When the fog lifts: a new perspective on chemo brain

fog brain

Image: Fibro Brain Fog T-Shirts

When I started to read Dan Barry’s “My brain on chemo: alive and alert“, in the New York Times, I thought at first I was in for a treatise on the side effects of chemotherapy – nausea, hair loss, fatigue and the lingering chemo brain. Indeed this two-times cancer survivor,  begins with a description of all these states, but he soon changes tack and begins to describe a very different type of chemo brain than the one we are used to reading or hearing about.

“And, I now think, chemo brain — but a form that seems to be the common definition’s opposite. My self-diagnosis is that I had a pre-existing case of fogginess that lifted during and immediately after my chemotherapy regimen: I suddenly experienced acute clarity. Then, as the effects and memory of chemotherapy faded, my confusion returned. Twice.

In 1999, before the diagnosis of cancer and the prognosis of let’s hope for the best, I was enveloped in the haze of the everyday. Rather than rejoicing in a loving wife, a daughter not yet 2, a job I enjoyed — in being, simply, 41 — I created felonies out of matters not worth a summons. Traffic jams. Work conflicts. No Vienna Fingers in the cupboard. Felonies all.”

And boy can I identify with this! DO sweat the small stuff was my default setting before my own cancer wake-up call.  Barry then goes on to describe in visceral detail his experience of chemotherapy until..”Gradually, from midsummer to late fall, the chemotherapy transformed me into a bald guy whose pallor was offset only by the hint of terror in his eyes. But the chemo also wiped away the muddle, revealing the world in all its mundane glory. I won’t tell you that I wept at the sight of a puppy. But I did linger over my sleeping daughter to watch her tiny chest rise and fall. I did savor the complexities of a simple olive. I did notice fireflies, those dancing night sparks I had long ago stopped seeing.”

“After the chemotherapy, radiation and a few weeks to allow things to settle down, as my doctor put it, I was declared “clean” in February 2000. Never again, I vowed, would I take these simple things for granted. I was blind, but now I see.”

Ah yes, another familiar fellow feeling there. I remember thinking just the very same thing and thinking how I had wasted so much of my precious time in the past sweating that small stuff. I too was a transformed person, no longer would I take things for granted – from now on I too would celebrate the everyday miracles. And I did!  Right up until the first week I returned to work and I sat in traffic watching the rain team down and fought for a parking space and faced a mountain of work in a unheated cramped office. Like Barry “The fog, of course, returned as the effects and memory of chemo faded…. How I hated traffic jams. And the Vienna Fingers! Who ate the last Vienna Finger?”

But the story didn’t end there for Barry. He was about to get another wake-up call. Cancer came a-knocking on his door again to teach him another lesson.

“Then, in the late spring of 2004, probably while I was railing about something eminently unimportant, my cancer impolitely returned. Once again I felt the frigid breath of mortality at my neck. I also felt like a fool. What is the use of surviving cancer if you don’t learn from it? Are improved by it? Am I so thick that I need to receive the life-is-precious message twice?

I returned to Sloan-Kettering for more chemotherapy and more of the same side effects — including my own manifestation of chemo brain. Fog lifted, world revealed.

After the chemotherapy came major surgery, which provided the exclamation point to whatever chemo was trying to tell me. Once again I was declared clean. And this time, by God! This time!

I became a walking platitude, telling friends without a trace of irony to live every day as though it were their last. Because, man, I’ve been there. And if I weren’t so repressed I’d give you a hug.

Slowly, insidiously, the fog of the everyday has returned to enshroud me. It came in wispy strips, a little more, then a little more, wrapping me like a mummy. Just the other day, in the car with my wife and my two daughters, I began railing about being stuck in a traffic jam.

Perspective, my wife said. Perspective.

I could not hear her. You see, I’m struggling with this pre-existing human condition.”

I love that Barry lets us know that it is ok to be human! We are imperfect human beings struggling with the human condition. Yes, we know that life is too precious to allow the small stuff to overwhelm us, but we are only human after all, and sometimes it does. The thing we need to remember is we always have that chance to become aware and then start again. Life is precious and we have been given this second chance – let’s seize it today.