Recently, a co-worker told me that most people fear public speaking more than they fear death. While I have heard this axiom before, my response to this comment was to laugh, raise my eyebrows, and say, "I would volunteer for public speaking any day."
I made this comment after a week-long conference in which I gave three large-group presentations and met with customers who began conversations by listing off all of the reasons why they don't like me. The conference ended with a particularly challenging and demanding customer encounter, but I handled the situation professionally. Afterwards, I high-fived my colleagues (corny, I know) and congratulated them on a job well-done. We were all exhausted and tired, but we had survived the week. Hopefully, the customers who had began their sentences with all of the reasons why they didn't like us would leave the conference thinking that we weren't so bad afterall.
Despite the relatively gruling work week, something happened during this conference that was very monumental - I stood in front of several large audiences and gave presentations with complete confidence. Although my presentations weren't the most interesting workshops ever given, my face didn't turn bright red (as far as I know), I didn't have to remind myself to breathe every two seconds, my heart was beating at a relatively normal pace, my voice didn't waiver, and I didn't pause mid-sentence, wondering what I was supposed to say next. As audience members asked tough questions, I answered without missing a beat. I even stood up in the middle of a colleague's session and voluntarily answered customer questions, walking up and reaching for the microphone with the ease and nonchalance of a pro. I accomplished all of this without imagining the audience members naked, staring above their heads, or reading my presentation from a script.
Now, for normal people this may not seem like a very large accomplishment, but if you knew me as a child, you might know that I was so shy that I couldn't order food in a restaurant on my own. In high school, I skipped lunch and went to the library, pretending to study, so that I wouldn't have to walk up to a cafeteria table full of kids and ask if I could sit with them. During my freshman year of college, my husband misinterpreted my extreme shyness as snobiness and created a fictional story about how I grew up with a priveledged childhood in a mansion and had a buttler named Geeves. In graduate school, I hated reading my written work so much that I would sit quitely, hoping that my professor would forget that I hadn't read and move onto the next activity without asking me to read aloud to the class, even after everyone else had read.
A couple of years ago, wanting to overcome my fear of public speaking, I volunteered to travel to give presentations at work. I taught a community college English class and an early childhood education course. I did all of these things quite badly, but my goal was to eventually overcome the public speaking jitteriness that caused my voice to quaver half of the time. My presentation skills were somewhat unpredictable. Although I almost always knew the material very thorougly and could recite it forwards and backwards, it was as if my body was physically allergic to speaking in front of people.
The day before my third chemotherapy treatment, I gave an in-house presentation to about 100 people at work. I wore a pink and red head scarf perfectly color coordinated with my outfit. I also pinned a pink ribbon on my suit jacket right below the gaudy gold name tag. I heard the workshop participants in the back row mumbling about my bald head, but I didn't care. I had bigger things to worry about.
I recently read a magazine article that advised readers to write their fears onto little pieces of paper and slip them into a lidded jar in an effort to be less afraid. Having breast cancer has made me a fairly paranoid hypochondriac and so I decided to write down my fears in an effort to let them go. If I get a headache, I fear that I have brain mets; new bone pain means that the cancer has spread to yet another bone; chest pain equates to a pulmonary embolism or punctured lung; wheezing means that my lung mets are pressing against my airways like a person stepping on a hose; feeling dizzy or faint means that the lung mets have caused my oxygen levels to drop; and having fewer hot flashes means that my endocrine therapy is no longer working and my estrogen levels are rising, thus, causing my cancer to grow. A fear of public hardly seems relevant in comparison.
In order to balance my list of fears with positive affirmations, I also wrote a list of things that I'd like to do in spite of my cancer. Some might call this a bucket list. Because I hate that term, I prefer calling it my "I have stupid cancer but I'm going to try to live my life anyway" list. Or, as a fellow cancer patient calls it, a "suck it to cancer" list. I was able to imagine a whole list of things I'd like to accomplish.
During the four months that I waited for my metastatic breast cancer diagnosis to be confirmed, I kept telling myself that if only my cancer was early-staged, I would be able to get through it. Right before my 29th birthday, a PET/CT scan confirmed that there was about a 90% chance that I did, in fact, have stage IV cancer, which meant that the cancer was incurable. My oncologist gave me the news over the phone while I was at work. A minute later, a co-worker came in my office to ask me a work-related question. I must have looked upset because she asked if I was okay. I smiled on my face and said that I was fine. Then, I proceeded to answer her question.
There's always the nagging fear that my cancer will progress before I'm ready. At some point, when endocrine therapy stops controlling my cancer, it's very likely that I will need more chemotherapy. Several oncologists have told me that once I start chemo again, I will likely continue to receive chemo for the rest of my life, unless I take a chemo "break" or find a clinical trial with an investigational treatment that doesn't require chemotherapy. This is a hard concept for me to wrap my mind around. I would volunteer for ten surgeries before I sign up for more chemo, but instead of avoiding it like the plague, maybe, when the time comes, I need to just do it.
I recently shared with my psychiatrist my most immediate fear, which is having to start chemo with no end in sight. I had a hard enough time getting through the four cycles; the thought of endless chemo sounds impossible.
She told me that once I get to the point that I need more chemo, I may not have a choice.
I reminded her that there's always a choice to receive or refuse treatment. Then, I told her how my strategy in the past has been to plan my life in spite of my cancer treatments. I went to see my favorite dance company perform the night before my friend shaved my head during chemo; I invited friends to do a spa day with me the morning of my 4th chemo treatment; I gave a work presenation while bald; I travelled out of state for work the day after my lung biopsy; and I've somehow managed to live with what once seemed to me like an impossible diagnosis of an incurable cancer.
"I think you're going to do just fine," she told me. "You're one of the most optomistic people I know."
I don't always feel like a very positive person. My coping mechanism seems to be having "realistic" expectations. I don't believe that I'm going to be cured, at least not with the current treatments that are available for metatstatic breast cancer. However, my cancer has been relatively stable for almost 10 months. My cancer pain is relatively well controlled and my energy levels aren't terrible. At least I haven't been sleeping on the floor of my office during lunch. I am extremely grateful that my cancer is stable and I don't even think about the possibility of the cancer shrinking. As for a cure, that's not a "realistic" expectation. When people talk about hoping for NED (no evidence of disease), I laugh, raise my eyebrows, and think about how I'm doing pretty well living with stable disease. Who needs NED?
Last week, I did a twist and a backbend in yoga, something I hadn't been able to do for a long time without being in pain. In fact, I remember one particular class in which I couldn't even lie flat on my back. My yoga teacher had to take my feet and physically place them on my yoga mat so that I was lying flat. At first, I told her that I couldn't put my legs down; it hurt too much, but then, of course, I did it anyway, mostly because she made me. I still won't attempt a handstand. I'm afraid of falling on my head, but I suppose that can be my new goal.
