no such thing as a bad day

Toastmasters CTM speech originally given on Sept. 8, 2005.
Award: Best speaker

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Gentlemen, please count off, and will every second man please stand up? (Remain standing.) Ladies, please count off, and will every third woman please stand up? (Remain standing.) I've asked you to do this to visualize the following: The American Cancer Society estimates that one in two men and one in three women will develop cancer in their lifetime. When I was 28 years old, I became one of those Americans.
(Please be seated.)

Like many people, I made a New Year's resolution in 2003 to get healthy and lose some weight. I started exercising several times a week, taking Pilates, water aerobics, and other classes. That year, I also learned that my 31-year-old friend Vanessa had been diagnosed with breast cancer. So I decided to combine my desire to get healthy with a way to help cancer research and signed up for the Breast Cancer 3-Day walk.

I didn’t know it at the time, but that decision saved my life.

Doctor Smiley
I had waited months for my appointment with the specialist. Dr. Smiley – his real name – was a very matter-of-fact man. As he examined me, he asked me why I had come to his office and if I'd recently experienced any aches, pains, or changes in weight.

I told him that I'd felt a nagging pain in the lower right quadrant of my abdomen while exercising. He asked if I'd had any back or flank pain recently and I said that I'd had quite a bit of back pain after a five-mile training walk with my 3-Day teammates the week before. Then he said, "Let's go into my office, I want to show you something."

The "something" was a CT scan taken a few weeks earlier.

He explained that the images in front of me were cross-sections of my body and that there was something very wrong with my right kidney. And then he said the most horrible words I've ever heard. He said that he was very sorry, but in his professional opinion, I had renal cell carcinoma, more commonly known as kidney cancer.

My mind reeling, I stared dumbly as he explained that the good news was that it looked like the cancer hadn't invaded my lymph nodes and that the gerota fascia (the sack in which each kidney is encapsulated) was distended, but had held.

Choices
He then said that I had a few decisions to make about my treatment. I needed to have surgery. Would I prefer a partial or radical (complete) nephrectomy? Laprascopic or open surgery?

I asked about the advantages and disadvantages of each procedure and what he would do if he were a patient with my diagnosis. He recommended the radical nephrectomy, because I had good kidney function and there was less risk of post-operative complication if they removed the whole kidney rather than just the area surrounding the tumor.

He also recommended the open surgery (despite the four- to six-week recovery time) because it meant that my doctors would be able to do a visual and tactile inspection of my lymph nodes and ensure that the cancer had not metastasized to the rest of my body.

He then ushered me out to see his nurse, who gave me the paperwork needed to get my surgery scheduled. Still in shock, I mustered a question – did they have any pamphlets on my condition? He did not but offered to lend me some medical texts. His nurse then said these magic words: "Call the American Cancer Society. They can help."

'Meet me at home, right now.'
I left the office and took my cell phone out to try and reach my husband, Eric. Choking on the words, I said "Meet me at home, right now." I then got into my car and drove the four miles home and called Vanessa, my friend who had been battling breast cancer for the past year. She calmly got online with me and we googled "renal cell carcinoma" and read about it until Eric got home.

He asked all kinds of questions I couldn’t answer and we cried together before calling our families that afternoon to tell them the news. It didn’t get any easier to say the word "cancer" each time I repeated it.

Then, we called the American Cancer Society. They were incredibly helpful, and referred me to the Kidney Cancer Association, which sent me information about what to expect during my surgery and other treatments.

The next few weeks were a blur of emotions and doctor's appointments, lab work, and doing what I could to get ready for my surgery.

I'm remarkable
I've learned that the "typical" kidney cancer patient is male, age 40-60, has been a heavy smoker most of his life, has been overweight for much of his life, and is of African-American or Scandinavian descent.

You do the math. With the exception of battling my weight for much of my life, I’m none of those things.

I'm what you might call a statistical outlier, the exception to the rule. I'm also what you might call lucky.

• Lucky because most kidney cancer patients are diagnosed at stage 3 or 4, when there's almost nothing that can be done to help them. (I was stage 1 when diagnosed.)
• Lucky because I had been exercising a great deal and was healthy going into surgery, so I bounced back in a matter of weeks, rather than months.
• Lucky because my treatment was pretty straightforward: surgery, recovery, and five years of close monitoring with periodic lab work, CT scans, and X-rays.
• Lucky because my five-year survival rate (when I'll be considered 'cured') is 60-98 percent.
• Lucky because my left kidney is healthy and functioning normally.
• Lucky because this week, I am two years years cancer-free.

Survivorship
I'm also lucky because I got a lot wiser about myself and the life I wanted to live at age 28.

Right after my surgery, I picked up Lance Armstrong’s book, "It's Not About The Bike: My Journey Back to Life." In it, Armstrong writes about making the most of one's survivorship. His survivorship has centered on the LIVESTRONG campaign, which has raised awareness and millions of dollars for cancer survivorship.

I also read Hamilton Jordan's book. A three-time cancer survivor, he was President Jimmy Carter’s chief of staff. His memoir, "No Such Thing As A Bad Day," pretty much sums up my attitude.

Those two books inspired me to think about what I would do with my survivorship and how I wanted to change my life. And boy did I change it … in the past two years, I've beaten cancer, survived a divorce, and lived in Paris. I've advanced in my career by changing jobs and employers, bought my first home, and become a graduate student.

What I can't do
There are lots of things I can't do because of my medical history. I can't join the foreign service or the Peace Corps. I can't get life insurance. I can't take calcium or vitamin C supplements. I can't take Advil or most pain medication. And I can never be self-employed, because getting medical insurance is pretty much out of the question with a pre-existing condition like mine. [Update: Thank goodness for the Affordable Care Act.]

What I can do
But there are even more things that I do precisely because of my medical history:

• I take much better care of the body that I've been given. Since my diagnosis, I've lost nearly 80 pounds. I exercise at least four times a week. And I do my best to eat right and buy organic foods whenever I can.
• Every day, I tell people how much I love and appreciate them. I also make time for those I love. The result: I am rich in experiences and friends.
• I am mindful of leaving a legacy, and making the world better for having been here. In short, I do all that I can to make a difference now.
• I do my best to avoid negativity and negative people because both are poisonous.
• I focus on what's in my power to change for the better. And have learned to live with the things I can't influence.
• I don't put off doing things that matter to me, like traveling. And I've made a point to expand my worldview, to live abroad, and to travel extensively.
• I constantly take classes and seek knowledge.
• I seek balance in my work and personal lives and safeguard my mental and emotional health.
• I take more risks and am more spontaneous.
• I live passionately and joyfully.

Every day is a gift
I do all of these things because I got the gift of perspective when I was 28. I took the time to decide what I wanted from life and what I wanted out of my life. If I’ve learned anything, it’s that we all should take the time to take care of ourselves and our relationships. I think of it this way: my new year’s resolution was really a goal, a promise that I made to myself to get healthy in 2003. That goal literally saved my life. So I ask you:

• Are you living the life you want?
• And are you focusing on the light, rather than the darkness?
• What promises will you make to yourself (and keep), starting today?