About the Feature
I was eight years old when the local toy store announced its prize drawing for thirty large stuffed animals. The animals were displayed on a raised stage in the middle of the shopping mall: Lions, tigers, zebras, and camels, from three to five feet tall, posed in a jungle of paper grass and polystyrene trees. Above, a brown gorilla hung from a green plastic vine. I stood, with my six-year-old sister, on the other side of the velvet rope that cordoned off the display and looked at the scene in awe. I could feel the plush fur of the lion under my fingers. I imagined my arms wrapped around the neck of a wildcat whose head reached as high as my shoulder. I knew one of those animals was destined to be mine.
When Moira and I told my father we intended to win animals in the drawing, he advised, “Sometimes you have to make your own luck.” We took his words to heart and talked our mother into bringing us to the mall three times a week. Leaving her by the sales racks at JCPenney, we moved methodically from Claire’s Boutique to Spencer Gifts to Merle Norman Cosmetics, requesting entry forms: Moira, in her yellow T-shirt with the shooting star appliqué, hair in messy red ringlets, tummy forward in an unself-conscious pooch; me, already beginning to suck in my stomach and sneak looks in every mirror to assess the shape of my nose or the wave of my brown blonde hair.
If asked, a salesclerk would often give us more than one entry, and after a while, many stores simply left the pads of forms by the register. “Let’s take the whole thing!” said Moira, the first time we encountered a pad unattended.
Although two years younger and shy with adults, she was more fearless than I.
“No,” I replied, “we can take two each, or three.”
“How about four?”
It was hard for me to break the rules, even those unstated, but it was also difficult for me to displease my little sister. After checking to make sure the saleswoman was helping someone in the dressing room, I slid my thumb through the rubbery glue and tore off a thick group of pages.
Back at the center of the mall, we sat on a bench and filled out our entries. Over dinner one night, our dad had theorized that creasing a slip in the middle, making a V-shape, might help it float to the top of the others. Considering this, we decided we should aim for even distribution throughout the tall box. We folded some slips into quarters, others into tiny squares intended to fall to the bottom of the box; we folded triangles, rolled cigarette-sized scrolls, and pleated paper accordions we hoped would lodge themselves at every level. Finally, we crumpled some into balls, though I worried this might be against the rules.
. . .
At five in the evening, I arrive at the Familial Cancer Centre in Melbourne, Australia, to find out if I have a genetic predisposition for cancer. It is February 2004. Two months have passed since my thirty-fourth birthday, my diagnosis of colon cancer, and a surgery, all of which occurred in the same weeks of early December. The surgery involved removing a fist-sized tumor, along with a section of large intestine. The scar, still red, runs the length of my stomach, from just above my pubic bone to the little hollow between my ribs. I’ve made this trip from our home in the remote town of Alice Springs to the large cancer hospital in Melbourne for a number of follow-up tests: PET scans, blood draws, and X-rays. The tests have come back clear, with no evidence of disease. In the wake of these results I feel lighter, unburdened. I believe that the difficult part of my journey is behind me.
It is by chance that the results from the genetics lab have arrived during my visit. Because I am flying back to Alice Springs tomorrow, the genetic specialist, Dr. Boussioutas, has agreed to see me at the end of his day. The Familial Cancer Centre stands apart from the hospital and its twenty-four-hour activity. Here, people go home in the evening, and most have. The doctor, the counselor, and I are the only ones left. We remain in the lobby, which is furnished with cushioned chairs and a loveseat positioned around a coffee table as if it is someone’s living room.
. . .
The animals, along with the ballot box, were displayed for a month.
Our mall, the biggest in the area, was a social center. People traveled from smaller towns on Friday nights to walk around: couples on dates, families, groups of teens. If one of these weekly visitors had completed two entry forms each Friday, he or she would have had eight entries in the box by the Sunday of the prize drawing. A more frequent or ambitious shopper might have submitted as many as two dozen entries.
My sister and I had made three visits to the mall each week for four weeks, covering at minimum thirteen stores per visit, averaging three entry forms per store.
We had placed 3 x 4 x 13 x 3 forms in the box. So, approximately 468 entries.
. . .
