What Cancer Has Taught Me About Fear

During my cancer journey, Gubar was one of my regular reads and I still follow her columns. Her most recent column reflects as well my experience during these strange times and the increased vigilance, as well as finding ways to focus elsewhere (this blog and my various articles are one of the results of my “living with cancer”:

Sequestered during the pandemic, I find myself thinking that cancer patients’ expertise in fear can help others heed its warnings. We all need tactics not only to overcome the destructive capacity of fear but also to tap its protective potential.

An iconic portrait of one petrified creature, Edvard Munch’s painting “The Screamcaptures the fright gripping many people today — of an invisible threat that has caused an exponential explosion of infections, a shocking influx of patients into hospitals, mounting deaths and the ghastly appearance of refrigerated trucksparked next to hospitals as mobile morgues. Munch’s figure holds his helpless hands up, even though they cannot muffle his involuntary response to what his wide-open eyes cannot bear seeing. His silent shriek echoes outward only to further imprison him. In a public place, he is immobilized beneath a bloody sky.

Munch’s original title, “The Scream of Nature,” indicates how well he understood fear to be ontological, not psychological: a force of nature, not just human nature. Nature has turned our world into a sinister dystopia.

Cancer patients understand this phenomenon, for we deal daily with dread stirred by organisms produced by the body they attack. The masks worn by those touched by cancer and the coronavirus manifest identical, overwhelming and rational anxieties — about contagion, isolation, degeneration, impending death — that escalate when people with cancer struggle to subsist during a plague year.

Regardless of age, cancer patients and survivors need to be more fearful these days than healthy children, young adults and people in their prime. With immune systems compromised by various treatments, we are highly susceptible to the coronavirus. We must take every precaution — of repeated hand-washing, of social distancing and sometimes of self-quarantining — even though such measures will damage the support systems we badly need.

Worse, many of us depend upon periodic medical interventions that may be compromised by the stress put on institutions dealing with the virus. We get regular blood draws, scans, infusions, pills and surgical procedures in hospitals. But are they safe places to enter in a pandemic? Nurses have been concerned that cancer patients will get infected in some facilities. Yet despite the best of intentions, the virtual consultations set up for me at my hospital have been a travesty because of glitches in technology. Will oncology services collapse under the strain of massive viral care? Biopsies are being delayed, clinical trials are being shut down, and research is grinding to a halt. Will people hospitalized with the virus be denied ventilators, if they have cancer and if a scarcity of medical equipment means that doctors must choose?

And yet, having survived months or years of living intimately with the mortal threat of cancer, the members of my cancer support group — who now connect via email — manage to carry on while keeping as calm as possible during the current health crisis. Not fully resistant to bouts of contagious terror, we nevertheless find coping mechanisms.

We know that fear can be debilitating, but it can also be self-preserving. The chronic patients in my support group cultivate vigilant fear: They use their trepidation to do everything they can to extend their survival without being capsized into despair, hysteria or paralysis. One of us picks up her shopping wearing Nitrile gloves, just as she did when in chemotherapy. Upon returning home, she swabs what she has bought with a disinfecting wipe.

Beyond this sort of physical caution — which remains crucial for keeping the death toll as low as possible — how do we maintain mental health? For only when we are free from the vise of terror can we take protective measures, most of which these days involve staying at home without going stir-crazy.

Cancer patients who steer between the Scylla of alarmism and the Charybdis of defeatism have devised oblique stratagems to navigate the difficult passageway of fearful vigilance. Within its straits, we seek not to banish fear — an impossibility — but to filter, buffer, intercept, sidetrack or dilute it so it can serve as a safeguard without obliterating us.

Concentrating on something besides the fright — on breathing or stretching, on an intriguing task to accomplish — distracts us but also gives us a routine or objective over which we can exert some control. Just as happiness cannot be attained by making it a goal — John Stuart Mill believed one must aim at “something else” to stumble upon happiness as a sort of byproduct — fear cannot be defanged except through indirect methods.

Especially within the narrowed circumstances imposed by the coronavirus, it requires ingenuity to discover quotidian undertakings that can convert fear from a virulent to a vigilant emotion. While we strive to remain conscious of our interdependence — our vulnerability to people who may be contagious, our responsibility not to endanger others — we need to engage in small but innovative enterprises.

On a practical level, consider what activities you enjoy in normal times. Begin to bake bread, one member of my support group advises; go on nature walks, another says. Organize digital pictures into a photo album, practice the guitar, check out a remote learning class, put together a film festival or a playlist, take a virtual tour of a museum, cultivate a garden, set up regular FaceTime or Skype sessions with family, try woodworking, use apps to play games with distant friends, devise home schooling lessons, sing on your balcony as many Italians did or for Yo-Yo Ma’s #SongsofComfort project, contribute to a food bank, or do as I am doing: Learn how to knit socks.

Munch’s screamer clearly cannot heed instructions not to touch his face or to take shelter at home, but we are trying to do so and trying to use vigilant fear as a bulwark against incapacitating terror.

In the cruelest month of April, here’s what many of us hope: That we will be able to look back on this alarming period in years to come and say that the power of vigilant fear — for ourselves and for each other — has seen more of us through than we had ever thought possible.

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

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