Elana

43 Ways to be a Good Human Being: Coronavirus Edition

March 22, 2020 By Elana 7 Comments

Help me improve this article! If you have any ideas of things to add, email me or leave a comment below and I will make updates. If you want me to credit you, leave a link to your website or social media.

See Part I of this post here: Love in the Time of Coronavirus

In my experience as a two-time cancer survivor I’ve learned that one of the best ways to deal with difficult circumstances is to transform your anxiety into action—to find a source of meaning and purpose during the struggle.

In the last week I’ve seen a really heartening trend, with people sharing ideas about how we can support our families, friends, and communities during this time of crisis. Here are a few ideas of specific actions you can take—it will help make the world a better place, but it will help you feel better, too:

Tip your food delivery driver extra—they’re putting themselves at risk to feed us all
Run errands for others who are elderly, immunocompromised, or otherwise at risk
Practice social distancing so we can all work together to flatten the curve—even if you’re young and healthy you could spread the virus to someone who’s not
If you’re sick or at risk of being infected, be careful to tie up your trash tightly to make sure to lessen the risk of exposure for your local sanitation worker
Remember that people who live on the margins of society will be the most impacted economically, so do what you can to support them
Give your cleaner the time off but still pay her
Give your nanny paid sick leave if you can afford it
Pay your hairdresser in advance for your next haircut
Pay your nail tech in advance for your next manicure
Buy gift certificates at your local restaurant, hair salon, or nail salon to use later to help keep them afloat
Instead of returning your theater tickets, donate the money to the theater so they can continue to pay their employees
If you know a marketable skill that can be done online (web design, coding, etc.), teach it to someone else
If you have money, share it
If you have time, share it
If you have a social network, support someone who doesn’t
Schedule a phone call or Skype date with someone who you suspect could be feeling lonely from the social isolation
If you’re single or live alone, partner up with a “Coronavirus buddy” so you have someone to share hugs with (as long as you’re each keeping your distance from everyone else)
Join your local Nextdoor to stay connected and keep abreast of neighborhood news
If someone around you coughs or sneezes, don’t immediately look at them like they’re a leper
Be kind to others when shopping
Practice patience with your friends or family who seem overly anxious, and support them without being invalidating
Practice patience with your friends and family who aren’t following all of the guidelines, and teach them how to do the right thing with compassion
Whatever the tone of your average social media post, make it 10% nicer (everyone’s under high stress right now so we can all be set off easily)
Be 10% more curious about other’s points of view than you normally are
Care 10% about the social good than you normally do
Share a roll of toilet paper with someone who needs it
Share a bottle of Purell with someone who needs it
Make a meal for someone who needs one
Only buy the food or household supplies you need so there’s enough available for everyone
Thank any doctors, nurses, or other healthcare providers you know for all the work they’re doing to keep us safe
Thank any respiratory therapists you know—they’re at very high risk for contracting the virus and help keep us breathing when we’re sick
If you have gloves or masks, especially N95 masks (the kind that filters small particles), donate them to your local hospital—doctors and nurses are already needing to reuse masks or make their own masks from office supplies
If you know how to sew, make masks to help hospitals with their shortages
Keep yourself as healthy as possible and avoid unnecessary health risks—the ER might not have the bandwidth to handle your broken arm from drag racing, for example
Postpone any elective procedures you have scheduled so the doctor’s time and medical supplies that would be used for you are available for someone else who needs them more
Donate blood if you can—there are major shortages right now because the Red Cross has had to cancel their blood drives
Share Coronavirus memes… because laughter, like Coronavirus, is contagious
Set up a “drop zone” on your doorstep for your food delivery person so they can stay 6 feet apart when they deliver your food
Keep yourself informed by checking the CDC website regularly—the situation is evolving daily and we all need to do our part to be informed citizens
Subscribe to an online news site to support the journalists who are working so hard to keep us in the know
Share your Netflix password with someone who needs some entertainment
Work to restore the sense of community we in the United States enjoyed in the aftermath of September 11, 2001; be more kind, civil, tolerant and patient with everyone you encounter
When this is all over we’ll look back and reflect on the role we played during this collective period of difficulty: set an example that you can be proud of 🙂

Have anything you want me to add to the list? Leave a comment and let me know!