At the Familial Cancer Center, Dr. Boussioutas recaps the situation: Colon cancer in one’s early thirties, if considered a random event, is statistically improbable. But, because my father has had cancer in the past, not once, but several times, we suspect mine is not a random event, and so I’ve agreed to have my tumor tested. Dr. Boussioutas explains that they have searched the tissue for a certain protein usually emitted by a gene labeled MSH2—one that plays a primary role in the body’s ability to recognize and defend itself against cancerous cells. They did not find the protein. Its absence indicates that my msh2 gene is defective, probably the result of a mutation, probably hereditary. I have a condition called hereditary non-polyposis colorectal cancer, or HNPCC.
Dr. Boussioutas explains how in the general population, a person’s chances of having some form of cancer before the age of seventy-five is 5 percent. For someone who has HNPCC, these statistics differ.
Chances of having colon cancer: 80 percent.
Uterine cancer: 42–60 percent.
Gastric cancer: 10–20 percent.
Ovarian cancer: 10 percent.
Sitting on the sofa, Dr. Boussioutas tells me not to worry unduly—but that I should have frequent testing, and if I’m thinking of children, I might want to do it sooner rather than later and, once I’m finished, have a hysterectomy, which will significantly lessen my chances of getting uterine cancer. He’s sorry but he needs to go. If I have any more questions, I can ask the counselor. I should have a nice weekend.
. . .
The drawing for the stuffed animals happened on a Sunday. We had written the time on my mom’s calendar and issued several reminders. Before we left the house, our father knelt down to talk to my sister and me. “Now, do you understand that one of you might not win? In fact, both of you could come home empty-handed. Are you going to be okay with that?”
We nodded our understanding, waiting for him to stand and go get the car, waiting for the long minutes to pass between this moment and the one where we would be at the mall, winning.
At the mall, a small crowd of people stood around the platform as the man from the toy store drew slips of paper from the box. I watched his hand, trying to see if he was holding one of our signature folds, but from several yards back, I couldn’t tell. Before he called each name I felt a thrill of anticipation. After he called each name, when a stranger was awarded a lion, then a snake, then a one-humped camel, I simply turned to the future, to the next name, waiting. And then it was. My name. The centerpiece gorilla, hanging from his vine, was mine.
“Wow. She really won,” said my mom.
In the years since, Moira has told me that, at the age of six, she was so overwhelmed by the heart-pounding excitement of my victory, she didn’t care if she won. I, however, recall waiting for her name, if not with the same need as I had waited for my own, still with an instinctive conviction that if the world were fair my sister and I would share the same fate.
Walking to the parking lot after the drawing, my father carried Moira’s two-humped stuffed camel that stood taller than she did. I had the gorilla over my shoulder, folded at the waist, its mitten-like feet knocking against my kneecaps.
“Well,” said our mother, “you’re certainly both very lucky.”
. . .
When I exit the research center, it’s still rush hour in the Melbourne streets. February is summertime; the sun has another hour before it slides suddenly below the skyline. My husband, Paul, is on a plane from Japan to Alice Springs, out of phone range. The evening is my own. Maybe I walk around. Maybe I eat or see a movie. It seems for several hours that I carry the weight of my news gingerly, that I refrain from pressing on its mass, from exploring the shape of my fears. I don’t think of my father, whose periodic episodes of cancer have dotted the landscape of my family’s life for thirty years. I don’t picture his stomach, its roads of crisscrossing inelastic scars, the unscarred flesh bulging in small hills between them. I don’t play the game where I weigh my fear of ugliness against my fear of pain. I don’t contemplate lying in bed next to Paul without my uterus, without the feeling of it contracting when I have an orgasm. I sidestep memories of my friend Lisa, telling me that after her hysterectomy, sex brought no pleasure, how she has recurring nightmares where her husband leaves her, waving as he is driven away on the back of a bus. It is not until later that night, in my hotel room, that I burst into tears. My sobs activate abdominal muscles still recovering from being cut, producing a deep ache in my belly.
. . .
