How does uncertainty play out in your life?
Living with so much uncertainty is hard. Human beings crave information about the future. Not getting answers around pancreatic cancer is one of the most challenging parts of the disease. I tell my patients it is unlike anything we have ever experienced. In our professional and personal lives, we are used to getting solutions to our problems. In managing any challenge, it is essential that we trust our team, believe in ourselves, and stay grounded in the present moment. Whether you have stage 3 pancreatic cancer or any other stage, staying disciplined, identifying and focusing on our strengths is vital to managing self-control and creating a positive mindset and a healing environment.
“Uncertainty is the only certainty there is.”
Dr. Judson Brewer, director of research and innovation at Brown University's Mindfulness Center and author of "Unwinding Anxiety: New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind," said, "information is food for our brain. But when there is continuous uncertainty that we can't resolve, that leaves people feeling anxious. They can feel overwhelmed because there's no resolution; the brain cannot solve the problem. That leaves them feeling frazzled, tired, exhausted. This last year has created a huge amount of uncertainty in so many different realms."
Cancer patients and caregivers, by necessity, must become adept at living in limbo. What will the scan reveal? Will my treatments be effective? Will cancer come back? We don't know. Will we be alive in two years? Some cancer patients become depressed or anxious, while others develop incredible resilience. I've been struck by how my patients find strength through uncertainty.
Fred Hutch psychologist and patient outcomes researcher Dr. Salene Jones described resilience as adapting to stressful events. "A person can be sad, unhappy, or stressed, and still, ultimately, be resilient. Resilience is not the absence of feeling stressed but finding a way to cope with it. It's OK to be a mess sometimes. Just not all the time."
Instead of resisting, practice acceptance of a cancer diagnosis - whether it’s stage 3 pancreatic cancer or another stage. Acceptance is about meeting life where it is and moving forward. Acceptance allows us to see the reality of the situation in the present moment. It frees us up to move forward rather than be paralyzed by uncertainty, fear, or argument. We accept whatever is happening in the moment. Practicing acceptance in the face of difficulty is complex and is also the most effective way to move forward.
To strengthen your resolve, imagine you are a different person or visualize yourself having accomplished the goal. I talk to myself as if I was coaching a best friend. A great stress reduction tactic is to not believe everything. I think my imagination goes wild in times of stress and can come up with the worst-case scenarios. It is as if I have an evil twin inside me, creating a canvas of devastating possibilities! However, evaluating these scenarios can be helpful so we can weigh the risks and prepare. I can't allow myself to feel threatened, afraid, unsafe, or vulnerable when alone with my thoughts. Instead of buying into every stressful idea, we can actively imagine the best possible scenario. I tell my patients to visualize a healthy body, a happy, productive self, cancer-free to help eliminate stress.
In that uncertain moment, we can check in with ourselves – what am I feeling right now? If possible, label it. Could you give it a name? Don't allow this to hijack our awareness and attend to what is happening in our inner world. Believe in yourself; tomorrow is another day. I refused to believe I had months to live. I took baby steps, and some days, it took everything in my power to get from one hour to the next.
At a shallow point in my divorce, I had to move in an unexpected time frame. My birth sign is Cancer; we have a primal need for security on the home front. I derive so much pleasure and nourishment from my home; it is my everything. I was unsure where I would be living, how I would make this happen in such a short time, or if any of my possessions would remain with me. My world as I knew it was falling apart. I took quick steps, focusing on the present and not allowing the 'what ifs' to take over. I had given thought to a few cities/states where I might reside, selected one, flew down for a day for apartment tours, and signed a lease within 48 hours. Uncertainty was everywhere; it was traumatic! Moving 1,450 miles across the country and knowing only one couple in this new city which was virtually unknown to me was terrifying. I was sad, emotional, and just plain miserable. The first few months in my apartment were devastating. Boxes everywhere, nothing made sense, and I felt so lost not knowing anyone or the surroundings. I knew nothing about this city; it was exhausting having to rely on GPS for absolutely everything! And my poor sense of direction did not make this any easier! Each day dragged to an increasing halt with the sun setting, the light escaping from my apartment; the solitude and silence were achingly painful.
“Loneliness is the poverty of self: solitude is the richness of self.”
Fortunately, I enjoy my own company. Nourishment of my imagination and wonder resonated therapeutically. I tried not to get ahead of myself. I practiced the exercise of imagining every stressful thought into the best possible scenario. Ten days before my move, I saw myself driving my SUV alone with a U-Haul behind me, loaded with my wine collection, touring some of the southwest, listening to books on tape, and savoring the desert landscape. I imagined this to be a great adventure! Until my girlfriends shook some sense into me with unsavory stories threatening my health, safety, and a completely unreasonable timeframe.
Tragedies I have experienced in early childhood have been excellent training for all uncertainty. I learned that I never really know what's going to happen next. I plan as best I can, but now, I pivot my thinking because of the many challenges, including my cancers. I can cope with more of life's unexpected switchbacks, accept the difficulties and keep going, even though it is so darn hard.
How we navigate a crisis, or traumatic event depends on how resilient we are. Resilience is the ability to recover from difficult experiences and setbacks, to adapt, move forward, and experience growth.
I have spent many a late night with a close girlfriend sharing stories of our life experiences and what tools we call upon in our resilience toolbox. While her childhood was not as toxic or turbulent as mine, she has had plenty of challenges that could crumble someone less strong, intelligent, and resilient. Yet, she has optimism written all over her with cognitive and emotional flexibility, social connectedness, a passion for making a difference with kindness, generosity, and integrity is always in the forefront. These tools belong to a resilient person, and we talk about our gratitude for the unexpected slings and arrows that have come our way. We continue to learn to accept what we can't change about a situation carefully and ask what we can change. Accessing our toolbox strengthens our ability to cope. And we are relying on each other. I love these discussions because we consider ourselves very clever, intelligent, determined, and capable of solving any problem!! Of course, a glass of wine enhances this picture!
