In a small white room outside of Rome, Italy, with nothing on the walls but a haunting crucifix, I was told: “Hai la leukemia linfoblastica acuta.” You have acute lymphoblastic leukemia.
Alone in a foreign country, I immediately sensed how helpless I was. I needed to get home, and fast. I needed my friend to immediately scratch all her plans and take the train with me from Rome to Milan to grab my essential belongings. I needed my parents to book my ticket. I needed them to huddle with my American physician and figure out the best hospital for my care in New York City. Quite simply, I needed.
I checked into Memorial Sloan Kettering in New York City one day and 4,000 miles later. And surprise, I immediately needed more help. This time from doctors, nurses, social workers, friends, and family. This powerlessness foreshadowed the next four years of my life.
However, I was proud. After an initial conversation during which I cried and said the token “Why me?” to the social worker on my floor, I would dismiss her every time she rounded my room. I would not fully give into the impulse—the impulse being to ask for help. Every time I asked for help, seeded full control, and admitted to being vulnerable, there was an internal resistance. And by resisting help, I created tension that exacerbated my pain.
Almost immediately, my doctors begged me to get on a selective serotonin reuptake inhibitor or SSRI. They could tell I was not well. Every procedure frazzled me; I was living in constant fear. The slightest noise made me jump. Yet, I would not speak for the most part. I could not communicate my sadness, my terror, my hopelessness. I just sat there frozen.
After a year of hellish treatment, I entered maintenance treatment and assumed my life would immediately return to normal. The oral chemo was supposed to be less intense, which I equated with getting my old life back. Well, spoiler alert, maintenance is a three-year marathon. I did not snap my fingers and feel better. When this realization set in, it triggered yet another breakdown, and finally, I decided to get on the SSRI. I was finally broken.
Why had I not listened to my doctors sooner? Why was I so proud?
I’ll tell you why, because of societal expectations from men. I did not immediately realize this, but after reflecting, I could pinpoint all my anxiety and depression to the tension created by resisting vulnerability. I grew up with four athletic brothers in a traditional family, in a traditional town, with traditional beliefs. This translates to the ideology that men are strong, providers, stoic, and never show emotions. For years, these thoughts made me hide parts of myself that needed tending to and expression. It turns out, I am a sensitive guy underneath the cutting remarks.
Unfortunately, it took cancer to prompt this self-reflection. It took needing help, needing to share my feelings, and needing to cry to understand that emotions are normal. Not addressing emotional needs creates toxic mental health and behaviors.
Beyond my doctors’ advice to start an SSRI (which pre-cancer I had told myself was only for crazy people), I also now see a therapist, dabble in meditation, and keep a gratitude journal. I read philosophy and self-help, I take daily walks outside, and most importantly, I share. I share what I am feeling and what I am going through; the feeling I was once allergic to has now strengthened all my relationships. In the past, I feared my honesty would turn people off. I am not sure when and where I came to that deluded conclusion.
Looking back, it is so, so clear that cancer is not only a physical ailment but a mental disease. I did myself a huge disservice by telling myself to tough it out. That I was stronger than everyone else. I was not. Patients, medical professionals, and caretakers all need to band together to address mental health throughout treatment.