Love in the Time of Coronavirus

March 18, 2020 By Elana 28 Comments

For the last week I’ve been consumed with anxiety. It’s been on my mind and probably most of your minds, too. CORONAVIRUS.

Partially I’m worried for myself, as being a cancer survivor and recent recipient of a stem cell transplant puts me at a high risk for serious illness if I were to contract COVID-19. And when our healthcare system becomes overly taxed, which is inevitable, will I still be able to get my routine oncology care? What if, God forbid, my cancer were to relapse this year (which is unfortunately the period of highest risk for me), would my doctors be too preoccupied with their other patients to take care of me?

But much more than I’ve been worried about myself, I’ve been worried about all of us—about society as a whole. At first I was hopeful—maybe the pandemic could bring us together? Maybe it could instill in us a sense of community and camaraderie and common purpose, like during wartime or an alien invasion (according to every action movie I’ve ever seen)?

The problem, though, is that pandemics historically have not brought people together. When the enemy is a virus, it could be anywhere, or in anyone. The doubt and mistrust can infect every part of us, including our moral code. There has been a lack of clear leadership and no singular voice guiding us how to conduct ourselves when our individual desires may be at odds with society’s needs. In that vacuum some of our base instincts have taken hold.

I see the mistrust and suspicion seeping through on social media, first with the dismissive posts criticizing others for worrying. “It’s just like the flu, guys.” “You’re overreacting,” “Just wash your hands and you’ll be fine.” In the last few days that tone flipped rapidly toward somber as most people have started taking it seriously. But then the anger came out. “Stop going to the gym, guys!” “You’re being so selfish!” “What’s wrong with people?”

It’s happened with my own family. When the news started turning I called my parents to see how they were holding up and was alarmed to hear they weren’t reconsidering their vacation to Hawaii next month. “It’s no big deal, honey. We’ve seen it all” (as I desperately tried to convince them otherwise, I had a sudden sympathy for how they must have felt trying to get me not to do dumb stuff as a teenager).

Otherwise normal people are hoarding food and toilet paper. First time gun purchases are up. This guy stripped a state’s worth of Purell from mom & pop shops so he could gouge customers by reselling it on Amazon at a massive profit. Suddenly every person around us is a potential enemy: Did she just cough? Is he buying all of the spaghetti? Why is he posting a photo at the gym? That’s so irresponsible! Won’t she just stop worrying and get off my back already? It’s not that big of a deal!

Let me backtrack for a moment with a brief story. A few weeks ago I wrote my first blog update in a while describing how I’ve been recovering from my stem cell transplant over the last few months. I wrote about how strict my husband has been about making sure I follow the anti-infection protocols at home to keep myself safe and protect my baby immune system and I jokingly used the term “Nazi” to describe him.

As I wrote the words there was a whisper in the back of my mind that someone might be offended by the joke, but I was tired and it was too much creative effort for me to come up with another phrase that packed the same punch I was looking for. For better or worse, when you’re an adopted half-Moroccan cancer survivor raised Jewish married to a half Ashkenazi half Persian Jew you feel entitled to make a lot of jokes.

Out of the 10,000 or so people who subscribe to my newsletter I received three replies from people bothered by the reference. The first person was quite harsh and called me abhorrent, among other things. That reply went straight into the trash, although it did give me minor stomach pains because it caught me off guard and no one likes to be on the receiving end of meanness from a stranger.

The second reply wasn’t unkind at all and was in fact otherwise complimentary but the level of offense felt a little dramatic, like I had done something terribly wrong. I emailed her back. Wasn’t “Soup Nazi” from Seinfeld funny? What about that recent Curb Your Enthusiasm episode with the antisemitic dog that only heels at “Heil Hitler”? She replied that she didn’t think Soup Nazi was funny at all, and I thought that was fair, because at least that was consistent. I disagreed but I understood her point.

It was the third reply, though, that made me realize I was wrong. It was so simple. It just took me a sentence to understand. She just described how she used to use the term “Nazi” as a joke, too, until her German immigrant husband explained to her why it was hurtful, especially for people living where it all had happened. She nicely pointed out that my (German) stem cell donor could be hurt by it, too.