For years, statistics were, for me, the bearers of love and self-esteem. I loved standardized testing like a competitive runner loves a race. There was a thrill to seeing the Scantron sheet hit my desk, to filling in the ovals to spell my name with a sharp number two pencil, then waiting to begin section one. The computerized printouts that arrived in the mail a few months later brought good news. They reported how many ovals I had correctly filled in. They listed the percentage of people who had not correctly filled in as many ovals as I had. I aced the Iowa Test of Basic Skills. My PSAT scores made me a National Merit Scholar, a fact my father tells dinner guests to this day.
But while I enjoyed flattering statistics about myself, I did not actually like statistics. I discovered this my junior year of high school, when I had to take a required class on the topic. Fortunately, the experience was made less painful because I took the class with my friend Amy. While the teacher drew a Bell Curve on the blackboard, underneath our desks we traded one of my olive green socks for one of Amy’s peach ones. Then we traded one of my navy blue Chuck Taylor Canvas Hi-tops for one of her black ones and wore our mismatched apparel for the rest of the day. The weekend I stayed over at Amy’s house to complete our project on binomial probability we drank Hot Damn! cinnamon schnapps while singing along with the Violent Femmes. In the early morning’s purple glow, still awake and still a little drunk, we walked her paper route.
Due more to test-taking ability than skill, I managed to traverse the remainder of high school and college without ever taking another math-related class. I graduated from Indiana University in 1992, the same year that scientists discovered the human MSH2 gene at the Dana-Farber Cancer Institute in Boston. As a polite girl, I would have nodded pleasantly had someone told me this fact; I would have feigned interest for a few seconds. But I had a lot of things on my mind. I was packing my books and clothes into plastic Yaffa blocks. I was updating my resume and taking my car to be serviced. I was calling friends, confirming a place to stay in Chicago while I looked for an apartment. My whole life was just beginning, and scientists in Boston had nothing to do with me.
. . .
In a Chinese story, a man has both a son and a horse. One day, his horse runs away, and his neighbors feel sorry for him. “Oh, what bad luck for you,” they say.
But the old man replies, “Maybe so, maybe not.”
The next week, the horse returns, bringing another horse with it. “You are very lucky!” say his neighbors. The old man says only, “Maybe so, maybe not.”
The old man’s son likes this new horse very much and undertakes to train it, but one day, he is thrown from the horse and breaks his leg. The villagers tell the old man, “That is bad luck.”
The old man responds, “Maybe so, maybe not.”
Soon after this, there is war in the land, and all the young men in the village must join the emperor’s army, but because his leg is broken, the old man’s son does not have to go. “Ah, you are very lucky,” the villagers tell the old man.
He says only, “Maybe so, maybe not.”
. . .
In addition to winning a stuffed gorilla, I once found a dollar bill on the sidewalk; I have twice let the parking meter run out and not received a ticket (although three times I have been ticketed); and in the seventh grade, I was caller number eleven on the radio and won free passes to a Styx concert. Because I loved the song “Mr. Roboto,” this was lucky. However, the concert was on a school night, and my mom wouldn’t let me go, which was less lucky. I put a sign on the bulletin board at the college where my dad worked and sold the passes for twenty-two dollars, so maybe that was lucky—though I would have preferred to go to the concert.
. . .
At the time of the stuffed animal give-away, Moira and I were both experienced practitioners of magic. We constructed impenetrable force fields around our croquet balls by circling our mallets over them and humming. Playing Monopoly, we incanted over the dice to prevent any number that would land us on Boardwalk, and if that happened to fail, we cursed the rent money before handing it over. When our little brother tried to hunt us down during hide-and-seek, we would cast spells, making ourselves invisible until, unable to find us, he started to cry, and Mom said it was unfair to use our powers against him since he was only three.
At the mall, we put our skills to use. We blessed every entry and traced ceremonial shapes in the air with each slip of paper before dropping it into the darkness of the ballot box. We focused our powers on the animals we hoped would be ours—I had my eye on a smooth black panther, as sleek and graceful as I dreamed of being—until our mother arrived to take us home.
. . .
Statistics and Magic
During World War II, when hospitals and battlefields suffered morphine shortages, medics substituted saline solution for the drug, and, as long as the soldiers were unaware of the switch, they reported a decrease in their pain. Many subsequent studies have shown that, depending on the illness, the placebo effect will take place in 30 percent of people tested, sometimes ranging as high as 70 percent.
