cancer was finished, because, since I did not know why I had
developed it in the first place, I didn't know how to ensure that
it never came back.
ENSURING that cancer goes into remission is the proper hope of
oncologists and patients alike. The psychological and spiritual
problems of living in remission, however, are rarely explored. As
the numbers of survivors increase, this is an area that is crying
out for some consideration.
Some react to remission with joy; others suffer depression.
Others suffer symptoms of post-traumatic stress disorder as the
experience, which begins at diagnosis, continues well beyond the
end of treatment, with flashbacks and depression. For some, the
world seems more dangerous, the possibility of serendipity too
frightening, and a new post-cancer identity needs time to
emerge.
Cancer is a disease that is burdened by taboos. People don't
really like to talk about it. For me, the loneliness of the disease
continued, and I felt unable to articulate how my experience had
changed me. I had my life back, but I didn't know what to do with
it.
Cancer had knocked my life-plan off-course. I had changed
somehow; getting on with my life as it had been did not fit with me
any more. And the chemo-suite cry of dereliction - "Why me?" -
continued to resonate for years.
In its popular understanding, cancer eats you up, like a
"demonic pregnancy" as St Jerome put it. The typical way of talking
about cancer is as a battle which must be fought - as if, by sheer
will, uncontrolled cellular multiplication could be defeated. The
corollary, of course, is that if the cancer "wins", it is because
the person with it did not fight hard enough.
I did not feel as if I had won a battle - I might just as easily
have died. On paper, my story was one of victory, but I didn't
believe my own Disney ending, because it didn't feel as if I had
been given a "happily ever after".
"REMISSION" is an odd term. For the penitent, it can mean the
state of grace that follows the absolution of sins. In a medical
sense, it is when the disease is no longer active. In both cases,
it has a sense of the pregnant pause. The one who is in remission
holds his or her breath, waiting for the sin to return, or for the
disease to sweep back. It is a word that says, "Yes, but . .
.".
For Christians, who proclaim the resurrection of Christ from the
dead, the question is: can remaining in a constant state of fear
ever be the end of the story? We know that there is hope in life,
as in death, and that new life in Christ, through faith, is always
on offer to us. But that new life may not spring up
immediately.
For older people who survive cancer, remission can often seem to
give a new lease of life. But for younger people, who have not yet
fully formed their identity, it can be more bewildering.
For me, it took many years, aided by five years of
psychotherapy. And that's OK. There are many precedents of waiting
for a resurrection - not least in the Gospels, which are all silent
on what happened between Good Friday and the events of the first
Easter morning. There is, after all, very little to say. Death
demands silence.
In the Old Testament, death is typically described with words
such as "darkness", "dust", "inactivity", "without joy", and
"powerlessness". For me, these words draw close to how I felt in
remission, as I tried, silently and subconsciously, to process my
brush with death.
CHRIST came to earth, and pitched his tent with us, dying a real
death. Holy Saturday is when Christians contemplate this death,
usually in quietness and grief as we watch and wait, however
uncomfortable that make us feel.
Like the disciples, those trapped by remission can be silenced
by their experience as they, too, live suspended between two
worlds, between death and resurrection. Jesus triumphed, and set us
free from the prison of sin and death; but Holy Saturday came
first. The Sunday required the Saturday.
For those dealing with this experience, it can seem to be a
place of dereliction and loneliness, but the Christian narrative
tells us that this is not the case.
Hans Urs von Balthasar wrote that Jesus has "solidarity with the
dead" because of his real death (solidarity meaning "being solitary
like, and with, others"). This paradoxical idea means that Christ
is with those struggling in remission, irrespective of the genuine
feelings of being alone.
In the negativity that can accompany remission, real healing can
emerge, because Christ was truly dead, and, in that passive and
negative state, the incomprehensible still happened.
ABOUT seven years after that February morning, I travelled back
to the chemo suite and met my nurse again. I was in my last year of
ordination training - having followed the sense of calling that had
grown after the "dust had settled" on my remission - and felt that,
in preparation for holding funerals and dealing with death, I
needed to resolve some things.
We talked about it all, and I remembered. And then, something
unexpected happened: I felt at peace about my cancer for the first
time.
In returning, I had, in a way, gone back to the place of death,
and, rather than finding it a place of terror, I encountered there
companionship and new life. What I had done, unknowingly, was to
live out a reunion within myself.
Lord Williams of Oystermouth holds that health is restored by
finding peace between body and spirit; and healing is about making
connections between self and body, between past and present,
between physical reality and future hopes.
The Hebrew word that is translated into the English word
"remission" means "release", or "letting go". With my story of
cancer, I found that I had released myself from its affliction, and
that the experience was somehow resurrected, and I was released to
new life.
The Oxford theologian Professor Paul Fiddes writes that
resurrection is a protest against the present reality. My glimpse
of resurrection life is but through a glass darkly, and the fuller
experience is yet to come. But such is part of God's plan for each
of us: whether our bodies have disease or are in remission, he
desires us to have life, and to have it in abundance.
The Revd Dr Gillian Straine lives in north London, and is
currently on maternity leave.