Rus Articles Journal

To win against cancer. Stages of acceptance of an illness - about what doctors of

do not warn we Continue to publish fragments from Katerina Gordeeva`s book “To win against cancer“, become continuation of the television movie of the same name. The book included interview with the famous people who faced cancer, comments of doctors. In this chapter - fragments from Marina Pak`s diary, the doctor and at the same time the patient of oncologists, and also reminiscence Laima Vaykule how it came to acceptance of the illness.

From Marina Pak`s diary

August, 2010
Ya I lie on 20 - m the floor of huge hospital. From my bed to edge of a balcony - only several steps. Under it - Kashirskoye Highway, a constant steam of cars, dynamics of city life, fires... All this there below, and here... Especially hard in the evenings. The main thought which knocks at a temple: why to continue, all this does not make sense, everything is over, to correct nothing. In the stuffy August evening hardly - hardly I crawl to a handrail. It seems to me if I pull hard aboard a balcony now and I will be able to drag through it the body, then I will be able to finish everything and at once. I crawl to a handrail, but for bigger there are not enough forces. Hardly I come back, scramble back on a bed. Also I howl.

Then Marina learns

: that August, in the evenings, when the oldest daughter Sonya left mother`s chamber, she could not leave hospital for a long time, even to depart from it more, than on hundred meters. It seemed to it that mother can make something with herself. Sonya faced below, in a public garden an entrance to Oncology center, and looked at the burning windows of Kashirka, trying to make out the most important at that moment of the life a window, mother`s, trying to feel at distance how there mother? What does it do? What thinks of? What is afraid of? Sonya even learned from doctors whether there are no chambers without balcony. It was impossible to stay overnight in chamber in any way. And this time - - for a family was night the most disturbing. Marina`s condition did not improve, she became reserved. Any attempts of talk resulted in a bigger estrangement and even hostility. It seemed to them - she purposely does not hear them. It seemed to it - they will never be able to understand it.

August, 2010
Ya I understand

From Marina Pak`s diary that it is a sin, it is ugly how I will lie below, it will be a shame to children... But one night I wake up and I understand: there are no fear and shame any more. Now I am able to do it. I sit down on beds. I mentally make this way to a balcony further - down. I see myself there, below, and me it is not terrible. I force myself not to rise, remain wild effort of will on a bed. I force myself to think of children, I force myself to think of what feels sorry for them for me. That it is dishonest to leave them without me, one that children still need me that I am necessary to them - any. Even such what I am now... I meet by
With these thoughts dawn, still sitting on a bed. Still without understanding as I managed to stop myself, I call the priest.

the Priest arrived. There was a long and difficult conversation. That which had to occur in a similar situation. Up to the end, of course, did not release Marina. But conversation with attentive, listening, though the stranger, the person made the business. It was uttered. He listened to it and nodded. Spoke: “Everything that you feel, - it is normal, also other oncological patients so feel. A depression - it is normal too, and fear - is normal. The person can be afraid. You should not cease to love yourself and to protect the life even in this state...“

He said to

the correct, important, quiet and attentive things, those which were so necessary to it. The clever and sensitive priest rescued to Marin Pak the fact that he managed to become her psychologist unexpectedly. Thereby onkopsikhology which rate both was not and is not present in a scale of charges of the Russian Ministry of Health.

I remember

Ya this history when we with Marina come to Laima Vaykule`s concert. On surprising combination of circumstances, Laima is the favourite singer of Marina. Without knowing anything about her illness, Marina all life admired sense of style, voice and character of this woman. After I told Laima a story of Marinina disease, Laima invited her, the heroine now of our general project “Win Against Cancer“, to the concert. Huge concert hall “Russia“. There are no empty seats. A concert here - here will begin. And I suddenly speak to Marina:“ You watch how it is surprising: having reached to the bottom despair in the illness, Laima called the priest too. And it was on other side of the ocean“.

