Erasing the Stigma of PTSD

I must have been about 16 when I first heard about PTSD. It was on an episode of Grey’s Anatomy, one of the very few storylines I still remember more than 10 years later.

Like so many other people, at first I was convinced that PTSD was something that happened to people in the armed forces, something that veterans suffered from. A mental health condition which, unlike depression or anxiety, would have very little chance of one day affecting me.

It took a few years for me to encounter it in another context. I remember reading that someone famous had suffered from it, and thinking ‘they haven’t been to war, that’s not it. They’re exaggerating’. As I got older, I realised how wrong I had been.

PTSD Can Affect Anyone

Post-traumatic stress disorder can affect anyone who has had a traumatic experience. And any situation that someone finds traumatic, even if it would not necessarily have been considered traumatic by someone else, can trigger post-traumatic stress disorder. An accident, childbirth, the loss of a loved one, assault, those are just a few examples of events that can lead to PTSD.

PTSD can happen at any time after a traumatic event. It usually starts within a few months, but it can sometimes take years to develop, even decades if memories have been buried deep.

The first time someone told me it sounded like I was suffering from PTSD, I shrugged it off. They were the words of a friend, in early summer 2020. I was only a few months out of surgery. Surely it was normal to feel anxious, to replay conversations in my mind, to see the same scenes over and over again, to be easily triggered, to have excessive emotions, to feel numb, to refuse to talk about my situation, to avoid places and people that reminded me of cancer. Surely, it would pass.

It did not pass.

In August, a psychologist told me they believed I could be suffering from PTSD. All the symptoms I described to them, my daily struggles, were consistent with an anxiety disorder, low mood, and trauma-related mental health conditions. Post-traumatic stress disorder was a likely culprit.

The Stuff of Nightmares

I will not get into the details of all the possible symptoms of PTSD – I am not medically trained, and there are so many resources online that can offer help and advice (I will link a couple of them at the end of this post). All I can talk about it my experience of trauma, the symptoms I have that are consistent with a diagnosis of PTSD, and how it affects me at the moment.

I have had regular flashbacks for months. Moments when I lose track of where I am, and find myself reliving parts of my cancer journey. I am irritable. For months, I felt completely numb. Now, I have all of the emotions, all of the time. I have insomnia. I live in fear that something bad is about to happen. I startle easily. I avoid places that remind me of cancer. I feel sick talking about my diagnosis. I get triggered by the smallest thing – a picture of an ultrasound or a letter from the GP in my letterbox. Smells, noises. Lights.

For the last few weeks, I have been dealing with one of the nastier symptoms of PTSD: nightmares. They happen every single night, at least once, sometimes three or four times.

I will wake up feeling panicky, exhausted, sweaty, terrified. Some of the nightmares are very clear – they are memories of the worst moments of the last few years that will play in my head, over and over again. So much that I feel lost. I feel like I am back in those horrendous months before surgery. I will be reliving hospital appointments, tests, results. Sometimes they are painfully close to reality, sometimes I get told my cancer is terminal. Sometimes I do not make it out of surgery. Sometimes I learn that someone I love is going through what I did, not me.

Some of the nightmares are only vaguely related to cancer, but feature hospitals, bad news and people getting hurt. They are disturbing, sometimes violent, they often end with me walking around aimlessly. I get lost in hospitals. I wait for hours in a waiting room that gets darker and darker.

Have you ever been terrified of closing your eyes? Have you ever cried of exhaustion, knowing at the same time that you would get no relief when sleep would take you? Have you ever been afraid of what your brain would make you go through when you needed a nap?

I fear sleep. Every night, I push back the time when I will actually go to bed, because I do not feel ready. I do not want to face the nightmares again. I do not want to wake up after a couple of hours, even more tired than when I went to bed, craving the thing I also want to avoid.

Each night, the cycles repeats. Fight sleep. Push back my bedtime to 10pm, 11pm, 12pm, 1am. Fall asleep, sometimes despite myself, sometimes with the lights on. And wake up, after a couple of hours, feeling absolutely spent, frustrated, heart racing and tears all over my face.

I think the most I have slept on a single night, in the last three weeks, has been about five hours. These days, it is closer to two or three hours a night.

And as a result, my symptoms during the day get worse. I am even more prone to tears, even more irritable, even more disconnected from reality. Even more likely to have an anxiety attack for the smallest thing.

I am tired.

We Are Not Alone

I know so many people with PTSD. Friends, family members, slight acquaintances. I have read about so many more people having it, living with it, trying to overcome it.

Our experiences are all so different, but they are all valid. Do not let anyone tell you you cannot have PTSD because your situation was not traumatic enough in their eyes. Do not let yourself think you cannot have PTSD because your trauma was somehow less than someone else’s.

Trauma is personal. Trauma is subjective. Trauma is welcome to pack its bags and go away.

Useful links:

https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/symptoms/

https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/about-ptsd/

https://www.ptsduk.org/

Family – The Burden of Genetics (I)

When I think about family, I usually think of people. A moving, imperfect circle, individuals all coming together, fighting, loving, arguing, hugging. People hanging out at big events, related by a multitude of ties, some unbreakable, some so thin they disappear over the years.

