I believe in Cancer.
I have seen it with my own eyes….held it in my own hands…and spent the majority of my adult life studying it, excising it and caring for patients afflicted by it.
I believe that cancer starts with an initiating event….a mutation in the nucleus, the core, the heart of a single cell. The precipitating event leading to this change is most often unknown, but may be part of that cell’s inherent program. This event causes the cell to divide, multiple, and add…but rarely to subtract. As it progresses, this bad seed escapes reasonable mechanisms to limit its damage and corrupts the previously peaceful neighborhood by recruiting likeminded cells to do the same. Its ultimate goal is to proselytize and proliferate its intolerant, undiscriminating nucleic message imbuing the same in its transformed progeny, which then insidiously permeate unseen channels en route to remote destinations where they exist among unsuspecting normal tissues as peaceless missionaries or sleeper cells. I believe in cancer because I despise it…yet I must acknowledge its existence.
I realize that over 1 and a half million Americans will be diagnosed with cancer this year and nearly 1 in 4 will succumb to it. I believe cancer is dark and frightening, and that while often mysterious, different aspects of it can be understood by Nobel laureates or by common men, women and children. I believe that even when cured by excision, radiation, or poison, its stain persists.
The first time I came to see cancer, I had been a surgical intern in NY City for all of a week. Upon being summoned to the solemn room of a 32 year old immigrant woman with terminal stomach cancer, all of my senses, developed and primitive, were accosted by the sight, sound, scent and even the bitter taste of its destructive end. Unable to speak her native Korean, the only comfort I could bring this family-less victim was the momentary warmth of my hand and the cautious authority of a newly minted physician. Like many, my visceral response was to hide from cancer….It was certainly never my intention to make this my life’s work….but over the ensuing years I have seen every human emotion resonate in its drum and I have come to believe that the forces of cancer can be transformative. I have seen them render the malevolent heart benevolent, the cowardly courageous, the spiritless spiritual, the prideful humble, the indifferent attentive and the impenetrable vulnerable. These are the indomitable lessons of cancer.
I believe that cancer is cunning and adaptive…..but most importantly I believe that all cancers start small….with an initiating event targeting the core of a cell, a belief, a soul or a society. They then grow in the fertile soil cultivated by forces beyond our control or limited by those within each of us.
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