Letter to a Young Patient
My Advice to a Young Adult with Cancer
Welcome to The Nonlinear Life. In case you missed it, read my introductory post.
Every Friday on The Nonlinear Life we talk about life as we live it today. We explore the urgent and emotional issues at the nexus of family, health, work, and meaning. We call it This Life.
---
Dear X--,
We tried to keep you out of the club. But, no! You had to go and nose your way in. Somehow, we didn’t manage to get the message across: YOU’RE NOT WANTED HERE.
But you’re here now. You’re one of us. You’re a survivor.
And there are a few things you should know.
Beginning in 1902, the Bohemian-Austrian poet Rainer Maria Rilke wrote a series of ten letters to a 19-year-old Austrian military cadet and novice poet named Franz Xaver Kappus. In the first letter, Rilke comments on the absurdity of their correspondence. “Nobody can advise you and help you, nobody. There is only one way. Go into yourself.”
Kappus later published the letters in one of the more famous literary works of the twentieth century, Letters to a Young Poet. (I recently wrote about a whopper secret involving those letters that was just revealed.)
Letters to a Young Poet by Rainer Marie Rilke
In the last few years, those letters have inspired a series of new works: Letters to a Young Athlete, Letters to a Young Artist, Letters to a Young Pastor, and so on. In that spirit, I thought I would write you a “Letter to a Young Patient.” As Rilke acknowledged, there’s something absurd about such a letter. Nobody can advise you. The is only one way. Go into yourself.
But as you know, I, too, was once a patient with some similarities to you: Though I was older than you are now, I, too, had a type of young-adult cancer; I was of an age when people don’t customarily get sick; and my condition brought out all sorts of awkward behavior from everyone around me.
Even more relevant, because I was public about my journey, I have known scores of people in your situation. With that in mind, here are some thoughts:
First: Tie goes to your body
To be a patient at any age is to get bombarded with fears, worries, contradictory data, sympathetic calls, invitations, expectations. As understandable as those may be, try to ignore them. The most important thing is to listen to your body. If there is ever a tension between what you want to do and what you can do, always defer to the can over the want. Your body is single-mindedly focused on healing itself; give it the space and support it needs.
Here’s a phrase of mine that might come in handy: No plans, no excuses, no apologies. Let everybody around you know that you can’t predict how you might be feeling at any moment, and therefore every day has a giant asterisk around it. “I appreciate your flying in from out of town, but I should warn you, if I don’t feel up to seeing you that day, I might bow out. Please don’t take it personally.”
Second: Win friends and influence people
In Dale Carnegie’s blockbuster How to Win Friends and Influence People, he gives this iconic piece of advice: “You can make more friends in two months by becoming interested in other people than you can in two years by trying to get other people interested in you.”
You, I’m afraid, have the opposite problem. As you shared with me recently, your friends have no idea what to say or how to conduct themselves around you. That’s one of the unique problems of having a young-adult disease. Brad Zebrack of UCLA surveyed hundreds of young adult patients and found that their top unmet need was connecting with other patients, but guidance about sex and intimacy was their second unmet need.
The reality is: Your friends are not going to know how to handle these situations—you wouldn’t have either a few weeks ago—so you’re going to have to take the lead. Seek out the information you crave. And when you do find yourself in an awkward situation, begin by telling the other person how you’re feeling. Tell them you’re in good hands with your doctors. Tell them you’re following the treatment and doing all you can to get the best results. Then tell them a joke. That shows them that just because you’re a patient doesn’t mean you’re not still yourself.
Because, as helpful as it is to have real talks with your contemporaries, sometimes what you really want is to take your mind off your situation—watch a ballgame, play a video game, even fool around. One of the most memorable scenes from the film The Fault in Our Stars, after all, was Augustus Waters losing his virginity.
I know becoming a precocious expert in difficult conversation was not at the top of your to-do list this year, but learning these skills now will have profound benefits for the rest of your life.
Hazel Grace (Shailene Woodley) and Augustus Waters (Ansel Elgort) kiss in 'The Fault In Our Stars'
Third: Ignore your mother (except when you need to listen to her)
I love your mother, as you know; and your father. But here’s the thing you need to understand: Having a major disease as a young adult is different from having the same disease as an adult or child. Adults have support networks, colleagues, even children of their own; children have their parents, schoolmates, friends.
Young adults are often awkwardly betwixt and between all of these groups. As the folks in the wonderful Facebook group Stupid Cancer will tell you, young adults are surrounded by transient people—students, teachers, even friends who are not in one place very long. Young adults often have to travel back to their childhood homes for treatment just as they’re settling into new homes. And, most challenging, young adults often have to recalibrate their relationship with their parents. Just at the moment they most want to be independent, they are forced once more to become dependent on their parents.
All that is true, but you’re not a child. You’re an adult. Gently remind your parents that you would love their advice, but, whenever possible, you would like to make the final decisions yourself.
Finally: Embrace the betwixt and between
Suleika Jaouad, a promising young music student who, somewhat akin to you, was diagnosed with leukemia at age 22, went on to crisscross the country and write a beautiful memoir called Between Two Kingdoms. She writes that accepting the ambiguity of a body that’s neither sick nor well is one of the hardest yet most critical parts of confronting illness.
“You must learn to live on fault lines.”
Jaouad and her traveling companion, Oscar
“Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick,” she quotes Susan Sontag as writing in Illness as Metaphor. “Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”
While it may bring you no comfort today, I deeply believe that learning that you are a dual passport holder will be one of the most profound lessons you will take away from this experience. It will make you more empathic as a friend, more observant as a student, more compassionate as a leader, more sensitive as a lover.
By learning to “swim in the ocean of not-knowing,” as Jaouad puts it, you move one step closer to not being the recipient of letters like this but to being the writer of them instead.
As my dad loved to say, stay loose. And as I like to say to anyone in your situation: No need to write back.
Lots of love,
Bruce
☀
Thanks for reading The Nonlinear Life. Please help us grow the community by subscribing, sharing, and commenting below. Also, you can learn more about me, read my introductory post, or scroll through my other posts.
You might enjoy reading these posts:
Tips for Prolonging Pandemic Family Togetherness
Or these books: Life Is in the Transitions, The Secrets of Happy Families, and Council of Dads.
Or, you can contact me directly.