I always saw my family as this group of people, some with whom I had great relations, some I barely ever spoke to. I had never defined family based on whether we shared any blood, any DNA. Whether someone had married into the family or was on the same branch of the family tree never mattered to me.

Until one day, when it became all that mattered.

I was told early on, the day after my diagnosis, that there were two potential causes for my cancer. One was that it was random. Faulty hormones, bad karma, a variety of factors that could contribute to my developing womb cancer at a ridiculously young age. The other explanation would be genetics. There could be, running in my family, a genetic condition that had until then remained undetected, and my cancer could be one of the many manifestations of this genetic mutation. The overwhelming majority of womb cancers are random, and happen in individuals who have no family history of cancer. But a small percentage are due to various genetic conditions, and these cancers tend to appear much earlier. Because I was completely out of the usual age range for womb cancer, I was a candidate for genetic testing. It would not change the treatment plan, or the outcome of this particular cancer. But it had the potential to change everything else.

I was referred to a genetics specialist on the very day of my diagnosis. At the time, I did not realise how much that weighed on my shoulders. I was told it would take months for me to get an appointment, and that it would only be the start of my journey into genetics – if I decided I wanted to get tested, after discussing it with the specialist. I agreed to speaking to the geneticist without even thinking about it. Since it was going to take months, it was better to get started early.

Pretty soon, I received a bunch of forms to fill in about my family, about where each branch of my family came from, our ethnic background. I then had to fill in separate forms about each of my first and second-degree relatives. Names, dates of birth and medical history of my parents, brothers, grand-parents, aunts and uncles. Date and cause of death, where applicable. Any medical history that could be relevant: cancers, unexplained medical conditions, etc.

It was an incredible, uncomfortable amount of work. I had to ask each of my parents to quiz members of their respective family. My mum’s family was straightforward. No cancer in the immediate family, and no trace of it for generations. It is actually quite unsettling to realise that I am the first in four generations to get cancer. That seems terribly unfair.

We hit a hurdle as soon as I started filling out the information about my dad’s side of the family. We know very little about his father, and his life after he left his family when my dad was just a toddler. My dad has always refused to look into it, to get in touch, to renew the ties before his father died, back in the early 90s. He could have had cancer, and we might not have known about it.

My dad also had to ask his elderly siblings, two of which are currently battling their own advanced cancers, about any genetic testing they might have undergone. It must have been terribly taxing. I have rarely been so grateful to have someone to delegate some of this work to.

We filled in the forms, using all the sections allocated and then more – the form only allowed for three siblings for each generation, and my parents both come from much larger families. I had to add a few extra pages of names and data, before sealing the envelope and sending it off to Oxford.

As I was doing this work, I also started looking more in depth into what a genetic condition could mean. I did the very thing that the nurse had asked me not to do during our first appointment, and I went on an endless search for answers on the Internet.

I read pages and pages of information about potential genetic conditions, thinking and overthinking anything I knew about my family. My aunt is battling breast cancer – there are several genetic mutations that can cause both breast and gynaecological cancers in some families. My uncle is fighting pancreatic cancer – although there are many factors that could have contributed to his specific cancer, it is also one of the cancers associated with Lynch syndrome, which causes a predisposition to a wide range of cancers, including womb and colon cancer.

Because of these cancers on my dad’s side of the family, and the unknown threat of his own father’s family history, I had somehow convinced myself that the likelihood of a family genetic condition was pretty high. Doctors had told me that my cancer was more likely to be random. But they had also told me before that the chances of me having cancer at my age were almost non-existent. When you are one in a million, how can you then trust that your cancer will follow the most common path?

A genetic condition like Lynch syndrome would have meant that, even if I beat this womb cancer, I was at a much higher risk of developing other cancers in the near future, if it had not started already. My life would be very different. I was scared. I was terrified. For months, I analysed every single thing happening in my body, convinced that it was the sign of another cancer growing somewhere else in my body. More than once, I asked myself if it really was worth undergoing treatment, if I knew cancer was going to be a very real threat in the future. If it was only a matter of time. I will be honest. There were days where the possibility of being riddled with genetics conditions made me think of giving up altogether.

The one happy thought I had was that, if I did have a genetic condition, I would never pass it on to any children. It is bleak, when your one ray of hope is that your hysterectomy means you will never pass on faulty genes.

By agreeing to speak to a geneticist, I had agreed to open the door to an ocean of possibilities, each scarier than the next. I agreed on the basis that it is better to know in advance what you are about to face. I have said it before, I hate surprises. Undergoing genetic testing is pretty much as close to finding out about your future as is possible in this day and age.

In early December, as I was coming to terms with the delay in my operation, I received a letter from the genetics clinic, telling me I had an appointment scheduled for Friday, 14th February 2020. Well. I was not going to have a hot date on Valentine’s Day anyway, so I might as well have an appointment with a geneticist.

It felt so distant, so far in the future that I pushed it to the back of my mind for a while. I focused on the task at hand for the next couple of weeks: getting the surgery done. Everything else could take a backseat. But the moment I saw my brothers again when they came to visit at Christmas, a new threat jumped into my mind.

If a genetic condition was to be discovered, it would not only affect me. It would affect them. It would affect my parents. They would have to get tested. I would be the one triggering a series of reactions I had not foreseen. Was I ready for this? Were they?

