Pine Boards &amp; Strawberries

Five years ago, The Sun reprinted Juliet Wittman’s candid account of being diagnosed with breast cancer [“On a Narrow Ledge,” October 1989]. Wittman has now written a book, Breast Cancer Journal: A Century of Petals (Fulcrum Publishing), about her ongoing struggle with the disease.

Though her career in journalism had trained her to be skeptical, Wittman found that some mind-body therapies gave cancer patients a “sense of control over a life that has suddenly slipped into chaos and terror.” In this excerpt, she describes her experience with Denver’s QuaLife Wellness Community.

— Andrew Snee

As the end of my chemotherapy treatments approached, they became more and more difficult to endure. Freedom was so near, I could hardly bear to wait for it another second. When a session was delayed because my blood count was too low, the mixture of feelings was overwhelming — the leap of joy at not having to suffer the probing needle and poisonous drugs that day, and the fury because the entire horrible business was being prolonged.

After my first injection of the last two-week series, I spent a sick, sullen week. At last my husband, Bill, took me in for the final treatment. As I walked into the doctor’s office and inhaled the familiar disinfectant smell, I was overcome by waves of nausea. I swallowed over and over as the nurse, Patti Kealiher, took my blood.

“Your blood count’s fine,” Patti said. “We can go ahead. Hey, your last chemo. Doesn’t that feel great?”

The nausea became more insistent. Was I actually going to throw up right on the floor?

“I’m sorry,” I blurted out, “but I really do feel very sick.”

“That’s OK,” said Patti. “Let me get you a pan.”

She placed a small, green, kidney-shaped pan beside me. I fought not to vomit.

“That thing’s so small. Do people really hit it?”

“Well, not all the time. Now just relax, and let me know when you’re ready.”

“You might as well go ahead.”

Patti began the infusion and started telling me a joke as the liquids drained into my body:

“There was this couple, and one night the wife asked the husband, ‘Honey, if I died, would you marry again?’ ‘That’s ridiculous,’ he said. ‘You’re not going to die.’ ‘Yes,’ she said, ‘but just suppose I did. Would you?’ ‘OK,’ he said, ‘strictly hypothetically, let’s say I would.’

“ ‘Would you have her live here in the house with you?’

“ ‘This is really dumb.’

“ ‘Would you?’

“ ‘OK. Yes.’

“So then the woman said, ‘Would you give her my clothes?’ And he said, kind of resigned, ‘Yeah, I’d give her your clothes.’

“ ‘And my jewelry?’

“ ‘And your jewelry.’

“ ‘And my golf clubs?’

“ ‘Of course not. She’s left-handed.’ ”

The nausea subsided; I rubbed the skin around the needle tip as I felt the familiar burning sensation. Then Patti was securing a ball of cotton to the puncture with a Snoopy Band-Aid, and it was over.

Several cancer patients had warned me that depression might come with the end of chemotherapy. As unpleasant as the treatments were, they had said, they gave a sense of protection, a feeling that significant action was being taken against the disease. Without the frequent hospital visits, the reassuring interchange with the doctor and the nurses, a patient often became frightened and adrift. Fortunately, one of QuaLife’s three-day workshops had been planned for Boulder that December.

My hair was still very patchy, but I decided not to wear my wig to the workshop because it might get in the way of any physical work we did, and surely among cancer patients my appearance would be unremarkable.

I arrived at the community building where the workshop was being held. In the hallway was a table on which were stacked labels, crayons, scissors, glue, glitter, and ribbons. Two or three people were working painstakingly with these materials.

“Go ahead and make your own name tag,” said the woman behind the table. “Do it any way you want. Get creative.”

I just chose a red pen and wrote my name in capitals. Then I proceeded to the main room, a little stiff, very conscious of my balding skull.

“So you’re Juliet Wittman,” said a tall woman with blond hair and clear, delicate coloring, peering at my name tag. “We’ve talked on the phone. I’m Sara Wolfe, director of QuaLife.” She hugged me.

