Less than a Decade, More than a Lifetime

Mary H/ December 15, 2014/ Paul Brenner, MD, PhD

I was given an assignment by Dr. Vicario to start a Support Group for the San Diego Cancer Center and Research Institute (SDCRI).  The group was composed of individuals with various types of cancer.  It was small for the first month or so, and then blossomed to fifteen, twenty-five or thirty participants.   Although individuals were free to join or leave at will, there was a core group of about fifteen or so who stayed until life took them and another would enter.  Each session lasted between 2 to 3 hours.

In the second year, Maura McBratney, a Minister, a saint, a gift, joined me as a co-facilitator.  Maura had dug herself out of chronic incapacitating attacks of Multiple Sclerosis.  And I was luxuriating for ten years with a low grade prostate cancer.  I honestly considered myself a fraud announcing at each session, “I too have cancer.” By my eighth year in the group, my cancer became aggressive. I personally experience an uncommon acceptance and excitement about bone metastasis: “Finally, I’m really part of the group for the first time.”

The people in the group confirmed to me what I sensed about cancer patients over a half a century of being a physician, I.e., the nobility of what it is to be human: to live moments of bliss and fear, dread and aliveness, knowing and not knowing, bodily pain and bodily silence, hopelessness and helplessness, never wanting to share with others what is happening for fear of retracting the statement next week.

Cancer folks live in the truth of the moment because that is all that exists.  Cancer confirms that we live in a binary world, at the still point where opposites co-exist in wave patterns that move at the speed of light yet experienced by the ill as a steady state.  Chronic illness is Life: You hope it can get better but fear it will get worse.  There is no choice other than to live into what is happening now, because that’s all there is. (Come on Paul? How prosaic! You and the Dali Lama!)
The well know this truth as well as the sick, but in health we are seduced by external needs, in illness by internalized emotions.  Cancer people know about each others’ inner life without asking.

For those with aggressive disease, thoughts of the future force the mind to stay in the present.  The mind cannot help but search the past for unfinished business, “could haves”, “should haves” and “why nots”, Questions arise as pop ups, “What does forgiveness really mean?”, ‘What is self-love?”, “Forgiving another is easy, but how do I forgive myself?” “What unfinished business do I have?”  “S..t, how can I resolve that one?”  “What’s death?” “Will I do it well?” “What the f… does that mean?  “How can I find peace in this moment, this second?”  Then, the final realization that no thought is worth thinking about.  Chronic illness teaches patience and silence.

The body tries to offer the answers.  Cancer patients know their body.  They learn to trust it more than their mind.  The body instantaneously senses through feelings, a knowing contraction or a relaxation before doctors says a word.  The cancer patient learns to move from distrusting the body to only trusting it.  The body does not predict, assume or question what’s happening now. Its messages are clear, precise.

The cancer person learns to trust themselves and those who are on “the same path.”  This cancer group functioned as an organism, a unit, sharing and informing its integral parts without judgment or a need to understand the particulars of “what” someone is dealing with, but more how they are responding to what they have been given.  Another’s cancer always seemed worse than their own.  The group confirmed for me what I had learned at The Cancer Center seeing individuals one on one.  The cancer patients are selfless individuals, “the other” is more important than themselves.  Pleasing and giving are the primary coping skills of cancer patients, their way of showing love.

However, in the Cancer Group, the self morphs further into the collective presence of love, pain and service to others.  At the end of the session, you can hear the silence; feel the fatigue as the group formed a prayer circle.  Following a long hug, the group would dissolve into a smaller klatch, then moved slowly out the door.  Too often they would meet again in the hall to chat further, before entering the other world, a world that is less alive, vibrant, colorful, humorous, poignant and far less present and loving.  The group became addicted to each other.

I am grateful to “my cancer group”, the collective group.  It is “their group.”  Each one referring to it as “my group.” I am grateful for the presence they have brought into my life, the honesty, the love.  The group ended December 16th, 2014.  I left four months prior to that date. I had lost my boundaries within the group.  I could no longer contain the groups love and pain.  I cracked. I felt that if I stayed longer, I would die. The pain was greater than the love. I lost my balance. I could not do one more group, see one more patient or attend one more funeral. I was spent.

“If I am not for myself, who is for me?
And being only for my own self, What am I?
And if not now, when?”
Rabbi Hillel 110BC-10CE, Sage and Scholar

I am grateful that I was a member of a group of varying individuals who met once a week and bared their souls, for 2-3 hours, over nearly a decade.  My group, “The Group,” a relatively small collection of people, showed me my limits to surrendering fully into the Collective and so into collective Life.  Life is, has always been and will continue to be suffering and love.  We humans gift impersonal Life with personal Love, but if I lose love of self, I am incapable of gifting Life with my love and for the gift of my life and love that was bequeathed to me by my ancestors.  Yes, I could no longer hold the still point where self, other and all Life have always and will always coexist.  My first book was, ”Health is a Question of Balance.”  I should have read it.  Hopefully, next life, I can stay fully in The Collective longer.

Paul Brenner, M.D., Ph.D.