Cardinal virtues, cancer and justice. It just is.

 

How often do we hear children say “that’s not fair!”  How many times have you asked why you or someone you consider a ‘good’ person was dealt the worst hand in this game called life?    The truth is…. life isn’t fair.  There’s little justice.  It just is.

Today’s reflection takes the cardinal virtue of justice – or it just is – as its theme. Buckle up, this could be interesting/thought-provoking/nonsense. Read and decide for yourselves.

Justice: Noun – just behaviour or treatment; the quality of being fair and reasonable.

Cancer doesn’t discriminate, it will happily strike the fittest, slimmest, most health conscious people if they’re genetically predisposed or exposed to certain environmental factors. The process of this disease is extremely complex.  Justice plays no part in cancer development, treatment or the long-term outlook. It just is and whichever hand we’re dealt, we have to make the best of it.  I could witter on about it forever; instead I’ll draw your attention to three points for contemplation – treatment, employment and family/friends.

Treatment:  We have a National Health Service in England. You might think it’s free; it isn’t. It’s partially funded by National Insurance contributions deducted from salaries at source. Most people also pay for prescription medicines, dental treatment, opticians and anything to do with hearing.  Cancer patients are exempt from prescription charges which seems fair and reasonable however we have to pay for dental work, sight and hearing aids in spite of the fact that some cancer treatments affect eyesight, damage hearing and teeth.

Another common misconception is that the NHS prescribes the most effective drugs, e.g. to manage side-effects. This is a fallacy.  The NHS prescribes on affordability; it often means cheap substitute drugs.  NHS administrators balancing the books assume this is OK because substitutes are designed to do broadly the same thing as their more effective (and expensive) counterparts.   However, cancer patients and medics will tell you substitute drugs don’t always work as well. They often cause unnecessary suffering and avoidable hospital admissions (that prove more costly than the more effective drugs), it’s more stressful for the patient and adds to the workload of our overstretched doctors and nurses.

Look at the words – unnecessary, avoidable, suffering, stressful and overstretched.  Now associate them with the justice – the quality of being fair and reasonable. It doesn’t make much sense does it?

In the US things are more confusing. I’d love £1 for every post I’ve read from someone fighting an insurer over the scans, medicines and follow-ups covered by their policy. The words fair and reasonable come to mind until I remember the mantra life isn’t fair.  I used to work in insurance; insurance companies want to make money, they don’t care that my US friends are fighting for their lives and need the best treatment to enable their survival (or provide a comfortable journey to the end of life).   Those without insurance are in an even more difficult situation; the most needy people treated in the poorest way by a civilised society.  Justice? No. It just is.

In low-resource countries the situation is desperate.  Fatality rates are highest in these countries because most have resource constraints that limit the capacity for detection, diagnosis and treatment.   In these countries women most commonly present with node positive locally advanced breast cancers; chemotherapy is required to treat them and often the underlying resources/infrastructure are absent.  When chemotherapy isn’t available these people only receive palliative care. Once again the poorest people are dealt the worst hand in the game. It doesn’t have to be this way; it just is.

Employment:  Scorchy over at The Sarcastic Boob wrote an excellent piece titled Professional Identity in Crisis.  Times have changed; for many women their careers are an integral part of their life so exclusion from the workplace for any reason (could be employer incompetence, failure to understand or appreciate what a person with cancer wants/needs during treatment, the effects of treatment itself or issues created by metastasis)  can have devastating consequences.  Continued social interaction during cancer treatment and the survival benefits of support networks at home, at work and in the community are well documented.  Eating healthily, avoiding processed foods and buying organic where possible is significantly more expensive than supermarket own brands.  Purchasing drugs that aren’t provided by the NHS or an insurer is very costly.  Work is important to the cancer patient for many reasons. Ultimately it’s important in a practical sense; cancer patients need money to live. Putting them on the bread-line or into the benefits system (where one exists) makes survival a thousand times more difficult.  Inducing stress by causing unnecessary worry is a proven route to metastasis!

Sadly too few employers understand cancer, too few seek to establish what the cancer patient wants to do and too few make adjustments that would enable the individual to balance work, treatment and the benefits that stable employment and sustained social contact can bring.   Too few employers think about the real issue a cancer patient is facing.