All of a sudden, the threat of genetics became unbearable, and the guilt, the guilt I felt at the idea of being the one throwing my family into disarray was undescribable. I could not do that to them. My existence was putting theirs in danger. My medical history could unravel their lives.

Spoiler alert – it did not. But the feelings were there, for months. And they deserve a blog post of their own.

New Year, New Challenges

There are similarities in the way I rang in the new year those last two years. Same group of friends (minus a few members), same no-drinking policy, same hope for a better year ahead. Minor differences – this time we were in France and had a seemingly unlimited supply of face masks and hand sanitizer. We played games, ate too much and had a chilled, fun-filled evening.

But instead of the fireworks of 2020, 2021 started with a panic attack and hot, burning tears.

I had felt them coming. I had had a few scary moments throughout the evening, moments where I lost touch with reality and slipped into my own mind. Moments when, unable to cope with two many conversations around me (and there were still only six of us), I retreated back into myself, into the mind that used to be my refuge, but has since become booby-trapped with dangerous thoughts.

After a year spent mostly in isolation, I had no idea how I would react to being around people constantly. Over the last three weeks, as I got reacquainted with my family and friends, it proved a challenge.

How do you talk to people who know of your vulnerability, but have not experienced it, witnessed it first-hand? How do you broach an entire year of physical and mental struggles with people who have only known you at your best, healthy self?

As usual, I pretended everything was fine. Most people are comfortable with that, that is what they are expecting. Most of my friends did not ask any follow-up questions. I managed to see both my parents and only mention the word ‘cancer’ a handful of times at most. They were not interested, they were avoiding the subject. It probably made them more comfortable to ignore the issue, so I pretended to do the same.

My mental health struggles, I was not able to hide as well. I felt down at times, which my friends noticed. I realised that confrontation, arguments and aggressive debates automatically sent me into a panic spiral. I cannot deal with conflict anymore – and in a family setting, conflict is sure to arise at some point, particularly if my brothers get started on politics. I guess I needed to experience it to learn of my new limits. I was given plenty of opportunities to test them, and I did not disappoint. Or rather, I did.

Big personalities make me feel small and inadequate. I used to be like that, and now I feel invisible. I no longer have the strength to battle for what I think, so I disappear in group conversations.

I do not want to disappear, but I also constantly feel like I am not enough. Like I am a hindrance, rather than a help. Like I am imposing myself on others, just by being there, by taking up space, quietly, without contributing much. I feel like I am a bother, like people do not want or need me around.

I struggle to make decisions. Weirdly enough, it does not affect me much at work, in a setting where I know I have to make calls as part of my job. But choosing between five different types of tea, what room I want to sleep in, or deciding what music we should listen to, all of that sends me into a panic.

It all culminated at New Year’s. Too many people around, too many different things to pay attention to, too many small decisions – where do you want to sit, what do you want to drink, which conversation do you want to listen to, too many things to look at and people to smile at. I could not keep the pretense long enough and I crumbled.

There were so many thoughts in my head at midnight. How everyone was hoping for a better year, even if quietly and without much confidence it would happen. I find it difficult to hope, to think about the future, which is what New Year is about. Closing the door on a terrible year, and leaping into a new, unknown one. To me, that sounds terrifying. 365 more days, and any one of them could bring terrible news and things.

Seeing people around me being happy is hard – it reminds me of how much I have changed, how I used to be one of them. It draws me into a downward spiral – I feel guilty about being down, about not being able to enjoy a few hours with my friends when I have the opportunity. My guilt transforms into shame, into self-hatred. Panic and tears settle in.

When it finally happened, just after midnight, it was not pretty. I withdrew into a dark room and let my tears flow, my breathing returning to normal after a good twenty minutes. It was my first panic attack of 2021, but I already know it will not be the last.

Last year, my only New Year resolution was to beat cancer. It was a worrying time, but the goal was clear, and could be achieved with medical procedures and treatment. This year, I do not have any resolutions, but I have challenges I want to reach and win. Feeling more confident. Achieving things and enjoying small victories. Letting go of the guilt. Allowing myself to shine and be myself, proudly and unapologetically. Having fun, saying goodbye to doubts and worries, and not being afraid to be happy.

Letting Go

I have always been obsessed with the idea of keeping it together. Finding a way to keep moving forward, even when it hurts, even when it means pretending. Focusing on things I can control, instead of delving into my issues and trying to solve them. Saving face, again and again.

Last week, for only the second time since my diagnosis, I let go. Did I forget that I was supposed to pretend? Did I not have the energy to hold back the feelings, to glue together whatever pieces of me were still whole?

The surge of feelings after my hospital appointment was both expected and unexpectedly violent. The whole experience was incredibly brutal.

First came the panic attacks the minute I set foot in the hospital. I was holding it together until then, but then I broke down. Teary, barely able to think, speaking in a whispery, soft voice that is very uncharacteristic of me, breathing hard but hardly breathing, the whole shebang. But a panic attack for me is not about letting go, it is not about losing control of your feelings. It is a sign of my body being unable to cope with a situation, and reacting physically, automatically, to what my brain cannot cope with. 

After I got home that evening, after I wrote to my friends to tell them everything was fine, after I posted here about my relief at being cancer-free, I finally let go and gave in to my feelings.

