I don’t know why I got cancer. Statistically, it seemed likely that I would join the One in Eight probability brigade at some point in my life, thanks to a family history of breast and colon cancers. At 37, the two-centimeter malignant lump in my left breast was still unusual enough to warrant a partial mastectomy, a dozen rounds of chemotherapy, four weeks of radiation, and a year’s worth of immunotherapy drugs. All that hospital and treatment time afforded me ample opportunity to come up with correlations and transform them into causes.
But I didn’t do that. I decided, when the phone call with my biopsy results came in on a Friday morning in late July 2016, that asking “why” was a pointless exercise. There was no good answer, even if there was an answer. I thought I might have one when I tested negative for BRCA, but it evaporated when I learned my mother’s breast cancer had no BRCA link, nullifying any chance of genetic linkage.
I accepted that an answer couldn’t change my diagnosis. An answer wasn’t going to treat me. An answer wasn’t going to help me recuperate. An answer wouldn’t even necessarily help with recurrence. All an answer would do is make me blame myself, when there was no reasonable way for me to know what caused the lump to grow, slowly, within and then out of my milk ducts.
I wasn’t always so sanguine in the lack of a “why.” It was my favorite word as a little girl because I wanted to understand other people’s behavior — especially when the behavior was at odds with what I wanted or needed. But as I grew older and accumulated major life events — death of a parent, the end of a long-term relationship, professional successes and failures, cancer — I no longer needed the crutch of underlying reasons. Asking “why” didn’t lead to a commensurate “because.” Embracing the random state of nature, and all of its messiness, seemed more honest to me. Crimes sometime lack motive, and so does the onset of disease.
Which is why Stephanie Mencimer’s Mother Jones feature on what the alcohol industry hid about the scientific links between drinking and cancer caught my attention. Mencimer, as she outlined in her piece, was stunned to discover that as far back as 1988, the World Health Organization declared alcohol to be a class 1 carcinogen, which didn’t stop the the marketing of drinking, in moderation, as a healthy lifestyle choice for women, rising breast cancer incidence be damned.
“I thought I’d done everything right: breastfeeding my children, a careful diet, plenty of exercise. I wasn’t overweight and didn’t have a family history.” All that remained was past alcohol consumption: “I’m not a heavy drinker, but like most women I know, I have consumed a lot of alcohol in my lifetime.” I, too, drank more than I should have in my 20s; I gave up drinking most spirits, and cutting down on my overall alcohol intake, after one epic night of vodka tonics resulted in the worst morning-after hangover on a friend’s couch (and her justifiable mockery of my behavior).
I, too, believe there is a strong correlation between drinking and cancer that needs to be publicized more effectively, overcoming Big Alcohol’s agenda in downplaying the linkage. My eyes widened at the stats about Utah, where the breast cancer rates of Mormon women are more than 24 percent lower than the national average.
Yet I also read Mencimer’s piece with considerable discomfort. The link is real, yes. Perhaps drinking did, indeed, cause her cancer, and that of many other women, myself included.
But if it did, so what?
The culture of cancer emphasizes “battles” and “beating the disease” and “positive attitudes” and “staying healthy,” and that’s fine for those who find such aphorisms helpful. Cancer wreaks a monumental physical and psychological toll, and any and every coping mechanism has value and should not be knocked.
But they didn’t work for me, because I don’t approach health issues that way anymore. It feels too much like a lock-and-key mechanism where doing that one thing will lead to a better outcome. It creates a petri dish for “good” and “bad” ways to cope, when women are already blamed too much for the way they behave and what punishment might result. It’s a groupthink approach when cancer is, more accurately, an umbrella of micro-specific diseases, all with the same name.
My breast cancer was not Mencimer’s because of age (she was a decade older upon her diagnosis), her own family history, and many more contextual cues she didn’t reveal in her piece. My treatment plan resembled others in theory, but in practice — as I discovered when commiserating with friends and acquaintances who were diagnosed at the same time — the drug regimen and side effects differed significantly. We were all on islands of our own making, drifting toward each other in a common pursuit, with different landmarks and obstacles.
I thought about a time, in my early 20s, when I lost a significant amount of weight. I had received a medical diagnosis of polycystic ovarian syndrome, and weight loss was my doctor’s recommended response. I also had nine months before starting graduate school, and I did not want to move to New York City as a fat woman. Losing weight became a full-time job, a rigorous process with an end goal in sight.
That sounds like a battle, right? Or something to conquer? I thought so at the time, and it was a useful construct at 22. But solutions to problems aren’t necessarily permanent. Maintaining weight loss depends so much on situational context, on changing metabolism, on age and lifestyle. What worked to keep those 70-odd pounds off in my 20s is not what works as I approach 40. The psychological scripts of youth are not those of middle age. The older I get, the more I find comfort in what I don’t know.
And since I don’t know why I got cancer, and can never know, I’d rather live my life and take pleasure in it.
There is no greater joy than the joy that springs from weathering a serious illness. It’s more than a reminder of the short, fleeting nature of life: It clarifies, prioritizes, strips away bullshit structures and builds new ones. Risks feel thrilling, nerve endings pulse with greater energy, pleasure and pain feel more potent yet also more bearable.
As Aminatou Sow wrote on Twitter, after being reminded by a friend that she was a month into cancer remission: “Apologize to someone you wronged. Forgive someone. Kiss the person you’re dying to kiss. Say the quiet thing out loud. I did it all this month & it felt thrilling to be alive.”
I asked Sow how she reached her own post-remission state of joy, and if she also took comfort in casting aside the search for answers. “I have to remind myself every day that I didn’t get cancer because I’m black or overweight or smoked cigarettes in high school or that my despicable use of spray deodorant isn’t karma finally dealing with me,” she told me by email. “I think that women are so conditioned to take blame for everything that it almost feels … like the right thing to do to blame yourself for illness. Gathering information, taking a deep breath, putting one foot in front of each other and whispering to myself ‘here we go again’ is what works for me. I don’t know why and I don’t even know HOW I do this but this is what I do.”
Cancer didn’t make me a better person or show me a new way of thinking. It didn’t purify my morality or sanctify my existence. More than a year in remission, with all scans and signs looking good, I am a heightened, streamlined version of my earlier self. I still work hard, and I rest more. I go out, but I stay in plenty. I eat right, but I won’t give up sugar. I drink less, but I still drink.
I’ve always lived my life wondering how the story was going to end. My cancer story appears to be over, but if a sequel is in the works, I’ll be ready, too. And once more, I won’t know why, and I’ll be all right with that.