Coping Skills – The Five Year Rule, Manageable Pieces, One Beautiful Thing A Day…The Cancer Exception

Surgical theater – Johns Hopkins

Today four people I know are having surgery. No one is my age. They’re all younger. Two are having knee replacements, one is having a hysterectomy, and the last is having a lipoma, generally a benign fatty tumor, removed from just below her back shoulder blade. Because of Covid hospital-crowding issues, the two knee replacement patients will go home today, as will the lipoma patient. The hysterectomy patient gets one night before getting booted out. That is, if there are no complications for anyone, which I hope will be the case for everyone. Indeed, if all goes according to plan, five years from now, they’ll look back on their experiences as a necessary evil that, after having been addressed, markedly improved the quality of their lives. On a day like today I’m reminded that I should recognize that overall, I’ve been pretty lucky, health wise. Aside from having a broken nose at age eight, two babies and two knee replacements, I’ve skated through almost seventy one years with few physical problems. Reminding myself of the positives is a tool in my coping skills toolbox. Focusing on the negative is a dangerous trap if you’re looking for a successful life.

Sisyphus – Titian

I’m a fervent believer in the necessity for developing coping skills in order to successfully navigate this crazy world. In my experience, there’s just no way to get through life without finding ways to contend with the problems invariably confronted by virtually everyone who lives past infancy, at least a healthy infancy. Except for those people who manage to bury their difficult issues somewhere below their consciousness, or to anesthetize themselves by whatever means they contrive, the rest of us are going to be confronted with situations that are overwhelming, painful, confusing and sad, to name just a few possibilities. Life has its own timetable although mostly, I think there’s a lot of random in how things shake out. In my own life, the benefit of hindsight informs my contemplation of how just the tiniest, seemingly insignificant choice from long ago, twisted a little differently, could’ve changed my future. But then again, that’s hindsight, a useful tool for understanding a past personal trajectory, but rather ineffective when coping with the present. After years of trial and error when trying on coping styles, I’ve wound up with three mainstays, tested by time and experience. Useful to me, apparently they have resonated with my kids, who’ve told me that they’ve both used them in their own lives, in addition to sharing them with their contemporaries. I guess they’re my little contribution to mental health, which for me is more important than other measures of success at living.

One of my top three skills is finding the ability to break down that giant ball of worries and responsibilities, the one that can feel like you’re carrying the proverbial weight of the world on your shoulders, into smaller, manageable tasks. I’m not too proud to admit that periodically, I’ve made a daily to-do list that includes going to the bathroom and brushing your teeth, up at the very top. Sometimes you need a simple starter, one doable accomplishment to reinforce the idea that you can get the next task done. If you inch your way along, eventually the load becomes smaller and so much less daunting. I’ve literally felt my anxiety ratchet down every time I put a line through a chore, slowing heartbeat by slowing heartbeat. Feeling overwhelmed is too hard to maintain on a daily basis. Chipping away at all the stress is the only way to survive, at least for me.

My already-pondering baby daughter
Busy thinking “and just who are you?”

I suppose some form of justice demanded that I wind up with a little girl who questioned everything as soon as she could speak and I’m certain, even before she could. Long ago, Michael referred to me as his little existential soulmate, restlessly hunting for meaning and answers while disbelieving so many accepted norms. It’s one thing to be an adult grappling with the big ideas. Having a little kid look you in the eyes while saying life has no meaning is another matter altogether. Back then I wanted nothing more than to arm my daughter with skills to navigate all the challenges she perceived so early in her life. I realized that one way I always got myself through the hard days was by finding one bit of beauty out there in the muddle of life trials. My task became translating that principle into real world situations. Over the years, I did precisely that, pointing out wonderful flowers, animals, trees and clouds which were easily identified by my observant child. I think she’d be the first person to say that strategy helped her. The irony is that my attempts to help her reinforced the same skill in me. Now I automatically find the beauty in every day. That hunt has hauled me through the darkest of times and is part of the fabric that makes me who I am. I highly recommend the strategy, especially in light of the dystopian reality facing us all these days.

