Five Reasons to Get Cancer

Early last November an ancient Chinese koan came to me as if written on a billboard and it has been with me ever since. Here it is:

The teacher calls out, “Master!”
And answers, “Yes!”
“Are you awake?”
“Don’t be fooled by others!”
“No! No!”

I was diagnosed with prostate cancer at the beginning of November and here is what I’ve noticed.

1. The kindness of mortals. If I don’t expect them to be rushed or distracted or impatient or narrowly self interested, in other words, if I am not rushed etc. Almost every interaction emerges slowly and is deeply felt–the way athletes describe a big game when time slows down and vision widens.

When the koan appeared I took it as a response to the biopsy results. The diagnosis seemed alright at the time I got it but I observed that the small consulting room became large, time slowed down and everyone’s eyes grew big. That room became a ship hanging in space, a ship I can still visit if I wish, and sometimes do. That moment was the last moment when I hadn’t quite absorbed the news, when I didn’t quite have cancer yet. Afterwards the thing that struck me was the feeling of nakedness with people, of falling into their eyes and swimming in the spaces there. In the end, this intimacy seemed to be more significant than the news about cancer–the response to a very interesting call.

At the same time, there were patterns that were the contrary of this nakedness. I noticed that I wanted people to be OK with where I get surgery which distracted me from the question–I wonder where I’ll get surgery? There is often a slightly craven piece in me that wants to be liked. I don’t much like that part but there it is. This is a big good thing about cancer for me, cutting that imagined thread, not thinking that love is turning aside to manage other people and how they feel.

2. It’s so obvious, once you know the trick. If you walk up to a cliff, a door will appear. The obstacle is itself the gate. This only happens if I’m willing to keep walking. Each wall is a large, rather smooth, dark expanse and I keep walking toward it without knowing what will happen and then a doorway appears. This is like calling out, “Master!” and hearing, “Yes!”
When you get a diagnosis you enter a different country with different habits and laws. The customs officials don’t care who you were wherever you came from, what the spring flowers were like, or whether you walked by the sea with your child, counting the waves. They are not so much heartless as determinedly uninformed; their iron rule is that you will conform to the laws of the new country and that you must find out these laws for yourself. Your initiation begins with insurance–what methods will be paid for, how much will be paid, to whom, and who is allowed to treat you. The density and heaviness of these tasks was puzzling until I realized that bureaucracy is just a feature of the underworld. It is just a set of customs and ceremonies that gathers around diagnosis. The Sumerian myth of Inanna describes the journey fairly closely. As you descend, you come to guardians at each gate and, though you negotiate, you surrender something-your crown, your jeweled belt, time, an idea you had, the belief that you would be able to function in a certain way for the rest of your life, the thought that you could avoid this journey. The prize for surrendering is to go farther down, to the next gate and the next surrender–in my case, closer to surgery.

The initiation phase took a couple of months; informing myself about the customs and treatments, wrestling the insurance guardians into opening the gates to the surgeon I wanted. Sometimes I knocked on doors with no one behind them, and at other times I had the image of stumbling in upon bird-headed beings making cuneiform incisions on clay tablets. This phase was devoted to the idea of the body as matter, money, plumbing, pain, something that involves time. The guardians were devoted to searching out and recording details that are minute and trivial in the land before diagnosis. I began to appreciate and even enjoy the monotonous repetition, the theater of it, the endless walking across an essentially featureless landscape. It occurred to me that perhaps this endlessness is the appeal of bureaucracy, a kind of false immortality that comes from immersion in trivia.

Hello, I have cancer and have been referred for a second opinion. I’d like my medical records.
Who wants them?
I do.
Which doctor?
Well I was hoping to hand carry them.
Where to?
To Stanford and Duke.
Why Stanford?
Well they answered my telephone call; UCSF didn’t.
What is the address for that?
I was hoping to hand carry them.
We can’t give you the records.
I think you can.
We can?
Hang on a minute…I’m back. Ok, come in and fill out a form and then we’ll put in a request. You’ll get it in 4 to 6 weeks.
Um, my appointment with Stanford is tomorrow morning. I was hoping to come in this afternoon…etc.

Or a variation,
What kind of recovery rates do you get?
40 to 60 per cent of patients get good functioning after a year.
Um, how many of these surgeries do you do per year?
About twenty.
Is there somewhere that does more surgeries?
Not that I know of.

The quest became essentially about timing, a dance. People said yes or no or send more paper work–just like the colleges my daughter was applying to at the same time. I came to feel warmly towards the people involved. It was a secret society, and gradually allies appeared who knew the hidden passwords.

The obstacle inside myself was also the gate. The thought that this or that bit of me won’t function after surgery or should function was refusing the call. It was like trying to see the gate before I was right against the cliff. When I just didn’t know I was much more light hearted.

3. The love of simple things. A wall, a chair. My ordinary thoughts can often have a certain amount of refusal in them–I don’t like that chair, it doesn’t look comfortable. That refusal disappeared. The chair, the wall, the eyes of the supermarket cashier are all monuments in a vast field.

