Mental Health and Cancer and Death

February 1, 2022

To say my mental health was perfect before cancer would be a lie (ask Rachel or anyone I have regularly interacted with in my 20s). To say cancer has exacerbated my issues would be an understatement. Over a year ago I was officially diagnosed with Depression and Anxiety- I say officially because I think it has always been there in some regard and the pandemic finally forced me (back) into therapy to figure things out. My depression manifests in different ways. I am not sad and crying all day or shaking and worried. There's times I feel alone when surrounded by people or I just want to watch TV and be left alone- it's a weird juxtaposition with no external cause. Anxiety has me over preparing for everything or the opposite- ignoring it and hoping it goes away. Sometimes it has me thinking of elaborate excuses to avoid things, even on the way to those things (COVID has been a great excuse for social anxiety, thanks COVID). They are both beasts I deal with daily but with medication, a therapist, a psychiatrist, and an understanding family it is manageable.

Then came cancer. When I first heard cancer in the ER I cried which I'm pretty sure depressed or not would have happened. As I stated before I was on plenty of Dilaudid but cancer sobers you up in a second. Hearing it felt like one of those movie scenes where the main character can see everything happening around them but they're stuck in place observing (like they do every week on Euphoria)- then you zone out for a bit from the rush of emotions and then cry some more.  Almost immediately after I thought about dying and my strong preference not to. Everyday since I have thought about death- sometimes extremely depressing and deep sobbing death and other times on a more existential or practical level. I tend to go back and forth since there's still so much unknown and the statistics I have been given so far are not the best BUT there's still so much unknown (I'll positively repeat this until I can't).

Everyone says I'll fight this- and I will to the extent my body and medicine can. The physical fight will be demanding and taxing but the mental fight scares me just as much if not more. While I won't give up and let myself just waste away until I die I do have to prepare in case. Practically that means getting a will/trust established which seems like something you do when you're older but if you have kids get on it. There's also writing out all your login details and ensuring beneficiaries are lined up on any policies you have have, looking at your life insurance, and thinking about your "death plan." I haven't written that out yet but I need to- I still have some time for that hopefully. 

I have cancer everyday. Some days I get good stretches where I'm distracted by my kids,  work or the Bachelor. Cancer is not on the front of my mind on those days. Some days it is all consuming. Laying on an MRI bed (I don't know if that's what it's called- judging by the comfort level it's probably not) multiple times for 45 minutes completely still with very loud mechanical noises in your ear reminds you constantly that you have cancer. Checking multiple health portals to see when your appointments are or if your test results are in reminds you that you have cancer. Sometimes the things that distract you from cancer remind you that you have cancer. Seeing your kids play (and fight) and wondering if you have an even more finite time to be there reminds you that you have cancer. Unwinding with your spouse with reality television and cracking stupid jokes- wondering how many more seasons of Married at First Sight you have left together reminds you that you have cancer. Work, yes work and wondering how many meetings you have left- thousands, hundreds, fifty, twenty- reminds you that you have cancer. Birthdays, holidays,  anniversaries- all remind you that you have cancer.

A lot of my preparation this week has been on my mind and spirit. I know I can die and that statistically my chances that I die sooner have increased- it's a  fact I can't overlook. So how do I prepare myself mentally for a possible death sometime a lot sooner than I expected? How do I hold it together for myself, my kids, my wife, my family, work, and so on? The truth is I have no fucking clue. What I am going to do is talk to my psychiatrist, go to therapy, take my medication, try and enjoy family time without counting the days/hours, and read.

When I say read I still have done little to no research- I am more scared of the internet horror stories sometimes than of the actual diagnosis. Luckily my amazing wife has done all the research of a small university (I mean that as a compliment, she's the academic so I hope that was a compliment). I have looked into a few books on mortality or cancer or death in general. I also finished my first book in probably 5-10 years two weeks ago: List of Ten which deals with Tourette's and mental health and suicide. That book was for "fun." I chose it for the personal connections to my family. I just started a new book yesterday which I think I'll finish tonight: When Breath Becomes Air. The book focuses on a neurosurgeon's reckoning with his own terminal cancer at age 36 (fun coincidence) and how he grapples with his illness, his family, and his acceptance of his fate. While it's heavy on the intellect and medical terminology it's also helpful. He goes through the stages of grief and details his honest thoughts. I have a few more cancer/death books- I don't know what else to call them honestly. I also have a few comedy books too so it's not all doom and gloom.

Please don't read this and think I'm not giving into death based on that last paragraph. I plan on annoying my wife and kids with great dad jokes for years to come. The reality is though that if my time with them has shrunk severely I would like to put myself in the best headspace to enjoy that time and prepare us all for the new normal.

But who knows, maybe I can live to 245 or 300?

Joe