Thursday, October 6, 2011

Who am I?

It seems a pithy question.  One that everyone asks themselves once in their life before concluding that they're at least trying to be a good person, or that they need to purchase a sports car right now. 

It takes on a different meaning when a kind gentleman is elbow-deep in your personality.

I had always thought of cancer as something like a balloon.  You can fill it with air and it takes up more space, but cancer cells are cancer cells and healthy cells are healthy cells.  The cancer crowds out the healthy cells but it doesn't replace them.  Inflating a balloon does not create more balloon.  My oncologist told me differently.  He said that the tissue within my tumor was functional.  It likely wasn't functioning well, and some of it wasn't functioning at all - to truly abuse the balloon metaphor, some of the tumor was cystic so there was obviously nothing going on in there - but it did have a function.  Furthermore, because my cancer is low-grade and has been there for such a long time, the bulk of the tumor did not have the classic look of cancer.  Typically, a brain tumor is a fleshy, irritated, pinkish color, and more veinous than surrounding, healthy brain tissue.  My tumor was much less so, especially around the edges where it transitioned to healthy tissue.  In addition, cancer cells tend to spread throughout the surrounding tissue, away from the primary tumor itself; thankfully the blood-brain barrier prevents these stray cells from metastasizing to elsewhere in the body (usually).

Basically what all that meant was that there was no way to avoid cutting out some healthy tissue along with the tumor.  Stuff that clearly had a function, and while it likely wasn't feeling very good due to the pressure from the tumor, some of it was totally clean.  It posed no risk to me whatsoever.

To give you an idea of just how much they removed, the main mass they resected was 8 centimeters.  As the doctor said, "very large."  This, bearing in mind that when they remove or destroy both sides of the frontal lobe we call that a "frontal lobotomy."  Given that the cancer has spread to the right frontal as well (albeit in a far lower concentration), I'm hoping that between neural plasticity and the radiation and chemotherapy I've received that they aren't going to have to gradually lobotomize me.  Even in my darkest times, I had always taken pride in my intelligence.  The tumor had to be removed, there was no question of that, but I worried that I would lose the one thing I liked about myself.

Judging by the size of the tumor and its growth rate, my doctors think I may have had this thing for more than 15 years.  My parents say I suddenly became very serious around the age of 5, which could also be a sign of the disease.  I may have had this cancer for as long as I can remember, with all the problems and abnormalities it brought with it: the severe depression, the distorted view of my own self worth, the lack of motivation, the fear of risk.  And I will readily admit, I have felt better since my surgery.  Those feelings have all decreased substantially.  When I look at old photographs of myself, I recognize myself and I remember looking at those same pictures in the past, but I literally look different.  I no longer see the same ugliness I used to.

That sounds like an improvement, then, doesn't it?  That I rid myself of these negative emotions and feelings, and that they are no longer holding me back, keeping me from having a life?

Except improvement is a change.  It means I'm different.  I hated that dark side of myself, that overbearing depression that made me wonder why I never got to be happy, but it was a part of me.  That cancer was derived from my body, made of my cells.  Sure it was killing me, but we are all dying from our imperfect bodies.  Who am I to say that cancer was not part of me?

It's hard to explain what it was like, trying to figure out my own identity during my recovery.  I felt like I had been shattered, and had to put myself back together.  Most of the parts were there, and most of the parts I'd lost I didn't much care for anyway, but it was up to me to see what I had left and to put them back together.  For a time I felt like I had been reborn, not in the sense that I had a fresh start but because I felt like a newcomer.  My memories were intact, I knew the people around me, and I was told that directly after the surgery I seemed like I hadn't changed at all (except for all the morphine and a haircut). But if you disassemble a house and use that material to build an identical house, is it the same house? 

I had been told that people wouldn't even notice a difference, but that I would.  The house knows it has been rebuilt, even if its occupants do not. 

I have yet to find a satisfactory answer.  There might not even be such a thing.

What I do know is that I am now who I am now.  I can work with that, and keep moving forward.

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