The Post-Cancer Reality Check

When I was going through cancer, I took every opportunity that was presented to me to find the lesson in whatever terrible thing I was facing at the time.

When it was over, I promised myself that I’d never go back to the way things were, now that I’d seen firsthand how fleeting life is. I now knew what was important in life: time with my family, meditation, eating well, exercise, and simply having space to enjoy my life.

I am a year and a half post-treatment now, and I’m coming up against a wall that I didn’t expect to.

As a cancer survivor — heck, as a human — there are a lot of “shoulds.” You should avoid stress. You should eat mostly vegetables. You should exercise a minimum of thirty minutes a day. The list goes on and on. But after having cancer, these “shoulds” now have the added pressure of feeling like “musts.” What happens if you DON’T eat well and exercise and keep your stress level down? Well, the insinuation is that if you don’t, your cancer will come back.

The wall I’m running up against is called “reality.”

Reality is, I am more privileged than most people and I still cannot make this stuff happen. I am lucky to have a well-paying job that I really enjoy, a supportive family and partner I adore, excellent health insurance, and a great amount of community support.

However, a full-time job 30 minutes away and two kids in the house means that a lot of the things I felt like I needed to do are simply not possible. I don’t have enough time off to volunteer in my daughter’s classroom every week — or really at all. I don’t have enough energy or time during the day to exercise on a daily basis, or meditate, or have the spaciousness to not run from one thing to the next. No matter how hard I try, I can’t seem to lower my stress level — life keeps happening.

Earlier this week I called my parents because reality was really upsetting me. I’m not getting home until it’s dark, I’m falling asleep at 8:30 p.m. because I’m exhausted, and I keep getting stressed and exhausted by life. Something has to change! My dad listened quietly and then said, “you know, this is what I dealt with the vast majority of my working career. Sometimes you just have to put one foot in front of the other and do what needs to be done.”

I was surprised by how much I hated what he said — it terrified me. And then I realized that I’d been telling myself a very scary story: If you don’t change your life, your cancer will metastasize and you will die. Life as it was, before cancer, is what gave me cancer.

When I really evaluate that statement, though, I don’t think I believe it.

The people I know who died from cancer — especially the young people — lived healthy lives and died anyway. Some people who live straight-up unhealthy lives either don’t get cancer at all or don’t have it come back despite drinking, smoking, and being overweight. To tell myself that I will die from cancer if I don’t exercise daily and eat 90% vegetables is unrealistic and is adding more stress. I can’t do all the “shoulds” and do what needs to be done to keep life going. And the truth is, I could do everything “right” and still have it come back.

When you’ve had cancer, there are all sorts of emotional things to deal with after its all “over.” As time has gone on, I think about cancer less and less. I haven’t convinced myself I have cancer in random body parts in quite awhile, for example. But every once in awhile, I realize that the trauma is still alive and well, hiding somewhere and affecting how I live my life.

Sometimes (maybe most of the time), life is hard and complicated. I truly believe that the source of most emotional suffering is wanting things to be different than they are. Some things are worth attempting to change — for example, a job you hate or people who don’t treat you well. But some things are just part of life, and acceptance of your circumstances is the difference between being thankful for what you have, and always feeling dissatisfied.

I’m trying to find the balance.


Birthdays After Cancer

I recently turned 37. For many people, aging feels like something to resist. Gray hairs need pulling, wrinkles need filling, sagging body parts need hiding. 37 sounds sort of old to me; I’m now late thirties, rather than mid-thirties. Typing that makes me want to cry, but not for the reasons people might think.

I am afraid that I am not going to live very long.

With every birthday that passes, I think, “I should celebrate being alive! If I hadn’t found my cancer, I probably wouldn’t be! Yay!” But that’s a double-sided coin. The other side is this: I made it to 37. Will I make it to 38? How much time do I have left?

Now, I know that this is all about mindset. Don’t focus on the negative! Live each day in the present! Be grateful for every day! Every day is a miracle! And yes, that’s true. It’s a cliché, and it’s true. No matter who we are, our days are not guaranteed.


But in the dark of the night — when all my nasty mind gremlins come out — I find myself ruminating on the negative and sometimes spinning out of control. The night before my birthday, I woke up at 4 a.m. worrying. I’ve been exhausted lately. There’s a red spot on my chest. I’ve had a few tension headaches. I got my period for the first time in two years. Am I dying? Did the cancer come back? What if I’m not meant to live a long life?

After we found out that my friend Jessica was dying, she and I sat on her couch talking about what an asshole cancer is, and how we were both normal people, living our lives, until one day we were Cancer People.

“I said to the doctor who diagnosed me, ‘this isn’t part of my plan,'” I told Jess. “For some reason I thought the people who had cancer knew they were going to be Cancer People, like they knew they were the people who would die young. But it turns out, they were just regular people who had plans, and those plans were cut short.”

She looked at me and said, “I guess it turns out I am one of those people, I just didn’t know it.” We cried then, and I’m crying now. It sucks. So hard. And cancer is an asshole.

In reality, anything can happen to any of us at any time. That is the nature of life. Whether it’s a cancer diagnosis or a car accident, devastating things happen to good people who had no idea what was coming. The older we get, the more experience proves this to be true.

Figuring out how to live in spite of a total sense of impending doom is proving difficult. In some ways, it keeps things in perspective — which has caused me to make important life decisions like changing jobs, independently publishing a book, and making work-life balance a non-negotiable. I ask myself constantly, “is this what I want to be doing? Is this how I want to be spending my day? What if I only have a year left? Will I regret what I’m doing?”

Unfortunately, the answer is sometimes yes, I would regret how I spend some of my time, if I only had a year left. Every day I want to be in two places: I want to be at work, because I love my job and I love my co-workers . . . and I also want to leave work in the middle of the day to pick my child up from school. And of course, sometimes I am wasting my time worrying about dying, when I know it won’t stop death and it sure isn’t helping me enjoy life.

But as Lizzo would say, “that’s the human in me.” Cancer has done a lot for me, but it hasn’t given me worry-destroying super powers.

About seven years ago, I went to see a psychic (hi Mia!) who correctly predicted pretty much every aspect of my life. Lately I’ve been thinking about part of my psychic reading, when she asked, out of the middle of nowhere, “Do you sometimes worry or get the feeling that you won’t live very long?” At the time, I was taken aback. No, I did not get that feeling. She told me that in past lives, I’d died young, but in this life, I will live a long life and I don’t need to worry.

