The expression on her face was a mixture of relief and confusion.
I’d seen that same look many times before. The first time I saw it was when I caught my reflection in the glass doors leading from the radiation oncology suite on the last day of my treatment for my first breast cancer. I was to see that look hundreds more times in the years I was an American Cancer Society patient navigator as I met with women in treatment for breast cancer in the 11 New York City public hospitals.
I approached her asking, “Is this your last day of active treatment?” She nodded. Tears ran down her checks as she answered, “I’m relieved that treatment is over; no more being poked and probed. But I’m also frightened about what happens next.”
I introduced myself as a survivor and asked if she had time for a cup of coffee. She nodded and we made our way to the hospital cafeteria. For the next hour she shared her fears about the future.
Her treatment had spanned a year. A bilateral mastectomy, chemotherapy and radiation had left her physically and emotionally spent. She was on a leave of absence from her position as a marketing manager for a mid-sized company and was not sure she wanted to return to her job. The changes in her body left her doubting her attractiveness and self-conscious about her appearance.
Her family was anxious for things to get back to the way they were before she got breast cancer. She didn’t think that was possible. She had been through too much. She was not the same person she was before breast cancer, not physically, not emotionally.
I wanted to tell her that she was right. She couldn’t go back to the way things were. None of us can. We are forever changed by having a life-threatening disease, by its grueling treatment, and by the questions that hit us at the end of that process.
Throughout our treatment, we have a team of professionals caring for us, watching over us. No matter how difficult it is at times, there is security in all that attention. Then one day it is over, the team says goodbye, your doctor says, “See you in three months,” and we are left to transition from active treatment to embracing life as a survivor, pretty much without a blueprint on how to go about it.
If there is no going back, then we have to give ourselves permission to have a new beginning. That begins with accepting the fact that we’ve changed. It means accepting our need to make sense of what we went through—and accepting the fact that our cancer experience may shape how we live our lives as survivors.
Permission can be about doing something we always wanted to do before we got breast cancer, but life and responsibility got in the way. Or it can be about following a new plan, one that provided a little relief and hope during the long months of treatment.
Permission is about thinking and saying—to ourselves, first and foremost—that it is okay to follow a different path, to change some things in our lives as survivors.
Permission doesn’t come easy, but it has to come if we are to make a successful transition from active treatment to finding those new beginnings as survivors. Without permission, we remain stuck at the transition point, unable to go back to the way things were, unable to move forward. With it, we can make the most of our lives as survivors.
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