Well, how much more obvious do I need it to be? I may be slow, but I’m not dumb. Of course I didn’t want to hurt anyone. The first two replies just made me think I had offended someone, which I’ve found is quite impossible to avoid when you have more than 10 people reading your stuff online. But hurting someone? Now I got it. I mean, I’m not a monster. That’s the last time I’ll ever make that joke again.

What a gift, isn’t it? To help change someone’s mind, to patiently guide them toward being a better person? To share your own story of growth, as she did, to help another person see it’s possible for them, too? I was open to this woman’s point of view because own self-reflectiveness made her credible. If we want to have the capacity to change a person’s mind, and therefore their behavior, we have to set the example first; we have to be the kind of person who is willing to change our own. Perhaps there are many ways to be persuasive, but the only one I know is to lead with humility.

I generally don’t try to change anyone’s mind about anything, except my patients, who are explicitly paying me to do so. It usually feels like an exercise in futility and an inefficient use of my limited mental and emotional energy. Believe it or not I am not a very outspoken person—my husband lovingly referred to me as a “mute” for a while because of how little I talk in group settings. I guess being a better listener than talker is what makes me predisposed to being a psychiatrist.

But I’ve started to feel differently now in light of the crisis we’re facing; the experience of having my own mind changed has shown me that to put that effort toward another person is a sign of respect; it is a gift through which we can demonstrate our love. We are currently experiencing a crisis and we are obligated to help those who need guidance.

I was still ambivalent about this post, though, until last night. My husband and I ordered PF Chang’s for dinner, and over Mongolian Beef and hot & sour soup I vented my anxieties about having a public voice about something in current events. I finished eating and opened my fortune cookie. It read: Others will follow your lead in the coming months.

Fuck. It’s on. Let’s do this.

There are basics we all need to know and follow: To start, follow guidelines on social distancing, not just for yourself but for the community. We need to flatten the curve, spreading out the infections over time so the healthcare system is not overwhelmed with a bunch of sick people all at once (we don’t have enough ICU beds or ventilators for all the people who will need them). Young people need to participate, too— while they generally don’t get sick they are likely the biggest spreaders of the virus, since they are the most active.

Don’t hoard toilet paper or food—the supply chains are fine, the issue is that everyone got scared at once and bought more than they needed. Care about yourself and your family, but don’t forget about your community or society as a whole.

Keep abreast of the news and CDC guidelines as the situation is evolving daily. Run errands for people who are elderly or immunocompromised. Remember that the people who will be most affected economically are those at the margins of society. Give your cleaner the time off, but pay her anyway. Tip your delivery person 10% more than you usually do. Be 10% nicer than you normally are, especially on the internet. If you have money, share it. If you have time, share it. If you have social support, share it. Sublimate your fears into action.

Whatever action you’re considering, envision that it’s not just you taking it, but everyone. Would the the result make the world a better place, or a worse one? This is an opportunity for us to support our families, our friends, our neighbors, or communities, and society as a whole. It is an opportunity for us to give help and also receive it. It is an opportunity to set an example for others by how we act.

Be patient with others as they get up to speed. Teach others without criticism or condescension. Lecture others 10% less; act 10% less superior. Be gentle when you tell someone they can’t visit or you can’t hug them. None of us wants to hurt anyone. We all want to be good people.

What we are all facing right now is scary and uncertain. It’s going to get worse before it gets better. Some will die, and many will suffer. There will be loneliness, grief, anger, and economic stress. It is a crisis. And a crisis is a chance for us to let our actions be guided by love—to become the people we have always believed and hoped we are.

I don’t know about you, but when I was a child I indulged in more than a few adolescent fantasies about what an amazing person I’d be if only given the opportunity—like I definitely would have been sitting with Rosa Parks in the back of the bus and hiding Jews in my attic during World War II. Well, now’s my chance. It’s all of our chances!

Sometimes a catastrophe is easier to handle than a minor inconvenience, and I speak from experience as a two-time cancer survivor. The stress of a minor inconvenience can be indulged, every aggravation played out in our minds, every annoyance yielded to—whereas the reality of a catastrophe demands action. It’s a make-or-break moment for all of us to discover who we are inside.

