June 21, 2006 - Closure

Closure. Teri, a friend of mine who’s a breast-cancer survivor, wrote to me recently, sharing some reflections on this word. Once she’d finished her treatments, her friends and family were eager to help her celebrate, even throwing a wonderful party for her. Yet she had a distinct feeling that their motives in doing so were complex:

“I know their intentions were pure. They did want me to be happy again. But I also know that part of that was so that they could be happy again. They wanted closure on thinking of me as sick. It was too hard for them to deal with so they wanted me to close it.”

But is closure ever possible, when it comes to something like cancer? Teri’s not so sure about that:

“Actually I am beginning to believe and accept the idea that I will never have closure on this. Every time I see the scar and the dimple on my breast I will remember that there was cancer. Every three months when I visit one of my doctors I will hold my breath as they look for new lumps. I can't imagine what my next mammogram will stir in my guts. Every time my body develops a new ache or pain there will be a little voice deep inside whispering cancer. Sure, I wish I could close all that off and lock it in the past. But I know that hasn't happened yet and may never happen. But that is OK with me.

I think I have decided it is OK because there are some parts of this experience I do not want to close. I have a new appreciation for life and I want to keep it. I have a new scale for measuring the real severity of a crisis. I ask more often - so does it really matter? I think more seriously about my body - what I eat, what I do, what contaminants are in the world around me. I really don't want closure on any of that.”

I realize I’m living through a protracted period in which closure is an elusive ideal. I’d like to be able to say, one day, “It’s over” – but since I have a form of lymphoma that may have some features of the indolent type (which typically cannot be cured, only managed), I may never reach the point where I can confidently declare myself cancer-free. The tendency to genetic mutation may still be there, buried deep in my DNA code. Some of my lymphocytes could start growing again, and there could be millions of them before any abnormality would begin to show up on a CT or PET scan.

Am I losing sleep worrying about this possibility? Not really. I’m aware of it on an intellectual level, but so far it hasn’t “stirred anything in my guts,” as my friend puts it. Maybe after I’ve had my next CT scan and I’m waiting for the results... but not now. Right now, I’m just glad to be getting back into normal life, even if it still has some ragged edges.