In a rare display of true emotion, only exacerbated by sheer exhaustion and the now familiar migraine that comes after panic attacks, I spent hours that night crying. I am not sure what I cried about. Relief. Fear. Anger. Acceptance. Loss. I let my feelings overcome me and tear at my carefully-crafted armour of false-strength.

And for two days, I could barely move. I was paralysed by my feelings. I felt sick, I felt useless, I struggled to even open my eyes. The only other time I can remember feeling so overcome with feelings was after the cancelled operation. I let my feelings wash over me, and take control of what happened to my body. I lay in bed, under the covers, with a pile of tissues and a box of painkillers at my side. I alternated between crying, drifting off to sleep for short, restless periods, and feeling sorry for myself. Feeling angry at myself.

Since October 2019 and the diagnosis, I had not taken a single sick day for cancer reasons that was not related to either a doctor’s appointment or the surgery. I came in the day of my diagnosis, and the day after. I came back from sick leave after surgery a week early. But last week, just like the week after they cancelled the operation in early December last year, it finally became too much. I had no energy. I had no brainpower. All I had were feelings a year in the making, an unrelenting migraine, and a week’s worth of insomnia.

So I let go. I let my feelings take over my body and my brain, and I stopped pretending, for two blessed days, that I was fine. I gave in. I knew my feelings and self-pity had an expiration date – I was travelling back to France at the weekend and needed to be back up on my feet by then.

Did it feel liberating? In a way. Because I did not go to work, I did not have to pretend to be ok. I did not have to repress my feelings and put up a brave front. I was unapologetically broken, and I was honest.

For two days, I did not make myself do anything I did not fancy. I did not eat. I drank lots of tea, I went for a couple of walks, I avoided people and listened to Christmas music. I cried for hours, in the comfort of my own bed, under the stream of the shower, in the woods at the edge of the park. I let go.

But there, at the back of my mind, were still uncomfortable feelings. Guilt, for taking days off when work was busy. For having the privilege to do so, when so many people cannot afford that. Uneasiness, for making people uncomfortable when telling them what was wrong. Anger, anger at myself for not being strong enough to keep pretending and live a normal life. Shame at not being a functional human being. Shame, shame, shame.

Two days. That is how long I allowed myself to let go for. And then I picked up the pieces of myself and put them in a suitcase and a backpack, and dragged them over the border to France.

If I Be Weak

This is how the chorus of one of my favourite songs goes: ‘If you be weak / Then I’ll be strong / When the night is long’. Later on comes the counterpart: ‘If I be weak / Won’t you be strong / When the night is long.’*

I used to listen to that song a lot, back in my late teens and early twenties. I listened to it with the arrogance of youth. I did not understand how someone could be both strong and weak at the same time. In my head, I was and would always strive to be strong, to be the one comforting everyone else. I was able to carry the weight of the world on my shoulders. I liked to pretend that the second chorus, that question about whether someone else would be there if I broke down, did not exist.

I had very old-fashioned ideas about what strength was. For me, strength had always meant not showing vulnerability, being reliable, being able to prove myself, rising to the challenges thrown my way without ever admitting how much effort it took. I spent years and years trying to prove I could do everything by myself. Being strong meant doing everything, and doing it well. I am highly competitive, and I have always strived to be the best at everything I did – giving up things that I enjoyed but had no natural talent for because I would not ‘win’, be it against myself or someone else.

I have spent the last thirteen months (happy thirteen-month anniversary to me – officially my third-longest relationship ever!) constantly oscillating between wanting to show how strong I am, how I am keeping it all together, and wanting to break down, to admit that I am weak and need other people to help me stand. It is a real balancing act. I want people to see me as someone strong, secure, reliable. But I also want them to see the cracks and acknowledge they exist, even if it makes them uncomfortable.

Some people acknowledge this weakness. It is the only thing they see. I had that revelation just a couple of weeks ago, when I received a letter from the GP advising me to call and schedule an appointment to receive the flu vaccine. I had received another one a couple of weeks earlier and ignored it – not on purpose. I simply forgot about it, because of how ludicrous it felt. After all, I am 28. I have never struggled with the flu – I get it every couple of years, spend a couple of days in bed with a fever, and have aches and a bad cough for a week. And that is it. Why would I need to have the flu vaccine? Surely other, weaker people could benefit from it more.

And then it hit me. Doctors see me as a person who is at higher risk. In their eyes, I am one of those weaker individuals. I need to be protected, to avoid adding to the numbers of hospitalisations over the winter months. I am not a normal 28-year-old anymore. I am different than I was eighteen months ago, when I was a healthy individual, for all intents and purposes. (Well, it is either that or the NHS spent so much money on getting me cured of cancer, they would be pretty pissed off if I then died of the flu) And so I booked an appointment at the GP, and I finally got my flu shot. My arm has only just stopped hurting. 

But that is just one point of view, the one of health professionals who know one aspect of my life only: the one where my body has let me down. Not everyone sees things that way.

The thing that makes me the most uncomfortable is hearing people tell me how strong I am. Of course, it is a perfectly standard, commonplace thing to say to people who have had cancer. If you have ever said it to me, please do not feel bad, do not feel like you did something wrong. I have said it to many people in similar situations. I will probably say it to others in the future. But it makes me cringe every time, and I want to be open about it.