The converse is also true. A “nocebo response” occurs when a person has a negative response or side effect based upon suggestion. In one experiment, when volunteers were told that a mild electrical current passed through their heads might give them a headache, two-thirds of them developed a headache even though there was no electrical current. In an unrelated study, women who believed that they were prone to heart disease were nearly four times as likely to die as women with similar risk factors who didn’t hold such fatalistic views.
Much of modern medical science is based on the view, popularized by René Descartes in the seventeenth century, that the body and mind are separate entities. This would seem to rule out the possibility of healing through belief, yet, in experiment after experiment, the 30 percent who succumb to suggestion implies that this is not the case. Pharmaceutical companies testing new drugs make elaborate arrangements to control for placebo effect, and the successes of alternative health treatments are often dismissed for the same reason. It only works because people believe in it.
This raises the question If it works, then isn’t belief enough?
If a woman who believes she is prone to heart disease is four times as likely to die of that affliction, what about a woman who believes she is prone to multiple forms of cancer? By believing I am destined to have cancer, am I increasing the probability that this will be so? If I could believe otherwise, could I lessen that probability?
. . .
Magical Thinking: The conviction of the individual that his or her thoughts, words, and actions, may in some manner cause or prevent outcomes in a way that defies the normal laws of cause and effect (Abnormal Psychology, Davison and Neale).
In 1975, Ian Gawler, a twenty-four-year-old man living in Australia, had his right leg amputated due to osteogenic sarcoma (bone cancer). He was told that if the cancer reappeared, he would likely die within three to six months. It did reappear, and by March 1976, his specialist thought he had two weeks to live. In June 1978, Ian Gawler was declared free of cancer. What happened in the interim? He tried, by his count, twenty-seven kinds of healing techniques, including the Gerson juice diet, visiting psychic surgeons in the Philippines, and traveling to India to see Sai Baba. He meditated five hours a day. He never stopped believing that healing was a possibility. Bronwyn Stewart was a nurse who refused surgery for cervical cancer. She embraced naturopathic methods and watched her test scores fluctuate for ten years before she was declared officially cancer free.
In February 2004, I drive from Melbourne to the Gawler Foundation in the Yarra Valley and spend a week hearing what Ian Gawler, Bronwyn Stewart, and others like them have to say about getting and staying well. They are convinced that how we think can affect our realities. They hold out their lives as evidence, so I believe them. By the end of the week I am floating on a cloud of certainty that I can prevent my cancer from returning. Until I get the call from the genetic counselor. When I hear Dr. Boussioutas recite my statistics, the cloud evaporates with the dawn of a new realization: Believing in the power of belief and actually believing are two very different things. I fear I have lost the knack.
. . .
I recognize the little girl as my younger self. She sits on the front steps of our old house in Indiana, weaving a potholder on a plastic loom. As I approach she asks, “Do you want to count love bugs? I get orange.”
I look at the seventies-style sedans and fake-wood-paneled station wagons passing in the street and try to remember the statistical preponderance of green Volkswagen Beetles compared to other colors. “Sure, I’ll take, umm . . . green.”
“Why are you here?” she asks.
“I was hoping maybe you could help me do a spell.”
She leads me to the backyard, where I help her move the plastic wading pool, sloshing water over the sides as we go, uncovering a circle of flattened yellow grass. She points to the white clover scattered across the lawn. “Pick a bunch of these and tie them together.” She disappears inside the house. I tie flowers into a chain, and when she returns, she lays it around the flattened circle.
“We have a PERFECT circle. You have to sit in the EXACT center and not talk.” I comply. She grabs fistfuls of clover heads and brings them to where I’m sitting.
“First, the magical flowers!” She throws handfuls of clover mixed with grass and stems onto my hair and clothes. “And theeennnn . . .” She extracts from her pocket an oval perfume bottle and splashes me with Jontue-scented water.
With all the ritual of someone performing a Japanese tea ceremony, she kneels and unwraps aluminum foil to reveal a mixture I identify as Cap’n Crunch, Froot Loops, and Honeycomb cereals.
