According to the Mayo Clinic, “The exact causes of cancer fatigue and how best to treat it aren't always clear.” The website then goes on to list possible causes from the cancer and/or the treatment. Not included in the list is the ongoing treatment for cancer is as much of a time-suck as a second unpaid job. When you already work 60 or more hours a week, you just never seem to be able to come up for air.
Like most people, the demands of living vary by the day or even hour. We stop everything to deal with the current crisis or claims on our time.
A typical day may look like this.
I struggle through the night, beating off the doubts and fears that a terminal diagnosis sends to disrupt sleep. Finally, morning arrives and somewhere between 4:30 AM and 5:30 AM, I let the dog out. She crawls into bed with me and snuggles close. If I’m lucky, I’ll catch a nap. If not, I’ll give up and try to get a head start. The day begins with coffee and a Neupogen injection before swallowing another Kytril and taking the dog for a walk. Time to check work email. Depending on the weather, I then exercise on the treadmill or outside. Getting ready for the day requires an annoying number of rests that slow me down.
I either walk or drive to the station, then catch the light rail to work. By the time I get to my office there are a stream of students waiting to see me even though it’s not official office hours. I triage problems in between getting ready to teach classes. After teaching, I try to squeeze in a sandwich in the scheduled break before official office hours. Mostly, my lunch goes uneaten until late afternoon. The nausea starts to creep back into my consciousness but I figure it will pass so I bypass the Kytril because it makes me feel even more tired.
I see students for academic advising, career advising or just being a shoulder to cry on. I listen to the hopes and dreams and tragic stories that exhilarate and tear at me. I hear the stories of childhood abuse, of rape, of heroin addiction. I try to calm difficult people. My body longs for me to put my head down for just five minutes but those breaks are rare.
There is always another student, another meeting, or another email. Some time after 6 PM, I’m ready to leave. I put on my coat and walk to the station in a dull fog of exhaustion. I stop to vomit because I should have taken a few minutes to take a Kytril.
I reverse the trip from the morning, get home, and take the dog for a walk while my husband rustles up some leftovers for dinner. But dinner is not the end of my day. I do the emergency cleaning, and then open my laptop. I have the next day to prepare for. There will be different students, different heartbreaking stories, different classes and different meetings. There will be research to read, data to analyze, and letters of reference and papers to write. Each event requires a different skill set and different preparation. In between, I can never find enough time to clean and cook, to spend time with my family, to read, and to connect with my friends on Twitter.
Once a week for two weeks out of every three, I make the 2-hour drive and present myself at the infusion center to have my day snatched away as nurses fill my veins with kytril, dexamethasone, gemzar and carboplatin. This cocktail is guaranteed to make me sick and tired but not guaranteed to improve my health. And again, two days later, the chemicals extract their real price on my body and time as I sit huddled on the couch with my laptop open, trying to make sense of the words that swirl on the page. The unique fatigue that accompanies chemotherapy closes my eyes without my permission and I lose another half-hour to a restless nap that came unbidden. Each moment the disease and treatment snatch from me is a moment that goes into my time debt that will paid out of time I would rather spend choosing my activity.
Always, time is the enemy. Fatigue is its indomitable weapon.