I have (possibly) been holding onto this prediction and praying for it to be true.

Yet I’m still having dreams that I live in a dangerous apartment surrounded by white supremacists and gang members and I’m trying to clean up an insane amount of trash in the bushes and I find a loaded gun. And that’s sort of how my life feels. Like it’s dangerous and no matter how hard I try to clean stuff up and make it nice, I might find something that could kill me, hiding somewhere unexpected.

My friends who are years out from their diagnosis and treatment tell me that this fear gets better with time. I’m looking forward to a time when every ache and pain I experience feels like a normal part of living and aging, rather than a sign of a recurrence.



Why I Chose to Remove My Breast Implants

I am permanently disfigured.

That’s a pretty horrible sentence, and I think a lot of people might try to talk me out of it. But it’s true. My chest is a topography of pain. There are two valleys where my breasts once were, skin stretched across and stuck to muscle, scar tissue forming strange ridges and tucks. Above the collar of my scoop-neck tank top, my skin is still soft. But if I lean forward, you might catch a glimpse of the cliff where my unspoiled self ends and the hollow cavities that cancer left behind begin.

A few months ago, I made a dramatic, life-changing decision: I decided to give up on my post-cancer breast reconstruction and have my implants removed.

And though this particular surgical outcome is new, the truth is that I’ve been disfigured since my original double mastectomy two years ago. But through a mixture of denial and hope, I wasn’t ready to accept it.

I think part of me hoped that with the right kind of reconstruction, I could erase what happened to me. I could get a beautiful tattoo, have a beautiful body, and somehow turn cancer into something that made me more attractive, rather than something that left me broken and scarred.

The reality is that cancer cannot be erased. We can remove it from our bodies, but we will never feel the way we felt before. We’ve lost our innocence, our naiveté that bad things happen to other people.

I had cancer, and the reality of the matter is that cancer sucks. It is a bad thing that happened. It is okay to move forward with the knowledge that it cannot be fixed and that I cannot go back to how it was before. Sometimes, bad things happen.

My reasons for removing my implants are layered and many. But at the very core, I made a decision to stop being at cancer’s mercy. Every day, I felt like I was fighting something foreign in my body. Any time I moved my chest muscles, I felt the implants contract. Getting in a pool or a bath made me feel like my chest was floating away from the rest of me. My body didn’t belong to me anymore, and that was cancer’s fault.

The morning of the implant removal surgery, my mother — a two-time breast cancer survivor herself — held my hand in pre-op as I cried. This was my fifth surgery post-cancer, and was the only one that I elected to have. There’s something to be said about making a decision from a place of power, rather than a place of reactivity. But I cried because I knew that however I looked when I woke up, it would be sad. What happened to me is sad.

My decisions after my initial breast cancer diagnosis two years ago were reactive. They were life-saving decisions. Which doctors would I choose? Would I have both breasts removed, or just one? What type of reconstruction would I have? All of these decisions were made in a state of shock, where I wasn’t entirely inside my own body or head.

For me, having only one breast removed wasn’t an option. I never wanted to experience cancer again, and would do anything necessary to decrease that risk.

The reconstruction was the next decision to be made, and I was presented with three choices that I assumed were all the choices. I got all the information about all of these options, but wasn’t a candidate for the first two. So really, my decision was made for me.

Once that decision was made — reconstruction with implants — I learned what the process would be like. “The goal,” my surgeon explained, “is to make you feel whole again and try to give you back some of what cancer has taken from you. We want you to look normal under your clothes. Unfortunately we have to remove your nipples, so you won’t look ‘normal’ with your clothes off. Also, you will no longer have any sensation in your breasts, because we have to sever the nerves during surgery. More likely than not, you will never feel anything on this part of your body ever again.”

At that point, I think I emotionally checked out. I didn’t care anymore, I just wanted the cancer out of my body. I trusted my doctors to make the recommendations that are made in these circumstances, and it seemed that they were doing just that. I would wake up from my surgery with no cancer and something called “tissue expanders” under my pectoral muscles. A year later, the tissue expanders would be replaced with permanent implants. “Though, by ‘permanent,’” my doctor explained, “we don’t actually mean permanent, because they expire after about ten years and need to be replaced. We’ll put the implants under your muscles, because if the cancer comes back, it will come back on your chest wall. By putting the implants under your muscles, any recurrence will be seen right away. If we put the implants on top of your muscles, the recurrence could happen underneath the implant and we wouldn’t know until it’s too late.”

If your eyes crossed reading that (or maybe you skipped it entirely), imagine how much of it I absorbed. Basically none of it. All I knew was that “too late” sounded like a terrible option. I agreed to the surgery, not able to focus on anything other than not dying. It would require one night in the hospital – how bad could it be?

The truth is, the process of reconstruction was by far the worst part of my cancer treatment. I will spare you the details, but suffice it to say that the reconstruction portion of my mastectomy was incredibly painful, and I lived with hard plastic expanders in my chest for over a year. They felt like a too-tight, circular underwire bra, constantly digging into my ribs. It was awful.

The implants themselves, which I got a year later, were much softer, but they served as a constant reminder of cancer that made me physically and emotionally uncomfortable.

Fast-forward to early 2019. After four cancer-related surgeries, I knew I needed one or two more if I wanted the implants to look better. As they were, they were uneven, lumpy, and had strange folds in weird places. The following surgeries would attempt to give my chest a more natural shape (they didn’t look “normal,” even under my clothes) and prosthetic nipples. And then, of course, in about 10 years I’d need to have the implants replaced, because “they aren’t meant to last a lifetime.” 

Up until this point, I wasn’t really considering having the implants removed. After all, I’d been through a whole hell of a lot to get them, and while I didn’t love them, they were fine. Until, that is, I saw the plastic surgeon to discuss my next steps.

Somewhat offhandedly, I asked her when I’d know that I needed the implants replaced, as I didn’t see an expiration date on any of my documents. She began to describe how my “breast” might begin to change shape over the course of a few days. Alarmed, I said, “you mean, I’m waiting for it to rupture? I thought they expired?”

Apparently the word “expiration” is a bit of a misnomer. The implants don’t expire like a carton of milk expires. They expire as in die, pass away, decease, perish, depart this life, be no more. I looked down at my chest and for the first time since I had cancer removed, I saw two ticking time bombs.