The real issue is life or death and I defy anyone facing the uncertainty of death to deny that compassion, just behaviour and treatment matters to them. It’s one of the only things that matter when everything else is sliding out of reach.

 Family and Friends:   Justice, family and friends is a conundrum.  Cancer is tough.  It’s tough on the patient but it’s equally tough on family and friends. They don’t have to go through treatment or side-effects but they share many of the same worries. Will the treatment work? Will the cancer come back? Will s/he die?   As with all traumatic life events some of us are better equipped for them others. It doesn’t mean some people are good while others are bad, we just have different approaches to difficult situations.

What many cancer patients need more than anything is a sense of certainty. Cancer throws everything up in the air and makes life very uncertain.  Family and friends are well-placed to generate certainty by remaining present, offering support, listening and providing a shoulder to cry on.    As the family or friend of a cancer patient, this can be difficult; fear isn’t reserved for the patient alone. Patients have no choice, they have to find a way around, over or through their fears.  Family and friends have more choices; they can choose to overcome their fears and be staunch supporters of the patient. Or they can be consumed by fear and chose to hide away.  I understand the second choice, fear and flight go hand-in-hand but I couldn’t do it myself.  I couldn’t abandon a family member or friend in need.  I understand some things look too hard, too painful and too frightening to endure and that might be true – but you don’t know for sure unless you try.

When family or friends decide it’s all too much, cancer patients have a variety of reactions. Sometimes they blame themselves for the impact they have on other people when dealing with a disease they didn’t ask for and have very little control over.  On occasion they may get angry and ask ‘how could s/he disappear at a time like this?’  Often they just get sad; the absence of dear ones who’ve been ever-present until cancer came a-calling is an emotional blow.

Fortunately I haven’t had this experience but many of my friends have and it’s hurt them deeply, far more deeply that the cancer itself.

Justice, treatment, employment, family and friends.  It’s not for me to tell other people how to behave but I pose a question – to health providers, insurers, administrators, employers, family members and friends….

Imagine you’ve been diagnosed with cancer.  Today, as you hear the words “you have cancer,” your whole world begins to fall apart.  Everything you thought you knew, all the plans you had, your hopes and dreams, they’ve all dissolved in front of your eyes.  You’ll feel this way tomorrow and the next day and the day after that.

It just is and you’re going to have to make the best of the hand you’ve been dealt.…. somehow.

So ask  yourself how you’ll assess justice, the quality of being fair and reasonable, when you can’t get the treatment/drugs you need, when your employer fails to understand the importance of your career or your need to work.  If that’s not enough, some of the people you hold so close to your heart just disappeared from your life in a flash.

Are you wondering what just happened to you? And what they hell you’re going to do about it?

Justice: a nice concept crying out for the practice of being fair and reasonable.

It just is.

 

Poker

Poker (Photo credit: maorix) Life isn’t fair so we have to play the hand we’re dealt.

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31 thoughts on “Cardinal virtues, cancer and justice. It just is.

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  6. Tracy, I’m glad that you mentioned what Cancer does to friends and family members trying to offer support. It’s hard on everyone involved. And what this post brings to mind most is that this world really needs to wake up and see that we can’t continue the cycle of half-baked justice. Yes, some things just happen with no rhyme or reason. How we handle them, well that’s a different story. Thought provoking as always. Happy New Year to you and yours! Keep that light shining in 2013 OK.

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    • Hello Glorious, it is very hard on friends and family, sometimes unbearably cruel. Often they get little or no support to deal with the emotional and psychological distress. I’d like to see a shift from half-baked justice to equality, true equality of for all. Humans have been around here for long enough to have learnt from the lessons of our forebears. I feel we have to stop repeating the mistakes of the past if we want to continue to evolve. I wish you and your dear ones much happiness for the New Year and beyond, good health and good spirits. I’ll be here, completing my climb thanks to your kindness and support 🙂

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      • Thank you for the New Year well wishes! I don’t know if you get tired of hearing this, but you really make me stop and think about some things. And they stay with me. You’re just being you and I’m honored to get some insight into your life albeit due to the big C. Whatever bit I do, I’m the one who’s grateful to be a support to you. You’re doing all the hard work…As for putting a dent in repeating mistakes, I think our hearts need to evolve beyond our intellect and technological advances.