As we talked, someone touched my head. I spun around. A slight woman with a huge, impish smile was standing behind me. She pulled gently on a wisp of my hair and said, “Yup. Oh yes. I remember this stage.”

I relaxed. Clearly she, too, was a patient. I examined her gray hair, which looked full, lustrous, and healthy. “I’m glad it’s a stage,” I said. “Sometimes I feel that I’m going to look like this forever.”

“Oh no,” she said. “It feels like that, but in just a couple of months you’ll see. My name’s Molly, by the way.”

Our intimacy was immediate and effortless.

We were asked to stand in a circle and give our names and reasons for being at the workshop. Once the circle was formed, I saw Patti Kealiher chatting with someone I recognized as another nurse from the hospital. As the facilitator called on each of us in turn, I found the group was composed of patients, family members, the two nurses, and a handful of therapists. Oncologist Paul Hamilton, who founded QuaLife, was also there. A tall woman with reddish brown curls spoke.

“I came because I needed help,” she said, “and QuaLife better be able to provide it. I found out a couple of days ago that I have metastasis. It’s in my bones. And I’d been feeling so well. I had no symptoms at all.” Her face crumpled, and the man standing next to her took her in his arms.

After the round of introductions there was a tapestry of lectures, songs, exercises, group discussions, and guided meditations. At one point, I found myself lying on the floor while two or three people touched me and murmured soothing words I’d requested. The words were, Let the healing come. Sara was one of the people in my group. When her turn came, the phrase she asked for was, There is joy and purpose.

In the afternoon, Sara gave a workshop on journal writing. Her cancer had been diagnosed when she was in her twenties. She had just graduated with a master’s in business and begun work on her first job. She lost that job and her insurance when her employers learned she was ill.

No one was sure what kind of cancer Sara had, and she took her slides to experts: a breast-cancer specialist on the east coast, a lymphoma specialist on the west. The first told her what she had was definitely not breast cancer; it must be a lymphoma. The second said exactly the reverse. Both doctors were pessimistic about her chances of surviving. What she learned from the experience, Sara told us, was that doctors don’t know everything. Also, that sometimes you have to go forward without all the information you need. My doctor, John Fleagle, had concocted the chemotherapy that saved her life.

Sara suggested a couple of writing exercises. As she turned to write instructions on the blackboard, she said, “I don’t really want to do this. I have a friend who was always raving about one of his classes at the university. It turned out he liked watching the teacher write on the board because when she did, her butt wiggled.”

She went on to another point, talking seriously and persuasively, writing as she spoke. All of a sudden, she twitched her backside at us.

The workshop was beautifully organized. A variety of healthy foods — nuts, fruits, herb teas, juices — were arrayed on one of the tables for all-day snacking. No sooner did we begin to feel stiff from too much sitting and listening than the organizers would propose a physical game or a relaxing stretch. Periodically, we all came together and sang loud, jubilant songs.

We heard a story about a man chased to the edge of a cliff by a savage tiger. Desperate to escape, he began climbing down. Then he realized there was a lion pacing on the ground below, waiting for him. He hesitated. Above him the tiger; below him the lion. He saw a strawberry growing in a crevice close by his hand and picked it. It was the sweetest fruit he had ever tasted.

Even the bathroom breaks were interesting. For some reason, all the breast-cancer patients consistently chose the same moment to visit the john. Upon realizing this, we roared with laughter, and pretty soon observations were being exchanged at the mirror or shouted over the walls of the stalls:

“So have you started tamoxifen? What’s it like? Are there any side effects?”

“Not really. The effects are pretty positive — you feel younger and healthier. Well, I have discovered a slight tendency to gain weight.”

“I had a lumpectomy. How bad is a mastectomy? Does it hurt a lot?”

“No, the node dissection’s the hardest part, and you’ve had that. There’s a kind of bruised, heavy feeling where your breast was.”

The tone was loud, intimate, hilarious. We sounded like girls in a dormitory primping for a dance, comparing dates.