Hearing that feels both like a compliment and a slap in the face, a duality which is exacerbated by the fact that I am responsible for people thinking of me that way. After all, I am the one trying to project that image, and still I am the one cringing when people recognise it, I am the one feeling sick, like I have been telling a lie that people believe. To quote a phrase that I have been using in every blog post so far – it makes no sense. I am happy to hear that people feel that way, see me that way. It makes me proud, it makes me feel like I am not as much of a failure as I feel most days. But it also hurts, because it feels as if they do not see how much I am struggling. They are ignoring my pain, ignoring the fact I was not cured with a simple snip of the scalpel, that it does much deeper than that. It feels like they will not allow me to be weak, they will not allow me to tell them I am not coping. Instead, I feel like I need to keep pretending, again and again. Keeping up appearances, forever.

But it is ok to be weak. It is normal. It does not mean I cannot be relied upon.

I remember when I first told my team at work. There were tears, there were words of support. But over the next days and weeks, I realised they had started avoiding telling me about their problems. They wanted to spare me. They wanted me to focus on my own issues, they felt like their work wobbles, their doubts, their personal troubles were somehow less relevant now. But it was not the case. I still want to be able to help and support everyone. My team need me. My family need me. My little brother needs my shoulder to cry on, he needs my enthusiasm, my support, my help to prop him up during a difficult time in his own life. It is a struggle, because I only have so much energy and emotional capacity, but I like it. I like knowing I will be there when they need me. ‘If you be weak, then I’ll be strong / When the night is long’

It is very contradictory. I do not want people to treat me differently because of cancer, but I also do. When I let people in, when I tell them about the last year, it is not because I somehow want them to feel bad for me. I do not want, I do not need their pity. What I need is for them to understand that, despite everything I show the world, I am also weak, and I need them to be strong for me. I need shoulders to cry on too. I need support. I need to be allowed to be weak. I need to know I can let go, and that things will not fall apart when I do. I am a broken vase that has been hastily put back together. I am vulnerable, but I still hold my shape. I need you to be there, super glue in hand, for the next time a crack opens up, and water starts pouring out. ‘If I be weak / Won’t you be strong / When the night is long’

*Armistice by Patrick Wolf. A masterpiece that has been playing on repeat on my phone and in my head since 2011.

One Step Forward, Two Steps Back

Getting better. That has basically been my only goal since I first received my diagnosis last year. Everything else, life, friends, relationships, work, the future, it all took a step back, to allow me to focus on this one thing. Getting better is the aim, after all.

I always pictured my experience as a hurdle that I would need to pass. After that, life would start again, it would go on, I would be on a clear path to getting better and back to normal.

But as time goes by, and I start having first-year anniversaries of all the significant milestones of my diagnosis and treatment, I realise that getting better is not a straight line. It is full of curves, of hills that I thought I could not reach until I conquered them, of slopes that are too steep, too fast for me to go down safely. It is not an easy path.

There have been milestones throughout the year. So many moment where I thought ‘I have done this, now I will be fine’, only to reach a new low after a few weeks.

There was the operation, on 19th December. The day they told me the cancer was confirmed as Grade 1, Stage 1a, and no further treatment would be needed, on 13th January. The day I was prescribed hormone replacement therapy, on 26th February. The day I received a letter telling me there was no sign of a genetic mutation, sometime in late spring. The day after my first in-person follow-up, on 28th August. On those days, I felt relieved. I reached a new high each time. I felt like nothing could touch me. Depending on the appointments, I had been reassured that I was doing ok physically, or at least that things would start looking up.

But because there are highs, there are lows too. And every time I feel great, I know now that it is not going to last. That no matter what I do, there will be a point where I feel anxious, where I feel low, where I feel down again.

It can be overwhelming, this feeling that whatever you do, there is no progress. I am stalling. I am wary of even thinking things are fine, because I know there will come a time, pretty soon, where I will struggle again. I am afraid of getting my hopes up, because I fall harder every time.

I am at that point again, two months after my latest check-up, and a month before the next one, where I start panicking again at the thought that something might be physically wrong with me. That the cancer is back. I have nightmares about it. I wake up thinking about it. I go about my day, and I think about it every minute. I try to go to sleep, telling myself that I am another day closer to receiving bad news again. It is completely irrational. I know the chances of it happening are very low, but I cannot control it. I have tried CBT, I still try and undo this negative thinking pattern, but it all-consuming.

I feel anxious, and I feel low. Because so much of my energy is focused on this, I feel tired all the time. I feel unmotivated. I do not have the energy to do anything. I try reading a book, and I have to give up after two pages, my brain will not let me focus on it. I will watch a film and switch after ten minutes.

I feel all the emotions, all at the same time. I feel sad. I am downhearted. I feel angry. I am frustrated. I cry. I am mad, and I slam on my keyboard. I swear at myself, I swear at clients, I swear at my friends – but only in my head, and in my flat.

What I thought helped does not anymore. I thought that yoga helped me relax, and now I just cry at the idea of lying down on my mat. I thought medication was working, but I feel worse than I did weeks ago. I started doing crafts again and thought I had found my focus again, but I have to force myself to pick up my knitting needles at the moment. I thought that writing had really helped, that it had allowed me to put words on my feelings, that I was seeing the light again, only to realise that I have taken a huge step backwards, and I am now back where I was six weeks ago.

