Salma Hasan Ali
Last year, I was diagnosed with breast cancer. A routine mammogram led to a more in-depth one and then to a biopsy. I was certain that nothing would turn up, as I did not fit the profile – I have no family history of breast cancer (I later learned that only 10 percent of cases show a genetic history), eat a healthy diet, exercise, nursed both my children and have never touched a drink or a cigarette in my life. Despite this profile, I turned out to be the one in eight women who is diagnosed with the disease.
The doctor called during the first days of Ramadan 2012: “I have some good news and some bad news.” Not too comforting a start. “It’s not malignant. But it is atypical.” OK, then.
The initial diagnosis was Atypical Ductal Hyperplasia (ADH), a process by which healthy cells start misbehaving. They stack up on each other and take on an abnormal appearance. Left untreated, they can become cancerous and perhaps invasive. I scheduled a lumpectomy.
In 90 percent of the cases, the surgery confirms ADH, my breast surgeon reassured me, and nothing more needs to be done, except for diligent annual mammograms. In 10 percent of cases however, the surgery reveals cancer. I’m usually much luckier.
Ductal Carcinoma In Situ, or DCIS, to be precise. It’s very early stage breast cancer, the best type to have if one could choose. The lumpectomy showed clear margins, confirming that the cancer was contained, not invasive, as is usually the case with DCIS. Radiation followed the diagnosis and the doctors gave me the option of taking a drug that helps prevent recurrence. I am, indeed, as lucky as I thought.
My husband was shocked; I’m supposed to be the one who never gets sick and keeps it all together. My kids – 16 and10 at the time – were scared. I reassured them constantly and tried to continue their normal routine. My parents redoubled their prayers for me. It’s amazing how much strength God gives you when you need it most. I remember being more organized, trusting my intuition, and staying calm.
But the shock of the diagnosis was still hard to bear, especially as it capped the most difficult year of my life. It felt surreal – attending breast cancer survivor seminars on Saturday mornings; parking in the spot for “Radiation Oncology”; slipping into my double layered blue gowns and sitting with other similarly attired women in the chilly radiation waiting room; trying to keep my legs from shaking with each creak of the door as I tensely anticipated my turn. How in the world did I get here?
But as I lay on the radiation table each day, face down, arms raised gripping the handles above me, two women manipulating me so that laser beams aligned perfectly across the five tattoos on my back – it felt all too real. Brazilian jazz played though the speakers—a sound incongruous with the environment I was in. I would try to distract myself by focusing on the picture of yellow tulips on the wall in front of me. Getting into position took longer than the treatment itself. The first few times — after the staff meticulously took down all the measurements and maneuvered me into the perfect position — I felt like bolting. Instead, I closed my eyes, recited Surah Fatiha, and clutched the black handles a little tighter. I felt something the first couple of times — a slight electric shock, a zinging sensation. Soon, I didn’t feel it any more. Perhaps I had gotten used to it; perhaps I wasn’t as acutely focused on feeling it.
Those seven weeks felt interminable; I thought they would never end, but they did. One year has passed and so far my bi-annual checkups have revealed only healthy cells. Alhumdulilllah. Often it takes a shock to the system to realign your priorities, adjust your perspective, and realize just how blessed you are. As I think about the impact that breast cancer has had on my life, I realize just how much it’s taught me about faith, gratitude, living life fully, taking control, and letting go. I’ll share some of these thoughts in the second part of this piece, and pray that I can stay faithful to these lessons.
I often think back to this past Eid al-Fitr to remind myself how easily life’s joys and challenges are intertwined. That morning we said Eid prayers with family and our Sunday School community; mid-day, we went to a wonderful lunch at a friend’s home (a friendship deepened through our shared experience with cancer); the day ended, untraditionally, at a Justin Timberlake concert. But in the middle, there was a visit to the hospital for my bi-annual MRI.
It was the only day available; I think God was making sure I had everyone’s supplications and happy energy. Within minutes, I had changed from a brightly colored chooridar, gold heels and bangles into a blue gown, white slippers and a hospital wrist band. Pure happiness and intense worry in the span of a few hours — a microcosm of life, perhaps. It’s in how we deal with both good fortune and difficult moments that ultimately determine our sense of purpose and contentment. I hope I can be faithful to the many lessons I’m learning through this journey.