Love is not just a noun, it is a verb—it is an act. It is what you do. It is an energy that, once created, can never be destroyed, but is instead set forth into the universe in perpetual motion, where it will exist for all of us, always.

Living to 100 Days

February 28, 2020 By Elana 72 Comments

Last week I was walking from my oncologist’s office to my car when I heard a voice calling out.

“Hey! Hey you! Hey there!”

I didn’t think he was talking to me but I was the only one there so I turned around. It was the guy manning the valet station. Once he caught my attention he waved.

“Hey there! How you doing?”

I waved back. “I’m good, thanks!”

He smiled. “Good, cause you’re looking good, too!”

(This was definitely the highlight of my day and the first time I’ve been catcalled since my stem cell transplant).

It happened again yesterday—I was walking back from the post office when a sexy salt-and-pepper put down his cell phone, smiled, and said hi to me for absolutely no reason.

It’s interesting for me because for the last few months I’ve been invisible. Don’t get me wrong—sometimes it’s nice to be invisible, to see people glance right through you as if you’re not there. Especially when you’re feeling bad, and especially when you feel you don’t exist in the material world at all, but in some strange in-between of presence and death.

When I first relapsed I’ll be honest and tell you I hoped I would die as quickly as possible. From everything I knew relapsed T-Cell ALL had a miserable prognosis. When I was first hospitalized and the on-call attending told me the plan was more chemo and a stem cell transplant, I put my head in my hands and cried and said, “I don’t think I can do it again.”

The reason I wanted to die quickly is that I’ve learned there is something worse than death, and it is fear. As I waited those first few weeks to see if the chemo was working and the tumor was shrinking (a necessary first step to having a successful transplant), I’d “test” my lungs on an hourly basis, breathing as deeply as I could to see if there was more space in my chest, shifting positions obsessively to see if the pressure on my lungs felt lighter.

I ruminated over the possibilities. If it didn’t work, how would I die? I googled “how do you die from lymphoma” but mostly got answers on how one dies from leukemia (usually a combination of bleeding and infection caused by cancer cells in the bone marrow pushing out healthy cells needed for blood clotting and fighting infection).

But I didn’t have any cancer in my bone marrow—just in my chest—so I thought it through to the most logical conclusion. The tumor would continue to grow rapidly over the following month or two until there was no space left in my chest and I went into heart failure or suffocated to death.

I frantically googled “psilocybin therapist Los Angeles” because I heard it could help cancer patients process death (unfortunately this is not the type of thing doctors advertise online). I was seized with fear, terrified every moment I gave my mind the space to think. What if what happened after death was even worse than this, worse than life?

While I waited I wrote my will and made an Advanced Directive. There was a question where you could specify what you’d want to happen to your body after you died. I never thought I’d care about such a thing—why would I? I’d be dead anyway. But when I really imagined it, I did care. I wanted to be buried in a Jewish cemetery, somewhere nearby so the people who cared about me could visit. I didn’t want to be forgotten.

But… none of that happened because the tumor shrank with chemo, and I went into remission. Then I fretted about finding a match on the bone marrow registry, but there she was—my little German angel. Then I worried she’d change her mind, or that the stem cells would get lost in transit (she donated her cells in Germany before they were couriered to Los Angeles).

I worried when I was admitted to the hospital while I got total body irradiation and high dose chemotherapy to eradicate my immune system and prepare me for transplant. I worried right up until I saw with my own eyes the bag of cells hanging off the IV pole as they were infused into my body. Now, I only had to wait and see if the cells took, or if a I developed a life-threatening infection, or if I got graft versus host disease, when the donor’s cells attack your own body, which can have serious consequences.

But… none of that happened, either. Sure, I felt like shit in the hospital, but I didn’t have any major complications and after a month I got to go home. I worried about infection but I didn’t get one. I wasn’t supposed to eat takeout but one day I was craving pizza so my mom and I ordered delivery and I ate the pizza and nothing bad happened (we did have to hide the pizza box evidence from my husband because he had an eagle eye on me to make sure I followed all the rules, which I found adorable. I’ve never seen someone use so much Purell in their life).

I walked around the block and nothing bad happened, so I did it again. I kept my eyes peeled for signs of graft versus host disease but didn’t get it. Then I had a follow-up PET CT and it showed no evidence of cancer in my body. Yes, I was (and still am) floored with fatigue, and my body aches, and I sleep 12 hours a night, but there has been no catastrophe, no transplant rejection, no relapse.

