Diagnosis Day, Part One: A Lesson in Gratitude

No one wants to be told he or she has cancer.  The initial lack of control and feelings of helplessness are often traumatic experiences. The usual reactions are anger, depression and terror-laced anxiety.

While survival rates for many cancers have improved, there are quality of life issues following the diagnosis, including the emotional difficulty of coping with the anniversary date.  Survival rates are measured in 1-, 5- and 10-year markers.  This often creates an emotional conflict as the diagnosis date approaches.  Each year provides a measure both of success and trepidation.  Diagnosis day is when the war on cancer begins in your body.  It is sometimes shortened to military lingo for the day an attack or operation is launched: D-Day.

As with most traumas, people can tell you the vivid details of their diagnosis. They remember the time, what was said, what they did, and what they felt.  D-day is etched in their psyche, and as the anniversary date approaches, so does the anxiety.

But one woman, Jen Cunningham Butler, has done something different. In honor of breast cancer awareness month I wanted to tell you her story.

“I called home to see if the biopsy results are in,” she says. “The doctor tells me to page him.  I do.  He tells me: You have breast cancer.”

“I was in my office about to walk out into the adolescent hum of opening night of the eighth-grade play,” she continues. “The seventh-grade ushers were waiting for me and their final instructions before parents and friends arrived. They needed me to help them, and I needed to drive home and tell my husband I had cancer. Dr Meyer had given me the number for Larry Shulman, head of breast oncology at Dana-Farber Cancer Institute. “In the event of an emergency please page me at…”

I hung up. Was this an emergency?

When I reached Larry he pulled up the pathology on his computer: “It’s invasive,” he told me. We agreed to speak the next morning to form a plan. I got ready to go out into the hall, trying to figure out what to do next.

It was Tuesday, March 8, 2005. 5:30 pm.

Over the next several days, weeks and months Jen lived in two different worlds of coping with work and home and the agony of additional biopsies, MRIs, CT scans then the surgery, the radiation, and the recovery.

“I could tell you of moments of jagged fear, the comfort of “to do” lists, the beauty of the people who steadied me,” she told me. “I could tell you how simply breathing became a gift of release and how the things I could do physically, like riding my bike (even though I was slow) with my cycling friends, calmed and settled me.”

But as D-day approached, Jen knew there was a predictability of anxiety based on what others had told her. But she was determined: “I needed to find a way to turn the day around.”

She did just that.

“Coming into that first-year anniversary, I thought about how much being strong, healthy and well meant to me. I thought about the doctors, nurses, radiation therapists and others who took part in my treatment. I thought about Ellen Moore, who listened to a healthy-looking young woman’s assertion that a very small lump was of concern and took it seriously. I thought about Dr. Meyer (if someone has to tell you that you have cancer, it should be him — professional, knowledgeable, kind, gentle, matter-of-fact).

“Ultimately, I decided that Diagnosis Day was a day to give back to the people who helped me through that time. They gave me my life, and I was grateful,” she said.  “As a teacher, every once in a while you get a letter or email saying, “You made a difference in my life.” The idea for Diagnosis Day undoubtedly came from that — from how we feel when a former student lets us know that the work we do is worthwhile. I knew I didn’t choose cancer, but I knew I could choose some parts of the journey.”

But Jen did much more than this.  She acted on her thoughts of gratitude for the team that worked with her, and became an ambassador of hope.  On March 8, 2006 she baked heart-shaped, individual chocolate cakes for the women in the radiation waiting room and wrote a note saying she was healthy and well a year out and hoped the same for them.

“I also bought presents for Dr. Meyer, Ellen Moore, Dr. Shulman, nurse Anne Kelly, and my wonderful surgeon, Dr. Beth-Ann Lesnikoski (with whom discussing options like “lumpectomy or mastectomy?” could feel like a conversation over coffee with an old friend). With the presents went notes that thanked each for their contributions to my care.”

Each year since 2005, March 8 has been a day of gratitude and service. She says there is still an undertone of shakiness as the day approaches, but the day itself has transformed.

“I go to Dana-Farber with presents for my doctors, radiation therapists and nurses and bring a tray of goodies and a note to the women currently in radiation. On year five, I wrote notes to the people who helped me in myriad ways, for the colleague who saw me emerge from my office that night in 2005 and took over the play ushers for me, to the school nurse who kept my confidences and helped me manage day-to-day life at work, to the friends who rode with me even though my pace didn’t match their training plans, to my husband who stayed true and kind and loving throughout. Each year is a little different. Each year I think of who or what continues to resonate. One year it was the Dana-Farber parking attendants who got a big bag of organic lollipops; their smiles and help during treatment meant more than they’ll ever know.”

But what struck me about Jen’s inspirational story was the fact that much of the good feeling she generated in herself and others was actually part of well-documented research on gratitude.  Jen had attended one of my Power of Positive Being workshops where I discussed the research on the gratitude visit.  Jen’s intuition about how to turn D-day around mirrored what we know about outcome studies in gratitude.  She came up to me after the workshop at Kripalu, a spiritual retreat in Western Massachusetts and the largest residential facility for holistic education and well-being in North America, and related her story.

In part two, I’ll discuss the research on gratitude and how Jen intuitively followed all of the principles scientists have determined help improve our well-being.  But for now I just want to celebrate a woman with courage: The courage to heal, the courage to change, and the courage to be grateful.