As a 5-year-old child, I had a terrible experience lasting several hours, during which I remember thinking that I should just let the people involved kill me, because the torture of letting them hurt me and of knowing that they would likely kill me, was worse than dying. This theme, of trying to survive torture, knowing I should just give in to death, haunted my dreams nightly for most of my childhood and adult life.
In hindsight, I suspect this experience and the general environment leading to the experience shaped my life and career in a very big way. I am fierce, strong, and resilient. I became an emergency physician, and have spent an entire career on the “control end” of trauma, grief, and the worst days of my patients’ lives. I worked in busy inner-city Emergency Departments seeing the worst of society’s woes reflected in individuals. I’ve heard the unforgettable, indescribable wail of a mother being told her child is dead, more times than I care to count. I have helped pluck people from the brink of death more times than I can count. I have cried in front of patients and families. I have been sent a handful of letters over my career thanking me for being the “angel” in that family’s life.
Being on the “control end” gave me a false sense of security that I was in control. But deep down, I was always scared. Because somewhere, in the back of my heart, I knew that my sense of control was an illusion. Control is the Great and Powerful Oz. In the end, there is a vulnerable, powerless little person behind the curtain and life can turn on a dime.
As we head into a new life with COVID-19, I feel the great privilege of my last 4 years of life which have taught me to not be afraid. NOT AFRAID. At all. My method to embrace fear might seem morbid, but please hear me out.
In November 2015, my son was diagnosed with an incredibly rare form of bone cancer. At the time of his diagnosis, there were fewer than 600 people in the history of the world who had ever been diagnosed with this cancer. There are no protocols, and other than surgery, there is no treatment. No one is going to study such a rare cancer- it isn’t worth the money on a societal level- I get it. So, if he recurs, he dies.
In June 2017, while my son was still recovering from multiple surgeries for his cancer, I was diagnosed with early-stage, but very aggressive breast cancer.
I had surgery, chemo, and radiation. My metastatic recurrence rate is much higher than I would like it to be for having gone through the treatment that I went through. This means that I have a larger chance than most early-stage cancer survivors of having my cancer return. Having had chemo and being on tamoxifen most likely puts me in a higher risk group for a bad outcome from COVID-19 too (as does being a health care worker). I tell you this to set the stage for why I’m not scared. To set the stage for why, despite it sucking to have cancer and have a son with cancer, I am thankful for the lessons of cancer.
Cancer’s lessons have freed me from my lifelong cage of fear and from the illusion that I have control. The lessons cancer has taught me have allowed me to live a better life for however long I have. I have never in my life, despite the uncertainty, been LESS afraid. I embrace fear and I feel gratitude to cancer’s lessons each day.
- I can do everything right and I can still die or one of my kids can die, at any time.
- All I can do is all I can do. Read that again.
- I only have control over my own actions and thoughts.
- I want to be happy and experience joy while living in the reality of whatever it is my day holds- good OR bad ( and most likely both). This holds true in sickness and health.
- My joy is my responsibility to create. If I want it, I have the power to make it as long as I accept the reality of my situation.
- Today (actually right this second) is all we have- so live it.
- Anything I am worrying about happening in the future is ruining my life right this second.
I am super stubborn and see fear as the enemy. Fear steals my time or makes the time I have less satisfying. Additionally, living in fear lowers my immune response and makes me MORE likely to get sick (with cancer or COVID-19). I refuse to aid the enemy. Cancer (and COVID-19) have snatched and may continue to snatch, many things from me that I will never get back. However, I REFUSE to hand over anything that wasn’t snatched directly from my hands. And my psyche is one of those things. No way. I’m not playing into the hands of the enemy. I will live my life to the fullest until I stop being conscious. I will embrace fear.
This does not mean that I don’t experience emotions like fear, grief, and rage. I feel sadness when things are sad. I feel physical pain, I feel loneliness, I feel the disappointment of the things lost. I cry at times when faced with the losses. BUT I know that these feelings can co-exist with joy and beauty. I embrace fear and I allow myself to live the duplicity every day. I take the time to focus on things that bring me joy.
An analogy I can make is this:
I am in a pitch-black room with a single flashlight. In that room is something horrible and scary and also something wonderful and joyous. I know they are both there. I have a choice. I can continuously shine my flashlight on the horrible scary thing to keep an eye on it at all times so that I can see it approaching me (note that I have no weapon if it does approach, only a flashlight), OR I can shine my light on the thing that brings me joy most of the time, occasionally shining it on the bad thing, just to see if it’s still there (it always is), then shine it back on the beautiful thing and live with that, knowing the bad thing is always there, always will be there, and may do me in at some point, but until it does, I choose to look at the joy.
One of the interesting things, when you have cancer or have a child with cancer, is that in order to make you feel better, friends and family offer platitudes of “I know you will kick its butt,” meaning that you (or your child) will remain cancer-free. To me, the kicking butt comes not in your disease status, but in your willingness to be ok and to find joy in whatever the physical outcome of your situation may be.
Live in the reality of either outcome and find joy in what there is to be joyful for.
It is by NOT accepting the bad outcomes as a possibility that we bring ourselves pain, fear, and suffering. My goal is to accept all the outcomes, good and bad, to find peace with them, and to work to create my best life within those confines. If I start to die, or if my child (any of them) starts to die, or if my partner starts to die, I will work to live the heck out of that experience. This is what it means to embrace fear.
I have learned that during hard times, there are many precious jewels buried in the pile of garbage that we have to shovel through. You always have the choice to be on the lookout for the jewels, to reach down into the garbage pile, pick out the jewels, polish them off, and revel in them, or just keep shoveling garbage. The choice is up to you. I know what I choose.
Mario Trabulsy, MD is a board-certified emergency physician with over 27 years experience in the field. She has been a renowned and award-winning Educator at University of Vermont Larner College of Medicine, and University of Vermont College of Nursing and Health Sciences. She is a fierce breast cancer survivor, lover and creator of joy, single mother of 3 young adult or teenage boys, a dear friend, advocate for, and mentor to many, an avid outdoor exercise enthusiast and single track mountain biker.