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  9. Justice: Noun – just behaviour or treatment; the quality of being fair and reasonable

    What an excellent post Tracy. You have managed to provoke much thought regarding this simple idea, ‘that we should treat others with fairness, equality and lack of prejudice.’ Unfortunately, as you well know, this world isn’t driven by fairness and equality. It seems to me that, ‘in general,’ the world is driven by greed, averice and materialism. This applies not only to those suffering from cancer and other life threatening conditions, but also to those people who are just not as well equipt as others to survive challenging situations. Our glorious leaders keep telling is that we must ‘keep taking the medicine,’ even though it is distasteful, and that ‘we are all in it together.’ This attitude reminds me so much of ‘Animal Farm,’ where we are indeed ‘all equal’ and ‘all in it together’ but, some of us always seem to be either ‘more’ or ‘less’ equal than others. Life isn’t fair of just, it just is!
    Love always. Silverback

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    • I find prejudice a difficult concept. I know we’re all predisposed to preconceptions, biases and suspicions about anything or anyone who appears “different” in some way. But our behaviour is all a choice, it’s conscious not hard-wired. We don’t have to judge, be unfair, dish out inequality or be prejudiced. Sadly is seems Orwell had some all too accurate visions of the future, in Animal Farm and 1984. Reading these books in my early teens went some way towards the choices I make now, alongside excellent parenting that created a mind open to the concepts of goodwill, charity and compassion. You were wise beyond your years when raising Andrew and I; we cannot thank you enough for that or for the love our family shares xxx

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  10. Extremely thought provoking Tracy and an excellent post. I don’t know you personally, nor can I truly understand what you are going through as I have no first hand experience, but I certainly have gained a great deal of perspective from reading your posts. Thank you for everything.

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    • Thank you so much, for this comment which helps enormously in encouraging me to keep on writing – some days its easier than others. Thank you too for your continued support and for ‘being here.’ I hope we’ll have many happy years reading each others blogs 🙂

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  11. Thank you, Tracy, for helping us empathize with life changing events that just are. You are a true warrior-poet. Your insight into the very heart of life is a beacon for us all to examine our lives, our views, and our privileges. Thank you.

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    • At heart I’m a simple creature who wishes for a peaceful, simple life for myself, my loved ones and for the rest of our small and beautiful world. I know I run the risk of being labelled idealistic and many may say my wish is fatally flawed, but it won’t stop me trying to change things for the better in any way I can during the time I have available to make a difference 🙂

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    • Your post helped bind together a number of thoughts I’d had since entering cancer-world earlier this year. So I thank you for being the catalyst that brought this piece together for me. The Boob is great, keep on writing because we all learn from your insights.

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      • I have had the same experience, Tracy. One blog inspires another. It’s an amazing community and one which I overlooked completely until I started to blog myself. I’m glad I could help!

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  12. I agree too – this is a brilliant post. Such an interesting discussion of how justice sits with cancer. Nowhere near it, not in sight…………… This resonates very powerfully. I am sharing on my FB page (Feisty Blue Gecko). Big hugs to you. Philippa xoxox

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    • Thanks so much Philippa. I gave this quite a bit of thought because there’s so much that could be said. You’ve summed it up with ‘nowhere near it, not in sight….’ I love your blog and send you warmest wishes for a healthy, happy year ahead in 2013. xxx

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  13. Hi Tracy, I admire your strength, wisdom and sense of equanimity. I hope your treatments are going well. We’re here for you in spirit, wishing you perfect health in the New Year. Be well.

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    • Thank you so much. I’m doing OK, I won’t say it’s a walk in the park because it isn’t, but equally I know it could be much worse. The support I receive at FEC-THIS from my wonderful followers coupled with that of near and dear ones make such a big difference. I’m sure many more people with critical illnesses would thrive if they received as much love as I’m given. I’m lucky beyond words thanks to all of you.

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      • Thank you both, I thought about this a fair bit as I really could write about it forever. I tried to choose elements it seems many people with cancer come up against through no fault of their own. I feel we’re getting better at understanding the disease at a functional and mechanical level but much more education is required regarding the emotional and spiritual implications and how the behaviour of others can help or significantly hinder the progress and recovery of individuals with cancer.

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