Thyroid Cancer
I’m writing while in bed, on a phone. I need the pillow support for my neck. My aching neck. With my knees bent and wrist propped on my hips, the only voluntary muscles moving are my thumbs and my eyes. The rest are things I don’t control: the rise and fall of the chest, a heart quietly beating and, of course, all of life outside my window.
And somewhere in-between the voluntary and involuntary, my thoughts. Fleeting, hard-to-capture, quickly-fading.
Only a few days ago, I was laying more comfortably in this exact spot when the alarm sounded at 4:45a. My lady and I quickly and quietly dressed, packed and snuck out of the house in the dark, leaving our kids to sleep. All arrangements had been made for them. The 4-year old would scream in anger when she woke up without her mother, but people were around and a plan in place for them. I would already have my throat cut open by the time some friends had swung by to take her to school.
Three weeks ago on this day, all of us were wrapping up a family week in Nova Scotia. The blood test and ultrasound indicated that the lump I’d felt on the right side of my lower neck was most-likely a benign nodule on the thyroid. Nobody was very worried. Then the following Monday, as a safety measure, they did a biopsy. As they jammed a fine needle in and out of my neck to gather DNA, I hoped this might be the worst moment of the whole ordeal. Five to ten days for results, they said.
The next day I received six straight calls from my primary physician while on another call. An urgent message in my health care inbox. As I struggled to get a doctor back on the phone, my body filled with dread. A fear I had not felt since I was a child. This was it. I could feel death’s cold shadow outside the window. My breathing got shallow, my eyes darted side to side, my lips got tight, my eyes filled with tears and I texted my partner : I have cancer.
Within a few days I was meeting with a surgeon who did more ultrasound work and confirmed what was found in the biopsy: I had a malignant tumor on my thyroid. He suggested removing the organ entirely. He told me there would be a 50/50 chance of needing radiated iodine treatment for the area, depending on whether it had spread. We’d know more after the surgery. And he told me not to worry.
Each year in the U.S., over 44,000 people are diagnosed with thyroid cancer. Over half a million worldwide. Despite its prevalence, it is not a highly-discussed form of cancer. It has a high success rate in treatment: 98% of people survive the first year, 95% survive beyond 5 years. Also, there’s a mystery around how we get it. There’s just something about thyroid cancer that feels more like a sickness than a cancer. Until you get it.
After the nuclear meltdown of Chernobyl in 1986, there was a huge uptick in thyroid cancer cases, offering the most-likely explanation of it: radiation exposure through iodine. The thyroid is purpose built to take in iodine.
Watch what fish you eat, I suppose.
Despite being a “good cancer to get, if you’re going to get one,” I felt death profoundly from the moment it was diagnosed. Cancer is cancer. It has levels, but they are all levels of destruction. Having the good kind of cancer is like having the good kind of nuclear war, hard drive failure or a 20-car pileup on the freeway. From the moment I knew that a growing tumor lived inside me, I sensed its pure insidiousness, its acid, its monstrosity. This will leave a mark.
I got my affairs in order, including organizing the entirety of all my media: photos, video, writing and otherwise. I designated a digital executor, in charge of knowing where all my passwords are as well as all my final wishes. I went there. For two weeks. Some might say unnecessarily, or even gratuitously. I never saw a choice. The good statistics and “you’re not going to die!” comfort from friends were a nice safety net under me, but I still felt high up, walking on a rope between two buildings.
Like you, most-likely, I’ve watched people die from cancer, at very close range, including my own mother. I’ve watched too many small lumps turn into large issues. Too many Stage 1s turn into into Stage 4. Too many small surgeries turn into long goodbyes. I couldn’t pretend everything was going to be okay when I didn’t feel it, when I’d seen it turn bad, unexpectedly, so many times. I became overwhelmed with the feeling that I needed everything else off my plate — legacy, passwords, instructions, beneficiaries, even the playlist for my funeral. I made a to-do list, and then I crossed it all off for two weeks.
I obsessed on what I was eating, and my blood. I got every blood panel done possible. I wanted to eat perfectly, walk, be with friends and family, see the sky, the beach and experience those things fully. That’s it. Walks, family, food and friends. It all boiled down to that. Which is the same routine of every cancer patient I’ve ever known. The last great memory of my mother before she started having a hard time talking was a walk she and I took on the beach. Her last walk.
I became incredibly present. So many worries faded for me. My time with friends and family were beautiful, loving and deeply connected. Even a lot of my own complicated psychology came un-wound. I have a hard time asking for comfort, but invited it wholly. I rarely felt stress or anxiety. I was floating. By the time the alarm went off to head to the hospital, I felt at peace with going, appropriately nervous, but also deeply curious. I saw every person at the hospital that morning: the other patients, the guards, the staff, the nurses and doctors… I really saw them. I wanted to hold them all. I wanted them to hold me, too.
It’s legitimately incredible how fast the experience of major surgery fades. I feel almost as if I’m chasing it right now, just a few days out. As I write, the memories feel only barely lasso-able from here.
If I have something to pull forward from the hospital itself, it’s actually not about the cancer, the cutting, the routine check-ins and the coldly persistent IV in the arm. No, its actually about going under. It’s about anesthesia. It’s about the two hours neither sleeping nor awake, without dreams, without knowledge, without awareness. It’s about two hours of my life, naked, in the hands of strangers, with only one thing in my possession: my life. It’s about a state of unknown.
I think I misread what I was aiming for in the weeks leading up to surgery. I imagined it was death that I was preparing for, but it was life. Not the life I was leading, complicated and structured… but pure life. Alone in the universe life. Life support life. Still life. Only life. Barefoot on the sand life. The life that sits at the edge of death and is, therefore, the most precious, most concentrated, version of it.
Coming out of hours of anesthesia is like restarting a computer and not launching any programs. You idle there on 1% of your CPU capacity. And… it’s amazing. The thoughts may be hard to access right now, but it feels relaxing and easy to not feel I have to. There is only this cut in my neck to heal now. That’s enough. I’m in no hurry to go back to the life I was leading. The one I know awaits.
When I missed those six straight calls from the doctor, I panicked. Real panic: the bad kind. But everything that has happened since then has made me a person who is not afraid of death, or missed calls. And I like it here, idling confidently, freely, lovingly on only 1% of my processing power. The rise and fall of the chest, the quiet beating of the heart… and so much available to feel with.
We do not know what causes thyroid cancer, and we do not know exactly how to frame it up among the myriad of diseases in our life. Its grand smallness and complicated simplicity offers an easy path on how to deal with it, but no path on how to have it, or have had it. It makes this all very personal. We must decide on our own. Was this a moment in time? A scary thing we eventually just remove, heal and forget? Or is the scar across the neck more of a shot across the bow? Has nothing changed or has everything changed?
Cancer is immense in any size; so dark and so powerful. It is death, measured in stages. It touched me and, as it always does, it left a mark. But the meaning of it all will only be defined by how I live from here on out.
