Can I be a cancer "survivor" when the bullet only grazed me?

In early 2016, a few months’ shy of my 43^rd birthday, I got my first tattoo: a small black dot in the centre of my chest, just below the nipple line. It was put there by a nurse at Toronto’s Sunnybrook Hospital as I was about to begin seven weeks of treatment for a cancerous tumour in my neck. During my daily doses of radiation, I lay on a metal table and was held in place by a rubbery, web-like mask that covered my head and chest. The tattoo dot allowed the technicians to position me on the table the same way each time.

Of all the things cancer treatment did to my body, that dot is the most benign.

In his heartbreaking 2016 memoir When Breath Becomes Air, American neurosurgeon Paul Kalanithi wrote that “all cancer patients are unlucky, but there’s cancer, and then there’s CANCER, and you have to be really unlucky to have the latter.” Kalanithi had the latter; his book was published posthumously. I was luckier: my cancer was all lower-case. The weird lump I’d found on the side of my neck — the one I’d specifically asked my doctor to tell me was nothing to worry about – turned out to be a malignant neoplasm. Cancer, but caught early and treatable.

Being on the milder end of the cancer spectrum is the illness equivalent of being a little bit pregnant. I had a little bit of cancer. The doctors handed me a word synonymous with slow, painful death, then told me I’d likely pull through. What I went through was bad enough to leave lifelong physical and emotional side effects, but not as bad as what was happening to other people I met at Sunnybrook, or even to friends of mine with neoplasms much more malignant than mine. How do you process the idea of having cancer when you feel like a mere dabbler? Can you be a “survivor” when you only ever got grazed by the bullet?

The first person I called after getting the diagnosis was my wife, Meaghan. Hearing her fall apart over the phone made me feel as though I were doing something perverse and cruel. Like getting cancer was a sick prank. I didn’t tell anyone else until after I’d done more tests and been given some assurances. I didn’t even tell my 17-year-old son or 12-year-old daughter until I knew I would probably be okay. (My toddler I'll tell when he's older.)

“Okay” is relative. Within a few weeks of beginning radiation and chemo, my beard fell out, the skin on my neck began to peel, I was ill and exhausted all the time, I couldn’t swallow food, and even water made me gag. After dropping nearly 30 pounds in less than a month and drifting dangerously close to kidney failure, the decision was made — thanks to Meaghan’s furious intervention – to insert a feeding tube directly into my stomach, a few inches above my bellybutton, through which I could pump meal-replacement shakes. (I have a small, puckered scar there now that I plan to tell people is a bullet wound.)

Throughout it all, I tried to keep going as though everything were fine. I continued to work, albeit with severely reduced hours. And I launched a second novel. At the Toronto launch party, despite feeling like garbage and despite the feeding tube hidden under my shirt, I mingled and chatted, made a speech, and played drums with the house band I’d assembled. I pigheadedly refused to be "the sick guy," and stayed on my feet most of the night. (Never underestimate the sheer power of denial.) Three days after the party, I was in an ambulance, in severe pain from what turned out to be a treatment-related blood clot in my lungs; denial has its limits.

Over the months of recovery that followed, my kids got used to seeing me on the couch, helpless and ill, but doing my best to appear fine. I tried to keep things as light as possible. I did the same when friends visited. My one-year-old wasn’t happy that I’d suddenly become a kind of ghost dad – there, but not able to interact with him in any meaningful way – but the extra attention he got from his mom was a kind of compensation.

The one person who knew that I was faking my good moods, and who could only watch as I got sicker and sicker, was Meaghan. She got tired of me dismissing the gravity of what was happening. “Why do you keep joking about your cancer on Facebook?” she asked me. Because it makes me feel better, I said. “It makes me feel worse,” she said. By trivializing what I was going through, I was trivializing her experiences, too.

She was right, but how could I not joke about it? True: having cancer was the worst thing that ever happened to me. But also true: some of the people I sat next to in the chemo ward did not survive to see 2017. I often spotted an older man there who'd lost half his jaw to the disease. In comparison, my little faux bullet wound was laughable.

When the MRI results gave me a conditional all-clear in August, the first thing I wanted to do was tell the young technicians in the radiation clinic – the ones who, every weekday for almost two months, had wrestled my half-naked, increasingly emaciated body into place on the table. I wanted to tell them I was okay, and thank them. None of them were around: a new batch of technicians had taken their place. It was as if the whole thing had never happened. Up until then I’d imagined getting this good news as a dramatic moment, with balloons falling from the ceiling and random hospital workers bursting into grateful tears. Instead, strangers in lab coats prepared the table for men and women who were sicker than me.

Nathan Whitlock is the award-winning author A Week of This and Congratulations on Everything. He lives in Toronto. 

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