Chapter 25: The old man in the little pink hat

Sunday, March 8th, 2020:

I was asked a very interesting question the other day. I was asked, “Do you ever wake up having forgotten [you have cancer] until a wave of sadness comes over you when you remember?”

Have you ever felt this? I recall feeling this during times of heartbreak. Let’s say you’ve been dumped: by a lover, by a friend, from a job, etc. Sometimes, you might wake up and have a brief moment of happiness until your heartbreak comes rushing back to you. I have felt this before, but I do not feel it now.

Interestingly, I have never felt this way about my cancer diagnosis. I was diagnosed with a brain tumor around 6 weeks ago. In the past 6 weeks, I have never forgotten this diagnosis, even for a brief moment after awakening. I wake up, feel like myself, and smile. I am still me, with or without cancer. I am not sad. I am not heartbroken.

My brain tumor, my cancer diagnosis, my happiness, my peace of mind, these are all a part of me. They are not a bad dream. They just are. And so, I just am.

I want to share a couple of short stories about two of my most memorable patients with you. As always, I will edit some details for privacy. I think you’ll like these stories. I hope they make you smile.

Patient 1: The old man in the little pink hat

While working in Thailand last month, I was a member of an oncology team in a busy, crowded hospital. Many of the wards (blocks of hospital rooms/beds shared by patients who need similar types of care) in this hospital were multi-bed wards. This means that many rows of beds were all lined up next to one another in one large room. Our team of 10+ physicians would walk as a group and stop in front of each bed, discuss the patient’s diagnosis, and give the patient updates on the plan for the day. You can imagine this could be quite intimidating for a patient to experience.

One morning, I was rounding with the oncology team and I met a patient I will never forget. This man was sitting in the last bed of a multi-bed ward. Our team had already stopped to talk with around twenty patients in the same room, all with cancer diagnoses of some sort. Many of these patients had looked sad, tired, confused, or scared. I felt myself feeling sad and somewhat helpless as I met one patient after another, each one looking more scared and powerless than the last.

But then, I met the old man in the little pink hat.

Imagine the cutest, sweetest, ninety-year-old Thai man you’ve ever seen. This man had cancer. His physical body was dying and he knew it. Unlike the other patients in his ward who were lying in bed, sleeping or crying or moaning in pain, this man was sitting cross-legged on the end of his bed wearing a small, knit, hot-pink hat. He smiled a huge, toothless smile as our medical team approached the foot of his bed. I have never seen someone look happier than this man. Standing in front of him, my entire mood changed. I smiled back. I felt happy. I felt optimistic. His mood changed my mood and the mood of the entire medical team.

When I was diagnosed with a brain tumor, I sat in my own hospital bed in Thailand. At first, I felt scared. I felt sad. But then, for some reason, a vivid memory of the old man in the little pink hat flashed in my mind and I felt a wave of overwhelming happiness. I silently thanked this man for giving me happiness at the most difficult moment of my life simply by being his calm, peaceful, and happy self.

Patient 2: The man with the forever smile

A few years back, I was working on a medical team in Chicago at a nursing home. I was instructed to talk with and examine a patient who had lived in this nursing home for the past year.

This patient had a very sad story. He had suffered a traumatic brain injury. Interestingly, this patient’s brain injury had altered his personality in such a way that he was constantly happy and smiling. I honestly can’t explain this medically and would need to consult a TBI specialist to fully understand. As far as I am aware, this is not a common result of traumatic brain injuries.

Anyways, this patient smiled 100% of the time following his injury. I asked the physician I was working with (who knew this patient both before and after his injury) if he had a neurologic injury that caused his facial muscles to always form a smile. She said no. Somehow, in an almost inexplicable way, this patient had suffered an injury to part of his brain that led to a dramatic personality change (sometimes this can happen with frontal lobe injuries, but this is a very extreme and rare example). Before his TBI, he was often cranky and irritable. After his injury, he smiled constantly because he was always happy. Everything made him happy. Meeting new friends, new physicians, eating food, watching tv, playing cards, sitting in his wheelchair, lying in bed. The simplest of activities made him happy.

I sat and talked with this patient for about an hour. The entire time, he smiled. I walked away from this patient thinking, “If I ever have a brain injury, I hope it’s exactly like the one this patient had. I hope it makes me permanently happy.”

You can’t make these stories up, people.

Patient 3: Myself

Today, I woke up early and read an entire book. I couldn’t stop. It was so simple, so beautiful, so well-written. This book is “The Art of Living” by Thich Nhat Hanh. My good friend S actually loaned me this book. Thanks, S. Can’t forget to give him a shout-out here.

In this book, Thich Nhat Hanh describes the notion of “non-action.” Non-action is the idea that not doing anything is sometimes actually the best thing we can do. Thich Nhat Hanh goes on to tell a story about this idea of non-action. He states:

“Imagine a boat of desperate refugees crossing the ocean. The boat gets caught in a storm and everyone panics. If everyone panics, there’s a high chance they will do the wrong thing and the boat will capsize. But if just one single person can remain calm, they will be able to inspire others to be calm. If, from a place of peace, they ask everyone to sit quietly, the whole boat can be saved. That person doesn’t exactly do anything. What they contribute above all is their calmness and the quality of their being.”

I tell you these stories today to emphasize a point. Since my cancer diagnosis, many people have asked me why I seem so calm. They tell me, “It’s ok to be sad. Don’t fake a smile.” They ask, “Are you actually ok with all this or are you just putting on a good face?” They say, “Express your emotions. Don’t act happy just for my benefit.”

Every time I hear these comments, I tell my friends and family that my attitude about my diagnosis is not fake. I am not upset. I am not mad. I do not wake up and think this is just a bad dream.

I am truly calm. I am truly happy. I am at peace. We can’t predict or prepare for the challenges life throws at us, but we can chose how to respond to them.

I think of the old man in the little pink hat and the man with the brain injury who became “forever happy” and I can strangely relate. I read Thich Nhat Hanh’s words, and I can relate.

Despite the storm, I want to be the calm passenger on the boat. There is no need to panic. Panic will only lead to the boat capsizing. Calmness, peace, and acceptance are the qualities I will use to keep this boat afloat.

Fondly,

Courtney

© CB2020