it is really difficult to believe

B when you are ill. An illness - it is absolutely identical on both sides of the ocean, in Northern and Southern hemispheres, in big and small families, at people with prosperity and below the poverty line. Material and geographical nuances influence comfort, household circumstances, tactics and quality of medical treatment. But inside at each oncological patient according to the same scenario the present drama of fight between despair and hope is developed. Here is how it is described by Laima Vaykule.

of Lyme Vaykule :“ The most terrible in cancer is not treatment, not chemistry and its terrible consequences, not pain and not nausea. The most terrible in cancer is a fear. And you with anybody cannot this fear divide. And it becomes stronger than you. You to anybody cannot talk about it. Though is not present, in the beginning I could speak about it with Andrey (the common-law husband of Laima Vaykule together with whom she lives more than twenty years. - Editor`s note). He was, perhaps, the only person with whom we together cried. And only he was allowed to my secret, to my trembling, to my sufferings, maybe, because it once in response to the next my hysterics that I cannot wait more for treatment and live in this feeling of fear, told:“ You do not worry if something goes not and to you it will become intolerable, we will get into the car, we will disperse - and we will drive in a wall, and everything, it will be one moment“.

She becomes silent. And I think that here now she, probably, imagines all that would not happen in her life if then they and would treat Andrey, having finished everything in a flash. But, it appears, she thinks absolutely of another: tries to restore step by step all changes of the state, all stages of despair. Wonderfully they will coincide with the classical scheme of adoption of the diagnosis by the oncological patient that it was developed by experts of the British hospice movement two decades ago. But about this scheme - later. Here - the real certificate, live memory of the former oncological sick Laima Vaykule.

of Lyme Vaykule :“ The first stage - very terrible. Perhaps, it in general the most terrible that ever in life happened to me: it when you go to bed and you clatter with teeth. Here then I am the first time when I was asked what book to bring me, told - the Bible because I did not know other answers. Until then I never not that did not read - even in hands, probably, held the Bible. I just respected religion from far away as all Soviet people. But here in that, the first, fear the Bible, I can tell absolutely surely it now, rescued me. Brought me the Bible, and it was my one and only consolation. I went to bed with the Bible, I fell asleep, strong holding it in hand.

A then woke up from a klatsaniye of teeth again. For fear. The bible for a while rescued, and the fear was all the same stronger.

the Second stage is hatred. To all who are healthy. I remember how all my musicians sat near me. And I sat aside. That is we as though sat next, but I was not near them. And they told something like that very ordinary: here it is necessary to buy the kid some boots... And I looked at them unseeing eyes and listened as if not I hear it, and some other person“.

Here it will stop. Will falter. Will begin to look for someone a look. Will think up that it should call. Will ask the assistant whether they are late for rehearsal of a concert. In a word, again, as the child, will try to think up one million occasions not to continue. And then itself will straighten out: “Yes that it I, already began, so it is necessary to tell“.

of Lyme Vaykule : “Katya, if to tell the truth, I hated them. I sat and with hatred thought:“ My God, well what boots! All this is so unimportant, all these boots, such nonsenses, such things unimportant absolutely! How it is possible to speak about it in general? I have a cancer, I die. Everything is over, and they speak about boots... “Yes, it was such wild, unknown to me mix of fear and loneliness until then. But I still am ashamed of that hatred“.

She is silent again. And I remember how people in Jurmala gossiped and even scribbled newspapers: “Lyme Vaykule`s star did not arrive to a funeral of the father, having preferred career in America“. In the head suddenly coincides: same there was also a moment of her illness. It turns out what it is not career? It is awkward to ask, but it is necessary to ask. And I ask. Distorts it.

of Lyme Vaykule :“ How they could write? What did they know about it? How people who are not devoted in this question at all can judge me? It is such tactlessness peculiar, actually, to journalists in our country.

Then I even did not tell

to mother about what is made to me the diagnosis. Nobody knew. Yes, so it happened that my father died when I had a radiation. And I really could not arrive to its funeral. At least because I physically was not able to do it. I remember how I called home and spoke to mother: “I have a record now, I cannot arrive“. And in a throat a lump. I do not understand still as I in general managed to say it, but it was necessary to hold on. Then hung up and, naturally, at once fell down with the grief and misfortune.

