In my graduate school Critical Theory course, I learned the phrase “always already.” This phrase shows up in different contexts in literary criticism and philosophy (Derrida, Althusser, Heidegger, and others all used it slightly differently), but generally it means the same thing: something, whatever that thing is, has always been the case; it was already the case when we thought we discovered that thing. In other words, most “things” – usually ideas – don’t have a discernible beginning.
This is how I feel about my life and cancer. For me, cancer had “already” been the case when I was born with a BRCA2 mutation because it was “already” in my family DNA; cancer was “always” the case for me even before I was diagnosed with it (note that there is not a 100% chance of a cancer diagnosis with a BRCA mutation – but it is very likely). And because I have a BRCA mutation – a predisposition to cancer that has already occurred twice – I often feel like cancer will “always” be the case for me. This is not to say that I will “always” actively have cancer – I do not have cancer right now, to my knowledge, but its possibility is “always already” there for me.
I have two appointments coming up, both of which are surveillance scans to ensure I do not have cancer. One is a full body skin check to look for melanoma in August, and tomorrow I have an endoscopy to look for pancreatic cancer. Neither of these is awful to go through; endoscopy does require light anesthesia, but I actually look forward to a lazy day sleeping it off. The awful part is waiting – if the dermatologist or gastroenterologist see something that needs to be biopsied, I’ll have to wait to learn if cancer has come back. That’s stressful, yet these are a regular part of my annual routine (although I confess it’s been a way too long since I’ve had the skin check) – surveillance is always a part of my life, whether it’s my every-six-month oncology check-up or a diagnostic scan, which I seem to need at least once a year for some kind of body anomaly (such as the lung CT I had in March to determine the cause of my cough accompanied by back pain – it was nothing). But, to be honest, I feel like I am always waiting for cancer to come back, as if it’s already there.
A few months ago, I decided to start watching Grey’s Anatomy – there are something like 25 seasons of this show, and I suppose I felt like I needed a mindless summer project that didn’t involve doom scrolling. I’m on Season Six right now, which means (spoilers ahead), Dr. Stevens is going through cancer treatment. There is a scene in an episode where she has just had an immunotherapy treatment. She has tons of energy, is bouncing around the room, making plans, excitedly chatting with friends, and then…. she is the opposite of that. She is in bed, barely able to move her mouth to form words, every bone and muscle limp. I remember that feeling. I remembered it so physically in my body that I noticed my own jaw had gone slack and my breaths were short – I felt that kind of struggle in my lungs you feel when you’ve swallowed too much chlorinated pool water. I became so limp that my iPad slipped from my knees where it had been resting. I was stunned by how close that feeling was – as if it were already there in my body, waiting.
Cancer was already a part of my life before I was diagnosed with it, even before I knew I had a BCRA2 mutation. I’ve gone through my family history in multiple posts here. My paternal grandfather’s mother and both of his sisters died from cancer when I was young, and then my grandfather died from cancer when I was in my 20s. My paternal grandmother had several melanomas removed. Three of my father’s first cousins have gone through cancer treatment, and his brother died from pancreatic cancer. My mother’s step-mother went through breast cancer treatment as did my mother’s aunt; I was not biologically related to either of these women, but they were family nonetheless.
Most of my life has been experienced between cancer diagnoses, either those I love or my own. The idea of cancer never intruded on my life until I learned of my BRCA mutation, but cancer was always already there – it was in my DNA. It was in my family. And then it was in my breasts. And in my thoughts…. constantly. There is not a day that goes by that cancer doesn’t somehow come to my mind. It doesn’t typically get in the way – I still live my life as a mom, a wife, a daughter, a friend, a professor, a writer. I do all these things, usually with positivity and joy. Still, I cannot escape it.
My body has physical scars from mastectomies that I see daily when I change clothes, and mental scars that apparently manifest when I watch medical shows, as well as every time I make or go to an appointment for surveillance. I think about it when I take my arimidex pill each day, and when I brush my hair and remember that I was bald. Maybe this is about time – it’s been six years (and one month) since my second diagnosis, which I suppose isn’t all that long ago. Maybe in time, I’ll think about cancer less. Maybe I’ll need less surveillance. Maybe I won’t need the pills anymore. My scars will continue to fade.
But I know, no matter what, cancer will always already be there.
Blogging BRCA 