Last month I passed the 100-day mark from my transplant, a clinically-relevant and symbolic signpost that the worst is (hopefully) behind me. Of course, though, I’m still at risk for relapse and there’s still a sense of existential dread. I was chatting with a friend recently about what age we feel. I (half) joked that I feel 65, and he said he feels 30 (we’re both in our late 30s). I asked him what being 30 feels like.

“Oh, you know.” He said. “It’s that feeling when you’re settled and have your career, but you still have energy and your health and you feel like there’s a lot of time life.”

Of course it made sense but I felt a little sad when I heard it, because it made me realize I don’t feel that way at all—I haven’t felt like I have time left since I was 30, before all this started.

I’ve discovered one antidote for the existential dread, though—shopping. Mostly for face creams, because that total body irradiation did not help my skin tone. I’m getting Invisilign and I prepaid my malpractice insurance for the year. I’m writing my book. My brother and his wife just had a beautiful baby girl and they asked me to be the godmother and I was elated to say yes. I’ve already decided I’m going to teach her piano and swimming and good grammar (don’t get me started on messing up object and subject after a preposition).

I live each day as if I have all the time in the world, and that makes me happy. There is a joy in being ordinary, in having the same petty worries and pleasures of a regular person who hasn’t repeatedly had to contemplate their own death.

Maybe someday I’ll feel so ordinary that I’ll vent on Facebook about how the kitchen windows arrived three days late or how the DMV is sooo disorganized and I can’t get an appointment to get my Real ID or how the kids these days won’t get off their phones. I’m not quite there yet, though.

But hey—at least I look good!

A Little Update

October 14, 2019 By Elana 36 Comments

Hi everyone,

I’m alive!!!!

I’m very alive and writing to you from my hospital bed at City of Hope where I’ve been admitted to receive my bone marrow transplant.

A quick update of what’s been going on since I wrote my last post about my relapse: The relapse was terrible news but things have been going as well as they could since then. One of the concerns with my type of cancer is that when it relapses it be resistant to chemotherapy (since how else would a cancer cell survive the 3 years of chemotherapy I had?). But for me that did not end up being the case and my tumor quickly shrank with 2 rounds of chemo identical to what I received before.

Then, I was extremely nervous about finding a donor match for bone marrow transplant, since like I mentioned before I am adopted (and have no full biological siblings who could have gotten tested) and am mixed ethnicity, which makes it a lot harder to find a match than when you are plain white.

However I ended up having several full matches on the registry, and the donor who was selected for me is a 37 year old woman in Germany (apparently a lot of donors come from Europe because they have better systems for signing people up there).

Even knowing I had a match didn’t alleviate all of the worry. I found myself wondering, Did she definitely agreed to donate? Has she signed anything? Does she wear her seat belt? Could we possibly wrap her in bubble wrap for the next couple weeks… you know, better safe than sorry?

But as the process proceeded forward as planned those anxieties fell away. I was admitted to the hospital last week for my scheduled transplant and so far have received 4 days of total body irradiation and 1 day of high dose chemotherapy to kill any remaining cancer cells and blast my immune system to get my body ready to receive the donor stem cells.

So far I don’t feel too bad—tired, but not bad. The main side effects the radiation gave me were super dry skin and a blistering tan, and not a good tan like you just came back from Spring Break, but a “I spent 40 years smoking cigarettes and rubbing baby oil on myself on Miami Beach,” kind of tan, or as my husband describes it, “You look like you got lost in a desert… a desert where they do atomic bomb testing.”

In 2 days I will receive the actual transplant, which isn’t a surgery or anything fancy but instead a bag with stem cells hung up on the IV poll just like any of my other IV fluids. Somewhere in Germany my donor is getting ready to donate her blood, where the stem cells will then be filtered out, packaged up, and put on a couriered flight all the way to me in Los Angeles.

I wanted to thank you all too for your awesome responses to my last post. To give you an update:

#1 – I got my money back from American Airlines! They reached out to me within a few hours of my last post going live. The customer service rep who called me referenced receiving “significant correspondence” on my behalf… so thank you guys for that (and thank you AA for doing the refund).