I arrived for the next morning’s session full of enthusiasm and found that a man from an organization called Inspirations was speaking. He was not only uttering the most insultingly obvious inanities, he was working the participants into a kind of call-and-response routine.

“So what is it we have to avoid?” he’d ask, and obediently the audience would respond, “Self-doubt.”

“What is it?”

“Self-doubt!”

“And again.”

“Self-doubt!”

And so on, ad nauseam.

I began to feel angry and alienated. Everyone else in the room seemed fully absorbed and enthusiastic, nodding and smiling and roaring out answers.

“Wasn’t he wonderful?” someone said later, during a break. It was Molly, the woman who had fingered my hair when I’d first walked into the workshop.

I hesitated. I really wanted to be part of this loving and responsive community. But truth won out.

“I hate it,” I said. “I hate what he’s doing: the manipulation and the yelling and the oversimplification.” I stopped. Would Molly dislike me now? But she just put her arm through mine companionably and said, “I’m sorry it’s not working for you.”

All the declaiming and consensus building was leading up to something. We were each given a smooth, square pine board and told to write our worst fear on its pale surface. I wrote, Dying of cancer. Then we were to put down the reason for our fear, what advantages derived from it, and why it was necessary to conquer it. It cripples me, I wrote.

I knew what was coming. The man from Inspirations wanted us to break those boards. He brought up two people from the audience to show us how it was done. One was Sara. She stepped up to the board as the man held it in front of him, took a deep breath, and appeared to center herself. Then she broke the board with one clean stroke of the heel of her hand.

We were told to stand in several circles and practice the necessary moves, and our rehearsal was accompanied by more patter. We punched the air over and over, while the Inspirations man and his partner circled the room, correcting our movements.

“All right,” said the man. “Is everybody ready?”

Patti Kealiher was standing next to me, flushed and sweaty. “I’m going to do it,” she said. “I know I can do it.”

As I so often had on this road, I found myself envying someone else’s certainty. I was afraid I wouldn’t be able to break the board and would end up looking foolish in front of this roomful of people. I also feared the way that failure might work on my imagination later — suggesting, on some superstitious level, that not conquering my fear would cause it to materialize. At the same time, part of me was coolly and cynically evaluating the techniques used to spur us into action.

Finally, four people stood at the front of the room, preparing to hold our pine boards out for us to break. We formed lines. The theme from Chariots of Fire was playing at full volume on the tape recorder, and the excitement and anticipation in the room were almost tangible. I had a confused sensation of noise, movement, glowing faces: a crescendo of action. I was one of the first people to step forward and hand over my board. Someone slipped a turquoise bandanna over my head, as if I were an athlete or a warrior going into battle.

I looked at the board. “Don’t look at that,” said the man holding it. “Look at me. Look into my eyes.” He was solid and kindly looking, with a squarish face and honest, warm brown eyes. I took a deep breath, adopted the stance I’d been shown, and slammed my hand into the board.

Nothing.

“Don’t let your hand stop at the board; try and hit through it,” said the man.

I tried again. Nothing. I could have sworn I’d held myself exactly as instructed, struck just as I’d been told to do. I’ll never do it, I thought. But I tried again. Still nothing. I didn’t know how many tries they allowed, but it was clear I wasn’t going to succeed. I imagined the people in line behind me were getting impatient and I prepared to slink away to the back of the room.

“Try again,” said the man holding the board.

I had completely lost faith in the process, but I took the stance and struck. I was just starting to turn away when I saw a huge crack beginning at the top of the board and sliding down to bisect it cleanly.

“You did it,” said the man. Suddenly I was in his arms, weeping for joy, and the people in the line were surging forward to hug me and pat my shoulders and murmur their congratulations.

I held the precious halves of the board to my chest and watched as the other participants stepped up for their turns. Almost everyone in the room broke his or her board; some, like Patti, on the first try, others after repeated attempts. For the very few people who failed, the Inspirations man had words of comfort: it was the effort that was important; that was healing, not the actual breaking of the board.

