The small c

So, I've been meaning to explain the title of the blog. I have a massive amount of work to do right now and very limited time in which to do it, so what better time than now to push all that to the side and think about more important things? And why not think about cancer?

Most of you know about the recent Showtime series "The Big C." It's about a suburban mom and wife who is diagnosed with cancer. I can't really tell you more than that because I've only seen one episode and lost interest (let's just say it lacks in subtlety). Anyway, the title of the show had already become a popular way of referring to cancer diagnoses. "Cancer" is too frightening and disturbing a word; it's come to signify a slow, painful death. And so we refer to it by its initial letter, and underscore its dreadful importance by qualifying it as "big."

So, yeah, our son has the "Big C." In those first weeks after the diagnosis and surgery, we refused to use the word "cancer." Hell, we refused to even think about the word. I remember the first day we were visited by a nurse from the oncology ward. She told us the ward she was from then paused and asked if it was ok for her to visit with us. She knew her presence signified a new reality and a new life for us. She new that she was a representative of one of the worst fears a parent could have. We of course asked her to stay.

I had to leave shortly after she arrived (I don't remember exactly why) but I remember talking with SW later about the visit. She told me the nurse was nice and they had a good talk. But something really troubled SW. The nurse had mentioned SB's "cancer." SW told her, "Well, we don't know that it's cancer yet." The nurse, SW said, smiled and then continued on with the conversation. We were indeed waiting on the pathology report to find out what kind of cancer SB had, but we were still not ready to believe that he actually had the "Big C."

When the head of oncology came by later, he took a very gentle approach with us, saying that if the pathology report comes back with a normal pilocytic astrocytoma (btw, it didn't) then one of the options would be to just wait and see. No chemo, no surgery, just wait and see. I think that this subconsciously reinforced the illusion that we were not dealing with cancer. Throughout that first week we talked about tumors, pilocytic astrocytomas, chemotherapy, oncology centers, but we did not ever utter the word "cancer."

Early in the second week, after another oncology nurse had mentioned cancer to SW, we talked about it together. This might sound funny, but it was over a week after diagnosis and surgery that we had a discussion about "cancer." When we finally spoke those words, it felt like we were speaking of death. If felt as if we were uttering some black magic, and we'd best keep our mouths shut. But we also knew that we had to be honest with ourselves so that we could be honest with SB.

"Does SB have cancer? Is that what this is?" SW asked me.

"Yeah, I guess. It's a tumor right?"

"But not all tumors are cancerous."

"Right, but then why are these oncology doctors coming around?"

The funny thing is. The hospital staff seemed just as wary of the word as we were. No one except for these two nurses from oncology ever mentioned the word to us. We had heard every other medical term to describe Max's condition and prognosis, but not "cancer." Perhaps this was because there are much more precise ways to talk about cancer and its treatment. Mitosis, anaplasia, glioma--these terms signified much more for our doctors. But they also allowed the doctors to avoid terms that signified as much to us.

I remember when very soon after our talk SW asked the head of oncology, during one of his several visits with us, if SB's tumor was properly called "cancer." He smiled slightly and awkwardly, and said, "Well, yes." The tone hinted at surprise. He paused for a second and then, as if realizing that we knew but just needed to told, he added, "SB has cancer."

So, what about the blog name? It comes from two sources. The first is a recognition of the peculiar sorrow, strength and joy that attends childhood cancer (and any serious childhood illness). How can something so terrible happen to someone so small and innocent? The "small-c" is a cruel puzzle. The second source is a desire to face "cancer" honestly, but not too honestly. No matter how big and scary it is, we want to shrink it--in every way. So the "small-c" is a way to not just face the facts, but to face down the facts.