“Is that safe?!” I asked the doctor. In the 1990s, she explained, silicone implants were taken off the market over concerns for women’s safety. Long-term studies were done, and they were put back on the market after being determined safe.

Now, before I get to the next bit here (which will really knock your socks off), consider this: silicone implants became popular in the 1980s, and there was a surge of women who filed complaints about side effects (from unruptured implants, mind you). In 1992 they were taken off the market, and women who wanted augmentations had to have saline implants — saltwater in a silicone outfit, basically. Then in 2006—just 14 years later—the FDA approved the use of silicone implants after finding no long-term risks to women’s health.

Oh, except for the rare risk of developing another type of cancer. Yes, that’s right: there’s a specific kind of cancer associated with breast implants. But if you’re the manufacturer of implants (or the FDA, or a plastic surgeon, apparently), you decide sweep that aside – it’s rare and won’t happen to you. Never mind you already HAD cancer at an age that was considered rare. Let’s risk it again in favor of “looking normal under clothes,” shall we?

After some research into the FDA’s approval of silicone implants, I came across this juicy tidbit: “Ruptures of silicone gel breast implants are often “silent,” meaning patients and doctors may not notice them. They can only be detected by MRI. For this reason, the FDA recommends that women with silicone gel implants get an MRI three years after implantation and once every two years after that. MRIs may not be covered by your insurance. Over the course of a woman’s life, these MRIs may cost more than the original implant surgery.”

Reading that, my jaw hit the floor. This was never suggested to me — not mentioned, not even hinted at — and now I’ve gone through one of the most painful experiences of my life and two surgeries. What now?

And then, two days later, my mind was blown when news broke that Mentor, the manufacturer of my implants, along with another manufacturer were being investigated by the FDA for failing to do the long-term studies on women’s health that they were required to.

For the first time in my breast cancer journey, I was straight-up angry. I believe my doctors to be well-intentioned, and I believe they made the recommendations they made based on the information available to them and the misguided notion that in order to feel whole again, one needs to do everything possible to make it look like nothing ever happened.

The reality, however sad it may be, is that implants do not make women feel whole again. Feeling “whole again” is something WE do, through lots of hard emotional work and self-acceptance. We got dealt a crap card. We had cancer, and we had our breasts removed. Trying to make it look like nothing happened, at least for me, is like trying to forget the entire experience — which never works. No matter what you do, PTSD comes up in nasty ways unless you face it. Some of us get to a place of acceptance quickly. Some of us never get there at all. But the idea that we “need” something hazardous to our health and potentially carcinogenic to get there is an insult. It also implies that the reconstruction looks good, which often, it does not.

This experience has made me realize that breast reconstruction is a feminist issue. During the most traumatizing weeks of my life, I was railroaded into reconstruction by well-intentioned doctors that assume I am incapable of feeling “whole” without breasts. My mother, in her 70s, had to repeatedly voice that she did not want reconstruction after her mastectomies to doctors who tried to convince her otherwise. And this is happening all over the country. This culture we’re living in makes us feel that despite surviving cancer, it is our desire and responsibility to look good — by any means necessary. Honestly, it makes me feel sick.

Despite the fact that I am disfigured by cancer, you would never know it by looking at me clothed. Ironically, I look more “normal under clothes,” since having the implants removed than I did with them, thanks to the modern prosthetics I wear from Handful (highly recommend this company for any woman — with breasts or without!).

Emotionally, it’s been a roller coaster couple of months. I am working on accepting what’s happened to me, and getting to a place where I can feel beautiful in spite of it. I am not there yet. Cancer has changed everything about my body — my breasts, my weight, my hair, my eyebrows – and none of it is considered attractive by western standards of femininity.

However I have never regretted, even for a moment, my decision to remove the implants, especially after a world-wide recall of a specific type of implant. This scarred, disfigured body feels like mine again, and without the implants, it’s starting to feel like a safe place to live again.

I’m just sorry I went through so much pain to get here.

Identity After Cancer

Last weekend I took my daughter for a lunch date at a local cafe, and I found myself transfixed by a waitress’ breasts. I fully recognize this sounds weird, and I’m not even going to attempt to defend it — it is super weird.

This woman was relatively small with an enormous bust. I realized after a few minutes of side-eyeing her, that I was transfixed in part because I think I might have looked like her. You know, before cancer. It made me realize why people (mostly men) used to stare at me before.

Treatment seems to affect most of us the same way. We lose our hair, our muscle mass, and any preoccupation with the mundane. Our bodies inflate from the steroids and then the inactivity.

When I meet other “cancer friends,” they are post diagnosis. Some are post treatment. I know these women’s hearts. I know them. But I know the post-cancer them. When I see photos of them on Facebook from before cancer, they have long hair and are thinner, and are sometimes rock climbing or bungee jumping or doing something they sure as hell don’t do anymore. So do I really know them?

I moved to a new city after my treatment, so I’ve met a lot of people who only know the After Cancer me. These people know the person I have become. Emotionally I am stronger, wiser, and have a laser-focus on what matters to me.

But my body doesn’t feel like it’s my own. It is a stranger. It’s a soft-in-all-the-wrong-places, weak, and sometimes scary place to live. I don’t know what I’m able to do anymore, physically. I worry about my aches and pains, unsure of what their cause is. I’ve had my hip and my chest x-rayed, worried that prolonged pain meant a distant recurrence to my bones or lungs.

When I meet people now, I can choose to tell them that I had cancer or I can hide it. If I tell them, most won’t have a clue what I’ve been through or how it’s affected me. Some get super awkward, because I’ve just dropped an unexpected emotional bomb and they don’t quite know what to say. If I hide it, I hide a huge portion of what makes me, me. And it makes it seem like this body and this hairstyle are what I’ve chosen to define me. Like I’m the type of woman who gets a short haircut, when in reality I do not have the cajones to do that.

I had dinner with a group of girlfriends the other night. I met these wonderful women through Charlie’s preschool. They knew me before cancer, supported me through treatment, and know me now. I felt seen. These women don’t treat me any differently than they ever have – though I do get the sense that they are perhaps extra thankful that I’m sitting at that table with them – and for that I am grateful. They know my whole story, and honest-to-god, I feel they know me.

Identity after cancer is a weird, murky thing. It’s sort of like going through adolescence and having to figure out who you are all over again (but without the seventh grade bullies, whew). I’ve been feeling more like myself lately, which I attribute to two really superficial things and one really deep thing.

