september welcomes summer in san francisco. the fog disappears and the days are warmer. the natives go wild for it and tourists don’t have to buy cheap fleeces at fishermen’s wharf. as i now spend so much time in our newish house in san francisco’s mission, i realize it’s always sunny in the mission. when the fog is rolling in on ocean beach, i’m sitting in the backyard sunning myself. when the fog horn is blowing under the golden gate bridge, i’m moving my herb plants into the shade for a break. so i haven’t experienced the traditionally foggy summer that i’ve come to love and hate all at the same time, over the past 9 years here.

but in a way, i’ve been still living in the fog. my head, my feelings…all foggy. i see the world through frosted glass. i’m numb. it’s different from the mental sleepiness i still feel from chemo brain. and of all the things i’ve shared with you, admitting this seems like the most difficult.

is it because my body has been through physical hell? is it because i have no estrogen? is it because i don’t sleep through the night with hot flashes every hour on the hour? is it because of the drug cocktail i’m on? is it because 13 women out of the 270 in my support group died of metastatic breast cancer last year? is it because the 2 people i know who died in august, died because of cancer (stupid fucking cancer)? is it because my friend sarah, who is 2 years out of chemo and has 2 small children, was diagnosed with metastatic breast cancer last month? is it because a woman, jen, a mother of 1 small child and whose blog i follow here entered hospice for metastatic breast cancer? is it because i have a pet scan tomorrow to make sure i’m not metastatic and to get a baseline for the future? is it because i’m too young to experience such grief in such a condensed way? is it because my heart is too full? is it because when i’m in the office, everyone thinks i’m “better” and i’m “back” because i have hair? is it because everyone thinks i should simply feel thankful to be alive? is it because on tuesday i slept for only 2 hours because of my third hacking upper respiratory infection this year, waited 60 minutes in line at the post office, 45 minutes in line for prescriptions at walgreens, cleaned up cat excrement on the carpet, crashed my computer 3 times, and put dishsoap into the dishwasher only to later walk into a kitchen full of bubbles (that was a doozy of a day but i didn’t cry, laugh, or react much at all…just floated)?

in cheryl strayed’s book wild, she comments that “grief doesn’t have a face.” it doesn’t. i seem to be coping fine but often feel like i’m falling apart, teetering on the edge of a great abyss, floating through life unable to really soak in and appreciate the incredible summer we have had seeing so, so many loved ones…and feeling anger rise up in my throat because i feel unable to  enjoy seeing loved ones. i’m doggy paddling.

the only other way i can think to describe it is like breathing in through your nose versus your mouth. through your nose, you can get a deep gut, lifted diaphragmatic breath. through your mouth, it’s shallow and isolated to your upper chest. i want to be a nose breather, but instead i feel like a mouth breather (a favorite insult of our friend mike m.).before chemo last week, i described my numbness to my oncologist. she knew right what the deal was and commented that i’ve had blinders on much of the past year, marching from chemo round to chemo round to surgery to radiation. now that i have a less regimented life and most of the acute treatment is complete, my blinders are coming off. i have to figure out who i am, what i am, where i find joy again, and what happened. and those answers don’t come easily.

her description was compassionate, honest, and acknowledged my difficult truth. it was refreshing.

as a society, we haven’t caught up to recognizing and accepting that the emotional impact of cancer can be greater than the physical impact…and we all know the physical impact suuuuucks. but, if i get cut open, you understand that i need time to heal. if i am ready to emotionally erupt, you are less understanding and expect me to bounce back quickly or bury it and move forward.

at a BAYS meeting, erin commented that her vision for the next book title might be aftermath. i support it.

my friend susy shared an article about the spoon theory with me, and it really resonated as a way to explain some of what life with an illness is like. you can read it here.  it’s an articulate way of describing how i feel as though i have limited possibilities and limited energy. i’d take it further and say i have limited patience and limited compassion too. and limited tears…they don’t come anymore.

so there it is. it’s out there now. i know that if you’ve never gone through this, you cannot understand, and that’s ok. i cannot get mad at you for not understanding either, although sometimes i want to.  i have found talking with other cancer patients, especially young adults, helps me feel normal, that this is to be expected. a co-worker who is now a friend had cancer when he was very young; we talk a lot about this collateral damage. after sharing his own frustrations about what the reality is for life with cancer, and eventually punching a hole in a wall over other people not understanding, his mom’s advice was “don’t hate, educate.” i like it. so i’m working on getting my story down better, to educate about what this aftermath truly looks like.

i am hopeful that the fog will lift, that i’ll regain my mental ability to focus, to be compassionate, to open my heart, to feel deeply again, and to be present…beyond just being alive.

xom