Twenty-Eight Million and One
By: Johanna S. Fowler
Like the golden oldie song says, “I am wise, but it’s wisdom born of pain.”1 Prior to October 16, 2009, I was a fit and healthy 46-year-old. In fact, I had enjoyed being known as a youthful, tall, thin, beautiful blonde with a great figure. That description changed with the diagnosis of breast cancer and subsequent treatments—which continue to this day.
The immediate first change was that the figure went missing after the right total mastectomy and sentinel lymph node biopsies. Next up for termination was the long blonde hair which all fell out two weeks after my first round of dose-dense chemo (eight more were to follow). The thin, fit physique quickly morphed into a 25-pound weight gain due to the chemo drugs, the steroids to combat nausea, and the anti-cancer drug Tamoxifen.
Tamoxifen must be taken for five years; it decimates the body’s natural hormone systems to deprive hormone-fueled tumors of the ingredients they use for growth. Tamoxifen crashed me into immediate, permanent menopause with all the attendant symptoms. So—there went the youthful. But I like to say, looking on the bright side, “At least I’m still tall.”
There is a new cancer book out now, titled The Emperor of Maladies.2 It traces the history of cancer and its various treatments over the last few thousand years it has spent vexing the human race. As a trial lawyer, I make it a policy to know my adversary because properly sizing up the adversary goes a long way toward winning the case. I must say, upon examination, that cancer is a very worthy adversary. I have come to know it well these past two years.
People like to refer to cancer diagnosis and treatment as a “journey.” This description is a complete misnomer because really it is more akin to an urgent mission straight into enemy territory in a war zone under heavy weapons fire. Like a modern-day combat soldier, I have been maimed (by surgery), poisoned (by chemo), attacked by a biological warfare agent (Tamoxifen), suffered post-traumatic stress disorder (for obvious reasons) and, significantly, often grapple with the potential for an untimely death at the enemy’s hands. Also like a soldier, the memories of this hostile engagement will haunt me for the rest of my life.
That being the case, I have emerged from this dreadful experience with many surprising and wonderful gifts. Some of these gifts relate to the physical aspects of being in the land of the living. For example, I am now much more stoic physically and emotionally than I was prior to cancer. I know that I can withstand significant physical pain; this knowledge will serve me well through future physical frailties. I have also worked hard to carve out a vision of myself that is not so related to my physical appearance because now I know how quickly one’s looks can change. At the same time, I have been striving to restore myself physically as best I can.
On the side of the intangibles, I realize that I have lived life with no regrets and am determined to keep that as my mantra for the coming years. I also have learned to discipline my thought processes to focus daily on the positive and lovely aspects of life in the moment, as it unfolds. I am more confident facing the regular challenges of life because, next to cancer, most everything else seems easy.
I am at peace with my spirituality and cherish the faith, family, friends, colleagues, and physicians who pulled me through it all. Actually this list would not be complete without mentioning other members of the task force deployed to get me to where I am today, including: nurses, surgeons, next-of-kin, pets, horses, self-help books, flowers, counselors, massage therapists, acupuncturists, nutritionists, Pilates instructors, florists, personal assistants, administrative assistants, neighbors, paralegals, websites, blogs, clients, cards and letters, Adriamycin, Cytoxin, Taxitere, Effexor, Oxycodone, The Bible, clergy, saltine crackers, and fizzy water.
To summarize, there currently are an estimated 28 million cancer survivors worldwide and I am honored to be number 28,000,001. My message to women is, “Get a mammogram.” My message to the 1 out of 3 Americans who will end up dealing with the wretched disease of cancer in some form is, “You are a lot stronger than you think you are.” And always remember that you may discover the Emperor is a coward, turning tail and running from you. Quite possibly he can even be thoroughly vanquished.
Johanna Searle Fowler is a native of Asheville, having been born at Mission Hospital, as were her parents and her son. She is married to a neurosurgeon, has two precious children, and practices law in the fields of complex commercial litigation and securities investor rights litigation. She can be reached at jfowler@fallsveach.com.
1 “I Am Woman” by Helen Reddy.
2 The Emperor of Maladies: A Biography of Cancer by S. Mukherjee.