The two superficial things are this: 1) I got my eyebrows microbladed (permanent makeup). My eyebrows never came back after chemo, and I woke up every morning looking like a cancer patient. This is one of the best things I could have done for myself, because I finally recognize myself in the mirror again. And 2) I got a new office job that gives me a reason to wear my cute clothes and jewelry again, which is fun and creative and me.

The one deep thing is this: My new office job is not about cancer. My new office job is creative and fun and I am surrounded by passionate people who have nothing to do with cancer. It’s a job with deep meaning — feeding hungry people in five counties — and lots to be done. This means that on a daily basis, I am using my brain to do something fun instead of getting distracted by cancer. This new chapter made me remember myself again. And like my eyebrows, my new office job is one of the best things I could have done for myself.

The months after treatment are long and confusing. There’s nothing to focus on except what isn’t right: your brain is foggy, your chest is super weird looking, random body parts hurt, you’re exhausted, overweight, and have no idea which way is up. During treatment, you know exactly why you feel awful. After treatment, you wonder if you’re supposed to feel this awful, or something is wrong.

I am coming up on my two-year Cancerversary. I was diagnosed on July 14, 2017. I finished treatment April 27, 2018 — over a year ago. If someone had told me that it would take me a year to stop feeling flat-out awful, it would have depressed the hell out of me. I’m pretty sure the only thing worse would have been to say nothing and then send me back to work, which is exactly what they did.

Healing after cancer is a physical and emotional process, and it takes time. I’m still working on it, and I have down days — especially when I get morbid about my life expectancy — but I can see some light now. And for that, I am thankful.

The “Collateral Damage” of Cancer Treatment

I’m going to tell you a story about sea anemones, and I swear it has a point. Please bear with me.

During my cancer treatment, Bear got us a 5 gallon saltwater aquarium. One of the inhabitants was a beautiful sea anemone, which I paid $25 for, but turned out to be a more rare rainbow bubble tip anemone worth around $75. Yes, I know, I basically won the lottery — try to contain your envy.

A fun fact about anemones is that they reproduce by splitting in half (like cells, come to think of it). One day during dinner, I saw that my one anemone was now two. And when we moved in July, one of them split again, and suddenly we had three. Each time this happened, I was thrilled. They are beautiful and fascinating and are a safe haven for our clown fish, Lucy.

Recently I had a dream that I woke up one morning to discover that my three anemones had split into five.

I often get messages in dreams, and this one felt like a sign of good things to come. I had an overwhelming sense that I would be in the right place at the right time. And over the last month or so, that’s come to fruition: I’ve gotten just the right information at the exact time I needed it. I went to a quiet retreat for cancer survivors in Sonoma, and a conference for breast cancer in Texas. And when I got home from Texas, I found four anemones instead of three.

The truth is, I have been quiet because I have been struggling. I have been struggling with the things most cancer “survivors” struggle with: figuring out how to live life after cancer with a host of side effects and some semblance of self-care and balance. Reducing my stress level is necessary for my continued health, and since I went back to work full-time, I haven’t been able to figure out how to achieve that balance.

Despite my boss’ effort to give me a single project rather than all of my responsibilities as a Marketing Director back, I still struggle with anxiety, confusion, lack of focus and an inability to organize. These are all symptoms of chemo brain, which is a documented disability. I have been to a neurologist, a psychiatrist, acupuncture, and a nutritionist. I exercise daily and I eat well (well, except for the Girl Scout cookies – thank God cookie season is over).

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Yesterday I stood in an airport parking lot, unable to figure out how to get to my car. It was on the other side of a fence, a half level above me. I could *see* it, but couldn’t figure out how to get to it. Finally I decided I should take the elevator up another floor and walk down. On my way to the elevator, I saw that all I needed to do was turn the corner to get to my car, which would likely have been obvious to pretty much anyone else. . . These sorts of lapses might seem like the “brain farts” we all have, but when they happen all the time, they are straight-up disabling. Imagine trying to do something and forgetting what you’re doing mid-task, repeatedly. . . One of the most frustrating parts is knowing that whatever is confusing you is probably totally obvious, but you just can’t seem to figure it out. This “chemo brain” is one of the many issues cancer survivors have post-treatment, and are basically left to figure out on their own. . . There is no framework for cancer survivorship. We know the framework for treatment in most cases, but the emotional, mental, and spiritual side of cancer is often ignored. . . I realized recently that I need to do some work on this, and I need to force my healthcare providers to do some work too. They keep treating the symptoms instead of the cause – going as far as suggesting two types of anti-anxiety medications and a stimulant, all at the same time (and on top of the insane number of pills with side effects I’m already on). This is like putting a bandaid on a bullet hole. . . I’ve decided to make my own framework. The book @radicalremission has nine things to change about your life to survive cancer – and because I’ve got nowhere else to start, I’m starting here. . . #cancer #chemo #chemobrain #breastcancer #youngsurvivalcoalition #breastcancerawareness

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The truth is, the system is broken when it comes to “survivorship.” When you’re done with active treatment, they give you a couple of weeks to get over your exhaustion (ha!), then send you straight back to the workforce. And the truth is, it’s too soon. Our brains are never given an opportunity to heal. We spend a year pumping people full of drugs, surgically taking apart their bodies, flipping their lives upside-down, and then send them back to their former lives, saying, “good luck out there. You need money and you need to work to get it.”

The past month has marked a shift in the way I think about myself and my cancer experience. First off, it’s okay to not be okay. And secondly, it’s okay to take some time to slow down and figure out what you need to do next.

During the first weekend in March, I went on a retreat where I felt introspective, stuck, and a bit depressed. I was fed up with how I was feeling physically and mentally, and frustrated with my constant exhaustion and confusion. Luckily, I was in the right place: essentially a cocoon of safety, guarded over by four mama hens. I desperately needed to recharge and figure out how to care for myself. The retreat was called Mending Under the Moon, and that’s exactly what it felt like.

Then the next weekend (because apparently I’m a cancer party animal), I flew to Texas alone for the Young Survival Coalition Summit, and returned with over a hundred new friends — and a fire in my belly. I signed up for a 200 mile bike ride in October with my new breast friend (ha ha), Tara. (Side note: cancer didn’t kill me and I’m hoping this ride doesn’t, either.)

