Don’t Ask a Survivor

When I wake up each morning — thank God for that little blessing — I will admit that I don’t always know what to write about. I’ll admit there’s a certain laziness on my part, but I just have to carefully observe the world around me, and add context and commentary to the narration. Today, for instance, this was initially going to be an Instagram caption on my on-going coverage of recovering from chemo. But my relatives’ recent obsession with radiation kind of refocused me, and made me aware of a rather dramatic gulf between survivors, the newly-diagnosed, and Cancer Muggles (that’s not my term — I believe it’s originally from the Instagram account @lmaolymphoma). When I got my most recent diagnosis, I chased my tail trying to figure it out. Every newly-diagnosed survivor is asking it. I’m semi-active in four different cancer support groups, and I’ve only been asked it once (I kind of prompted it). What should you never, ever ask a survivor?

Why did you get cancer/What caused your cancer?

After watching Chernobyl, my mother got really interested in the lingering effects of radiation (as it turns out, Chernobyl was a mild summer breeze compared to some of the nuclear testing that occurred post-war), and discovered that the area of Northern California I grew up in had (relatively) high levels of radioactive cesium (if any of my Down Winder friends are reading this, I guess I might be an honorary member of the tribe; hey, guys)(if you grew up with me, you should probably consider regular cancer screenings). I know I have a genetic predisposition to cancer (I had that tested). I know that trying to answer the “Why me?” question is useless, because I literally went to grad school looking for the answer, and it didn’t really satisfy me (suffice it to say that, if you believe in Creationism, God is an unforgivably incompetent genetic engineer). Admittedly, there are some pertinent issues to take into account — if you’re a pack a day smoker; if you are downwind of Chernobyl, if you have a genetic predisposition to cancer; these are all good things to take into your survivorship (especially if they increase the odds of cancer in the future), but there is — I guarantee you — no survivor in the world who knows, 100% certainly, why we got cancer. Care to know how I know that? We got fucking cancer. If we knew from whence our disease sprang, we would have avoided it.

I got glioblastoma just as an excuse to experiment with broad-brimmed hats and really severe mohawks

Cancer survivors don’t ask each other that question unless it’s a really bizarre, freakish medical case (as I am); we ask each other far more important questions, like; “What is your treatment regimen? Is it working? Who are your oncologists?” We tend to treat our disease as if it’s a fate to be worked around. Which is the insight all the newly-diagnosed need to cope with — once you’re on Planet Cancer, you’re not leaving, no matter what anyone might tell you. Figure out a way to make it work for you; time spent looking for an emergency exit is time not spent in an infusion center or refilling prescriptions or doing any of the other of hundreds of brand-new, mission-critical life-saving-but-banal things you need to do to survive.

I’m picking on this question in particular, because the subtext of it, in today’s society, is a form of victim-blaming. The subtext is, “I’m scared of your cooties. Tell me who gave them to you, so I can avoid them.” It’s yet another recitation of Mitch McConnell’s long-standing policy that sick people choose (or deserve) to be sick. My father, who’s a bladder cancer survivor, mentioned that he’s always asked by new oncologists if he smoked. He smoked for three years, and when he had his last cigarette, Jimi Hendrix was still alive (this is true). He likes to bring this up, occasionally, because he’s found his oncologists’ response — usually along the lines of, “That explains it” — telling. Dad’s preferred interpretation of events — one which is supported by most of my grad school education — is that he is a 70-year-old man with a fairly common type of cancer. If he came down with heart disease, no one would wring their hands and try to get to the bottom of this medical mystery, they’d recommend he get more aerobic exercise, avoid fatty foods, watch his blood pressure, and take any pertinent meds. Cigarettes undoubtedly contributed, but, unless you have a DeLorean sitting in the garage, figuring out what caused your cancer isn’t a terribly useful exercise.

I know for a fact that, of all the questions that flood your mind after a stage 4 diagnosis, this has to be among the most useless. I’m fairly certain about that, because I actually asked Head Warlock in Charge about the odds of someone getting three different brain tumors (sort of — Tumor #3 is a recurrence/outgrowth of Tumor #2), he sort of shrugged and said (I’m paraphrasing, but not as much as you’d think), “Some people just get lucky.” When one of the pre-eminent necromancers on the west coast doesn’t think a question is worthy of further investigation, either the answer isn’t important, or it’s in some horrific cave guarded by dragons or something. “Why” is a great question for able-bodied philosophers; sometimes it’ll bring a shred of relief from the terror of existence (it rarely did in my 17 years before cancer, but that’s another essay for another time), and one of the hardest, but most-useful mind-sets for the newly-diagnosed is to stop asking “why,” and just roll with inshallah. “Why” is a question you can always come back to; it’ll be there when you wake up and when you go back to bed. It’s no longer a useful question. “Who” is somewhat more useful — as in, “Who else has successfully navigated this disease? Who can help me? Who can drive me to my infusions?” “How,” as I’ve learned, is the question in the abyss that gets shit done. “How do I survive this? How do I get more treatment? How can I better weather treatment? How do I recover?” They’re far less exciting than “why,” and there isn’t the promise of some big reveal at the end of the story that “why” has, but “how” will get you to the end of that story more certainly.

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Patrick Koske-McBride

Patrick Koske-McBride


Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”