These are the drugs I take on a daily basis: Bupropion HCL XL, 300 mg, norepinephrine-dopamine reuptake inhibitor; depression. Citalopram, 40 mg, selective serotonin reuptake inhibitor; anxiety. Mylan-zopiclone, 15 mg; insomnia.
These are the drugs I take on a regular, as-needed basis: Oxazepam, 10-20 mg, benzodiazepine; anxiety. Prochlorperazine, dopamine receptor antagonist, 10 mg; nausea (though it apparently is also a potent antipsychotic). Ondansetron, 1 mg, serotonin 5-HT3 receptor antagonist; nausea.
These are the drugs administered as part of the chemotherapy: Paclitaxel, intravenous dose unknown, mitotic inhibitor; cancer. Carboplatin, intravenous dose unknown; Target unknown (to me); cancer. Diphenhydramine (Benadryl), intravenous dose unknown, antihistamine. Pegfilgrastim, 1 mg, subcutaneous injection; stimulates white blood cells. Dexamethasone, intravenous dose unknown, anti-inflammatory and immunosuppressant; nausea. I think it might also work with the Benadryl to prevent allergic reactions to the chemo agents, but I’m not sure. It is the worst of everything listed, even the pegfilgrastim which leaves me feeling like my bones are being broken from the inside (but the pain can be controlled by narcotics). It makes me want to crawl out of my skin and I opt out of taking the three days of oral dex, preferring nausea to the feeling of sharing my skin with some reptilian other.
I was talking to my psychiatrist about my compulsion to tell people about my cancer recurrence. He asked me about the context — if I feel this need to talk with my support group, with family, with close friends, with acquaintances. I nixed family from the list — too loaded and difficult, and besides, they read my blog — and added strangers and people I’ve just met. He mentioned a few times that my support group is an appropriate place to talk about whatever I need to talk about. I assume he was suggesting by omission that other places and people, outside of close friends, are perhaps not appropriate.
He asked me about this compulsion and what drives it. Control was one of my answers. I don’t want to be pitied (which at one point I sobbed out to him with such heaving breaths that “pity” was lost in strangulation, both swallowed and spit out at the same time, which is ironic considering that a person crying with such verve that they can’t even croak out the word “pity” is emblematic of someone who is, at the very least, pitiful) and if I bypass people finding out about my situation by other means, and deliver what needs to be known about me in a matter-of-fact tone, that I can keep people from feeling sorry for me because I don’t feel sorry for myself. I also postulated that I like to be in control of what information is disseminated about me because if I don’t, it’s only a matter of time before I hear that I died last week and was buried on Tuesday.
He said that it sounded like I was afraid of breaking down in front of other people, any people, and asked what would happen if I did. I laughed. I’m not afraid of breaking down in front of other people, I do it frequently, I said. Sometimes it’s cathartic, sometimes it feels as though some kind of connection was made, but often it is mundane, even alienating. And I can’t do it all the time, I finished, it’s exhausting.
I’m not sure what he was suggesting or asking me to think about. I break down. More than most people, less than some. I cry more often in front of people than I do when I’m alone. It starts to feel disingenuous after a while.
I said I felt like the Ancient Mariner. He said I was distressed. I started crying and said in a voice that sounded childish and sulky and sorry for myself, I am distressed. No stress on any of those words.
He wasn’t incorrect in his observation and I wasn’t incorrect in my agreement. But as I sat there crying, it felt less correct.
He asked me why I felt like I had to disclose my situation to everyone, if I could just choose not to. Why tell everyone? he asked. It isn’t necessary for them to know.
But it is necessary, or it is for me. I felt myself getting defensive when I tried to explain myself to him. The problem (in my eyes) is that we were focusing the discussion on why I need to talk about the cancer. But it’s not just the cancer. I talk about everything. Sometimes I feel like I open my mouth and it’s like I’ve dropped a spool of ribbon down a steep and long hill. Words keep unraveling from my mouth and getting tangled and knotted and I have little control or maybe it’s care about where the ribbon ends up. It’ll run out eventually, and then it will stop. I don’t feel like I have to disclose. I just disclose.
And maybe I’m distressed. But I’m not distressed in the same way all the time. When I found out about this most recent recurrence, I was distressed. Distraught, overwrought, beside myself. But with the assistance of about half the drugs listed above, the volume on that was turned down. There’s less feedback and distortion. If I am distressed, it is about the same things lots of other people are distressed about. How do I live in the world without feeling like I’m wearing a mask I don’t know well enough to tear off? How do I communicate and connect when words are so often inadequate? How do I present myself in a way that feels most like myself when so much of myself feels alien?
Of course I’m distressed. Most of us are.