It is disheartening. I keep feeling like things are looking up, only to be disappointed again. Disappointed in myself, both for letting myself feel like this and having had the hope to think that maybe, it would not be the case this time.

It is a pattern I will have to get used to. Triggers that I will need to identify, and can prevent before I fall into a downward spiral again. What started it this time? I cannot pinpoint a single factor. There are a multitude of reasons, some more personal than others. Cancer anxiety. Family issues. Politics. Workload. Lockdown. Worry about not being able to finally go home at Christmas, and see the family and friends I have not seen for over a year. Watching my friends achieving things, reaching their goals, whilst I am still here, stuck in my post-cancer rut, unable to move on.

Thirty days until my next appointment. I know that if everything goes well, a new high point awaits me on the other side. And it is higher, better, deeper each time. I will feel happy again. I will feel like I am back to normal again. But if you are looking for me in the meantime, I will be hiding under a blanket with a Christmas-scented candle burning next to me.

The Language of Trauma

I was a very late bloomer when it came to talking. If you believe my mum, I did not start speaking until I was almost three. I apparently had too many other things to do, like climbing fences to jump into pools and running away on supermarket car parks (both of which happened on several separate occasions). Clearly, words were not my priority back then.

French is my first language, and for almost nine years, it was the only language I could speak. In my second-to-last year of primary school, I was given the option to start learning a foreign language. It was the first time they were going to offer to teach languages to our year – up until then, only pupils in their last year of primary school had been allowed to learn a language. I was very excited – my older brother, who is two years older than me but was only a year ahead in school, would be starting at the same time. I have always been very competitive, and I loved the idea that there would be one thing in which we would both be at the same level. We did not have much choice, our school only offered English and German. My brother picked English. Because I was a very contrary child, and I had heard that German was much harder to learn, I chose German. Twenty years later, I still cannot resist a challenge.

I loved German lessons that first year. Because so few of us had chosen German (English was the overwhelmingly popular choice), we were all together, last-year pupils and younger ones like me. I was having lessons with some of my brother’s friends, and I felt like I had finally reached his level. To be honest, I had even surpassed him – German was harder, so I had basically won. I loved German, but my parents were pushing me to switch to English, as they believe it would be much more useful.

At the end of that first year, I made the choice to quit German and start English instead. That would mean that I would be behind the other pupils when school started again in September – they already had one year of English under their belt, and I did not.

I do not know if I had a gift for languages back then or if it was my competitive spirit shining again, but after a few months, my level of English matched the ones of my friends. By the end of the year, I had won the English language challenge set by the school, and was given my very first French/English dictionary as a prize. I put it on a bookshelf at home, and did not pick it up again for years.

In secondary school France, you usually study only one foreign language for the first two years, and then start a second foreign language in your third year. The secondary school I went to offered to study two foreign languages (English and German) from your first year – it was part of a short-lived attempt at getting more French people to study German. My brother had only studied English (with the aim of picking up Spanish in his third year), so I obviously decided I would outdo him and join the double-language course.

For years, my German and English were pretty much on par with each other. When we had to declare a ‘main’ foreign language, I chose English, encouraged by my parents. I liked English classes, but it was not until my first year of the equivalent of sixth form that I truly fell in love with it. I had an amazing teacher that year, who was in his very first year of teaching English. He had a passion for the language, and for making us read and write, instead of asking us to learn grammar and lists upon lists of words. I started reading in English, first books and then way too many Harry Potter fanfictions.

That year, I decided that, despite having chosen a science-laden course in sixth form, I wanted to pursue arts and literature at uni, and more specifically English (by that time, my German had become much weaker). After graduating, I chose a language course and, one thing leading to another, I ended up with a master’s degree in translation, with a very marked preference for English.

Two days after my course ended, I moved to the UK and started my new job within a week. Since then, my English has improved a lot (at least I would like to think so), and has replaced French as the language I am most comfortable in.

I do not consider myself bilingual. I think you can only be truly bilingual if you grow up surrounded by two languages, and learn to use them at the same time, so you have similar relationships with both languages. I grew up learning French and for year, English was a language that only applied to specific contexts, like classes, work and dissertations.

I started dreaming in English halfway through uni, but it was always in dreams with an English background. I would dream of something happening in the UK, or in English class, etc. It was not until a couple of years after I moved to the UK that English became the language that I think in. When I talk to myself (and trust me, that happens a lot), it is now usually in English. I swear in English, I cry in English, I work in English. I read almost exclusively in English, I watch TV in English. I cannot remember the last time I read the news in a language that was not English.

As the years went by, I started struggling more and more with French. Phrases, specific words, I keep forgetting them. They sound foreign to me. My phrasing is ridiculous – I use English sentence construction and just use French words instead of thinking of the actual French phrasing. I speak proper French in two contexts: when I speak to my parents, and when I work with French clients (although I still have to double check what I write to make sure I have not used any English).

I am lucky enough that most of my friends from back home are fluent in English, and do not mind me using a mix of French and English when talking and writing to them. To be honest, I switch between the two depending on what comes naturally at the time. I will often start a sentence in French, and finish in English. I will use English words in the middle of a French sentence, and will react in English to their French messages.

