Helping the ill remain hopeful: New book by doctor who survived cancer
National Post
Thu 08 Sep 2005
Page: A20
Section: Body & Health
Byline: Jane E. Brody
Source: The New York Times
How can you find hope when your chances of survival seem hopeless? How can you find joy while undergoing treatments that make you miserable and barely able to function?
These are the challenges faced by millions of people who have cancer or other life-threatening diseases. Among them, for nearly a decade, was Dr. Wendy Schlessel Harpham, a Dallas physician. When recurring lymphoma forced her to relinquish her medical practice, she began writing books -- including Diagnosis: Cancer, After Cancer and When a Parent Has Cancer -- to help other patients and their families.
Dr. Harpham's new book, Happiness in a Storm, is written for anyone facing a progressive or potentially fatal illness such as cancer, heart failure or Parkinson's disease. The subtitle sums up its message: "Facing Illness and Embracing Life as a Healthy Survivor."
After a diagnosis of Stage 3 lymphoma in 1990, Dr. Harpham had eight rounds of treatment, mostly experimental, for her initial disease and six recurrences. Did she worry about dying? Of course she did. She mourned the loss of her medical practice and feared that her three young children would have to grow up without their mother.
Each recurrence brought her closer to the brink. But a seeming miracle occurred in 1998, after a fourth treatment with a newly licensed monoclonal antibody, and she has been out of treatment now for six years.
Between the often-debilitating rounds of treatment that left her plagued with fatigue, Dr. Harpham lived as fully as possible.
As she defines it, healthy survivorship does not necessarily mean the patient has been cured of cancer. Patients become survivors from the moment their illness is diagnosed and they remain survivors during treatment and afterward. They can be "healthy survivors" even if they are living with terminal illness.
Dr. Harpham maintains that healthy survivorship is based on obtaining sound knowledge, finding and nourishing hope and acting effectively. While it is perfectly natural for every patient to want to be cured, she points out that for many people these days, cancer has become a chronic disease. They are not cured, but they continue to live. Cure is not the only route to physical healing.
For most patients, the path to the best scientifically established treatment starts with learning all you can about your condition, the available therapies and their likely consequences, then deciding on a treatment plan and choosing a medical team well-equipped to carry it out.
Ideally, you would want a doctor who is empathetic, returns phone calls and provides emotional support as well as good treatment, admittedly a rare combination. Failing that, choose good treatment and seek other sources of emotional support.
Take into account the doctor's knowledge and experience in treating your disease and his or her availability to see you, whether you can understand the doctor's explanations and advice and whether you are treated with respect and understanding and provided with realistic hope.
Patients have many resources for learning about their disease and finding the best treatments. The Internet is awash with reliable sites. There are also reputable Web sites listing clinical trials that are testing new therapies.
Also important to physical healing is to adopt such health measures as good nutrition, exercise, sleep, relaxation techniques and healing relationships that can help you feel better as well as improve your condition.
Humour helped Dr. Harpham over many rough spots. When her second recurrence was diagnosed on the same day as the first but a year later, she quipped, "I've consolidated my recurrences so that I won't have too many bad-news anniversaries."
Fear is natural when facing a life-threatening illness or injury. But when fear is front and centre, joy is impossible. To help tame fear, Dr. Harpham suggests focusing on factors you can control, such as diet and exercise; distracting yourself with activities you enjoy; practising relaxation or self-hypnosis; participating in a support group; and, if needed, getting professional counselling.
It is also natural to grieve. Sadness about having a potentially fatal disease should not be played down or discouraged but acknowledged. Dr. Harpham said she found it helpful to think, "Today is a bad day" and to allow herself downtime, as long as the time was limited.
It is also important to find ways to nourish hope.
"When illness strikes, hope takes on new meaning," Dr. Harpham says. "Healthy hope is the belief that you can help improve your situation and feel happier.... Hope is an ongoing choice."
Dr. Harpham makes it clear that choice is yours.
As she put it, "Cancer gave me today, every day, in a way I'd never known before. Since I no longer take much of anything for granted, everything has an added element of happy surprise -- made it to see this, do that, stay here and go there! The ordinary has become marvellous. Even unpleasant times are less painful, for they are proof that I am still here."
I am intensely grateful that modern medicine gave Dr. Harpham the opportunity to write a book that will help me, and many millions of current and future cancer survivors look differently at life's setbacks, aches and pains and inevitable losses. It is a book I expect to read many times as a guide to the meaning of joy and satisfaction, and the many routes to them, regardless of the turns my life and health may take.
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