I was wondering what had taken place, the abrupt disappearance of my estrangement and disbelief. It wasn’t that I found the talk that had preceded the board shattering any more credible or reasonable than before. It was just that an undeniable surge of love and joy had propelled me into a stranger’s arms and caused me to weep on his shoulder.

“I hate it, I said. “I hate what he’s doing: the manipulation and the yelling and the oversimplification.” I stopped. Would Molly dislike me now?

The next day began with a trust exercise in which guides led blindfolded participants through an obstacle course. I was very nervous about it. When I was designated a guide, I felt a moment’s relief — I wouldn’t have to struggle through the muddy course unseeing. But then I started thinking about my faulty sense of direction. Suppose I misled someone, got him or her lost on the course and made a complete and public fool of myself? Or suppose someone actually got hurt because of my inept leading?

QuaLife people showed us through the course. Our partners were to be wheeled across a deserted road in a wheelbarrow. Then they were to crawl through a drainage tunnel, climb a net made of knotted squares of rope into a small shed and leave the shed by climbing through a window, navigate a swaying bridge suspended from two wooden horses, walk across a seesaw, and finally make their way through a group of thick trees with face-whipping branches.

I was assigned my partner: Joyce, a therapist whom I had liked instinctively from the beginning of the weekend. She was a lithe, slender woman in her thirties, with a short, fashionable haircut and wonderfully precise and intelligent features. As we set out, her hand in mine was light and dry.

The QuaLife staffer walked over with the wheelbarrow, and I had to indicate to Joyce, without any words, that she was to get into it. I had to learn a complete new vocabulary. I could try to pat, pull, even shove her into place, or I could take her hands and place them on the wheelbarrow so that she could learn its shape and her task for herself. Looking around, I saw that all the guides had different techniques. Some took complete control, others indicated what was ahead to their protégés and then stood back a little. All the blindfolded people learned differently, too, some clearly preferring one technique over another.

Joyce was a bit tentative about the wheelbarrow. Then came the muddy drainage pipe. She began crawling rapidly, and I crawled behind her, my hands on her waist. Suddenly she stopped and gave a little scream. “I could have sworn I heard a rat,” she said as we emerged.

I felt very protective, but at this point Joyce seemed almost completely to lose her need for me. It took only the slightest touch to send her moving confidently in the right direction, as swiftly and easily as a dancer. No sooner had she felt the net between her fingers than she’d scaled it — so fast I couldn’t follow her, but had to run around the shed to catch her and guide her through the window. She stepped lightly across the swaying bridge. At the other end a QuaLife staffer took her hand.

“You’re changing partners,” he told me.

I was distressed. What I had felt for Joyce as she moved with such grace and sureness through the course was something akin to love. Why was this man taking her away from me? Had I done something wrong? Looking around, however, I realized that everyone was changing partners on this leg of the course.

My new partner clung to my arm; she seemed lumpy and heavy after Joyce. I soon found myself adopting different tactics with her, being altogether more watchful and concerned. But eventually we got into a rhythm, and she negotiated the seesaw and some barrels half submerged in mud with no problem. My last job was to lead her vigilantly through the wooded area, protecting her from brambles and branches. Then we were in the clear, and we half ran, half skipped back to the community center to join the others.

The redheaded woman with the bone metastasis was laughing.

“She’s unbelievable,” said her partner. “She almost gave me a heart attack. We were going across that bridge — you know how it sways under you — and she just stopped and started jumping up and down and laughing like a bloody lunatic.”

“It was great,” said the woman, lighting a cigarette. She smiled fondly at the man, and they walked together into the building.

We were told later that the exercise had been a metaphor for the patient-caretaker relationship. In most cases the guides had been cancer patients, the people being led, helpers. So each group got a sense of how it felt to be the other. I thought of the odd almost-love I’d felt for Joyce. “This seeing the sick endears them to us,” Gerard Manley Hopkins once said. “Us, too, it endears.”