I sometimes struggle to identify the language I am reading in, or confirm whether I just used French and English. Honestly, it is not great when part of my job is identifying source languages in documents my clients send. I will confidently start working on scheduling a French to English translation, only to have the translator ask me to confirm what I need, since the source text is already in English. Sorry, my bad.

My English is not perfect, but it has become the language of my daily life.

What I never imagined that there would be things I would only ever be able express in English.

I have been asked about my decision to write this blog in English. Was it a conscious decision, was it done in order to increase readership, to give it a better chance of becoming viral? Absolutely not.

English has clearly become the only language in which I can think of my experience, and the only language where I can express my feelings.

There is a reasonable explanation for it. After all, I got my diagnosis in the UK, all my consultations were conducted in English, all my phone calls and appointments were in English. The words the doctors used, I only knew them in English at first. Everything was explained to me in English. Everything made sense – as much as a cancer diagnosis at 27 can make sense – in English.

I never had any issues understanding what the doctors were saying in English. My issue was communicating the same in French.

I struggled speaking to my parents about it, struggled to explain what was happening. The details, but also the bigger picture. I had to look up words in the dictionary, I had to read medical articles in French in order to find the French way of saying what was happening to me. It was not easy. They tell you you should avoid googling your condition too much, that it is only going to add to your anxiety. But I had no choice. I had to do it, in order to be able to tell my family about it.

As a result, I know everything there is to know about womb cancer in both languages. It does not mean I feel comfortable talking about it in French.

A few months ago, a friend made me realise that, even though I spoke to them in a mix of French and English most of the time, I automatically switched to English only whenever I spoke about cancer.

In my head, it is very clear – cancer happened in English. The language of my trauma is English. Is that a way to detach myself from it?

I am very much of the opinion that I have two very different personalities. French Lauriane is self-conscious. She can be moody, tough and sarcastic. She had to tell people ‘that’s just my face’ when they ask her if she is mad. She is pessimistic, she does not play well with others. English Lauriane is more confident. She is more resilient, she has been through a lot, but she is also more open. She is bubbly. She is invested. She says please and thank you. She will smile and give you a hug if you need one. French Lauriane would run away.

It is quite common amongst people who speak several languages. For me, I believe it is also related that there was a clear cut between my life in France, as a child, as a teen, as a student. The moment I moved to the UK, the moment English became my main language was when I became a proper adult.

Because I have these two identities and they are very separate in my mind, I feel like cancer only affected a part of me. It struck English Lauriane, but she can take it. She is positive, she can get through a lot. She has learnt to deal with it. The French part of me was always here, in the background, but separate. Detached. It was not her language, it did not feel as real. A part of me is safe from it, protected by the language barrier.

Whenever I think about cancer, I think in English. I have flashbacks in English. I have panic attacks in English.

I did not realise how obvious that was for a long time. I was speaking about my mental health struggles with a friend, who mentioned finding a French-speaking therapist in the UK. And immediately, my reaction was to say no. If I ever was to share my burden with someone, to find a way to deal with it, it would be in English. The part of me that is broken is the part that speaks English.

But that is also the part of me that feels strong enough to get over it. The only part of me that can express feelings. I have never said ‘I love you’ in French. I have never said ‘I am scared’ in French. I have never said ‘But what if I die?’ in French. Do I feel comfortable doing it in English? Absolutely not. But I have.

Would I technically be able to speak about it in French? Do I have the words for it? They do not come naturally. French might be my first language, but my fingers do not fly across the keyboard as fast when I write in French. I feel free writing in English. There may be mistakes, there may be typos, but it is the language in which I can talk about fear, about depression, about anxiety. Feelings are stronger in English, and they are bubbling inside me, waiting to be put on paper.

There is a story I like to tell. It is about the operation, but it is a fun one.

For weeks before the operation, I joked with friends about not knowing what language I would speak when I came to, when I woke up from the general anaesthesia. You know, these stories about people who have been in horrible accidents, who wake up and have forgotten their first language entirely, or suddenly speak Chinese despite never having studied it? I laughed and told my friends my mum might need to call them to understand what I was saying, if I ended up only able to speak English. Or maybe, I would only speak French, and the doctors and nurses would try and explain things and I would blink in confusion and have to request an interpreter (good thing I have contacts in the business!).

I do not remember much from the first few minutes after I woke up, but I remember my mum looking at me and questions which I answered with confidence, only to see a puzzled look on her face. Apparently, I woke up speaking English, and it took more than half an hour for me to start speaking French. I understood what my mum was saying perfectly, but the words coming out of my mouth were in English and I could not articulate them in French.

Is it a coping mechanism, a barrier that I have built in my mind, which I will ultimately need to take down in order to make peace with what happened? Was it a safe place for me to store my experience, whilst protecting a part of me from the truth? Will I ever be able to express myself in French?

English is the language of my experience, it is the language of my cancer, the language of my trauma. But it is also the language of my hopes and dreams.

My Cancer, My Rules

Something happened today.

It was nothing major. It was nothing that had not happened before. But it is something that always makes me terribly uncomfortable, that makes me want to run home and hide under a blanket for a couple of hours.

