[2020-10-15] Stoicism
I've been having an excellent week. In the past 7 days, I've reached a minimum of 7,500 steps every day and exceeded 10,000 steps on three of the days, and my pace continues to improve. I've had both physical and mental energy in abundance. I've experienced no nausea and virtually no pain (just the odd pang in my belly if I walk too quickly). I am taking no medications. And I'm drinking more water each day than I ever have.
I was a little fatigued yesterday evening and wondered whether that was because I am at my lowest white blood cell count in the cycle between chemotherapy treatments. But this morning, I felt re-energized and was up in time to join my son on his morning walk before work. We walked for 50 minutes.
On one of the days that I exceeded 10,000 steps, I took a call with a friend and walked throughout the conversation (which is a great way to accumulate steps, by the way). He had cancer 10 years ago. We compared stories about treatment, coping with nausea and fatigue, and the impact of cancer on family members. We talked about the fact that cancer is often viewed as a single disease when, in fact, there are many different cancers and even variations within each type. And, of course, the treatments are very different. His was short and intense; mine is long but gentle (at least by comparison).
We discussed what is and isn't in our control. I talked about my layer cake analogy:
- first layer: my base health and everything I'm doing—walking, eating well, drinking more water—to maintain my strength to face each round of chemotherapy;
- second layer: my successful surgery and the fact that it provided additional information that we didn't have when I was first diagnosed;
- third layer: chemotherapy, which I seem to be tolerating well; and
- icing on the cake: my positive attitude, daily reflections through my blog, and tremendous support from friends and family.
When I reflect on my cancer, some of what has happened and will happen is within my control and some is completely outside my control. This is what the ancient philosopher Epictetus called the dichotomy of control. Bill Irvine, professor of philosophy at Wright State University and author of The Stoic Challenge: A Philosopher's Guide to Becoming Tougher, Calmer, and More Resilient, explains this concept on Dr. Laurie Santos' podcast The Happiness Lab:
Sometimes you do have a say in whether bad things happen to you. If you never check the gas gauge in your car, bad things are going to happen and you're to blame and shame on you. But there are other things where a bad thing happens that you couldn't have foreseen, but you do have control over the frame you put around it. You've got a very interesting choice of whether you're going to play the role of victim or play the role of target, and it's a huge psychological difference because if you choose to play the role of victim then you're going to feel sorry for yourself, you're going to be asking for people's sympathy, you're going to be probably depressed. If you play the role of target, then you can rise to that challenge. As a result of doing that, you can gain character and you can change the world.
Thinking back to July 29, the pain in my upper right abdomen was like the light on the gas gauge in a car. I could have ignored it, but I didn't. I called Telehealth Ontario. I went to the emergency department at the Queensway-Carleton Hospital. I stayed at the hospital for 10 hours through various tests. And I ultimately left with a diagnosis of cancer—a bad thing for sure and something outside my control, but my response to the diagnosis wasn't outside my control. I could, like many people before me, go through the requisite tests and cancer treatments.
I didn't know much about stoicism before I listened to The Happiness Lab podcast, which was recommended by a dear friend. I had this notion that stoicism was like the British stiff-upper-lip, maintaining composure in the face of adversity at whatever cost. In fact, Irvine explains that stoicism proposes that:
It isn't what happens to us that has the effect; it's how we frame what happens to us—it's how we interpret what happens to us. And so we may not have a lot of power over what happens to us, but we have considerable power over what we do with what happens to us—with the psychological frame we put it in.
The psychological frame I have chosen to put around cancer is captured in my mission: wring every positive thing out of cancer, grow from the experience, and be an even brighter light in the world, both during and after treatment. There have been many positive things that have come from cancer: more time with my immediate and extended family, the push to finally legally wed my sweetheart, an opportunity to write every day, surgery that alleviated symptoms that were uncomfortable, many renewed and new friendships. I feel that I've grown from the experience, gaining insights that I have shared and can continue to share with others who will come after me. And—though it may be immodest to say—I do think that I am bright light in the world. My goal is to live many more years so that I can share the legacy I am building—from diagnosis through treatment to recovery.
I could dwell on the negative or worry about the things outside my control, but that's not my nature. Irvine states:
If you spend your day thinking about, anxious about, dwelling upon the things you can't control, you are the biggest fool on the planet.... You're wasting your time, you're wasting your energy, you're causing yourself grief.
He provides an interesting metaphor to illustrate this point. If you had a neighbour who banged on your door every five minutes and said "you should be angry about this" or "you should worry about that," you would get a restraining order. Except it isn’t a neighbour, Irvine says. That pestering is coming from inside your own head.
Instead, to have a good life, stoics focus on three things: things they can control, values that lead them in the right direction, and goals they are able to achieve. I can control my perspective on cancer and the steps I take to best prepare me to undergo treatment. I can choose to find the positive in my circumstances. And I can aim to derive value out of this situation. I guess that makes me a stoic.
