Heart Failure as Teacher

…two roads diverged in a wood, and I — 
I took the one less traveled by, 
And that has made all the difference.

(From “The Road Less Traveled,” by Robert Frost)

It’s a familiar poem, one you were likely introduced to it in a high school English class.  Frost’s portrayal of a traveler choosing a direction as he comes to the fork in a road is a metaphor for life. We make choices daily, between one thing and the other, weighing one possibility against the other, assessing the benefits, costs, and risks.  Sometimes, our hearts wage war with our minds, our dreams with reality; other times, old habits, patterns and drives learned in childhood play repeatedly, pushing us toward old ways of being, even when our hearts cry “no!”  Ultimately, we have choices, deciding on one course of action over another.   Whatever we decide, we live out our choices, and our lives are changed by the choices we make.  Call me a slow learner, but my heart is winning that persistent battle between old ways of being and the way that, now, I am trying to live. 

     How we spend our days is, of course, how we spend our lives. –Annie Dillard

Living with heart failure has made me more aware of mortality and the relative shortness of life.  “It’s not that we have a short time to live,” the Roman philosopher, Seneca wrote in his treatise, On The Shortness of Life, but that we waste a lot of it…life is long if you know how to use it.” 

Being a patient with heart failure has forced me to consider the “busyness” of the life I’ve led for the bulk of my adult years. Busyness driven by the need to achieve, something drummed into me early in life, and, when I don’t, feeling guilty or somehow inadequate.  It’s meant that for much of my life, as my husband and daughters would tell you, I have a very difficult time saying “no” to other’s requests for my participation in activities, initiatives, committees and the like, often pushing my desires aside to meet other obligations and living with more stress than is healthy.  It’s hardly a surprise that years of New Year’s resolutions to make more time for fun, relaxation, and even family, have rarely been successful for long.  Again, Seneca: “learning how to live takes a whole life.”  Perhaps I’m starting to understand what he meant. 

Some of my greatest teachers, as it turns out, are the cancer patients who join my expressive writing groups.  Week after week, they write, sharing their fears, questions, and lives through their stories and poetry.  They write with honesty and authentically.  Writing is the mechanism by which they release all the feelings–many of them conflicted–triggered by a diagnosis of cancer.  For some, they come to the group to write knowing they’ve been given a certain death sentence.   The suffering is real; the treatments often debilitating with surgeries that permanently alter their bodies. 

Two weeks ago, I led three workshop sessions for a group of young adults who had survived childhood cancer.  Survived, yes, but many who still bear the evidence of an aggressive and unforgiving illness, and who already are experiencing serious and long-term health issues from their disease and its treatment.  The clarity with which they write about the lives they intend to live–and are living–inspired and, at the same time, humbled me.  I came away grateful for their honesty, awed by their courage and determination to live life as fully–and meaningfully–as they can for however long they might live.

When I first returned to Toronto after several years living in California, I was eager to get involved in the work that I’ve found so meaningful, and Gilda’s Club welcomed me immediately.  But I was also inspired by discovering a vital and growing community for heart failure advocacy.  Besides, I have one very inspiring cardiologist in Dr. R., and when she asked if I wanted to be engaged, I said, “absolutely.” 

That’s still true, but it’s taken me the better part of a year and a half to define how I want to be engaged.  And that requires choices.  I slipped, all too easily, into old ways of being, saying “yes” to committee involvement, reading research like a graduate student, becoming a patient partner…and my life was, for a few months, dominated by heart failure.  That involvement had the effect of making me think more about it–not always in ways particularly beneficial to my fear of progression and my life ending sooner than I assumed.  In short, I was leaning toward depression, or at the very least, a case of the good old-fashioned blues. 

I began writing about it, and this blog was birthed.  But it’s been a challenge at times ( because of all the reasons I’ve written about in the past few months) as I’ve tried to figure out if what I write is helpful or interesting to other heart failure patients.  My “Writing Through Cancer” blog is, by comparison, relatively easy for me to write, but I have years of leading writing groups and hearing cancer patients’ stories as a source for inspiration. Perhaps my struggle in writing this blog has helped me gain clarity, although in ways I have yet to fully articulate, about how I want to live for however long that may be.  Maybe Seneca was right: it does take nearly a lifetime to learn how to live.

As I write this, I recall a poem I used many years ago in a class on writing and healing. Entitled “What Matters Then,” the poet asks the question of the reader and, beginning with a single gardenia on a branch, moves us to the essential, from bush to branch to the single flower.  It’s a winnowing down, something that resonates with me now as I am gaining the clarity to live each day engaged in what truly matters to me.

…What matters then?

A single gardenia broken

from the dark-leafed branch.

What matters then?

The dark leafed bush.

What matters then?

The gardenia.

–Margaret Robison, Red Creek, A Requiem

What matters to me?  That I live as fully as possible each day.  That I have time with my family, husband, daughters and grandchildren.  Especially the grandchildren; they are the best medicine of all for my heart.  That I give back–it’s why I continue to volunteer in leading writing groups for cancer patients and what motivated me to become a patient partner.  That I make time for art and creativity:  writing, poetry, reading, music, art.  That I stay as physically active as I can.  That I practice humility:  there are always new things to learn.  That I recognize and accept my limits.  And not unimportantly, that I practice gratitude as my daily mantra.

What has living with heart failure taught me?  I think it has taught me how to live.  And that’s something, isn’t it?

Waking up this morning, I smile.

Twenty-four brand new hours before me.

I vow to live fully in each moment

and look at all beings

with eyes of compassion.

            -Ticht Nhat Hahn, Buddhist teacher

Writing Suggestions:

  • What have you learned about yourself from heart failure?
  • How has your life changed–in ways that are positive?
  • How do you want to spend your days–to live your life?

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