“We wanted you to understand that sometimes a patient needs complete nurturance and protection, and other times the patient really needs for you to stand back and let him or her go it alone,” Sara explained. “And we wanted patients to know how difficult it sometimes is making the right decisions when you’re a caretaker.”

At the end of the day, we were each given a wine glass of apple cider with a strawberry in the bottom, to remind us to savor the moment. As we sipped, we watched a slide show of the weekend we’d just spent together. Afterward, there were fervent hugs and promises to stay in touch, and I left the building feeling strengthened and happy. Only one thing troubled me. One of the slides had been of me, just after I’d broken the board. It showed my face contorted under the turquoise headband, my head a variegated map of thin, fuzzy hair and bald spots. I looked hideous.

That evening, Bill made no objection when I placed the broken board in a position of honor in our living room. He refrained from telling me that it is not particularly difficult to break a board when you strike along the grain. (I learned later that most of the female participants’ spouses had been quick to point this out.) “I know this must seem silly to you, with the karate you’ve had and everything,” I said, “but I never thought I could do anything like this.”

“I think it’s great,” he responded. “You should take it to work and put it on your wall. Then if anyone messes with you, you can say, ‘Watch out. I broke that board with my bare hands.’ ”

The next week, I talked to my therapist about the workshop.

“It bothered me a little, because my response seemed so shallow and predictable,” I said. “I mean, to be manipulated by all those new-age exercises into feeling love — actual love — for people I’d only just met.”

“It is love,” he said, “and it’s quite real. Of course, it’s situational. You may not like the same person at all if you meet him or her in some other circumstance. But at the time that it’s happening, it’s real. And there’s no need to denigrate or dishonor it. Take it for what it is.”

A few months later, QuaLife set up a Boulder branch, and I came to find meetings there a reliable source of comfort and strength. I asked Bill to attend some sessions with me. “These people are beginning to mean a lot to me,” I said. “I’d really like you to meet them.”

“I’m sorry,” he said. “You know I’ll always be available when you need me. But I’m not comfortable with the idea of sitting around with strangers, talking about how I feel.” That seemed fair enough.

For me, however, it was both astonishing and nourishing to hear people I hardly knew talking without coyness or pretense about the deepest aspects of their lives. It was as if, having been diagnosed with cancer, they had simply decided there was no more time for bullshit.

“I don’t mind the way I used to when someone cuts in front of me in traffic,” said a man who leaned heavily on a three-pronged cane. He’d already told us that five years ago his doctor had given him a year to live, and that now his bones were deteriorating rapidly. “I just think, ‘I guess you’re in a bigger hurry than me.’

“I’ve had the most wonderful five years of my life. My wife and I don’t postpone things anymore. We visit our children. We travel. I’ve never been happier.”

A round little woman talked about her mother’s death: “She didn’t want to be buried in anything formal; she had this pretty, lacy nightdress she wanted to be buried in. So that’s what I did. One of my friends looked in the casket and said, ‘I can’t believe you really did it.’

“She used to sing in a choir, and at the funeral all her friends came and sang for her. It was a very joyous thing.”

“I think it’s beautiful that it was so peaceful for you,” said another woman. “If I have to die, I want to die well. I want to find a way to die that lets my children go on with their lives and not be traumatized.”

At the beginning of every session, each participant would rise in turn and explain his or her reason for coming. Some of these people were not cancer patients. I respected those who came to support a sick family member and the therapists, whose interest was professional. I even respected those drawn to us by their fear of our disease. But I resented the people who seemed to be there out of curiosity or some strange psychological need.

“I just love being with you people,” said one such woman. “You’re all so wonderful.”

“My God,” I whispered to Molly, who was sitting next to me, “there are cancer groupies.”

“Yes,” she said, “and death groupies, too.”

While I sometimes had to cope with my resentment about people without cancer attending our meetings, I found out later that people with advanced cancer sometimes resented the presence of people like me. They wanted to speak freely and not have to hold back for fear of frightening us. They knew that a cancer patient erects the same barrier between herself or himself and someone with metastasis that most of the world erects between itself and the cancer patient.