The first, and most important, has to be gratitude. While I think I’ve always been aware of my blessings, it’s easy to slip into an entitled frame of mind and assume that life will continue to go on smoothly. It doesn’t work that way. For anyone. My path had been free of bumps for a long time when, in the span of twelve months, my father suffered a stroke, my daughter went through a really painful time, and I got this unexpected diagnosis. It was a lifetime of worry, fear and heartache wrapped up in one year. I really didn’t think I would ever smile again.
But with the deep embrace of family and friends, who formed such tight concentric circles around me, falling was out of the question. Each doing what they instinctively knew could help – unflinching shoulders to lean on; phone calls and emails of support and sustenance; prayers in overdrive and hugs in abundance; and all the practical things from cooking to babysitting that make pushing through trying times a little easier.
Hard times are a fact of life. Getting through them is an act of faith. And the support of family and friends is a lesson in gratitude.
Paying more attention to lifestyle choices, including diet, exercise, stress and one’s environment, has been an important learning lesson, still in progress. I had a fairly healthy diet before, but I’m pretty sure I’d never eaten kale. Now I juice it most mornings, with cucumber, celery, green apple, lemon and ginger. It’s delicious, really. Revamping one’s diet can seem daunting but I try to follow a simple rule of thumb: eat natural, nutrient-rich foods like greens, vegetables, beans, nuts, seeds, fruits in abundance and limit processed foods, sugar and red meat. Regular exercise has to supplement a healthy diet. I’m neither an athlete nor an outdoorsy person, so, once again, I keep it easy. I make time for a brisk 45 minute walk each day, and add in yoga and strength training, each once a week, though I’ll be the first to confess that some days it’s my good intentions that get the most workout!
While almost everyone can agree on the importance of diet and exercise, most people are not fully conscious of the impact of toxins, found in personal care products, household cleaners, and in the environment, on our health. Only after my breast cancer diagnosis did I begin to pay attention to the lasting ways in which these toxins meddle with our systems, causing hormonal fluctuations. Women are particularly prone to absorbing these seemingly innocuous substances through our creams, cosmetics, deodorants and fragrances; the chemicals in these products, many of which are known carcinogens and endocrine-disrupters, then seep into our largest organ—our skin—and build up over time. I’ve found The Environmental Working Group and the Breast Cancer Fund to be excellent resources for figuring out what to use and what to toss.
Finally, I’m keenly aware that my cancer appeared during the most stressful year of my life; I can’t help but think there’s a link. As hard as it may be, finding ways to reduce stress through prayer, meditation, breathing, exercise, massages or whatever works, is essential. As a writer, days still go by when I haven’t left my computer to exercise, or am feeling particularly stressed due to an impending deadline. That’s when another lesson comes in – be gentle with yourself, and keep trying.
A health crisis, either your own or that of someone you love, definitely realigns priorities and provides perspective. In my case, I’m trying to focus on the things that carry meaning for me, not spread myself too thin, or measure my success by other people’s standards. I’ve made it a point to surround myself with people who make me smile and provide positive energy, and not to get bogged down in the stuff that saps my soul. My passion is finding committed people, listening to their stories, and sharing their inspiration. My dream has always been to write a book, a collection of portraits of ordinary Muslims doing extraordinary things, especially so our children can read about heroes in their own faith. One day, I always thought. Now, I think. Inshallah.
If I had the chance to start a movement and emblazon a pithy slogan on a yellow plastic wristband, selling millions worldwide to raise awareness and funds for cancer, it would be “LiveKind.” One of the most important things I’ve become more conscious of during this journey is how each of us, all of us, is going through something. We may look fine on the outside, seem to have it all together, but it’s hard to know what we’re really feeling on the inside. Chances are, some pain, some sadness, and some insecurity.
You never know who may need a little extra compassion; probably each person you meet. It reminds me of a short video that I love, which takes place in the corridors of a hospital. It shows different people, some in hospital rooms, others sitting in the waiting lounge, others walking in or being wheeled out, each with a caption giving some idea of what they are going through. The video opens with a quotation from American philosopher, Henry David Thoreau, “Could a greater miracle take place than for us to look through each other’s eyes for an instant.” It ends with a question, “If you could stand in someone else’s shoes. Hear what they hear. See what they see. Feel what they feel. Would you treat them differently?”
LiveKind. It’s foolproof.