Yes, I heard that on a funeral I was condemned for the fact that I did not arrive. These people spoke: “Ah, well of course, she has Laima on the first place of a pit!“ And business was not in career at all. Just it there was a wish to be closed in the shell: I - separately, and all other, healthy, - separately. They live there, rejoice, gossip. And I here one - with the misfortune. And there was no wish to speak about it with anybody, and especially with any strangers for which to listen to your story - a profession.

Though if it is honest, doctors in America, in hospital, offered the psychologist. But I is proud refused: what it still it - the psychologist? We are Soviet, for us the psychologist is as humiliation. What we had psychologists? So, girlfriends, something happens - and will sit down to mill everything with the girlfriend. But cancer is not that history which can be discussed behind a coffee cup. And, of course, the psychologist whom they offered was necessary. Just I did not understand it“.

It any practicing onkopsikholog should know

. It is described in textbooks: cancer has no friends. There are just stages of acceptance of an illness. In principle, the doctor has to explain to the patient when and what he should face. Here is how in a traditional onkopsikhologiya it is accepted to describe five stages of acceptance of a fatal illness.

  1. of Denial. the Patient cannot believe that it is valid happened to it.
  2. Anger. Indignation of work of doctors, hatred to healthy people.
  3. Auction. Attempt to conclude the bargain with destiny. Patients think, let us assume, that they will recover if the coin falls an eagle.
  4. Depression. Despair and horror, loss of interest in life.
  5. Acceptance. “I lived an interesting and rich life. If I am fated to accept death, I will accept it adequately and in time“.

These five short points, actually, - a long way: five steps through which to step to the ordinary person moreover and bearing on itself illness freight, very hard.

almost I do not know

Ya or I know very few people who managed, having passed the first four steps, at once to appear on the fifth. And even those whom I know perhaps, too passed through denial, anger, the auction with destiny and a depression, but I at the same time was not present. By force of the character, will power or just in view of our infrequent meetings my friends covered this difficult way imperceptibly for me. But all admitted: there is no such will power and there is no such character that allows to accept an illness with possible death effortlessly. Another thing is that both the professional help, and support, and participation of relatives, native do acceptance of an illness more natural, less destructive for the personality, an emotional condition, sincere health of the oncological patient.

Ya I ask Laima how many as a result of months she carried out in the American clinic how many seconds, minutes, hours the illness pulled out from her life. How many it cost money? She smiles. And, having touched my hand, tears off a stream of questions.

of Lyme Vaykule :“ These are too different questions, Katya. It is impossible to answer them at one stroke. The simplest in this history - money. It is almost impossible to believe in it, but my rescue cost me twenty five dollars which I paid for an insurance. And my treatment cost several hundreds of thousands of dollars. The insurance worked. Very few bureaucracy was required: to confirm that my state does not allow me to leave that treatment needs to be begun immediately, in America. The clinic gave such confirmation. And I began to be treated immediately. It, of course, luck. Because today I understand that without money you were gone. In this sense I was lucky. For the rest - not really. Though, besides, how to tell?

? I think, no.

This last step in understanding of an illness does to

the person extremely open, ready to love: you appreciate mother, you appreciate the family, you appreciate every minute when you with them. Expression “the soul is open“ is even not absolutely exact expression. To tell more precisely, - you are learned to live on a gap, for all, and for yourself already on the last place. Here that I which began to hurt, that, the first, loved “I and only I“ - it remained there, in chamber of hospital. There was another I which did not see to itself the place at all on light where there are no all others, the love to which became meaning of life.

time problem Appears, however: you are not able to do something fluently, by the way any more. There is important every minute. And this minute is filled with improbable sense when you hold someone infinitely expensive by a hand. And this minute rings from tension when for any reason of this loved and native one is not present nearby: you badly talked or just parted on affairs and it is impossible to phone. And it seems to you the most important on light right now to hear its native voice“.

From the book “Win Against Cancer“