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Point of View

My "cancer privileges"

By Sarah Buckingham

Iwas in the hospital after surgery for breast cancer when my friend Diane told me flat out that I needed to take advantage of my "cancer privileges." She'd had colon cancer three years earlier. She said she had come to realize that if you have cancer, you're entitled to special privileges. I didn't have to apologize for being sick or needy or, for that matter, for anything.

"You still said please and thank you, didn't you?" I protested, aghast at the idea of not apologizing for asking a favor.

Diane laughed. "Yes, Sarah, you can still be polite," she reassured me. "But think of it as giving those around you the gift of taking care of you. I let people know when I wasn't up for a visit," she went on. "I called people when I needed things."

"What would you say?" I asked her. I was still uncertain.

"I would say, 'I need Cheerios.' And Cheerios came. Please think about it," she said before we hung up. "You deserve these privileges." I teared up at the idea that anyone might care for me that much.

Meals: After I came home from Dartmouth-Hitchcock, my sisters Amy and Susan took turns cleaning and shopping and driving my daughter, Helen, around. By week three I was able to drive. But shopping was still hard, so my friend and minister, Donna, arranged for people from church to bring me meals for the next three weeks. Flowers came, too. And came and came. And cards. Susan and Helen taped the cards around the living room walls. I felt cared for.

My friend Laura accompanied me to my appointments, taking notes and putting her arm around me. What could I ever do to repay such kindness? "Pass it on," she told me.

Friends from work assembled a big basket of goodies—food, magazines, Burt's Bees skin products. I accepted the offering humbly.

When I started chemo six weeks later, I tried to go back to work; but the nausea I had and work simply didn't mix. So, using my cancer privileges, I extended my leave until the end of chemo.

When people called or visited, I tried not to let on how awful the chemo was. Who knew which of them might one day need chemo; if I made it sound too bad, they might decide against it, as my sister Molly had. "Please don't worry about me," I said a hundred times over.

Mutant: I tried to exercise but no longer felt steady walking. "Exercise is important," every book said. So I tried swimming. I hadn't been well enough yet to get a prosthesis, so I had just one breast, and I was bald. As I walked into the pool I felt like an elderly mutant and worried how fat my butt looked. I wasn't cutting myself much slack.

I called Diane. "Doesn't sound like you've got the cancer privileges thing down," she said frankly. "It's not so much what you do. It's how you feel about yourself doing it." Oh. So I was allowing myself to receive cards, flowers, meals. I was even letting my ex-husband do my yard work. But I still felt rotten about accepting help. Diane continued, "When I got pregnant a year after my treatments, I realized I deserved pregnancy privileges, and then new-mother privileges."

But if everyone goes around allowing themselves privileges, then who will be the helpers? Won't society be a spoiled mess? "You're thinking too much," Diane said. She knows me too well. "Embrace the privileges. They're yours."

What Diane said started to sink in. Next time I walked into the pool, big-butt mutant that I was, I held my head a little higher.

When my sister Molly died, I was midway through my chemo. I allowed myself to feel frail as I flew to her funeral, to be as social or unsocial with family as I pleased. That still sounds selfish: ". . . as I pleased." But I wore my wig for the first time at her funeral so I'd look healthier to others. I could give back and have privileges. Hmm.

I began to realize that I'd always felt unlovable and awkward. I was constantly apologizing, as though the world let me exist if I didn't cause too much trouble. When I finally embraced my privileges, I was able to stop apologizing. To see that people think of me in kind and loving ways and that I could too. That I could, and should, grant myself privileges even when I was healthy again. Just for being me.

The horrors of chemo ended and I went back to work. I felt much better. Life was normalizing. Then radiation began. The night after my first treatment, Helen and I were watering our neighbor's goat. It was dark, we had weak flashlights, and the ground was uneven. Add chemo brain—a sort of not-always-with-it feeling—and my fall was destiny. I heard a pop and couldn't get up. Broken foot, crutches, wheelchair, and 27 more days of radiation. I needed a whole lot of help.

Last straw: A few days later, I called my friend Rosann in Virginia. She'd told me to call her any time I needed to just bitch. So I did—about hiding how bad chemo had been, about missing my sister, about how breaking my foot was the last straw. The next day, Rosann found a store near me that delivers meals and ordered dinners for a month. I let her do it. I let her find a way of caring for me, long distance.

I owe Diane a call. I want to tell her I feel well. I want to thank her. It was a wonderful gift that she gave me two years ago—a gift that changed my perception of the world. Everyone does deserve special privileges. Privileges make you feel that you matter, that you're lovable. Society doesn't lose anything by granting privileges to everyone. That's because with the gift of privileges comes the strength to grant them to others—to give in a way that makes someone else feel special and important.

Thank you, Diane, for my privileges. I plan to hang on to them. I feel privileged to be who I am. Pleases and thank-yous included.

The "Point of View" essay provides a personal perspective on some issue in medicine or science. Buckingham, a reference librarian at Dartmouth College, was treated for cancer at Dartmouth-Hitchcock's Norris Cotton Cancer Center in 2004 and 2005.

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Dartmouth Medical SchoolDartmouth-Hitchcock Medical CenterWhite River Junction VAMCNorris Cotton Cancer CenterDartmouth College