Dear Cancer: Twisted Symbiosis

Dear Cancer,

When you made my blood your home, I understood you. I always wanted to feel like I belonged somewhere. Walking through my middle school during overcast January days, I kept my head down, unsure of who thought of me as a friend or as a convenient distraction from their own loneliness. Where I couldn’t hide my thick eyebrows or the shape of my nose, I would encase my body in my generation’s unofficial uniform—smudged black eyeliner, low-rise skinny jeans, and overpriced sherpa boots with zero arch support.

Under false pretenses, you and I peacefully coexisted for a year. My body wasting, my hips aching, and my mind playing tricks on me as you expanded. I leaned into my waifishness with pride like the other girls my age did. At thirteen, we are meant to feel alien. Our altering bodies, a prerequisite to adolescence.

I increasingly noticed your presence as the pain in my hips evolved from a knock to a deranged pounding. The peace between us was faltering. In a dream, you politely warned me that you were getting comfortable and that this is what the future would be: a hot pink beanie, brown skin gone ashen, my dark circles swallowing my eyes.

I would try to explain you to my doctors, but they thought I was just a kid playing hooky. Ten appointments with my pediatricians, vials of blood, an x-ray, and still, no one could see you. My pallid face and slight limp grew more apparent each week.

I remember the day they stuck needles in my hips and snaked you out. What did it feel like for you? When I woke up, I was without pain for the first time in a year. I skipped to my parents’ SUV buoyant on the normality of not hurting. As we drove home, the painlessness of my hips formed an anxious silence—I knew then that you were made of something rotten.

When they found you, I was confused. My oncologist first told me your full name, which I was not familiar with. When he finally said cancer, my face flushed with shame that I housed you in me this whole time not knowing who you were.

Nothing exciting happened in my small town, so when my classmates heard of you, a few girls latched onto our story, eager to co-author it. They made me bracelets and told me to “stay strong,” that I would “beat you.”

Our society has anthropomorphized you into an enemy to be defeated, as if America’s burgeoning military has jurisdiction over DNA. We humanize your immortal cells and insert them into war and battle metaphors. The war on cancer indoctrinates us as fighters and heroes to feel powerful in our atrophied muscles and dizziness and depression. You are not a sentient being, you are an accident.

But it is easier to believe you have human capacities to understand and to change. It’s easier to believe my words have as much impact as chemo does.

Knowing this, I still feel something like empathy for you. Your name is a pejorative, applied to infestations of vilified significance: cult leaders, termites, political ideologies. Was your name ever used in the context of beauty? My name means joy. Perhaps I grew into my name; yours has become a self-fulfilling prophecy.

I think you were jealous. When you were slinking through my marrow, you saw what you could not have. So you tried to take what you could. My energy, my appetite, my smile. You played cat and mouse with my joy, but you had no use for it when you saw that I could make more, however fleeting.

When I started to heal, you became vengeful. I walked hollow-eyed around school, made invisible by the label “remission.” You were expelled from my blood but rooted stronger than ever in my psyche. I understood that it was boring to survive, but it was also an ill fate to die. There was a younger girl in my town whose blood you also inhabited, invading her spinal fluid and brain at the end. Her death, a sick tragedy, was blamed on her doctors and not you. No one would accuse you because in our metaphors, we twist the narrative so that you are not allowed to win.

Surviving meant that my own sick tragedy would not be spoken of. My shame of you overtook any pride I thought I was entitled to. I did not know how to cope with the truth that everyone believed you to be gone when I still felt you as much as ever.

As if in response to the outside world’s faith in your absence, another version of you grew in my blood, with a new name and face—a rare side effect from my chemo. They called you “secondary,” but your new form was strong and more desperate than before.

When this other version of you self-imposed, I rolled my eyes and thought, this again. This variant you chose to embody entailed an extreme treatment course. Even so, I became complacent, reclaiming our unhealthy kinship. I underestimated your persistence and naively welcomed the challenge you presented.

My own cell lines were completely diminished and you saw your opening. You invited more sickness, until I was full, choking on viruses, fungi, bacteria. I brought up black Shingles scabs and blood with my wretches, thumbing futilely at my Dilaudid PCA. When I saw the nerve damage in my drooping face, I thought I’d rather be dead than have such an obvious physical reminder of you. You nursed and fed my depression like it was your spawn, and I wrapped myself around it, claiming the despair. Here we were again, twistedly symbiotic. My body was an inlet for tubes filled with powdered food, poison, blood. You poured out of me like red, hot tears stained with chemo, burning a hole through my future.

All the while, I didn’t mind being so sick. My thoughts were constantly blunted by the slew of medications that softened the sickness and pain. When I finally received new bone marrow and they told me you were gone for good, I had to confront the new clarity of my mind. No more space cadet-ing into nothingness. My dissociation was replaced with titillating nervousness about the death of empathy from the world I reentered after two years of isolation. My friends seemed to glide on without a backward glance to ensure I was close behind. While no one was directly cruel, they were impatient and vexed by my social and physical incompetence. I would have traded the snake pit of high school for narcotic-glazed, afflicted monotony.

I thought medical school would quell my anxiety around you and my late effects, but, three years in, I have only grown more imaginative. I can picture a thousand ways where we meet again or how my dysfunctional body will further deteriorate. I fear that every day that I am less guarded, the more likely relapse is. This irrationality cannot be intellectualized away.

But now I at least acknowledge the impact of the mental and physical effects. For years, I lived in self-inflicted purgatory where I denied my deafness, depression, neuropathy, and lack of antibodies, trying to live a dishonestly able life. Skipping immunoglobulin infusions and avoiding accommodations was easier than acceptance. I accept the permanency of my treatment complications the same way I accept that you may never leave me alone.

At times my minutes, hours, days are consumed with thoughts of you. My emotions are still so powerful and amorphous that I can’t delineate the border between nostalgia for your presence and fear for your return.

Is it strange that I sometimes miss you? I know the feeling is mutual.

Yours,

Farah

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