Trigger warning – this post talks about suicide, death and pain.
Cancer
I have cancer. Well, maybe I have cancer… I did have cancer (lyomyosarcoma), and had a tumour removed in 2019, and then on my first year scan in 2020 they found another tumour and removed that. When I have five scans in a row with no tumours they say I’m cured of my cancer. I get my next scan in Oct 2021, so I guess I’m in cancer limbo.
I occasionally forget about it. Surgeries are currently enough for my management. I’m lucky: no chemo, radiotherapy or pain (yet – if it decides to metastasise things might change). Just some cool scars, and my insurance paid out a “lump sum” which is a great pun. I got a tattoo that ran from my first cancer scar to my discectomy scar that says “Die without a scar, Die without a living story”, a tiny house and a motorcycle. I have lived through far worse.
So when it comes up that I have cancer, and I see people’s responses, ranging from horror to compassion, it’s a bit unreal. For me it’s a non-event. I tell them that something has to kill me. The reason I got trauma cover in the first place was because I could imagine accidentally doing something horrible to myself as part of all the risky things I do. But I do get it – cancer kills people. There have been a number of deaths by cancer that have happened around me. There are also a number of people around me who suffer daily and profoundly with it. Living with it can be awful, painful, protracted and soul-destroying for the sufferers and the ones who love them.
There are people out there who will say things like “you said you had cancer years ago, and yet you’re still not dead” to cancer sufferers, as a justification for withdrawing their support and association. Admittedly, there are people who play up illness for sympathy. They’re balanced by those who can only afford sympathy for the better-be-over-soon ailments. Are you one of them? The diagnosis is the start of the journey, not the end.
Asthma
Anyway, I came much closer to dying from asthma about 20 years ago. I had never really had it before, so didn’t recognise that the cough I had was anything more than a nasty cold. It just got worse and worse. Finally I decided I had to go to the doctor, and called in the morning for an appointment, and got one in the afternoon. Then I thought about it a bit more and decided to go to the hospital A+E. So I walked up to the bus stop, took the 40 min trip into the city, then walked across Grafton Bridge to the hospital reception. I told them “I’m having… a bit of trouble… breathing”. They looked at me and took me to a room. I was impressed with the quick service. They got me to blow into a thing. The first time they said “no – all your breath”. The second time they said “once more for luck?”. The third time it was below 80 cc and they stuck an orange dot on my sheet (I had seen the triage chart on the wall, and I was thinking “I’m not in severe shock!”) and sent me to the nebuliser. My doctor was furious with me. He paced up and down at the foot of my bed, gesticulating forcefully, saying “The next time, you don’t need an appointment! You just come straight in!”. I said I didn’t know it was asthma. He said “And you get an ambulance! People DIE on their way to the hospital!” I said I didn’t know it was asthma. Just as quickly as it appeared, it was gone. I guess it had its chance…
Here comes the hard part…
The disease that came closest to getting me was depression. It’s the strangest thing: tell people you have cancer and they’re all solicitous and caring. Tell them you have depression, which is as deadly as cancer, and they don’t want to know, or they think you just need to snap out of it. We all know of people who have committed suicide, or are currently suffering depression, as well as those who have died of cancer and are suffering from cancer, so it’s not like we don’t understand the misery or the danger. I think the difference is that while the thought of getting cancer is a dread horror for most of us, we think we have empathy for a person with depression, because we’ve all been sad. And since we got over it, so can they. I hope to show that this belief is fundamentally flawed.
First, we should consider the nature of pain. Studies have shown that emotional pain and physical pain are interpreted in the same way in the same part of the brain. In other words, words can hurt you just as much as stick and stones. All pain is pain. The experience of pain is also very subjective. The worst pain anyone has ever felt is the worst pain they have ever felt, even if it’s just a broken finger. On a scale of 1 to 10, where 10 is the worst they have ever felt up until then, this is currently 11 or more, but becomes the new 10 for the next assessment. When you see someone suffering at their 10, you remember your 10. If your 10 is way higher than theirs (you have suffered far more than a broken finger) it can be easy to be unsympathetic to their suffering, and tell them to harden up, forgetting that this is still the worst that they have ever felt. If your 10 is less, you have no idea how much they are suffering. I doubt it is possible for anyone to truly imagine any pain that is worse than the worst they have ever felt. If you have never experienced a pain that makes you want to die to be rid of it (imagine someone comes with a gun and says “do you want to be put out of your misery?”) you will not empathise with someone with suicidal depression.