#2 – I got a book agent! I had a number of agents reach out to me and will be working with a great agent from Inkwell. I’m working on shoring up my proposal to submit to publishers in the near future.

#3 – Thank you to everyone who signed up to be a bone marrow donor. I should clarify the terminology, because what I am receiving is not technically a “bone marrow transplant” and is instead a “stem cell transplant,” the difference meaning that stem cells are harvested from the donor through a blood donation and without any surgery, and then they are put into me via an infusion. Then the little stem cells will somehow find their way to my bone marrow and create a new immune system, also without any surgery. So the process to be a donor is usually NOT surgery or anything painful, so don’t let that dissuade you.

If you haven’t already you can sign up to be a donor at the Be the Match website here. Imagine being the person to save someone’s life—someone who may not have any options other than you. That’s what my donor is to me—she does not know me but she is giving me a chance to keep living, and the years I have going forward will only be possible because of her.

#4 – Thank you to everyone who signed up for my Life Teachings membership program! I am having a great time in the program making videos and answering member questions. I am also making daily videos from my hospital room with updates about my transplant process and little life lessons from the trenches.

Here’s a picture my husband took of me recording one of my videos yesterday:

#tan #radiation #lostindesert #atomicbombtesting

You can sign up here for the Life Teachings Membership Program for $47/month. It’s easy to sign up or cancel at any time. I’m also offering a discounted rate of $17/month for cancer survivors who others who under financial stress. Email me if you’d like to sign up for the discounted rate (give me a couple of days to get back to you).

Thank you for following along with me and I’ll be back soon 🙂

What Would You Do If You Had 10 Years Left?

September 5, 2019 By Elana 40 Comments

“This existence of ours is as transient as autumn clouds

To watch the birth and death of beings is like looking at the movements of a dance

A lifetime is like a flash of lighting in the sky

Rushing by like a torrent down a steep mountain.”

– The Buddha

What would you do if you had 10 years left?

This is a question with which I am intimately familiar.

During the worst moments of my cancer treatment the suffering was unrelenting—waves upon waves of physical and emotional pain knocking me down before I could get up again. There were mouth sores so raw I begged a nurse to give me novocaine, physical pain that woke me up in tears, cramps of nausea that left me looking at food, starving, but unable to eat it. Then there was the psychological terror of knowing I was living a nightmare I could not escape. It was in these moments that I’d play little games in my mind.

The first little game I played was imaging to whom I would give my cancer if I could make someone else bear the burden instead of me. I’ll be honest and tell you there was no person, other than my brother, whom I would not have cursed with the worst fate imaginable if it would have made my suffering end. My parents? Well obviously, they would have taken it from me if they could. Acquaintances? Sure, of course. What about friends? Close friends? Friends’ children? Oh yes, all of them, too.

I found it funny (in a morbid sort of way that one finds things funny in these kinds of situations) that people reading my blog called me “brave” and “courageous,” when little did they know I would have killed them, too—would have wrapped my hands around their pretty little throats and strangled the life out of them if it would have given me one moment of relief.

The other little game I’d play was to pray. It was a game because I knew no one was listening, but still it gave me some measure of comfort to imagine there was a higher power out there with whom I could bargain—perhaps we could come to a mutually agreeable arrangement?

Oh, I made all sorts of promises. At first I promised that if I survived I would never make another mistake, never hurt another person, because after so much ceaseless suffering it’s hard to come to any conclusion other than you must be here because you earned it, and because you deserve it.

The worse things got the more I escalated my promises and reduced my demands. If only I could make it through this horrible experience I wouldn’t need much. Couldn’t I just have 10 more good years? I would live to 45. And you can do anything in 10 years!

You could build a business, learn any skill, make a lot of money. You could write a book… multiple books, maybe even win a Pulitzer prize! You could get married, start a family even… you couldn’t live to see them grow, but still, I was in no position to be greedy.

Well, I survived, (the details of how are described in other blog posts), and since then my promise has never been far from mind. I set about reconstructing my life with a relentless pressure believing in my heart I had only 10 years to accomplish all I was meant to do. How could I not keep my promise when the universe had done its part?

