Big, important things are going on in the world, we all know that. Climate change, US politics, the situations in Gaza and Ukraine and Sudan (among many other places globally), the spread of misinformation, artificial intelligence. It all feels very overwhelming at times and I can feel helpless, wanting to do something but unsure what. More on that later. Amidst all of this angst, sometimes it's the small things that add up, literally. With the rising costs at the grocery store, I'm sure I'm not the only one trying to figure out which item is the best deal, but I feel like it's getting less obvious. Which brings me to the toilet paper math.

Are you, too, being bombarded with fundraisers at every turn?
Every kid, in every sport, activity and school seems to be selling something at this time of year. So far, I’ve bought a poinsettia, sausages, Christmas desserts, cheese, chocolate, lasagna, and a variety of raffle tickets. I don’t resent these purchases, having already lived the years of young kids in multiple activities, but the system never seems to change. I remember, as a teenager myself, doing endless fundraisers and bingos for my figure skating team. I remember, during my kids’ school years, doing an active trade with other parents: “I’ll take three gift cards for two packs of pepperettes.” “I’ll trade you ten rolls of gift wrap for five pizza kits.” In such cases, no money actually changed hands, making the entire process feel completely ridiculous. I understand, of course, that without fundraising, the costs of kids’ activities would not be manageable for many people, but surely that could be overcome differently, more efficiently, rather than staying the same for forty years?

Dear Bilbo Baggins,
 
I’m sorry, and I don’t wish to hurt your feelings, but I never wanted you. When I was diagnosed with rectal cancer, I was quoted a risk of 10-15% that an ileostomy** would be required, which seemed low enough not to be a concern. Then, at my pre-op appointment, they had set aside 45 minutes with the stoma nurse, to prepare me “just in case,” and I got an ominous feeling in my gut.
 
Waking after the six-hour surgery, I immediately felt the right side of my abdomen and there you were. At the time, you felt like the worst possible outcome, a nightmare, even though my cancer had been successfully removed and you would probably not be permanent. Who wants to poop on the outside of their body? Who wants to have a bag connected to their abdomen?

As I went through my last two cycles of chemotherapy, I looked forward to ringing the bell that hung on the wall of the oncology unit, signalling the end of treatment. I imagined shouting “Yee haw!” and going crazy with the bell rope. Maybe doing a little happy dance before an exhilarated final exit out of the unit, skipping like Dorothy down the yellow brick road.
In the days leading up to the end of treatment, however, I noticed I was tearing up each time I thought about ringing the bell. Hmmm. When the big moment came, I could barely smile for my photo before collapsing in tears that lasted for a couple of hours.

Two of the recent Spider-Man movies (Into the Spider-Verse and Across the Spider-Verse), as well as the critically acclaimed movie Everything Everywhere All at Once, depict the concept of multiple parallel universes (universi?), something that appeals to me recently. As I journey through the Chemotherapy Multiverse, where many people don’t know what to say to me, where I feel nauseous and fatigued, where all activities centre around a location to empty my ileostomy bag if required, I like to imagine another me, living a parallel life. Maybe she’s hard at work on her next book, training for a race, climbing a mountain. Maybe she’s found a new profession or is learning a new language. I’m not complaining—my treatments will hopefully add years to my life—but I do hope to exit the Chemotherapy Multiverse soon and re-enter the healthy one.
          One part of the current Multiverse is a tendency to flounder among what ifs.

I’ve become someone who naps. I napped before, but sporadically. Now that I’m on chemotherapy, my naps are as necessary as those of a frustrated toddler. I’ll do a 3 km walk (I used to run up to 10 km three times a week), or mow the lawn, or go and get groceries, and then I’ll hit the wall. This trend has made me think about napping patterns through our lives, and the different types of naps. Here are my top ten; which is your favourite?

Our lawn is beautiful this year…beautiful, that is, if you enjoy looking at dandelions.
 
To many, our lawn is a scourge, an eyesore in an otherwise lawn-manicured neighbourhood, and if you listen carefully, I’m pretty sure you can hear several elderly, retired neighbours tsking and sucking their teeth as they look out their windows and estimate how long it will take our dandelions to contaminate their pristine green carpets.  As an added bonus, we seem to have developed a healthy amount of forget-me-nots, plantain, and thistles.  Admittedly, I am not a huge fan of the thistles, Scottish connections notwithstanding, but the dandelions are growing on me (pun intended) as I learn more about the down sides of cosmetic pesticide use.

In the book Manifesting with Purpose (Friesen, Lowrance, Plancon, West 2023), the four authors discuss their experiences achieving individual desires through positive thinking, imagery, deliberate action, and affirmations. It’s an appealing premise, that we can control our futures in this way. Perhaps, we think, success is not just luck, or timing, or privilege, but a by-product of purposeful thoughts and intention. I’ve read articles in which sports psychologists guide their Olympic athletes through imagery–over and over–of a perfectly-executed race or performance, to increase the chance of success.
         There are two things that bother me about this generally appealing manifestation concept. First, of course not all the Olympic athletes win. Some get sick, or injured, fall at the start line, or simply have a bad performance. Does that mean they didn’t try hard enough to manifest their win? This line of thinking leads to the “who wants it most?” approach to success. More likely, there was a combination of factors that just didn’t go their way. Not everyone can win all the time.
          Second, what about the corollary, when bad things happen? Are those a product of manifestation also? Did I manifest my own illness?   

I’ll let you in on a secret: I don’t always pick up my dog’s poop.
I’m not the person leaving my pet’s giant turd in the middle of the sidewalk, or on your front lawn. In the woods, however, as long as the deed is done off the trail, I leave it alone. My excuse for this behaviour is the environment: the forest is full of scat of various kinds, and the volume of plastic required to pick up every doo-doo would be extensive. My dog produces 2-3 stools per day, which would add up to 730-1095 plastic bags going to landfill annually, to break down over forty years or however long it takes. In the woods, the organic matter is gone with the next rainfall. I was pretty satisfied with my plastic reduction strategy, until I got an ileostomy.

What word came to mind, seeing that title? Rude terms for female anatomy or sexual acts? Or did you know I was referring to cancer? As doctors, we’ve often tried to bury the c-word, falling back on terms like mass or tumour, trying to soften the blow, because as soon as the c-word is out there, assumptions are made: weight loss, baldness, chemotherapy, death. Sometimes patients don’t hear another word for the entire visit. Let’s take things one step at a time, I’ll say, let’s not jump right to wigs and caskets. The power of the c-word is particularly important to me currently, having received the diagnosis myself; my own rectal cancer is curable, yet I see the anxious impact of the c-word on myself and on others.
          How do we reduce the potency of a word?