As a result of my cancer and the surgery, my body is no longer producing the hormones that are essential to women under the normal age of the menopause. Because I was so young when my cancer was caught, and because it was diagnosed at such an early stage, I was prescribed hormone replacement therapy (HRT). Most women who have had endometrial cancer will not be given HRT, as oestrogen can increase the risk of recurrence in many hormone-driven cancers. In my case though, the benefits of taking HRT would far outweigh the risks, so I was offered to start treatment back in February. Since the start of the pandemic, that has meant monthly calls to the GP, who renews my prescription over the phone, and trips to the pharmacy to collect it. I will need to keep that up until I am 51, the average age where a woman reaches menopause naturally in the UK. That is a mere 23 years of treatment.

I am terrible at renewing prescriptions, so I have dozens of alarms on my phone. I miss them, I snooze them, I end up asking friends to remind me to re-order my prescription. It is not time-consuming – usually a 5-minute phone call to the GP and a 3-minute visit to the pharmacy do the trick. Sometimes though, it gets exhausting.

When I rang the GP last week, asking to renew my prescription, the receptionist asked me what medication I wanted to re-order. I gave her the name, and her immediate reply was ‘Oh, if it is for contraception, you will need to speak to a nurse.’ No, it is not a contraceptive – my body took care of that all on its own, thank you very much. ‘It’s not. It’s HRT, hormone replacement therapy.’ A pause. ‘Ok, I’ll speak to the doctor about this.’

It used to be a trigger. The reminder that I no longer need contraception used to drive me to tears. Now, I just close my eyes for a couple of seconds and breathe deeply.

I nipped out at lunch today to go and collect it from the pharmacy I have been going to since my diagnosis. I pushed the door and waited my turn. A few people in front of me, a chatty new pharmacist, it took longer than usual. Since I am not one to make small talk with strangers, I expected that once my turn came, it would be over much more quickly.

I gave my name, my date of birth. And the eyebrows of the pharmacist shot up above his mask. ‘Is it hormone replacement therapy you’re here to collect? Sorry, what was your date of birth?’ I gave it to him again. ‘That’s really young to be on HRT – who have you spoken to about it? Is it your GP or…’

I had just popped out to get my prescription on my lunch break. I was not ready to give anyone my life story.

I get that he was genuinely surprised. After all, it cannot be often that a 28-year-old woman comes into his pharmacy asking for HRT. But the way he said it, it felt like my right to get HRT was being questioned. I felt the need to justify myself, and so I did, feeling terribly uncomfortable whilst uttering the words. ‘Yeah. I had cancer, I had surgery, and I’m now on HRT’, I said it as quietly as I could, mindful of the people who had come into the pharmacy behind me. ‘But did you speak to your GP only, or did a gynaecologist…’ He was not being as careful as me, his voice was strong and loud. ‘Yeah, I went to a specialist menopause clinic.’

I was annoyed, I was ashamed. I am open about having had cancer, but it is my story to share. I write about it on this blog, I tell my friends about it, I have opened up to more people than I ever thought I would, and it is my choice, I do it in my own time, when I feel like it. At 13.20 today, out on my 30-minute lunch break, I was not ready to discuss it. And I was not ready for the people in line behind me to get front row seats to my life story. But I was forced to do it, because of his questions, because of how insistent he was, because I did not have the energy to stand up for myself.

He went to the back to fetch my prescription. From there, he shouted: ‘You are not also taking the patches, are you? Because sometimes they can interact and…’

‘No.’ Just let me pick up my prescription and go, please. I did not say that, but I wanted to run out of the pharmacy and back to the safety of my flat.

‘Ok, so here it is. What dosage are you on, oh, it’s two pumps a day, isn’t it. Oh yeah, I can see there it used to be one, and now it’s two, the prescription was updated… Oh, do you pay for your prescriptions, or do you have an exemption?’

I was about to say I was exempt, when he interrupted me again: ‘Oh, of course, if you had cancer you must have a medical exemption certificate. Let me check, yes, we have it on our system, valid until 2025!’

And once again for the people in the back?

I am a private person. When I decide to open up, it has to be on my terms. When I muster up the courage to tell people I have cancer, it has to be my choice. When I resolve to explain what treatment has done to my body, I want to be in a safe environment, not in a pharmacy, in front of strangers. Even the 6-feet rule does not prevent anyone from hearing what is said loud and clear by an over-enthusiastic pharmacist.

I could not have run out of there any faster. I signed my name at the bottom of the form, ticking the ‘medical exemption certificate box’, took my prescription and made it out within seconds. Was I rude? Maybe.

Mostly, I was shaken. Within ten minutes, I had felt judged, exposed and patronised. I do not need my health, my private life to be discussed in front of strangers when I am picking up a prescription. The people behind me could have been anyone. They could have been my neighbours. They could have been clients, they could have been colleagues. I felt naked, which is pretty incredible considering I was wearing two jumpers, one on top of the other. I felt like I had no control. I started shaking.

I know hearing about my case might surprise some people. They might have questions, they might have opinions. They might want to discuss it at length But it is my life, and I will share it according to my rules. Maybe tomorrow I will pop by the pharmacy again and give that man the link to my blog. If he has any questions, there is a time and place for them.

It is my cancer, and I have earned the right to control my story.