And it was not the sickness that was the hard part, but the recovery. It’s easy to get cancer (only a little bad luck is needed) but it took a special type of grit for me to put all the pieces back together afterward, and that’s what made me proud.

In a few short years I met my future husband, got married, graduated residency, took my psychiatry residency boards (and got in the top 10th percentile), got off opiates, put myself on an anti-chronic fatigue regimen that recovered my energy (which I have since taught patients), started my practice, built the practice so full that I could barely take on new patients, and started a promising online course teaching holistic treatments for anxiety.

Damn, it felt good.

When I turned 36 at the end of last year (“year one”) I pulled out my moleskin notebook and multicolored pen set and diagramed out my goals for the decade to check that my first year’s accomplishments were on track. They were.

But who wants to live like they only have 10 years left? Buddhists talk about meditating on death to appreciate life, but let me assure you it’s overrated, and a luxury afforded to those who are not actually dying. I much preferred being able to take life for granted, to make plans without pressure, to imagine a future that was guaranteed, and to live as if I had all the time in the world to do what I wanted to do.

Only recently—in the last six months perhaps—has the pressure started to fade. It happened naturally, without effort, as an inevitable conclusion of life proceeding normally.

Maybe I didn’t have to complete all my goals in 10 years… maybe I’d have a little more time. I started to take vacations. I noticed my first few grey hairs and wondered if I should keep them or dye them. I noticed the first signs of aging in my face—just a subtle loss of elasticity—and wondered if a mini facelift at 48 would do the trick.

I planned a once-in-a-lifetime trip for August with my husband. We would have flown to London to visit friends, then to Zurich to connect with my birth mother and two of her sons, my half-brothers (I’ve known all of them since I was 17), then taken a train to Frieburg, Germany to meet my Moroccan birth father and his daughter, my half-sister, for the first time. I splurged on business class tickets because my husband is a special snowflake when it comes to sleep and I wanted him to be happy.

But—and you knew there was a but, didn’t you?—as all this tension I felt started to weaken, something much more sinister was growing.

It started in July, so similarly as before. First a cold that turned into a cough that didn’t go away. Then a feeling of pressure in my chest that weighed me down as a tried to sleep, so I shifted from right to left to center trying to find the position where I could best pretend it wasn’t happening.

During the day I felt fine and made jokes that this was how my cancer started the first time, and people laughed.

I put it off for as long as I could. Last month, in early August, I sat up with my husband at night and told him the same words I had said over five years ago—”Something is wrong with my lungs.”

The next day I cancelled my morning patients and we went to the ER. I knew it was serious but was hoping it was something a little “less serious” like a pulmonary embolism or heart attack (a girl can dream, right?).

The workup (chest X-ray, CT scan) was fast and by midmorning I knew. They told me right before I was wheeled away for a Doppler to look for blood clots (which now seemed like a pointless exercise) and as I left my husband in the ER room I saw him put his head in his hands and start to cry.

I was admitted to the hospital to start chemotherapy immediately. I spent those first few days in disbelief or crying. I honestly didn’t believe I would ever relapse (although on the other hand—and this is perhaps a topic for a future post—I planned my life as if I would).

I cried because I couldn’t fathom going through the treatment again, and briefly considered not doing it. I cried because I emailed my patients to tell them what was going on, and got so many messages in response telling me to focus on myself because the world needs me and I realized that I really, truly, do not want to die.

I cried more because I couldn’t go to my trip to Germany. The day before I went to the ER I had messaged my half sister and told her how excited I was to meet her, and where we were staying in Frieburg and maybe we could meet for lunch on Wednesday? She messaged me back two days later to confirm (at which point I was already in the hospital) and when I saw her message I sat there clutching my phone, my thumbs hovered over the screen, having no idea what to say.

The cancer is the same as before— a chest mass that is a relapse of my T Cell Acute Lymphoblastic Lymphoma. The plan is a different this time and the prognosis is… less hopeful.

First I will do a few rounds of Hyper-CVAD (the same initial chemo regimen I did before) which will hopefully put me into remission, and then I will get a bone marrow transplant.

In terms of survival, I won’t put numbers here because my husband will read this and hearing any numbers gives him a panic attack. You can google “prognosis relapsed Acute Lymphoblastic T Cell Lymphoma” if you want to know.