Being in a room with over 700 women who’ve been through your exact same trauma is pretty incredible. The entire conference was focused on “the collateral damage of cancer,” including (but not limited to) trouble with memory, concentration, and confusion; fatigue; financial strain; anxiety, depression, and PTSD; neuropathy (tingling or numbness in your extremities); sexual problems; lymphedema (swelling of extremities due to having lymph nodes removed). I don’t have all of these issues, but I have quite a few, and learning that I wasn’t alone was incredibly validating.

I realized that I’ve spent the last six months under a rock, trying to wrap my head around what’s happened to me, and what I really needed was help. I needed a community that understood what I’ve been through, and to take advantage of the resources that are out there for me.

I am done trying to manage my life until I can’t do it anymore.  When I returned from Austin, I started calling all of my doctors. “I need help,” I said. “I have cognitive problems and I need someone to help me figure out what’s wrong.” The oncologist told me to talk to the psychiatrist. The psychiatrist said she would help me, but that she wanted me to try two types of anti-anxiety meds and a stimulant at the same time. The neurologist told me to talk to my primary care doctor, who told me to talk to my oncologist. Finally, I saw my breast surgeon for my semi-annual checkup (still no cancer, yay!), and her reaction was exactly what I was looking for. “This is not okay,” she said. “I will figure out how to help you.”

And she did. I ended up with a new oncologist and time off work to figure out how to improve my issues. We are starting by taking a “drug holiday” (weirdest term ever – this is a pretty crap vacay, if you ask me!) from the intense drugs I’m on to prevent reoccurrence, which have severe side effects.

The relief I feel is downright incredible. My issues aren’t solved at all — it takes awhile for the meds to wear off — but I’m really hopeful that getting these out of my system and starting on something different is a step in the right direction.

And in the meantime, I’m keeping my eyes out for my fifth anemone!


When Breast Cancer Isn’t a Lump: How I Found My Cancer

Every month on the first of the month, there’s a social media movement called #feelitonthefirst to remind women to do their self breast exams. 

I haven’t participated before, and I’m participating now with an extra reminder: don’t just to do your self exams, also trust your instincts. My cancer had no lump, and neither did my mom’s. If something doesn’t feel right, on a gut level, get it checked out.

We don’t often hear stories like mine, or like my mom’s. Most people think cancer = lump. Awhile ago, a post using lemons to show visual signs of cancer went viral, and that was really helpful in raising awareness. But I had no visual signs, nothing I could feel with my hands – and I realized that I haven’t really shared exactly how I found my cancer and what my diagnosis was like.

So. I will share the entire story, because I want to make people aware that I could, at any point, have stopped advocating for myself. I could have said, “oh, I’m sure it’ll be okay.” And the end result would have been very, very bad.

I say this not to pat myself on the back, but to give you — my friends — any amount of prompting you need to listen to your bodies, do your self breast exams, listen to your intuition, and DO NOT PUT OFF GOING TO THE DOCTOR. Yes, when I was screened I got bad news. I had to face a lot of scary stuff. But if I’d avoided it, if I’d delayed it, I would have had to face all that scary stuff — and I would likely have died, too. Early detection is so, so, so important.

My whole life, breast cancer has been a topic of conversation in my family. Before I was old enough to really understand what it meant, both of my grandmothers, my only aunt on my dad’s side, and my only aunt on my mom’s side all faced breast cancer. Both of my aunts had premenopausal cancer (considered more aggressive) and it tragically claimed my aunt Lois’ life in 1983. She was 41.

My doctors always told me that I’d need to start getting mammograms 10 years before my Aunt Lois’ first diagnosis; by that calculation, my first mammogram should have been at 29. But when I asked my doctor to begin my early screenings, I was told that recommendations for early detection had changed; research showed that increased screenings resulted in mis-diagnosis & over-diagnosis, which was dangerous. The new recommendation was that, unless you had a first degree relative (ie, a mother or a sister) who had cancer, you should get mammograms at 40 like everyone else. My dad had been screened for the BRCA mutations (a gene more common in Ashkenazi Jewish populations that puts carriers at high risk for breast and other cancers), and came up negative. I was told that I shouldn’t get early screenings. 

I accepted this until 2016, when my mom was diagnosed with post-menopausal breast cancer. I was 33 when she went through radiation & a lumpectomy, and I again asked my doctor if I could begin early screenings. “That’s a good question,” she said, “I’m not sure.” In November of 2016, we went to Hawaii to celebrate the end of my mom’s cancer treatment, with no idea that it was our last big hurrah before the Olsher Family CancerFest really swung into high gear.

At my yearly exam in March of 2017, I asked my gynecologist about early screenings again, at which point she personally put in a referral for a genetics screening; I had it done within two weeks. Let’s pause here for a moment: this is the second time I directly asked for early screenings, and I only asked because my mom had been diagnosed. As you will see in a moment, my mom’s first breast cancer diagnosis saved my life.

I was tested for around 80 genes and came up negative for all of them. Because of my family history, however, I was still considered high risk and was placed in the “high risk cancer clinic” at Kaiser in San Francisco, headed up by an incredible breast surgeon by the name of Dr. Samantha Langer. Dr. Langer was scheduled to lead a group for women with high risk for breast cancer, but the class was canceled last minute because Dr. Langer was called into an emergency surgery. I asked to be rescheduled, but her schedule was so busy that I was given the option of waiting for the next group class, or seeing Dr. Langer individually. My gut told me to see her individually. This was April of 2017, and I was 34.

In June of 2017, just two months later, I started to have a strange sensation in my left breast. It felt sort of like a tickling sensation, which I described as “milk being let down” from my years of breastfeeding my daughter. The sensation went from the side of my breast to my nipple. I felt no lumps, but I had a strange gut feeling that I should get it checked out. “I’m sure it’s nothing,” I thought, but I made an appointment with my OB/GYN and was in her office within days, on June 8. She didn’t feel any lumps. 

On June 26, I had my scheduled individual appointment with Dr. Langer. As a reminder, this is a breast surgeon who does early detection for a living. She told me that I had a 20% risk of developing breast cancer in my lifetime due to my family history alone. She told me that I likely carry a genetic mutation for cancer that hasn’t been discovered yet, given that I was the only woman in my family not to develop breast cancer. She told me that I should be screened early. She told me I could opt for a preventative double mastectomy, if I wanted. She told me that I’d have breast MRIs and mammograms alternating every six months. She warned me about the number of false positives, and that at some point, it was likely that someone would see something “funny” on a screening and I’d have to go back for a follow-up screening. She warned me that this can be very anxiety provoking.