When I was first diagnosed I noticed that I was attracted to archways, and found tunnels with their promise of an endless journey, moving from twilight into deepest night, intensely appealing. Without thinking that there might be a connection, I bought a watch, bought time. I bought new luggage–for setting out. A winter coat and blankets–to keep me warm. Again without thinking about it, I found myself drinking pomegranate juice, the food of the underworld. Faced with any task, I thought “Oh I can do this because I have cancer.” Clean up the dog shit, spend hours helping my daughter with a project. Time is what I have an infinite amount of, since I don’t know when it will end. I can waste time, enjoy a raindrop soaking into the ground.

4. My own reactions have sunk further into a kind of stillness or darkness, as if a wind is blowing out of the depths. I was driving along looking for a vacuum cleaner store. I noticed a guy tailgating me and then stopped noticing him. I slowed, found the store, turned and parked. Then a man drove up towards me in a Subaru. He and his dog were both looking at me. I turned the ignition back on and wound down the window. He yelled at me for driving like an old lady and some other stranger beings. He had driven round the block to do this. I didn’t go through the operation I sometimes do of explaining him to myself. I felt happy, and simple, as if honey had been poured over me. “Thank you,” I said, smiling radiantly. “Thank you.” He paused. He rolled up his window and drove away.
Meanwhile the koan kept me company, when I woke in the middle of the night, when I went to bed, when I taught retreats.

“Are you awake?”
“Yes! Yes!”

The koan feels autonomous–that it has a development beyond my thoughts about it. It gives me a sense that the timing of events is probably perfect, everyone has conspired to make the timing perfect. I can rest in uncertainty, held up by large forces moving in the dark. “Don’t be fooled by others.” The others are me.

I had a dream which went in this direction too. In the dream, I’m in the center of five or so very tall beings. They have wavy, thin bodies, and are about 60 feet high: they are spirit beings called Mimis and are seen on rock paintings in Northern Australia. The Mimis are interested in me and I keep seeing through the eyes of one of them. I see myself, the man below, dancing and moving about in connection with them. Because of this his movements don’t make sense in the day world. The Mimis might be able to heal. One stretches a long finger down towards me. They live in another realm that intersects with ours and mostly their purposes are not to do with ours but sometimes they intersect and are interested. That’s what’s happened here.

Aboriginal people of western Arnhem Land say that their ancient Mimi rock pictures were painted not by humans but by the Mimis themselves. The drawings, usually in red ochre, show elegant, graceful extremely tall and slender human figures in action–running, dancing, leaping, making love, hunting, fighting–the human things. Mimis live in the nooks and crannies of the rocky landscape, coming out at night. They are so thin and frail that they can come out from their hiding places only when there is no wind, otherwise they might be blown away. The Mimi are the Dreaming ancestors who taught people to paint, hunt, dance and compose songs. It seemed good to have them interested in my case.

5. Cancer can be funny, like anything else. This is better than the alternative.

A friend, herself a surgeon, offered to come into the theater.
“How is it watching someone you know get cut open?
Her eyes grew wide in appreciation the way they do when she looks at her two year old. “It’s great. I’m fascinated.”
She met my surgeon.
“As you know, I’m in ObGyn, I don’t get to see inside guys.”
“Oh good, you should come along. I’ll tell the anesthesiologist.”
Then we all laughed.

That there are excellent things about cancer seems a joke too. I understand odd things. For example when I lose something precious, I can be happy for the person who found it.

All these forces led me to the G1 clinic in Duke University Medical Center. The Medical Center is defined by corridors which are color coded–Orange, Brown, etc. and are nonetheless incomprehensible at first. G1 is the urology place-the stream team they call it. Anesthesia is the dream team, radiology the beam team, I decided not to ask about fertility. The physician’s assistant has done the orientation so often that it’s a kind of standup routine. He’s a guardian spirit, helpful, skeptical, suggesting what to believe, what not to believe, how to get into a research protocol, offering his cell phone number.

How many surgeries does the team do in a year?
A couple of hundred.

Surgery is, among other things, a manual skill like tennis and it’s generally acknowledged that you are better at it if you practice a lot.

Over 90 per cent have good functioning within a year, usually much sooner.
We don’t like to spill blood.

I’m scheduled for surgery first on deck on the morning of February 22. Kind people have given me hypnotherapy, acupuncture, bodywork, Taiji instruction, and also refinanced my house. There is a rational part of my thinking that says, “This is good, I have a genetic history for this cancer, get it out of me if you can.” And then there is something more like a lizard consciousness that is deeply perturbed and says, “Knives, blood–Bad!” Sometimes the lizard’s eyes roll in his head. Sometimes he feels sad with an intimate, animal sadness. It’s not a poor-little-me sadness–it’s just that his eyes are wet with the kindness and sorrow in things. I must say that I like the lizard.

So far it all comes down to this. It’s the joke of life, a funny joke, not a bitter one. I have stepped off an edge and am falling, happily towards an outcome, like Alice down the rabbit hole. I can take marmalade jars off the shelves and look at the pictures as they go by but no decisions are needed. The universe is managing things and I imagine that I’ll emerge in a place that’s different from anything I might expect. I don’t have to listen for the call. The call comes and the response just appears, “Yes.” Unexpectedness is itself a kind of freedom.

“You have cancer!”
“Yes, I do!”

(NB: Rachel Boughton edited this piece. It was originally written February 21, 2006 for Shambhala Sun.)