Anna Donald: Making meaning in the now, for the now

First, I want to thank the many people who have posted such thoughtful comments to this blog. I’ve been a bit overwhelmed, though not surprised, by people’s generosity (again and again, cancer has revealed to me the kindness of strangers as well as friends). To my embarrassment, I haven’t been able to get my login details to work, so haven’t posted replies. I will certainly reply to several people’s kind suggestions once I figure out how to do so. (BMJ help!)

Second, I’ve been slow to blog due to an eventful week. The son of a close friend was one of six young people killed in a boating accident last week on Sydney harbour, just below Taronga Park Zoo. Earlier that day, I had remarked to another friend that there are many people concerned for me living with advanced cancer. But, because I know a lot of people, by chance alone a few will probably die before me. And now this. I guess we’re all in a state of shock.

It brought home (again) how Shakespearian-fickle life is – I really don’t know what’s coming next. I had no idea I would get Stage IV breast cancer – that was what unfortunate young women got, not me! And tonight, I am alive while my young friend is dead. It made me reflect, again, how lucky I’ve been – I’m already twice his age. I have travelled the world, married happily and had every job I ever really wanted – all before I was 40. Maybe I wasn’t ambitious enough. But it was enough for me. I don’t want readers to think that I’m not interested in (many!) more years of life. But I was struck, again, by how happy I am, already, with what I’ve been dealt. More would be great, but not essential to being happy now. I hope I see Vietnam and Iceland, but it will hardly be a tragedy if I don’t.

No doubt, I’d prefer quality and quantity. But more life is just more – and how much more do you need? – in this horrifically banal age of eat till you drop because there’s nothing else to do: 1000 films to see before you die! 1000 albums to listen to! 1000 destinations to visit! 1000 books to read! Eat! Eat! I feel tired thinking about it, like some kind of laboratory rat. (I know about such things. My engineer-uncle used to design rat cages for the psychology department. No matter how many pellets they’d already eaten, the rats would keep pressing the food lever like demented – well – rats. My job, aged 3½, was to let them run around inside my playpen on the lawn, which involved several mass break-outs and a lot of scrabbling beneath azalea bushes to retrieve them before the kookaburras did).

Of course it’s nonsense – worse – sacrilegious – to suggest that life is a rat’s cage. From where I stand now, I would argue that life is absolutely sacred. More life means time with people I love: my husband; my parents; my brother’s family. For these people alone, never mind my extended family and dear friends I will do whatever I can to live longer. It’s just that if quantity isn’t possible, as it wasn’t for my young friend, then you want to know that you’ve jolly well made the most of what you have.
Early last year, I woke up in University College Hospital after the day of tests which revealed the extensive nature of the cancer. I remember laughing at myself because of the relief I felt that all the youthful angst and navel gazing was worth it: the therapy, the workshops, the earnest conversations, the meditation, the reading – because I could honestly die free and peaceful, if that was my lot, at the ripe old age of 40. I hadn’t lived a perfect life by a very long shot, but I’d honestly tried to work away at those parts of me that left me (and others) less than impressed. Not that I’d always succeeded. But at least I knew I’d tried pretty much as hard as I could and the relationships that really mattered to me were in reasonably good shape.

That was all very well. I didn’t die. I kept living, with the scary knowledge that it really, really matters how you live. So it’s not OK to shop till I drop. It’s not OK to sow misery and depression among others. It’s not OK to sit like a blob waiting for – what? Death? More treatment? Godot? Which is why I spend most days reading, reading, talking, blogging trying to make something of this time, however long I’ve got. Rubbing off a few more rough edges. Taking a brush to my more desultory habits without becoming a prude (unlikely) or a moralist (eminently possible; please God and Readers strike me down if I start to sound like one). Making meaning in the now, for the now – probably the only life insurance policy I’m able to have. It’ll do me just fine.

Anna’s 4th blog: Wednesday, 07 May 2008

  • Dr Guillermo Acebedo

    Dear Ann:
    You should see the letter published by Journal of Med. Ethics on May 2007: Calendula officinalis for gastric cancer.
    Our patient is doing well after 17 months treated with Calendula officinalis (Lab. Mayflower. Colombia. S.A.) as we reported to the editor of BMJ.
    Thanks for publishing these important findings.
    G. Acebedo
    ACS. member.