Then I asked her to examine my left breast, because that odd sensation never went away. She didn’t feel any lumps.

On Friday, July 7, 2017 I had my first screening – a breast MRI. Then the following Monday, July 10, Dr. Langer personally called me. “As I warned you about, they saw something ‘funny’ on your MRI, and I’d like to schedule you for a diagnostic mammogram and ultrasound on Friday.” Here’s what that means: they’d seen something not right (“funny”) on the MRI, and now were planning to use other imaging techniques to see if the “funny” thing showed up again, or if it was an anomaly with the MRI. If they saw the “funny” thing on the mammogram and ultrasound, too, I’d have a biopsy. For what it’s worth, lots of women get all the way to the biopsy and do not have cancer.

I remember sitting at the conference table at Red Tricycle, where I was the Marketing Director, telling my CEO and our Editorial Director that I’d be out of the office that coming Friday afternoon. That I was sure it was nothing, but I was a little nervous.

The diagnostic mammogram was no big deal. I’d never had a mammogram before, and it didn’t hurt. The mammogram tech took a few extra images than she would have for a regular mammogram, told me the doctor would interpret it for me, and then sent me to wait for the ultrasound tech.

Two ultrasound techs, who were extremely kind, examined my breast using the ultrasound before the radiologist came in. They pointed out various “calcs” they saw on the image (which I now know means calcifications – white spots on the image that are totally normal but can sometimes mean early stage cancer). Then the doctor came in and quietly examined my breast in the same way the techs had. I said, “Dr. Langer said you would know if I need a biopsy or not. When will you know?” He was very grave when he said, “I already know.” He set down the ultrasound  probe and said, “do you want me to be frank?” I looked at him and said, “yes, please.”

“What we are seeing can be nothing other than cancer.”

What they saw in my screenings was not “funny.” It was cancer. Cancer that took up such a large part of my left breast — from under my arm all the way to my nipple, exactly where I’d felt those sensations — that I would need to have my entire breast removed, no matter what. A mastectomy. There was no way to only remove the lump because I had no lump. PLEASE HEAR ME: I HAD NO LUMP.

My initial diagnosis was DCIS (ductal carcinoma in situ, or cancer cells in the milk duct) with no evidence of invasive cancer (cancer that has spread outside the duct). Stage 1, maybe even Stage 0; but because of the size of the area involved, they wouldn’t know my stage for sure until they removed my entire breast during surgery and had it analyzed by a pathologist.

My story does not stop here, though.

(I know, you’re probably like, “Sara, this story has about 3,000 words already, how is it not over and why in the heck are you giving us every detail?!” And the reason is this: Women need to know. Women need to know that not every cancer starts with a lump in the shower. I want you to know every bit of this because it could save your life, or the life of someone you know. When you think to yourself, “I think I heard about a woman once who had this weird tickling sensation – maybe I should get that checked out.” Or when a friend of yours casually mentions in 10 years that she has a strange sensation – you can say to her: “Sally, go get that checked out right this minute.” That’s why.)

So, back to me: here I am, with cancer in my left breast and no option other than having my breast removed. I wanted to have my surgery done by Dr. Langer in San Francisco. I had a feeling about her and I wanted her to do it. I opted for a double mastectomy. The left mastectomy wasn’t an option; the right mastectomy was preventative. I never wanted to go through this again.

My surgery was scheduled for September 14, 2017. During the time between my diagnosis and surgery, I continued to feel that sensation of milk being let down, and I started to have another gut feeling that the cancer was changing. I felt where the cancer was and still felt no lump – but it felt a little different. I can’t describe how; it just felt like the lumpiness of my breast was lumpy in a different way. I wouldn’t have noticed it, I don’t think, if I hadn’t known there was cancer there. To be clear, I was not zen about this. I was anxious. But I also knew that the only thing that could be done was already scheduled to be done; they couldn’t move my surgery up. So I waited, knowing that we would know a lot more about the cancer once the surgery was over.

When I woke up from my double mastectomy, my mom was there. I asked her if the cancer had spread. She said, very sadly, that yes. It was in one of my lymph nodes.

For those of you who aren’t as well versed in cancer as I am now, the lymph system is essentially the door to the rest of the body. It is what helps your body drain its waste, and once a cancer cell gets into the lymph system, it can start to reproduce in other parts of the body. Cancer that has spread to other parts of the body is called metastatic, or Stage IV cancer. At this time, there is no cure for Stage IV cancer; there is only living with it until your body can’t live with it any longer.

So to put a point on it: My cancer was spreading before it was forming a lump anyone could feel. After the pathology came back, they found a 1.2 cm lump. I had a teeny, tiny tumor, the size of a pea, and cancer that was already spreading to the rest of my body. I strongly believe that, had I waited to find a lump, it would have been too late. As it was, I was Stage 2a.

Fast-forward to January of this year; I am in the middle of chemo treatments, and my mom, who has moved in with us to help care for my family, mentioned a strange “burning” sensation from the top of her breast to her nipple. I will not tell her story as it is not mine to tell, but she advocated for herself as I advocated for myself. She refused to accept “no” for an answer when she was told by a radiologist “we don’t do mammograms for pain” and she had a follow-up screening after a mammogram came back negative, in part because her gut told her to. Keep in mind, she’d already had cancer in her left breast, and the first time was nothing like this – this was a new experience for her. As a result of her persistence, she was diagnosed with aggressive breast cancer in her right breast and is currently undergoing chemo herself. (If you are the praying type, please keep her at the top of your list – this has been brutal for her.) And also: SHE DID NOT FEEL A LUMP.

Breast cancer looks like a lot of things. It feels like a lot of things. But sometimes, it doesn’t look like anything. You can’t feel anything with your fingers. Everyone gets breast pain, so I’m not saying you have cancer if you have pain. I am saying that you should never listen to someone who says breast cancer doesn’t cause pain. Because sometimes it does.

I recently passed the one year anniversary of my cancer diagnosis. On that day, we moved to new city. We began blending our family with my boyfriend’s and looking to the future. We are doing this because I will survive breast cancer. I will survive cancer because of all the times I could have given up and I didn’t. Instead of facing a very high survival rate, I could be planning my daughter’s future without me in it.

Follow your intuition.