Empathy is feeling another’s pain. I’m not even sure it’s useful for a person who would consider death – you just get two people suffering for the price of one. It’s like a drowning person also drowning their would-be rescuer. Empathy has its place when someone is suffering a new 10 that you left behind a long time ago. “Oh that truly sucks. It’s horrible when that happens. I feel for you.”
Compassion is care and warmth for a person, even when they might not be so warm in return. It’s understanding that a person in pain has enough to deal with without you imposing your issues on them as well (though you can ask to share – sometimes we can build each other up). Compassion doesn’t need to understand or share the pain, it just accepts it’s there, and accepts the other as they are.
Sympathy is sorrow or concern for a person, and what they’re going through. In many cases it’s the best we can do, knowing that misery is misery, pain is pain, and we don’t want that for people we care about. We can hear their story, act as a sounding board to help them find their own solutions, and ask if there is anything we can do to help the sufferer get through their crisis, but at the point we tell them how to sort their lives out we have segued into pity.
Pity comes from a place of superiority, where it’s believed the sufferer brought the pain on themselves, but you’ll maybe rescue them because you’re a nice person and far more capable than they are. It’s patronising and cold, and related to the just world fallacy that people deserve the bad things that happen to them. No-one wants your pity, and there is no mechanism in life that gives people all and only what they deserve. Even most religions are smart enough to say the pay-back will come in the next life.
Depression
So, depression. My experience of it was best described, I think, as chronic ego depletion. To do the things we have to do to exist in a social world, we have to exert some control over ourselves. This takes from a finite source (according to some studies) of times we can do this before we have to recharge or run out and lose control. Some people measure this source in “spoons” – some people have a lot of spoons, and can do a lot of socially righteous things, and some people have a lot less, and our supplies can fluctuate for a variety of reasons. If you have ever had a “blue day” where you don’t want to go to work, or talk with people, or fuss about with your appearance, you have experienced a day with low spoons. The way to recharge those spoons, while you still have some, is to do something self-indulgent eg staying in bed eating a tub of ice-cream, or having a good cry (if you’re a woman – men aren’t allowed this in our society, which makes it harder for them), or going for a ride on your motorbike.
The difference with depression is that you have far less spoons to start with, it’s far harder to recharge, and you can completely run out. If you have exhausted your supply of spoons you lose your self control, and with it your self-respect – we know the exact things to say and do to hurt ourselves the most. You hate yourself for your self-indulgent behaviour, because it shows how useless you are, and you can hurt anyone and everyone, including yourself and anyone you love, because you have nothing left to stop yourself… and you hate yourself while you do it. (This doesn’t mean you will hurt yourself or others – it’s not an excuse for your flaky, anti-social or self-harm behaviour, or a justification for others to stop being your friend, it’s just where things can go.) You want to die to stop your own pain, and all the pain you believe you cause everyone else because you can’t force yourself to behave in the way you think they expect you to.
So why do so many depressed people get to hear words like “you’re such a drain to be around” or “you always let me down”? They already believe that to the core of their being. That could be the last straw. If you ask them to do something you impose either a cost of spoons to comply, or self-respect if they fail you. Which would you rather take?
Do you pity them when everything looks like a struggle, and they couldn’t even bother to brush their hair properly? You can’t say “oh, I know how you feel” if you can get out of bed and look someone up to talk to them. Can you only afford sympathy for the better-be-over-soon ailments? Please. Have compassion. Depression, like cancer, if it doesn’t kill you, can hang on for a long time, can be awful for the sufferers and the people who love them, can be overcome (and can give the survivors an astonishing strength, depth of personality, and ability for compassion), and in my experience at least, is a far worse level of pain than a mere major abdominal surgery.
anacrusisblog 