Last year, as I drove through Columbus, I saw a fundraiser sign for breast cancer research staked to the ground next to a stoplight. Illustrated pink ribbons bordered the sign. Without skipping a beat, I thought, “What a nice thing to do for them.” Them, as in breast cancer patients. What a nice thing to do for them – those who are unwell, who wish there were a cure, who are fighting for their lives. Them.
It took me a few long seconds to realize that them was referring to me, too. In the moment, I hadn’t made the connection between the sign I was seeing and the reality I was living as someone with breast cancer. I was one of those people – one who was unwell, who wished there were a cure, who was fighting for her life.
Perhaps the most personal change I’ve experienced during cancer is the evolution of identity. Prior to cancer, I thought I had my life figured out. I’m an older Millennial, born in the mid-1980s. Shortly before my diagnosis, I had a career as a teacher, I had just moved back to my home state of Ohio, and I was looking for work. I had control over my identity: I was a healthy, hardworking, single woman who lived a relatively carefree life and was looking to settle down. I was living the dream.
When I was diagnosed, two years ago to the day (September 14, 2017), my identity shifted immediately from a healthy person to one with a serious, potentially fatal illness. It was jarring to receive such a diagnosis, to feel my life coming apart after decades of meticulously building it. In the span of a short phone call, when my surgeon called to relay the news – “So the results came back, and they are positive” she said in a melancholy tone – I turned immediately from “healthy person” to “cancer patient.” The label was never explicitly stated by anyone, not by the surgeon, not my oncologist, not by any of the nurses or techs, but I felt the label nonetheless. No one ever said, “Hey, Megan, cancer patient,” but they may as well have. The conversations I had with most people in my life during that time revolved around my illness, so that aspect of my identity was front and center.
I underwent 16 rounds of chemo, had a mastectomy, underwent 33 radiation treatments, had a prophylactic mastectomy, and completed hormone treatment in a 14-month timespan. Treatment was grueling physically, mentally, and emotionally. Now that I have come out the other side, my identity once again has shifted. I am one of the lucky ones who survived, and I am now a “cancer survivor.”
As soon as I completed treatment in November 2018, I found myself having to change my language. Instead of saying, “I have cancer” I began saying “I had cancer.” Instead of saying, “I’m in treatment” I began saying “I was in treatment.” If my medical history ever comes up in conversation, I say “I’m a recent cancer survivor,” which evokes very different responses from people than when I used to say, “I’m a cancer patient.” When I used to tell people I had cancer, their responses were usually rooted in heartfelt pity. When I tell people that I’m a cancer survivor, they respond with something like, “Wow! You look great! I wouldn’t have even known. Congrats! Is that something you say congrats for?” To their credit, in general I think people don’t know how to talk about cancer in a way that centers the experience of the patient or survivor. But hearing that kind of a response seems to dismiss, unintentionally of course, the arduous experience of cancer treatment. And in my case, it makes invisible my fear of recurrence.
In the various identities I’ve had over the past two years – healthy person, cancer patient, and cancer survivor – so much is interwoven emotionally. The way I view my personhood and agency in my own life has shifted drastically with each change in identity. Isn’t agency, the ability to act or intervene, an important aspect of who we are as humans? I haven’t always felt, in the past two years, that I had much agency at all. I came to terms with the fact that I could not control what was going on inside my body, and I relinquished any sense of control to the doctors whose collective agency saved my life.
There is one important aspect of my treatment in which I did have agency. I did not have much of a choice when it came to losing my left breast to cancer, but I did get to choose whether I remained flat or had reconstruction. As a flat woman, I am happy with my choice and am grateful I had a surgeon who respected my wishes. (Not all breast cancer patients are that fortunate.) As a woman in this world without breasts, body parts that society links directly to womanhood itself, I have wrestled with the fact that I still consider myself a woman, but other people may see me as “not a whole woman” or “less of a woman.” People label me according to how they see my body, and those labels may not match how I see myself.
I’m realizing that perhaps what I really want is for my self-ascribed identities – former cancer patient in remission but fearful of recurrence, survivor grateful to be alive, former patient still dealing with fatigue, 100% woman – to be seen and acknowledged by those around me. I want my lived experience of suffering through cancer to be recognized, instead of deprioritized in favor of “how great I look.”
I’m reminded of driving past the fundraiser sign for breast cancer research. If I saw that sign today, I might think, “What a nice thing to do for them.” And in this case, exactly two years later, I’m fortunate enough to say that them wouldn’t be referring to me. I am not Them anymore, but I stand with Them through their own journeys and acknowledge their own evolving identities.