Making Peace with Cancer

Today was my last day of radiation, and for all intents and purposes my “active treatment” is over. No more chemo, no more radiation; the hardest part of this “journey” is (hopefully) behind me. I keep thinking I should be celebrating or feel more of a sense that things are over.

I realized this afternoon that I don’t feel like cancer is over because I don’t think cancer ever ends. And I don’t mean that in a depressing way. I just mean that cancer has become a part of who I am, and there’s no putting it behind me. You can’t ever be done with cancer, because it changes who you are, fundamentally.

The word “survivor” implies that the thing you survived is now over.  That was hard, but I survived it. Like it’s a marathon or something. The truth is, at this point I am no closer to or further from death than anyone else is. I have faced my own mortality a lot younger than most people, and I’ve learned a heck of a lot as a result. But every day I go to bed alive, I have survived, just like you have.

Accepting that cancer has been part of your life is scary. Once it’s been there, it never leaves, and there’s a real loss of control there. There is no going back to “normal.” Normal is gone now. Cancer changes who you are, physically and emotionally, forever. Something you did not choose changed you forever, and if you don’t like how it’s changed you or you don’t quite know how it’s changed you, it can be a real struggle. You cannot ignore it, and you have to find a new identity. You can fight that, but it’s the truth. At some point, you have to make peace with cancer.

I have found peace in my cancer diagnosis, because I truly believe that my purpose in life is to conquer some really hard stuff, so that I can help other people do it, too. It has changed the way that I approach my life for the rest of my life, and I am so grateful for that. It has made me more comfortable in my skin.

Every moment that I have, I am living to the fullest. And I don’t mean that in the cheesy inspirational-quotes-on-Facebook sort of way. I mean, if I am laying around on the couch, I am 100% laying on the couch. I am totally okay with that choice, and I am really enjoying it. I am not making myself feel guilty for what I “should” be doing. If someone else has a problem with my laying on the couch, I truly don’t care. My life is much easier and more peaceful now that I’ve mentally gotten out of my own way.

And quite honestly, I have cancer to thank for that.


The featured image is me on the radiation machine (a photo Bear captured covertly, as it was totally against the rules). Crazy, right?

What Happened to My New Relationship When I Was Diagnosed with Cancer


Have you ever noticed how quickly people fall in love during action movies? They’re brought together during times of extreme stress, and at the end they live happily ever after, simply because they survived a hijacked bus or a zombie apocalypse.

But the truth is, healthy relationships aren’t based on surviving a common disaster. What happens when you get off the bus and Macho Man doesn’t help out around the house? Or you try to have a kid, and you realize that you can’t stand his parenting style?

There are other pitfalls to relationships that start this way, too. When you don’t like someone’s behavior, it’s easy to attribute it to their heightened level of stress. “Oh, I really wish Macho Man would stop shooting people . . . he’s not a killer, though, he’s just being chased by the FBI, it’s not his fault.”

But sometimes (in fact, most of the time I’d venture to guess) people show their true colors during times of stress. If someone calls you names because they’re having a hard time at work, they’re probably a dick.

The truth is, a lot life is dealing with stress. Work is stressful, money is stressful, kids are stressful. At some point in a long-term relationship, you have to face the death of a loved one. One of you might face a life-threatening illness. If your partner’s behavior makes the situation worse instead of standing beside you and working cooperatively, you’ve got a problem.

When you get married, you pledge to care for one another “in sickness and in health,” hoping that the “sickness” part doesn’t get much worse than a man-cold. But in my case, I’d been dating Bear less than a year when I was diagnosed with breast cancer. We hadn’t taken any oaths.

I’m not sure how I expected Bear to react to my diagnosis, but he had a much stronger reaction than I expected. In part, I think my own denial made me think “this isn’t really cancer, so why is everyone so upset?” I know him and his values, so I didn’t expect him to leave me, but I definitely didn’t expect his immediate level of total dedication.

The first things he said to me the night I was diagnosed were: 1) I will find you beautiful, no matter what, 2) You will not fight this alone.

Since then, his sense of humor, positivity, and kindness have helped keep me afloat. When I was trying to eat a mostly plant-based diet, he brought me a bouquet of vegetables instead of flowers. He slapped a “Fight Like a Girl” sticker on the back of his car and sports a “Fight Together” shirt. He made me a boob cake for my 35th birthday (laughter keeps you alive!) and helped my 7 year-old daughter shave my head after I started chemo. On my hardest days, he has helped me to set small goals so I feel like I’ve accomplished something – which makes long, tedious days much easier. He’s helped me physically recover from surgeries, has attended every appointment, and has made sure that I feel supported every step of the way. He has never assumed to know what I am going through, and has allowed me to process this in the right way for me, without telling me what I “should” be doing. I can imagine that, in and of itself, is difficult.


To me, though, what he said to me the night before my double mastectomy really sums up the kind of man he is. He took a long walk with me, held me as I cried, and said, “I don’t want you to worry that this will affect how I feel about you. I’m not here for what you look like, I’m here for you. You’re going to have scars, but I’ve been thinking about it, and I actually think that’s pretty cool. Every scar tells a story, and the good thing is that I get to be part of your story.”

He wants to be part of my story of survival. And he is.

If I’d had any remaining doubts about him (which I did not), his actions during this process have solidified that I have found a Unicorn.

Cancer, as much as I hate it, has shined a spotlight on all aspects of our relationship and forced us to support and understand one another in ways that life wouldn’t have required us to do for years. We’ve had to talk about uncomfortable things, deal with really complicated emotions, and be empathetic to the other person’s needs.

Bear doesn’t have a big ego, and he doesn’t like attention. So I share this not because I think he will love it (guaranteed he will turn bright red), but because as a partner he has shown up for me every day, and I am so grateful for him. I wish that every cancer patient had a partner that is half as amazing as he is.

Last Valentine’s Day, he told me he loved me for the first time. This Valentine’s Day, I will have my last chemo infusion with this man by my side. This man, who has shown me with his actions every single day that he loves me.

I may be right in the thick of breast cancer treatment, but I feel like the luckiest human on the planet to have found this man. I am so grateful.

Happy New Year from the Cancer Patient: Here’s What I Have to Say


You could fill stadiums and football fields with the stuff I don’t know. I am terrible at names, for example. I am one of those ignorant people we’re ashamed of who can’t name most of the people in power. Math (especially common core) is not my strong suit.

But what I do know is this:

There are good people in this world. So many of them. There are people who are truly selfless. They don’t do kind things because of the likes they’ll get on Facebook or because they get something out of it. They do it because they are generous, good people.