“You are completely other,” the world tells us. “I have undertaken a regimen, a way of life, a stance, a kind of thinking that protects me from ever becoming you.” And so we say, internally, to those worse off than we, “I had a less aggressive kind of tumor; I had no lymph-node involvement; I chose a wiser course of treatment; I’m following a more stringent diet — my case is different enough from yours that I will never be in your position.”

Someone slipped a turquoise bandanna over my head, as if I were an athlete or a warrior going into battle. I looked at the board. “Don’t look at that,” said the man holding it. “Look at me.”

Those with terminal cancer look at us silently. They know that they, too, constructed a list of reasons to expect to stay well forever. But then one day, feeling strong and secure, they felt a lump or a small ache. Or received notice from their doctors that the latest blood test revealed tumor activity. Suddenly they tumbled from the little perch of safety we all cling to and fell into the abyss. It can happen just as abruptly to any one of us — or to someone who has never had cancer at all. These dying men and women want to protect us from that knowledge. And deep down, they also want to rub our noses in it. But primarily, they want us out of their workshops and sessions so they can talk together without worrying about our feelings.

At most community meetings, however, a deep understanding of our common predicament was as strong as our occasional desire to make separations. In one meeting I heard a woman with metastatic ovarian cancer and a very poor prognosis give careful tips on vitamins and diet to someone who had nothing worse than a mildly suspicious Pap smear.

One night, a couple, Doug and Lois Cox, described Doug’s struggle with a cancer that had begun under his tongue and moved to the lymph nodes in his throat. Doug had read Dr. Bernie Siegel’s Love, Medicine, and Miracles and had been impressed with the doctor’s approach and his assertion that patients could exert some control over their physical functions through visualization and maintaining a positive state of mind. When Doug had radioactive pins inserted in his throat for thirty-six hours, he visualized his blood flowing away from the incisions, and he instructed Lois to direct the blood away, too, speaking to him whenever he became groggy.

Later, when the doctor came to remove the pins, Doug and Lois didn’t remember to visualize the blood flow. “Hey,” the doctor said, “this is odd. You’re bleeding more now than you did when I was putting them in.”

Doug used the same techniques to help himself through surgery and chemotherapy. In visualization sessions, he imagined a beaver busily nibbling away on his tumor cells.

Lois told how Bernie Siegel had come to give a speech in Denver while Doug was still in treatment. Unable to attend, Doug had sent the doctor a note.

“On Sunday, the phone rang,” Lois said. “It was Dr. Siegel. He wanted to speak to Doug to find out how he was doing.”

“We talked for a while,” said Doug. “You know, I’ve heard that some people think he’s a phony, or that he’s getting tired out and less giving. I wish I could tell them about that phone call and what it did for me.”

Watching the gratitude and wonder on Doug’s and Lois’s faces, I once again cursed my own skepticism and wished I could believe as fervently in new-age ideas about healing as they did.

Now they were talking about a turning point in Doug’s illness.

“We were in the kitchen,” Lois said. “I was just fixing dinner, and Doug was feeling really ill. And —” She turned to him. “Perhaps you should tell this?”

“No,” he said, “go ahead.”

“Well, I was just putting the pans on the stove, and — I think we were having chicken — and Doug was sitting at the table — and I said something. I said . . .” Her voice faltered.

“You said I should go ahead and die if I wanted to. You said it was OK to die.” There was pure love in his voice.

“That did it,” he said. “I don’t really know how. It took the burden off somehow, and I was able to get better.”

Sara Wolfe was sitting next to me. Beautiful Sara, who had survived her supposedly incurable cancer by five years, was pregnant. Later in the evening, I asked if I might feel her stomach. Without a moment’s self-consciousness, she took my hand and held it firmly against her hard, round belly.

“Wait,” she said. “The baby was kicking just a minute ago. Oh, there it is.”

Against my palm, the faraway flutter of life.