“I read and walked for miles at night along the beach, searching endlessly for someone wonderful who would step out of the darkness and change my life. But it never crossed my mind that that person would be me. ”
My move across the country was traumatic, exhausting and lonely with all the challenges that accompany a move, and then some! However, I could not have predicted what lay ahead in the extraordinary setting that provided a community of support, friendships, and social connections. My apartment building is on 4 acres in the heart of the city, providing an aesthetic, rarified beauty. What is more distinct are the residents of all ages that provide a unique community much like a dorm! You can be as private or social as you wish. So many neighbors, now dear friends, have opened their hearts and homes to me, adorning my door with never-ending treasures and treats.
They have provided ongoing care and support during my hospital stays and home recoveries which was extraordinary. Trays laden with flowers and gourmet meals 3x a day for months nursing me back to health. We have shared solace and assistance during weather crises, enjoyed many fun-filled poolside dinners, champagne croquet tournaments, cocktails in the garden, card games, movie nights, and so much more.
I am so grateful for the one couple I knew in Dallas that made it possible for me to move to the only available apartment. But honestly, the minute I moved in, the community of neighbors embraced me in a way I have never experienced. Their support was and is tangible, emotional, informational, generous, and loving.
A fire has changed this fairy tale story, and once again, uncertainty has reared its ugly head. Two months ago, a 4-alarm fire ravaged one apartment on the top floor, leaving destruction in its path. Fortunately, no one was injured. However, soot, smoke, and water damage have forced many residents out of their precious dwellings for the next 12-16 months. Each week we are presented with new information about damage discovery and what units need to be evacuated.
The fire occurred on floor 14; I reside on floor 4 on the other side of the building. As my pod is now scattered across the city, we still get together, but of course, it is different. I miss the casual drop-ins, spontaneous cocktail get-togethers, late-night visits, wardrobe consultations, and potluck dinners we shared with ease, laughter, and enjoyment.
We are committed to each other and continue to make the effort to stay connected. I celebrated a birthday recently, and the incredible celebrations created on my behalf were extraordinary, unbelievably generous, and beautiful, heartfelt expressions of love.
This month I celebrated 15 years as a pancreatic cancer survivor and my 70th birthday. While I revere these milestones, there is a vulnerability that accompanies them. I know a few long-term pancreatic cancer survivors who suffered a reoccurrence and lost the battle after a long, brave fight. Dispassionate discipline is required not to allow this thought to occupy my mind. I can intellectualize this and practice discipline to work on the emotional side. Nourishment of my imagination and wonder resonates in such a way that I can eliminate the fear. I make peace with the darkness. I refocus on a better feeling, things that will shift my focus and mood. This might be in the form of exercise, an awe walk, or anything outdoors. Music, art, laughter, cooking, reading are all things that help shift my mood.
Entering my 7th decade has occupied my thoughts with gratitude and fear. Losing my apartment community has created a heightened vulnerability by not having them physically on site. I miss them!! I recently enjoyed cocktails with neighbors at 7pm, was in bed at 10 pm, and found myself texting them at 4:30am, doubled over in excruciating pain. They rushed me to the hospital, where I went into emergency surgery for an obstructed bowel. And, of course, they were there for me for my recovery, attending to every need.
I am terrified I will have to move. However, I am practicing the counsel I give to my patients. And that is to stay grounded in the present moment and focus on one's strengths because imagining every worst-case scenario is pointless and only increases anxiety. My resilience toolbox is overflowing. I have the most incredible community of loving, caring friends that I know will support me in ways I never imagined as I will do for them. I will always be there for them. Meaningful social connections are crucial, ever more so in crisis. The pandemic didn't reveal that relationships matter; it just put it into sharper focus.
I am devoted to my cancer coaching and advocacy work that keeps me extremely busy. How lucky and blessed am I to have this opportunity to reach out and make a difference?! Research has shown that dedication to a worthy cause or a belief in something greater than oneself has a resilience-enhancing effect, as does the ability to be flexible in one's thinking.
Just a month ago, America's path out of the coronavirus epidemic was lined with optimism. However, vaccinations have slowed, the virus is spreading with variants, and the CDC advises masks again. Uncertainty still hangs in the air. So, what are we meant to learn from this? Finding meaning within chaos is a core component of resilient leadership and coping!
I read that the opposite of uncertainty is not certainty, rather presence. I believe the pandemic has made many more present, attentive, and better listeners. I hope this remains with us forever.
Last night I watched an episode of 'Heartland.' Valedictorian Soraya gave this thoughtful speech at her high school graduation:
"...thinking about the future, everything is uncertain, and anything could happen. Maybe graduation is about accepting uncertainty. Accepting we don't have all the answers and we are going to screw up some of the time. That doesn't mean we shouldn't be afraid to keep going and to take big bold steps even if that means we fall down now and then. Today we take the first step together and even if we fall, at least we will be there to help each other."
I love this message! I will continue to take big, bold steps. I don't have all the answers, and I will continue to fall. Knowing my family and friends are there for me has never been more important. I hope this is true for you as well. Promise me you will never stop telling those in your life that they are loved, respected, needed, appreciated and adored.
How does uncertainty play out in your life?
Comment below or send me a message and let me know if I can help you with your uncertainty.