Since my cancer diagnosis, these people have come out of the most unexpected places. My babyhood best friend. Someone I didn’t know well from high school. A lovely woman I met on a press trip to Hawaii. The group of women I blogged with a decade ago. Moms at school I never even spoke to. There are countless community programs run by volunteers who really, honestly care about the people they serve.

Other people have shown up in ways I never would have expected. Friends who sneak food into your refrigerator and arrange get togethers so you don’t get depressed. Friends who leave a bag of unicorn-themed things on your doorstep, bring scarves for your head, an incredibly expensive wig, and lemon treats because they heard you’ll lose your tastebuds. Friends who say truly thoughtful and caring things to me, online and in person, to lift me up.

And there’s the people you hope will stand by you – your parents, your aunt, your partner – who go above and beyond every single day. Who support you as your hair falls out, you melt down, or you simply don’t know what to do next.

Cancer has shown me that I will never be able to properly thank all of the people who have done kind things for me. That the two survivors who work at Charlie’s school will never know how much their thoughtfulness means to me. That there’s no way to describe how much the weekly cards from my boyfriend’s parents brighten my day every single time. That my cousins, aunt, and two close friends will never know the gratitude I feel every time I put on one of the scarves they gave me.

This is not because I don’t thank them – of course I do – but because I truly can’t express just how much it means. To know that you are cared for, and thought of, by people who expect nothing in return.

Since this journey began, and I began sharing my experience, I’ve been told that I have inspired people. But all I’ve done is share my experience. What is truly inspiring to me is the absolute breadth of giving I have witnessed, with no ulterior motive. It truly has changed my life and inspired me to be a better, more generous person myself.

Before I had cancer, I didn’t know how many amazing people I’d surrounded myself with. I didn’t know how to let people help me. I didn’t know how to let other people carry me. I thought I was the helper, but all this time I’ve not known the first thing about what truly giving is.

These people have inspired me and have shown me a generosity that I will absolutely never forget as long as I live. Yes, cancer has changed me. But what has truly changed me is seeing the people in my life for who they are. Good, good people.

Thank you.

I May Be Having an Existential Crisis

For the past few days, I’ve barely been able to control my panic. Something happened the other day in the bathroom. I was passing by the mirror, and I saw my chest. I’ve seen my chest in the mirror a hundred times since my surgery, but something about it really upset me this time. Instead of facing it, I swallowed the panic.

The panic keeps trying to surface. It has something to say, but apparently I have no interest in listening to it. This morning I touched my head and more hair fell out. Panic. Swallow.

We got a very new and peaceful aquarium. Yesterday I was sitting on my hygge couch, staring into the aquarium at the crabs and fish, and all of a sudden I thought, “am I going to die? Will I sit here as I die and watch this peaceful scene and die quietly?” Is that how my story ends? You can say no, but you don’t actually know.

My daily life consists of making it through. Some people work through chemo, and I can’t imagine having to do that, because making it through is all I can do. Taking walks, trying to drink water despite my mouth feeling like it’s coated in something slimy…these things are all I can do. And it is hard to imagine coming out the other side of this and not just “making it through” every day. I am so completely overwhelmed by CANCER that I can’t handle even the most simple of tasks.

I am in pain from the chemo and my email is overflowing. I am supposed to answer these emails from kind people. I can’t. I can’t bring myself to do it because of the panic. I feel like I might start screaming. I am screaming on the inside even when I am not screaming on the outside. Screaming on the outside feels like it would take too much work, which is maybe the only reason I don’t do it.

How do I get to the point where life goes on? Part of me wonders if I might die because I can’t imagine what it will be like to live on the other side of this. When I thought about my future, I didn’t envision myself as an 80 year-old with breast implants sitting in a rocker. Attempting to reconcile this future I didn’t imagine for myself is part of what makes life so totally confounding right now. How is it even possible that I will go through the rest of my life with these scars across my “breasts”? How can I possibly reach 80 when, at 34, I had cancer?

Cancer cut my life in half. Before cancer, I cared about work. I cared very deeply about meeting my goals and worked really hard to meet them. Now my goals feel stupid. Who the hell cares how many clicks we get, how much money we make? On Facebook I see e-books for people looking to get quick results from advertising, or guidelines about when to post inspirational quotes to get in front of more people. Who cares about bento boxes for kids’ lunches or holiday cookies? Who cares if anyone clicks on any of this shit?

I don’t have cancer now. We cut it out, didn’t we? But it could come back. Even if I don’t have any breast tissue left, it could come back somewhere else. We don’t know that it won’t. How do I go forward with my life knowing that I can’t trust my own body? Is the pain in my lower back because I’ve been sitting wrong? Or is it cancer in my bones? How do I go forward knowing that my friend thought she needed to see a chiropractor and get a stand-up desk, when in reality this horrible illness had returned, and that was it: Stage IV? Now she’s gone.


You know the joke, “why did the chicken cross the road?” No one thinks this joke is funny, because it seems too obvious. But last year my friend Michelle blew my mind when she pointed out that the answer is actually really deep: “To get to the other side.” If the chicken successfully crosses the road, he’s on the other side of the road. But if he gets hit by a car, he’s on the Other Side.

I was walking my whole life on one side of the road. Doing my thing, living my life. And then cancer came, and it made me cross the road, and I’m praying I get to the other side instead of the Other Side. I can’t stay where I was, thanks to cancer. But I’m confused. Because everything here looks the same, but everything is different.

My child is in the variety show at school and there are things to be done. I have to pay my rent and I have to pay the electricity bill. I have to pack school lunches and I have to figure out how to do it all without screaming.

None of these things matter. How do I go back to a life where I’m finding things to write about that will get “clicks”? As a fellow marketing friend of mine said, Amazon grows and grows and grows, but why? What is the point of any of this? More than a half million people work for Amazon, day after day, toward the common goal of growing. All their meetings, their phone calls, their emails, their daily stress . . . it all centers around growing the company, but WHY?! To what end?

There’s so much noise, so much superfluous shit and so little of it is important. On this side of the road, I’m looking at all these things I used to look at every day – the bills, the variety shows, the work goals, the office gossip – and I’m seeing it differently. I’m swallowing my screaming. Because even though I know these things are stupid, I know that no matter which side of the road I’m on, they’re still there. And they will be until I’m on the Other Side.

And I don’t want to go there.