Survivor’s Guilt

Sometimes, I feel guilty for surviving cancer because some people are not so lucky. Why did I get a break when so many, like Amy, did not?

There’s nothing fair about the way it happened, the way Amy died just 15 months after a breast cancer diagnosis seemingly similar to mine. She heard the same string of chilling words—you have cancer—as I did, just months after a doctor hurled them at me, over the phone, a day before Thanksgiving. Both in our early 30s with husbands and small children, Amy and I felt like two peas in a pod, situated in what we believed were almost identical positions. We were both young, both with early stage breast cancer. We both knew our cancers, while caught early, were considered aggressive because of our age—young women tend to have aggressive forms of the disease—but we also knew we had a high likelihood of survival, about 93% for at least five years.

Amy and I had common hopes, fears, and worries, and, on several occasions, we cried tears we were sure flowed from the same well. We also shared an instant urge to reach others with our breast cancer stories. Amy welcomed local newspaper reporters into her world and allowed them to capture through words and photographs her most intimate cancer moments. I began authoring my own breast cancer blog and then ventured into the world of freelance writing. We both wanted to make our experiences matter. And judging by the flood of reaction we received from our combined efforts, it’s clear we did.

Amy and I shared victories—we both managed to escape the threat of lymph node involvement—and we shared cards and e-mails. Thank you for holding my hand through this journey—it would have been pretty lonely without you, Amy wrote in one e-mail.

Amy and I also shared care packages, family photos, even hats. If misery loves company, then Amy and I were in love. And in celebration of our love, we basked in the glory of our most important similarity—our cancers had not spread. This was key to our survival. Or so we thought.

A mutual friend—her high school buddy and my college roommate—matched Amy and me. Ericha was one of a few close friends who after my diagnosis offered to hop on a plane and come to my rescue in Florida. I never accepted her offer—I was sure I could handle cancer all on my own—and so she stayed in Ohio where Amy, also an Ohio girl, welcomed her assistance. It worked out well this way.

Ericha helped Amy as she recovered from surgery, reconstruction, chemotherapy, and countless physical and emotional twists. She watched Amy’s kids—ages 4 and 1 at the time—and cleaned her house and drove her to appointments and selflessly assumed some of the burden drowning this young wife and mother who continued working as a nurse while managing a life with cancer.

“I quit my job,” Amy told me just after she announced her cancer had returned. She said she should have quit after her first diagnosis. She should have taken better care of herself. She should have played with her children, spent time with her husband, given up the chore of work. She would do it right this time, she said. She would crush cancer. She was sure of it.

I wrote and published a post about Amy on The Cancer Blog just after she told me how cancer had shown up in her brain and lungs, just five months after her chemotherapy for breast cancer ended. I wrote about my shattered hope, my fear this would happen to me, my complete and total sadness. And then Amy left a comment on my post. She wrote:

Jacki, I am not giving up. I will beat this again. Don’t you give up yet. I have Luke and Ella and they alone are worth fighting for. Just everyone send me your prayers and positive vibes. Quoting the cancer crusade couple, “Setbacks are a chance to pause and review the lesson of life.”

Amy, the one staring down death—doctors said she had two to 12 months to live—was comforting me. Amy, with her spunk and spirit, convinced me she would annihilate this evil disease. I believed her.

Amy lived for only five weeks after she wrote these words. Ericha called me with the news of her death just as I was leaving my house one Saturday morning to run in a race. I stopped in my tracks when Ericha told me—Amy passed yesterday—and I felt nothing but shock and sorrow for the duration of the run I struggled to finish. I finished for Amy, though. If she could fight cancer—twice—then I could surely pound out a few miles in honor of a friend whose face I never did see.

Amy and I talked about meeting at the beach with our families one day after we’d survived cancer for a few years. We dreamed of going on the Oprah show and proudly announcing our survivorship. We talked about a lot in our short 15-month friendship. What we didn’t talk about was that our situations really were very different. Perhaps we weren’t aware of it at the time. Perhaps we subconsciously chose to find common ground in the midst of our harrowing journeys, to ignore the fact that we were not traveling the same path at all.

Amy had a family history of breast cancer. I did not. Just after Amy completed her chemotherapy, her mother was diagnosed with the same disease that now has affected four generations in her family. Additionally, Amy’s tumor was slightly larger than mine, she received a different chemotherapy protocol than I received, she was not eligible for a year-long drug treatment I accepted to keep cancer at bay and because she had chosen the radical route of removing both of her breasts—I had a lumpectomy—Amy was not a top candidate for the radiation therapy that zapped me five days per week for seven weeks. She wondered if she should have demanded this treatment. She wondered if it would have made a difference in her survival.

The final and perhaps most significant difference in our diseases is that while Amy’s cancer, like mine, had not spread to her lymph nodes, it had found a way to penetrate her bloodstream and was spreading in a secret, silent, and deadly fashion. My oncologist, who dried my tears when I sobbed about the unfairness of Amy’s death, said some young women have a very aggressive disease right away. Amy was one of these women. I, apparently, am not.

There’s nothing fair about the way it happened, how Amy died just 15 months after a breast cancer diagnosis I have now survived for almost four years, how Amy died so quickly and I didn’t, how there is no cure for this mysterious disease that strikes far too many women and some men too.

Amy’s husband sent me an e-mail just after she died. He wrote:

You were a great inspiration to Amy. Your quote ” Fight the Good Fight” was front and center on our fridge. Please don’t let this news get you down, Amy would want your chin up, would want you to keep fighting. Thanks for all your support.

My chin is up. I am fighting. And Amy—thank you for your support.

3 thoughts on “Survivor’s Guilt

  1. I know what you mean about the survivor’s guilt. I have felt it too more than a few times, even though who knows if ultimately I will continue to be a survivor? That’s the thing about cancer, it’s so unfair and so unpredictable. Thanks for the beautiful tribute to your friend Amy. I’m sorry for your loss.

  2. Things happen for a reason. Maybe some were not able to survive because it was to late for them to recognize the problem. Maybe it was the end of the road for them. But being a survivor means you have the chance to create another survivor and help others make it through, to become an inspiration and to help others become better.

  3. What an amazing lady Amy must have been, and what a heartbreaking story. I’m watching my mum watch her best friend die of breast cancer at the moment. Her treatment is basically just giving her more time, but sadly it is not saving her life. Yet she just strides on and on, perhaps a little bit in denial and continuing to believe she will fight it off. I guess that is the only way some of us can leave this life… to go out fighting. I feel I’d not have the strength of character for that and would just… give up. For this reason, I’m in awe of some of you women fighting for YOUR lives. You inspire me, and put me to shame. Keep fighting the good fight. x

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