The Cancer Journey: Storytelling Nodes

“There is little in the practice of medicine that does not have narrative features, because the clinical practice, the teaching, and the research are all indelibly stamped with the telling or the receiving or the creating of stories.” --Rita Charon, Narrative Medicine

“Illness is the night side of life, a more onerous citizenship. Every person who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick.” --Susan Sontag, Illness as Metaphor

“Furthermore, we have not even to risk the adventure alone; for the heroes of all time have gone before us; the labyrinth is thoroughly known; we have only to follow the thread of the hero-path. “ --Joseph Campbell, Hero With a Thousand Faces

I. Stages of the Journey (PLOT)

A. Pre-diagnosis 1. Health--Innocence 2. Old Order/Disorder 3. Precursors, warning signals

Separation: Crossing the Threshold B. Determining encounter 1. Immediate revelation 2. Period of uncertainty

Initiation: Treatment C. Initiation: Treatment 1. End of uncertainty 2. Gathering Helpers i. Medical (Oncologists, Surgeons, Nurses, Radiologists, etc.) ii. Family (spouse, parents, siblings, friends, community) iii. Spiritual (pastors, books, tapes, inner resources)

Trials 3. Setting a Course a. Woundings b. Torment (Physical, Emotional, Financial, Spiritual) c. Confinement

Return (Outcomes) D. Homecoming, Homegoing 1. Remission, Recovery 2. Death (Acceptance, Denial)

CHARACTERS (Dramatis Personae) II. Protagonists/ Antagonists/ Supporting Roles

Hero Types 1. Patient as Hero Of Cancer Journey a. Warrior b. Priest c. Sage d. Scholar

Hero Types 2. Patient as Victim-Hero a. Captive b. Servant c. Innocent d. Fool

Helper Types 1. Doctors 2. Nurses 3. Family members 4. Friends and community support 5. Spiritual counselors and resources 6. Death as Helper/Friend 6. Death as Helper/Friend

Villains/Antagonists 1. Disease as Antagonist a. Malevolent b. Impersonal

Villains/Antagonists 2. Doctors/Medical System a. Doctors as Usurpers of Hero Role b. Doctors/Medical System as Obstacles/Obstructions c. Doctors/Medical System as Agents of Torment/ Wounding/ Confinement

Villains/Antagonists 3. Family members/ friends/ community antagonists

Villains/Antagonists 4. Death as Ultimate Antagonist

Narrative Types III. Narrative types (1-5 scale): A. Focused/ Digressive B. Explicit/ Implicit C. Detailed/ Ellisive

Narrator Types IV. Narrator types (1-5 scale): A. Expansive/ Reluctant B. Emotive/ Detached C. Serious/ Humorous D. Engaged/ Resigned

Brenda Johnson Themes: Separation and reconnection; death of an old self/ giving birth to the new Talismans: “turned out to be one of the best things that ever happened in my life”; “...why did it come to me? Because I was young enough to be able to fight it and be able to handle it.” Hero: Captive – Servant Narrative: Focused 2 // Implicit 4 // Ellisive 4 Narrator: Expansive 2 //Emotive 1 // Serious 1 // Engaged 2

Diane Felder Themes: Living to the fullest; accepting consequences Talismans: “God bless breast cancer – it saved my life.” “I don’t know what’s to come. I know this is what I’ve got now. And I love it so much – I’m gonna fight for every bit of it. Yes, I’ve had a great life, which leaves me wanting more.” Hero: Fool — Warrior – Sage Narrative: Focused 2// Explicit 1// Detailed 1 Narrator: Expansive 1// Emotive 1// Humorous 2// Engaged 1

Cathy Collins Themes: Job’s Patience (catalogue of losses) Talisman: “It’s not about me.” Hero: Captive – Servant -- Sage Narrative: Focused 1 // Explicit 1 // Detailed 2 Narrator: Expansive 1 // Emotive 1 // Serious 2 // Engaged-Resigned 3

Marcia Shell Themes: Transformation of affliction to mission; betrayal by medical system Talisman: “cancer was the best thing to happen to me.” Hero: Innocent; Scholar – Priest Narrative: Focused 2 // Implicit 4 // Ellisive 4 Narrator: Expansive 1 // Emotive 2 // Serious 1 // Engaged 1

John McLain Themes: trust in the Lord; The Man who went forth to learn fear… Talismans: “The Lord looks after me”; “I’m ready to go--my bags are packed”; “It’s not the size of the dog in the fight—it’s the size of the fight in the dog” Hero type: Warrior (spiritual); Innocent/ Servant Narrative: Focused 1// Explicit 1// Detailed 1 Narrator: Expansive 1// Detached 2// Serious- Humorous 3// Engaged-Resigned 3

Vickie Phillips Themes: power of friendship; ability to receive; Carnival humor Talismans: “I am not my cancer”: “I can laugh or I can cry and I just decided that I would run with the laughter part.” “I didn’t get a death sentence—I got a chance to live...” “We’re all on the same rock.” Hero type: Fool-trickster // Sage Narrative: Focused 1// Explicit 1// Detailed 2 Narrator: Expansive 1// Detached 2 // Humorous 2// Engaged 1

“The power in suffering to promote integrity is not only a Christian belief, it has been part of almost every religious tradition. Yet twenty years of working with people with cancer in settings of unimaginable loss and pain suggests that this may not be a teaching or a religious belief at all but rather some sort of natural law. That is, we might learn it not by divine revelation but simply through a careful and patient observation of the nature of the world. Suffering changes the life force, sometimes into anger, sometimes into blame and self- pity. Eventually it may show us the freedom of loving and serving life.” (118) --Rachel Naomi Remen, M.D. Kitchen Table Wisdom “The power in suffering to promote integrity is not only a Christian belief, it has been part of almost every religious tradition. Yet twenty years of working with people with cancer in settings of unimaginable loss and pain suggests that this may not be a teaching or a religious belief at all but rather some sort of natural law. That is, we might learn it not by divine revelation but simply through a careful and patient observation of the nature of the world. Suffering changes the life force, sometimes into anger, sometimes into blame and self- pity. Eventually it may show us the freedom of loving and serving life.” (118) --Rachel Naomi Remen, M.D. Kitchen Table Wisdom

“And where we had thought to find an abomination, we shall find a god; where we had thought to slay another, we shall slay ourselves; where we had thought to travel outward, we shall come to the center of our own existence; where we had thought to be alone, we shall be with all the world.”