Losing a Comforting Ritual: Treatment

For those who have never been seriously ill, treatment often seems cut and dried. You get sick, you get treated and, in theory, you get better. One day you’re a patient, the next you’re not. Simple, right?
Well, sometimes it’s more complicated than that. As I was being treated for an aggressive prostate cancer this past year — surgery, hormone therapy, radiation — I experienced an unexpected side effect: post-treatment letdown.
It tended to arrive right as a cycle of treatment was ending. It snuggled up against its old friend uncertainty and whimpered, “So, what’s next?”
None of us want to be sick, be obliged to take our medicine. But we are also creatures who love habit and ritual, and medical treatment is a very structured exercise that plays to that craving.
When I had radiation for about two months last winter, it began to feel as familiar as a job. I knew the names of the hospital parking attendants and the receptionists. The nurses, doctors and therapists all smiled and said hello, and I did the same.
Each day I arrived at radiation oncology, checked in, got my hospital bracelet, changed into a drafty gown, then waited with my fellow patients — my colleagues in cancer — to be treated. Once a week, my weight, blood pressure and temperature were taken and I met with my radiation oncologist. I had become a regular at the radiation spa, had even learned to artfully jiggle the key in the stubborn locker doors.
Then it was over.
Which is a good thing. But even though it was a relief to be done with the radiation, it still felt like getting fired or laid off. For two months I was the subject of intense attention by the medical staff. And there was the professional yet intimate laying on of hands each day as I was positioned just so in the TomoTherapy machine.
For 33 sessions, it seemed then, radiation oncology and I were infatuated with each other. But as I got dressed after that last session and then made my final goodbyes, suddenly we were “just friends.” And there was no shortage of patients to take my place.
We patients know that not having treatment is a sign of progress. But sometimes having treatment, doing something, is easier than the uncertainty, than the waiting. It’s like being stuck in a traffic jam and taking the first exit that comes up just to keep moving. When treatment ends, it’s just you and your mutinous body warily thrown back on each other.
I noticed a similar letdown when I returned to work late last summer after my radical open prostatectomy in July.
For seven weeks, my only goal was to recover from surgery. My days were measured in naps and in languid laps around the block, in Percocets and the draining of my catheter. The world’s worries were not my worries. If I couldn’t see it out my bedroom window, it didn’t concern me.
And because I was recovering from cancer surgery, and because I already knew that I would need additional treatment once I healed from the operation, I reveled in the most minute of details: the black pads of my dog’s feet as smooth as a baseball glove, the wet-cellar smell of a vintage science fiction paperback, fireflies winking and waning at dusk.
Pierced by a keen sense of my own mortality, I was much more interested in discerning the small miracles embedded in each moment than I was in catching the 9:03 Midtown Direct to Penn Station. And there was a part of me that was disappointed when the time came to once again catch that city-bound train.
Don’t get me wrong. I was glad I felt well enough to return to work, glad that I felt strong enough to navigate the hurly-burly of New York City. But in returning to work, I was also trading in a certain depth of perception. Cancer and surgery had slowed me down, made me look and listen, smell and touch with the eagerness of an explorer entering uncharted territory. Midtown Manhattan doesn’t quite encourage that kind of dawdling.
These days — four months out from my last hormone treatment and five months from my last radiation session — I don’t feel so much let down anymore as a bit confused about how to refer to the status of my health.
I am still a cancer patient, still being monitored. I might even still have cancer, but then again I might not. One day I’m a patient, and maybe the next I’m not. And on that day, I guarantee you, I won’t feel let down at all.
Dana Jennings is a reporter and editor at The New York Times. His postings on coping with prostate cancer appear each week at nytimes.com/well.