Acceptance is a key to healthy living and loving relationships. While I could cite the science of this to the nth degree, I think illustration is useful.
As I write this I am waiting at the Arizona Cancer Center; it is my 15 month checkup, after the amputation of my right ring finger for what is called, subungual melanoma—a very rare cancer under the fingernail. The Center has only had five cases, and this
is one of the world-class places for the treatment of melanoma.
The atmosphere of the Center is both calming and anxiety provoking. The beauty of the place calms one, as it is exquisitely decorated resembling the most beautiful hotels in our achingly beautiful desert. Worried faces populate the waiting areas; hushed tones whisper fears. Head scarves cover the insults of chemotherapy—not as a symbol of faith in God but faith in science to heal or avert cancer.
“Will it return?” reverberates in my own mind, waiting to see my favorite oncologist. He jokes, “I better be your only oncologist.” It is the black humor that passes between us.
Acceptance is but the one thing I can do to prevent a return of, or restrain, the cancer cells in me and in all of us. I recall being scanned by giant machines that image my body. I recall inviting those cells to find some other space to live in the world or not harm my body as they sought to live as alien Darwin machines in me.
I had heard their faint song in my body some 2-1/2 years ago. How did I hear them? A story begins the saga. When I was twenty, I was very ill from mono in college. One of the psychiatrists at the student hospital at my university had me take the Minnesota Multiphasic Personality Inventory (MMPI). I scored two standard deviations above the norm among men for sensitivity to bodily functions. The psychiatrist seemed concerned by this, though I clearly did not present as a Munchausen case seeking attention for every sensation as years went by without needing to see a doctor—until my recent quarterly ritual visits to the Arizona Cancer Center.
Acceptance at a personal level is more than about thoughts. Acceptance embraces feelings and sensations, too. Acceptance is about noticing and welcoming thoughts, feelings and sensations—pleasant or not.
So how did the acceptance—manifested by higher levels of sensitivity to my own body sensations—play out in my cancer. I am an N = 1 project, which my oncologist points out is the only relevant issue considering one’s own health and sickness.
Here is the flow of thoughts, feelings and sensations that unfolded with my own cancer. I felt the nail split on my right ring finger on vacation in June of 2006, and it grew inflamed where the nail knifed into the nail bed. The split and inflammation persisted, and I brought it to the attention of my primary care doctor—a good man who carefully listens to me. He cultured the nail bed for fungus and ordered some antibiotic crème, which reduced the inflammation. Healing did not happen, so I asked for a referral to a dermatologist. More crème and an oral antibiotic. It looked better but did not heal. Then a punch biopsy that hurt like Hell, but showed only odd granulated cells. My sense and feelings of unease persisted. I could see oddities, and something in me communicated all is not well throughout my body. I asked for a referral to a hand surgeon, thinking a resection—cleaning out—of my nail bed might jumpstart the healing, as the granular cells were a sign of disrupted intra-cellular communications that do manifest in cytokines communicating with the central nervous system. I wondered if that might be the unease I sensed in some weird way.
I did not take the advice of many who said, “Just pay no attention. It will heal on its own.” That felt like avoidance to me. The wonderful hand surgeon did a resection. I had bratwurst for a finger the next day as I flew to Eugene to work with Tony. He wonderfully changed my bandage, with such tenderness and concern.
My sensations and feelings of “wrongness” persisted, despite the surgery. I had thoughts that my finger would need to be amputated to save my life, and I even had unwelcome thoughts that this would happen on my birthday—the day before Thanksgiving in 2007.
A few weeks later, my surgeon called while I was giving a lecture on evidence-based kernels to psychology students at the University of South Carolina. I finished the lecture, and he called back. He had two biopsies performed on the tissue from my finger; he was not happy with the first, as it was inconclusive. He did not dismiss his thoughts. The second more detailed biopsy showed it was melanoma in my finger. This was terrifying as such melanoma is rarely discovered before Stage 3 or 4, and carries high mortality.
My hand surgeon had arranged for me to be seen within the week by the Arizona Cancer Center for the surgery workup, which would certainly lead to an amputation of my right ring finger to prolong or save my life. That surgery did happen, on my birthday, as that was the only open time in the operating room.
Then, Thanksgiving came with that long weekend. I would not hear from the biopsy of my finger or my lymph nodes for 7-10 days. Then, I would know scientifically what stage my cancer was and the nature of my future treatment and survival probabilities. On that Sunday of Thanksgiving weekend, I was learning to peck at the keyboard to answer emails from the outpouring of love and support, when new thoughts, feelings and sensations came to me. Yes, I had pain—including phantom pain—in my finger and under my arm. There was something ineffably different, however, in me. I no longer felt the cancer talking to me through those cytokines, that seemed to generate the ever so slight uneasy thoughts, feelings and sensations that I had come to know and accept. Those tiny thoughts, feelings and sensations were entirely absent, no matter how hard I tried to find them internally. That was when a thought came to me: “The cancer is gone; I—that sense of transcendent self—am OK.”
Four days later, my oncology scheduling person—Lindy—called me, who I had bonded to. There was joy in her voice, as she told me I had no lymph node involvement and a Stage 1 tumor. This was a good as it could be at that moment. Today, as I write this is 15 months sense those events, and all the tests to date show no cancer.
All of this is a story of working at acceptance—noticing my thoughts, sensations and feelings, including the ones that were and are so unpleasant. As I write this, I can see had I not embraced those thoughts, feelings and sensations, I might be facing a far more uncertain health path.
Today, I hypothesize that acceptance of one’s own thoughts, feelings and sensations leads to better self-care. Such acceptance enables people to make early choices to act for health and well-being, as one notices the currents of physiological and psychological processes in response to context and history. We may not have a language to describe the song of cytokines calling to our immune and central nervous systems. We can, however, accept that they do scientifically “sing”, and we can sense that via the complex thing we call our brains.
I no longer hear the cancer sing. Perhaps, they heard my invitation to move on or live quietly without harming me. I accept that they can come back, welcome or not. Now comes my commitment to live a healthy, well life filled with good friends and love as well as daily works that fit my goal to better the world.
CODA:
We have good data to suggest that acceptance is related to health, and I expect that science will grow. Just today, I received notice of a scientist who published a prospective, randomized study of breast cancer patients who received psychological support. Women who received such support were 45% less likely to have cancer return and 56% less likely to have died from cancer.1 To make use of such support, one must accept all the thoughts, feelings and sensations that come with cancer.
References Cited
1. Barbara L. Andersen H-CY, William B. Farrar, Deanna M. Golden-Kreutz, Charles F. Emery, Lisa M. Thornton, Donn C. Young, William E. Carson III,. Psychologic intervention improves survival for breast cancer patients. Cancer 2008;113(12):3450-58.
Tags: Acceptance, Cancer, Commitment, Prevention