  • mercedes

    dear Anne,
    I’m an Italian doctor, I mean leaving in Italy too. I felt very impressed when I read your blog the first time, you’re so brave!and full of life! Sorry for your young friend’s death…
    a great hug!

  • Dr Anthony Papagiannis

    Dear Anna,
    These days I happen to be looking after a 31 year old girl in her sixth year of widespread ovarian cancer. Despite her advanced disease she manages to wear a smile that drives us all to tears. Another friend, slightly older, had her remaining breast removed yesterday, 10 years after her original mastectomy, for a relapse of her disease. Dramatic reminders of our ‘brittle’ earthly nature, that draw aside the curtains behind which we live while we are healthy. If only we could look beyond the visible, then we could live our remaining days (however many or few these may be) under the prism of eternity, with faith, hope and love. Please keep up the good work, and keep hoping!

  • Susannah Denny

    I was stunned to see your photo and details of your blog in the BMJ this week. I find it hard to believe that you have breast cancer, having spent our clinical training together in Oxford all those years ago. Will be thinking of you. Susannah

  • Tom

    Excellent post. And I heartily agree: go for quality and quantity, but focus on the former… ‘better to live on your feet than to die on your knees’, or some such thing.

  • Dr.Viveck Atheya

    Dear Anna,
    We dont die because of a disease.We die because our time has come.This time is individual’s very own.Indian monks hypothesized that ones’ number of breaths is preordained(so the yoga & Praanayaam -to decrease the No. of breaths per unit of time and try to prolong life).I hope this fact gives you something to think about and help u with ur quest to reach fruitful conclusions regarding Life-Disease-Death.

    Viveck Atheya

  • Catherine Harkin

    Hi Anna. i too am a member of the Cancer Club and had a mastectomy in 2006. i identify with a lot of what you say……..the depth of terror i experienced going through the diagnostic processes was like nothing i’d ever met before, and i will never, ever call a patient “anxious” again. i am considered “cured” but you never know do you…….and i had the same idea as you, that even if i die now i’ve already lived longer than most women in the developing world and had a pretty full and exciting life. the only way i could cope when the fear overwhelmed me was to think, well, i AM going to die………but not today. some time it will be today……..but until then you might as well live.
    i did find the reactions of colleagues quite strange in some cases……..i’m not sure whether it was the word “breast” or the word “cancer” that caused one of my colleagues to burst out laughing but i did find that a tiny bit inappropriate….. like you i was amazed at how kind and understanding many people were, but i found it odd and hurtful to get the “leprosy” reactions of those who felt embarrassed or didn’t know what to say. i’m proud of my scars………i went through a lot of pain to get them, and since i had a LD recon i can now flex one of my boobs which is an interesting party trick that i’m happy to demonstrate to anyone who wants to see it. going diving off the Barrier Reef three months after the op was quite a struggle, as was the first post-op Munro……..but it’s great to be well again and appreciate all the good things of life………

  • Neelima

    Hi Anna,
    I have been also struck by the same beast…My life has changed ..from anger, rage, why me times… I was looking at the world through the tinted glasses of immortality before which I removed after the diagnosis.I can see the picture clearer now . I laugh at myself now…how death seemed to frighten me before…doesnot do it now. I say to myself…I came from no where? I will go in to no where.That is the ultimate truth.Rest is all maya.It is all a matter of time…for each one of us.I just pray to GOD if there is make the journey for each one of us you

  • gurpreet khaira

    Dear Anna,
    The Anna I knew never shut up, never gave up and never took no for an answer. I’m proud of your academic achievements and all that you have given to medicine. I, as you know, became to the humble GP -much to your diappointment for not fulfilling what you perceived was my academic potential. General practice has taught me one thing though-that cancers often don’t follow the prognosis; that there is something more powerful than predictions-call it God, faith or love.
    Thankyou for sharing your journey. I’m sorry we lost touch with each other-after finals and the birth of my children.
    If you spot this email and feel inclined I’d love to share your busy life via email. You are the person who persuaded the editors of the OTM to substitute he with he/she as a humble medical student.
    Thinking of you Anna-with love Gurpreet & Harmeet

  • Luis Gabriel Cuervo

    Dear Anna,

    It is good to open the page and find your wonderful transparent smile. Thanks for reaching out to your colleagues and friends from all over the world, allowing us to hear from and learn from your thoughtful insights.