Numbers aside, understand that I already know I’m a person and not a statistic. In the end, though, even if I end up on the good side of a 1 or 2 or 3-year survival curve do you think that’s all that I want?

No, I want 10 years. It was promised to me. I went through all that pain and torture over 3-4 years expecting 10 good years in return, and I got less than two.

And if I’m honest (and maybe this is the problem, that I wasn’t being honest the first time) I’ll want another 10 years, too. And then another, and another… enough decades that when I do die (because we all die eventually) it will be without the feeling that I have now—the sinking realization that something has gone horribly wrong for me along the way.

****

So now being a seasoned cancer veteran (a sad claim to fame) I know I will get sincere comments and emails from people asking me what I need or if there’s anything they can do to help.

First, please don’t feel obligated to do anything for me. I probably won’t have the energy to take you up on any offer or respond to messages (although I will appreciate reading them). Mail will be hard for me to handle. I also DON’T want advice.

Now I’m just going to be straight with you about what I DO want because if you’re able to help me with one of these below things, it will be the most meaningful way you can help me:

#1: Help me get a book deal: I’ve been working on my book the last couple years (a memoir about my cancer experience) and have a near complete proposal done, but have slacked on submitting it to agents because I’ve been so busy with my practice and I’m not that familiar with the publishing world.

If you have any helpful connections to agents or publishers (or are one), I want to hear from you. Being able to put this book out into the world is probably the most important thing to me right now. If you’re reading this in email hit “reply,” or just email me at elana(at)zenpsychiatry.com. If you put “Book Related” in the subject line it will help me see your message faster.

#2. Sign up for my Life Teachings monthly membership program: One of the worst things about being sick for so long the first time was not being able to work. Realistically I won’t be able to continue working in my current capacity, but I want to do everything I can to continue to feel productive.

At this point I’ve amassed a lot of knowledge and have been doing really rewarding work helping patients in my private practice. While my ability to work with patients one-on-one will be curtailed, I want to be able to continue sharing the information/knowledge/wisdom I’ve gained that could be helpful to others.

So what I’m doing is creating a new online membership program called the Life Teachings Program that will be a monthly subscription where I will be uploading videos, lectures, and teachings on topics like integrative psychiatry, anxiety, trauma, PTSD, cancer recovery, and my personal cancer experience—basically everything I teach in my practice, plus some more personal things. The program will be about teaching practical things I know from my personal and professional experience that could help you live a better life.

It will cost $47/month and I’ll release new videos and teachings as often as I’m able. You can join or quit whenever you want. If I’m not able to keep it up, I’ll shut it down. I have already uploaded my Overcoming Trauma video course from a few years ago and a segment of my 9 week holistic anti-anxiety program Freedom From Fear & Anxiety on meditation and relaxation practices specific for helping anxiety.

#3: Register to be a bone marrow donor: I actually just found out that there are several potential matches for me on the bone marrow registry database, which is a huge relief since I am adopted and mixed race and don’t have any full biological siblings. My transplant team is in the process of reaching out to these people to confirm they are available to donate, so somewhere out there is a stranger who will hopefully save my life. If this is something you’d be willing to do for another person, sign up to be a donor on the Be The Match website. It’s especially hard for minorities or mixed race people to find a match, and the difference in prognosis when you have a full match is significant.

#4: Help me get my goddamn money back from American Airlines for my trip to Germany: [Update: AA has refunded my ticket thanks to you guys!] thought that getting lymphoma a week before my trip and needing a bone marrow transplant would be a reasonable excuse for a refund (especially for a business class ticket), but apparently they disagree. They did offer me a voucher, which I appreciate, but there’s no way I’ll be able to use it within a year, and it feels overwhelming to have to coordinate other people using it and paying me back with everything else going.

You can use Twitter to tell them your thoughts at @AmericanAir (cc me @ElanaMD), or Click Here to Tweet my Pre-Written Message. As a side note, American Airlines has a collaboration with Stand Up To Cancer (who incidentally interviewed me a few months ago)… and I feel like if you’re going to do something like that you have to practice what you preach and be compassionate to people in extreme situations.

Thank you for reading and I hope to write another post soon with an update.