“When in Doubt, Write the Truth” by Elana Miller, MD

Elana Miller, MD, ZenPsychiatry.com

Elana Miller, MD. Photo courtesy of ZenPsychiatry.com

Editor’s note: Today I have something special for Joyous Paradox readers. Elana Miller, MD, the psychiatrist whose gutsy and eloquent posts I read at her Zen Psychiatry blog, has given me permission to share her remarkable essay about her experiences with cancer, “When in Doubt, Write the Truth.” Elana was diagnosed just before Christmas 2013 with stage IV acute lymphoblastic lymphoma. She wrote about the shock of her diagnosis in a widely read post, “Love Is… (Holy Shit, I Have Cancer).”  

“Hey there,” Elana writes in the About Me page of her blog. “My name is Elana and I’m a psychiatrist based out of Los Angeles, California. I write, I surf, I meditate, and I play ukulele. Here are a few of the things I believe in:

  • Not settling for being ‘not sick,’ but instead pursuing optimum mental wellness.
  • Discovering joy and happiness in everyday life, even amidst chaos and stress.
  • Synthesizing Eastern perspectives on mindfulness and spirituality into the Western view of the mind and brain.
  • Integrating traditional psychiatrist treatments with complementary approaches.”

Telling the truth is one way of finding joy, even in hard times. Read on, and see what you think. — MAB

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I wasn’t going to write a post today.

Usually by the time Tuesday rolls around, I’ve had a burst or two of inspiration and have at least an inking of an idea of what to say. But this week… nothing. Oh sure, there were a few ideas. They felt insincere, though, so I let them go.

This morning I told myself, why stress about this? People will understand if I take a week off from the blog. I figured I’d say, briefly, that I was feeling sick and not up to writing. Then, I’d come back to it next week.

It wasn’t until tonight that I realized what was really going on. The problem wasn’t a lack of things to write about. The problem was that the truth was painful, and I didn’t want to tell you.

But, how could I go wrong by telling you the truth? There is a purity in the truth, a vulnerability, a rawness. When you tell the truth, no one can tell you you’re wrong (or, you can safely ignore the few who try). When you tell the truth, you build a foundation. When you project an image, you build a house of cards.

Oh, and the truth is not an excuse to smugly hide behind while you say careless and insensitive things to others (“But I was just being honest”). That’s called being a douchebag.

Anyway. So, I decided, when in doubt, when I don’t know what to write about, I will tell you the truth.

I just ask you one thing in return. If you can, just stay present with me for this story. There is no need to reassure me, to tell me everything is going to be alright, that everything happens for a reason, that this all will be over soon, that I’ll be a better person for it. Do you really know if these things are true any more than I do?

(Oh, and for the love of god, please don’t tell me to “Be positive!”)

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The truth is that I’m in a lot of pain. By early evening my body aches from the weight of the day. If I’ve had chemo or a shot of Neupogen, it’s much worse. I feel sicker on the days I have chemo, even before the infusion, as if my body knows what’s coming and wants to tell me, “No, thanks!” The pain meds help, but not as much as they used to.

I thought switching from inpatient to outpatient chemo would be a breeze, but I was wrong. I thought the worst was behind me, but it’s not. As my body gets weaker, and less able to recover, the side effects get worse. I try not to think of how much treatment I have left (nine months…), but it’s hard to forget.

I didn’t have any nausea before, but I have it now. Even when I’m not nauseated, I have no desire for food. I’m losing weight, and even my cancer pants are getting loose. (Definition of cancer pants: the fashionable, smaller-sized pants one buys after losing weight from cancer treatments because one looks like a hobo in her regular-sized pants).

I’m lonely. It’s not so exciting anymore that I have cancer.I see people around me returning to their normal lives, and I don’t get to. I wonder if maybe I have to walk this path alone. If I didn’t feel so sick, and therefore emotionally hypersensitive, I probably wouldn’t care as much as I do.

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This hypersensitivity is both a blessing and a curse, because I can now read the subtle differences in how people say, for example, “Let me know if there’s anything you need!”

Because I need so much, I can read when a person means it, and will be there for me in any way that is humanly possible. I can read when the words are said out of obligation, or carelessness, or because a person would like to think they’re generous but isn’t really thinking about what they’re saying and will artful dodge my requests when I follow up. The latter hurts more—a lot more—than if nothing was said in the first place.

I’m tired, all of the time. I used to shoot out of bed early in the morning, even on the weekends, excited about all the things I would do that day. Now, I wake up around 11, and spent most of my time on the couch, watching mindless TV. When I have more energy, I play Sudoku on my phone.

Don’t get me wrong—I’m not bored. I imagine boredom as feeling as if you have nothing to do. I have the opposite problem. I have so much I’d like to do, but I can’t do any of it.

I’m not quite sure why I’m telling you all this, other than I want you to know, and want to remind myself, that there is no shame in being in pain. It doesn’t always need to be fixed. It doesn’t always need to be corrected.

I know that people often try to reassure others in pain for the most well-intentioned reasons. We see another person suffering and it breaks our heart. We want to reach out and make it better. We want to say the “perfect” thing.

If you find yourself in this situation, let me offer an alternative. First, connect with what you’re feeling. What is happening in your body? What emotions are rising up? What thoughts are passing through your mind? Maybe you hate to see them suffer, or your heart goes out them, or you care so much that it hurts.

First, connect with your inner experience. Then, say something true.

When in doubt, speak the truth. When in doubt, write the truth.

– Elana Miller, MD

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Related Post: Staying Mindful While Facing Cancer: A Worksheet from Mindful Hub

You can read more posts by Elana Miller at her blog, Zen Psychiatry.

5 thoughts on ““When in Doubt, Write the Truth” by Elana Miller, MD

  1. When going through chemo life can become so small, no strength to do anything but be – mindfulness and living in the moment helped me. Just for that moment I was okay and small things like watching leaves being blown by the wind in a tree, or feeling the wind on my skin helped me get through it.

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