A few weeks ago, my palliative care physician asked me a simple question that nobody had ever asked me before – “Was all that worth it?” She knew I had been receiving treatment for my cancers for 6 years now – 6 years of chemotherapy; a stem-cell transplant that provided me with 6 months of stability; CAR T therapy, which provided me with an additional 20 months – allowing me to be able to do things with more ease and breathing room for planning. Additionally, multiple surgeries, numerous radiation treatments, a bone-marrow cancer treatment (a daily battle), and now a combination of medications to help control my bone-marrow cancer, as well as a recent round of radiation for prostate cancer, because apparently one cancer isn’t enough.
She obviously knew all of this information already, having reviewed my file, read the notes, and scanned through the imaging studies, and understood the cumulative burden of treatment over time. However, she then looked at me from behind the chart and asked something no one had ever asked me before.
“Was all that worth it?”
I have been asked many questions over the past 6 years regarding my cancers. These include, but aren’t limited to, questions related to my level of discomfort, the extent of the side effects associated with my treatments, my willingness to complete advance directives and quality-of-life assessments, how I’m managing the stressors related to my diagnosis, if I require any emotional support, and if I fully comprehend my prognosis. But I have never been asked, “Was all that worth it?”
That may seem unusual. Six years is a long time to be living in the world of cancer without asking yourself the philosophical question – whether the cost of living in this world is too high. However, while you’re in it – really in it – you rarely can ponder your existence in such a manner. Your focus is on attending to the next appointment, managing your side effects, celebrating your successes, enduring the setbacks, and just continuing to go through the motions because ceasing to continue will mean something you’re not yet prepared to acknowledge.
However, sitting in her office at that moment, the question hovered in the space between us. Was it worth it?
I thought of those six months following my stem-cell transplant. That’s when I began to feel as though I was turning a corner. Those six months allowed me to begin making plans that extended beyond my next scheduled appointment. During those six months, hope became almost a threat, because I knew, deep within myself, that the cancer would likely recur. And it did.
I thought of the twenty months following my CAR-T therapy. Longer. Enough time for me to forget, occasionally, that I was living on borrowed time. Enough time to allow me to begin to consider life in terms of seasons rather than the number of weeks remaining until my next scheduled scan. Enough time for me to experience what it meant to be alive again, without the constant consideration of the potential ending of that life.
I considered the tough times – and there were a lot of them. There were days I couldn’t even get out of bed. Nights when pain kept me awake. Times I caught glimpses of myself in the mirror and didn’t recognize who I was looking at. The times I watched Joyce’s face, I saw the toll this was taking on her as well. The surgeries. The waiting rooms. The test results that changed everything, again and again.
When she asked me if it was worth it, I responded quickly.
“Yes. It was and is worth it.”
Here is what I’ve learned, what these six years have shown me in ways that nothing else could: Life is a gift, provided to us by someone with no expectation of repayment. A gift that precious and generous can’t possibly be discarded because the path ahead is arduous, lengthy, or unpredictable.
Notice I didn’t say the journey has been beautiful. I didn’t say I’m grateful for cancer — I’m not. I didn’t say that all of this was part of some larger plan that makes sense if you view it the right way. I’m not using platitudes.
What I am doing is telling the truth. And the truth is that life, messy and painful and uncertain as it is, is still worth showing up for. No matter how much effort it takes to show up. No matter how many times the remission clock resets. No matter how many cancers you accumulate. No matter how often you have to adjust to the targeted medication, it is merely a maintenance program rather than a cure.
I have lived 6 years I wouldn’t have otherwise lived. 6 years of sunrise mornings and everyday conversations and ordinary moments that only become ordinary until you realize they are ordinary compared to the possibility of not experiencing them at all. 6 years of being Joyce’s husband. 6 years of watching my children grow into adults. 6 years of writing, connecting, and attempting to find significance in a world that frequently seems devoid of it.
The physician nodded. She didn’t attempt to offer any additional context or diminish my response. She merely accepted it.
Since then, I have reflected on that question many times. Is it worth it? Is it still worth it? Will it be worth it tomorrow when my side effects feel intolerable, or next month when the scans may reveal something new?
I believe the answer to that question may always be yes. Not because I’m brave or because I’m fighting harder than anyone else. Not because I possess some unique understanding or unwavering faith. Simply because life, in all of its messy, difficult complexity, remains a gift that I’m unwilling to give back.
Even when the journey is arduous. Even when it’s lengthy. Even when it’s uncertain.
Especially when it is all three.
