Crossing the Divide: Lessons in Knowing and Not Knowing in a Brave New World

By Christine Wilson

In late June, a couple days before my sixtieth birthday, I was working in my vegetable garden—my beloved, overplanted little plot wedged into the front yard of my suburban home. There is a moment like this every year with the garden: a perfect day. With my hands in the warm soil, surrounded by juvenile tomatoes, broccoli, carrots, beans, and peppers, the world seems infused with hope and joy. Life is good; the veggies will be abundant and beautiful; summer might even last forever.

The usual elements were all there, but this one felt a little different. The prospect of being 60 seemed both impossible and a little frightening. Sixty was an age at which, as I had told a friend, you can’t pretend to be young anymore. It seems a point at which so much of your life is defined, and the end is definitely in sight—no matter how good you feel or how many people tell you that you don’t look your age.

I did feel really good though—strong, healthy, active, and engaged. I had recently escaped from a relentlessly stressful job to begin my own healthcare consulting practice. Despite fears that I would end up bagging groceries, it was going very well. I had clients who wanted to pay me to do what I love: communicating to the public the excitement and the importance of what is happening in cancer research.

Satisfied in my work, hands in the dirt, I decided—right at that moment—to be happy. For the first time, I made a conscious choice to embrace this era of my life, to make my sixtieth birthday a gateway to appreciating life’s many positives: my three grown sons, my good friends, the early success of this new phase of my career, my little vegetable plants pushing their way upward, and, of course, my health, which had always been excellent. It was a satisfying moment, but, as it turned out, my feeling of well-being wouldn’t last long.

Two days later I was at a tennis clinic on a hot day with five of my hard-hitting lady tennis buddies. One, a doctor, suddenly announced between shots that she thought my thyroid looked enlarged and asked if she could examine me. Right on the court, she palpated my sweaty neck and proclaimed that I had a definite nodule and that I should get it checked out. Once home my own examination confirmed that something was there, although to this day I ask myself when I would have noticed it without Dr. Deb’s intervention. Wasting no time, I tapped into my personal network and scheduled a next-day appointment with one of the top head-and-neck surgeons in Philadelphia. Within 24 hours I had undergone a thyroid ultrasound and a fine-needle biopsy and had received news that I had a 4.5 cubic centimeter nodule in the left lobe of my thyroid gland that had to be removed.

The surgery went really well. I walked out on my own power the next day, surprised by the relative lack of pain from having my neck cut open. I was back at my computer within 36 hours of surgery, and by the weekend I had resumed my long walks with the dogs and trips to the grocery store. The tennis racket stayed in its bag though, and the weeds took advantage of my absence to mount an assault on the garden, but those were temporary setbacks. Once again my essential good health had prevailed. Though I had experienced a surge of pessimism following the diagnosis, those worries had been tempered by my last conversation with the doctor who saw me before I left the hospital. He was reassuring, telling me that the surgery had been easy and that they had been able to get the nodule out with no problems. “You did great” were his parting words.

And with that—except for this tiny little portion of my brain that kept telling me that the news wasn’t good until I heard the final pathology report—I let go of the fear that I had cancer. A week after the surgery, I fairly skipped into the surgeon’s office, feeling unduly proud of my swift recovery, ready to thank him and put the whole thing in the past. But in the second sentence he uttered, after he asked me how I was feeling, he told me they had found cancer: a Hurthle cell carcinoma with another micro focus of papillary cell carcinoma. I did a mental double take and replayed in my mind what he had just said for a split second before it really sunk in. With the shock came anger—mostly at myself. How had I let myself be so blind-sided? How, with all that I knew, with all the hours I had spent lying awake at night weighing this possibility, had I been so unprepared to hear those words?

I think I was calm and focused as we discussed the next steps—more surgery, radioactive iodine treatment, a consult with an endocrinologist who specializes in thyroid cancer; but in the minutes after he told me, as he showed me the path report, I had the physical sensation of having just stepped over an actual line, of crossing from one side of a river to the other and entering completely different territory. I was surrounded by familiar concepts and people, I could speak the language, and I thought I knew all the landmarks, but everything had changed. I was a stranger in a strange land.

The world of cancer is not one-dimensional. It’s not as simple as either having cancer or not having it, and the disease does not always arrive with one knockout punch. In fact, a diagnosis is often followed by a series of blows—one piece of bad news sequentially piled on another. In my case it has gone something like this: I hope the nodule is benign; surprise, it isn’t. I hope it’s the “good” kind of thyroid cancer; nope, this one is more aggressive. I hope it remains contained; if it does spread, you’re in deep trouble.

Still, I retain my hope in the real possibility that I will muddle through the treatment and live to be a grumpy old lady who dies peacefully in her sleep in her nineties. And I am prepared to do battle with this thing, no matter what happens next, and beyond—as far as I can take it. I am not passive, and I reject the notion of myself as a victim. Like most cancer patients, I hate that word. Except for this cellular betrayal, I’m still a strong, healthy person, a tough competitor, ready to take on the mantle and the responsibilities of being a cancer survivor.

In retrospect I marvel at my now-simple wish for happiness on that warm, sunny June day a year ago. Then my fear was of becoming old; now it is of not becoming much older. I am scared of what lurks at the end of the path and of all the steps in between—of the serial losses, the ambushed hopes, the relentless biological force that can potentially break me down physically and emotionally before it kills me.

As for that self-proclaimed era of happiness, it never got off the ground. There are far too many difficult times ahead and unanswered questions to feel any sense of well-being, and happiness just seems like one of those goofy, vaguely self-indulgent illusions that get the better of you every once in a while. Still, as I face these challenges, I continue to appreciate the feeling of my hands in the dirt and the warm sun on my back. I can still smell the tomatoes and the honeysuckle as I remember the soft promise of that afternoon. I know that there will be other good moments. But what I realize, within my new, post-diagnosis reality, is that in crossing over to this new world, I have experienced the last true moment of innocence in my life.