    What a privilege to learn from your perspective on the very important issues that you are bringing up! You certainly enrich the issues with your unique set of skills and with your talent. The challenges you face and so brilliantly display of bringing together evidence (or its lack of) values and context are humbling and a continuous learning experience. I appreciate your allowing us to reflect on the realities of facing such a situation, and enriching these reflections with selfless insight and pragmatism.

    I am humbled the strength, courage and determination you have had to overcome fears and to share your learning experiences thriving in these challenging times, in a very unique way. I will continue reading your blog with delight, knowing that all that that makes you so special can come with the strength and response seen in people who beat the odds and overcome such health problems.

    Warm regards,

    Luis Gabriel Cuervo

  • Birgitta

    Dear Anna
    I am so impressed that you have the strength to share your thoughts and feelings with us. You are really a wonderful person. And your blog is turning into a very interesting document, also because of the replies, that display a lot about the different views on disease of different cultures. So here is my contribution:

    I got breast cancer when I was 42. I had 14 positive nodes of 16 removed and thought I would be dead before christmas, but I am now 56, alive and well, stronger and wiser and probably a much better doctor than if I had not been ill.
    I had chemotherapy but also used complementary medicine, and it was very important for me to choose the treatment that felt right for me. My childen went to a Waldorf school, so I used some anthroposophy healing methods and homeopathic medicine and I also used visualization daily. When my white blood cells were too low for me to get the full dose of chemo, I could use visualization to get it up above 2 and get the full dose, which I wanted, now I had decided to have the stuff.

    I read with great interest about your meditation training and I really think you can get far by mobilizing the healing systems and powers of your own body. So I look forward to following your blog and your thoughts. Good luck, be as happy as you can. A big hug from me!

  • gurpreet

    have been looking out for your next blog; hope your feeling ok.
    Have been thinking of you lots and can picture your face asking ‘ why? why? why?’
    I can see you’ve searched high and low for the answers. I wondered if you have ever read ‘Japji sahib’-the sikh morning prayer-it may give you some comfort. There are some translations on the internet but most of them are pretty poor-your nearest temple in Sydney may have a good one otherwise let me know if you want me to send one to you.
    Anyway, Anna -there are clearly lots of people who care about you a great deal; how many people can say that their life has touched so many.
    Sending you a huge hug and lots of love-gurpreet.

  • Ghislaine Young

    As with several others Richard Smith alerted me to this blog. Synchronicity or mere coincidence? I have been aware of thoughts of death ever since my father died in an accident when I was only a child. I realise that at a subconscious level I entered nursing because it appeared that doctors and nurses were on the other side of the “big divide”. More recently a close friend has been diagnosed with pancreatic cancer. For a time I started to feel guilty whenever I laughed, relaxed or read a novel, when others were made to count every second. But as you so rightly say Anna “more life is just more” and all there is, is the present. My hero the metaphysical poet said so eloquently: “no man is an island entire of itself… any man’s death diminishes me because I am involved in mankind, so never send to know for whom the bell tolls, it tolls for thee”. Anna you are blessed because you are seizing every moment, you love and are loved in return. Its is more than any of us can ask for in life. I shall leave my final words to my all time favourite medieval hermit, Julian of Norwich, who speaks on the nature of the Divine: “Love was his meaning…Hold fast to this and you shall learn and know more about love, but you will never need to know or understand about anything else for ever and ever”.

  • Jade

    dear anna,
    you came to our school on the 8th, duncraig and i found it very interesting and just would like to say thankyou as i have never met an author of a book i have read an enjoyed.

    kind regards