Coupled with looking for beauty is the quest to learn something new, no matter how small, somewhere in each successive twenty-four hours. I remember when I thought time was limitless. Sometimes the dragging minutes went on forever. I couldn’t wait to get to “next.” I believed I had more than enough daylight ahead of me to experience everything, learn everything, feel everything, with room to spare. That innocence disappeared a long time ago. Every dream, every fantasy about all that open space was simply that – dreams. Now I make deliberate efforts to absorb as much as I can, following my brain down any rabbit hole that pops up in my mind. The machine that’s my mind needs renewal. The world is packed with interesting ideas and facts, many of which I’ll never unearth. But I try. Never a fabulous student when I was supposed to be one, I’ve morphed into a scholar. Perhaps I won’t employ what I learn in a practical sense. But I’m satisfied knowing that formal education didn’t interfere with my passion to learn. Here’s today’s discovery.

While getting gas at a station near my house, I glanced up at a tree on the parkway. Bare branches are so interesting as they reveal the complex networks normally hidden by leaves. I was instantly struck by the similarity to the human circulatory system. When the traveling display called The Human Body came to the Museum of Science and Industry in Chicago, Michael and I attended the fascinating exhibit. My gas station tree looked just like the blood vessels which dangled in their case at the museum, but upside down. I couldn’t find a photo of that exhibit but I did find an illustration on the Johns Hopkins School of Medicine website. I’m by no stretch of the imagination, the first person to notice the similarities between the branching patterns of trees and blood vessels. What I didn’t know was that these never-ending patterns which repeat themselves in nature and math are called fractals. That name was coined in 1975, years after my formal education ended. I’d brought my observations up in a conversation with my son who happens to be a biologist. He responded with the moniker “fractal,” and a general description of the phenomenon, which I built on by exploring further online. Little intellectual jaunts like this one are healthy for me. They are the opposite of mental stagnation which is the enemy. I don’t want to live stuck, never learning anything new. I want to continue being dynamic as long as I’m breathing.

Michael and our oldest grandson, January, 2017

I’d say the centerpiece of my coping skills arsenal is the five year rule. While raising my kids, there were always these dramatic moments when one incident was blown up to such a magnitude, that they felt that life as they knew it was coming to a calamitous end. Grabbing onto those soaring emotions seemed critical in deflating their chaotic experiences, to bring them back into the realm of normal. I can’t recall how old my daughter was when I first managed to blurt out, in the midst of one of those moments, “what were you doing five years ago today?” I do remember the look of astonishment on her face, along with her earnest attempt to recall whatever that activity was in her past. Of course, she couldn’t remember. And so that question became part of our family’s management style, with both kids, as well as Michael and me, regularly reminding ourselves about perspective and ratcheting down the hyperbole about various challenging incidents. For the most part, I’d say this tactic is a great tool for keeping balance through life’s ups and downs. I know my kids use this skill and share it with their friends. But at this particular moment in my own history, the five year rule doesn’t apply. I know exactly what was happening five years ago, including minute details of that time.

Michael in the oncologist’s office – January, 2017

Five years ago, in January, 2017, Michael had been in remission from his Merkel Cell cancer for almost a year. He hadn’t been in treatment during that time. I was noticing changes in his behavior which were making me nervous and uncomfortable. I was coaxing him into multiple appointments with his cancer team, who in turn, were ordering scans which showed no evidence of disease. Five years ago I was in an anxious state, knowing that Michael was different, and not in a good way, with no evidence to support my opinions. He was irritable, had experienced a significant decline in appetite and was being driven crazy by my laser-like attention focused on him all day and night. But his behavior was simply not normal. A bit more than five years ago, on January 31st, 2017, I would be using all the trust between Michael and me, and all my persuasive powers, in convincing him to go with me to the hospital emergency room where I would demand an MRI of his brain. There we would receive the dreadful diagnosis of a meningitis-like metastasis which had infiltrated his brain, but which was invisible on all the previous scans he’d had earlier in the month. We had four months left in our decades-long relationship, months which were the most difficult in our lives.

Michael in the emergency department- January 31st, 2017

I could easily recount, in vivid detail, the excruciating details of five years ago. I’ve always had a good memory, but the events of that time have retained their harsh edges, coupled with the intense emotions which accompanied them. So I guess the five year rule, although an effective antidote to many of life’s overwhelming moments, sometimes falls short in creating perspective. Michael’s cancer and its cost to our family is seared into my brain. Although time has helped in allowing me to continue living what I hope is a rich, productive life, I can be in five years ago in real time, still feeling all that was happening during that experience. Cancer is the exception to my helpful rule. I suppose there’s something like that in everyone’s life. Now I’ll just have to work my way through the memories…

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