“Now you must eat three bites—and ONLY three bites—of this,” she commands. I dutifully chew, feeling the Cap’n Crunch scrape the roof of my mouth.
“You are now protected against cancer or anything else bad!”
She looks at me curiously. “Do you feel better now?”
I think I’m buzzing a little from the sugar in the cereal. “Maybe.”
This is the same diplomatic response I give after Reiki, reflexology, numerology readings, and aromatherapy. I always want to feel different. I want my cells to tingle. I want visions. I want something to convince me that everything has changed and I don’t have to be so scared anymore.
“You have to super-believe,” says my younger self, as if she has read my mind. “I don’t think it works if you don’t believe.”
. . .
Statistics and Luck
As Dr. Boussioutas noted, it is not uncommon for carriers of genetic variants like MSH2, or BRCA1/BRCA2, the variant predisposing one to breast and ovarian cancers, to have high-risk organs removed prophylactically. My friend Rosie recently had surgery and treatment for cancer in one breast. If she is found to carry a BRCA1 or 2 mutation, her doctors will encourage her to have the other one removed to prevent reoccurrence. Removing a healthy organ that might never become diseased might seem extreme, and yet, with a young daughter to raise and an 87 percent probability of contracting the disease, can Rosie afford to wait and see if she gets lucky?
Such a decision, on the surface, would seem to involve a simple weighing out of numbers, a facing of facts. But to accept this method of making a life decision requires a number of underlying assumptions, the primary one being that where one’s own health falls in the statistical spectrum is random, unaffected by any number of potential variables. Stephen Jay Gould, a scientist, essayist, and cancer survivor, did not agree with this assumption. He pointed out that statistical distributions apply only to a prescribed set of circumstances. Is there statistical data that can tell Rosie about the circumstances of the 13 percent of people who, despite their genetic predisposition, never experience disease? Are there numbers that identify what traits these people might have in common—factors such as diet, exercise, community, spiritual satisfaction, a sense of purpose? Is it possible that some combination of these could affect which numerical pile a person lands in, or is it all really just a matter of luck?
. . .
One night while writing this essay, I enter the bedroom I share with my husband and find, taped to the wall next to our bed, an index card with the words DREAM LOTTO printed in black Sharpie. This is Paul’s reminder when he goes to bed at night to dream of the winning lottery numbers.
. . .
When she was eleven, my friend Jill had a stroke that paralyzed one side of her body. She tells me, “It took me a lot of years to accept it, but I don’t regret what happened. If I weren’t in a wheelchair, I wouldn’t be a writer.”
Many lottery winners have reported that their sudden wealth led to the dissolution of treasured relationships and even financial ruin.
The old man whose horse ran away knew it is impossible to see what chain of consequence might follow any single event. Yet for most of us, it is hard to shake the conviction that the luckiest events are the ones that most closely conform to our preconceived desires.
Had I been given the power to choose the results of the scan that diagnosed my cancer, they would have been negative. I would have never experienced a life-threatening illness. I would have been “luckier.”
Jill asks me, “What about your cancer? Do you feel that because of it, you’re a stronger and better person?”
. . .
Please rate the following statements as true or false.
T / F: There is a mind-body connection.
T / F: A painful experience equals a “bad” experience.
T / F: Decisions should be made to minimize pain,whether physical, mental, or spiritual.
T / F: Life is chaotic and random.
T / F: Life has meaning beyond what we know.
I once attended a lecture by the Buddhist teacher Sogyal Rinpoche. He told us that Tibetan Buddhist monks who were held prisoner and tortured by the Chinese later expressed gratitude to their captors, because in conveying suffering upon them, their captors had assisted the monks in their journey toward enlightenment.
The Hindu mystic Ramana Maharshi said, “You thank God for the good things that come to you, but you don’t thank Him for the things that seem to you bad; that is where you go wrong.”
Buddhists and other philosophers hold that there is little use in labeling our experiences good or bad, or our selves as fortunate or unfortunate. What is important is that we use our circumstances, whatever they are, to practice compassion, wisdom, and equanimity; to become closer to our true nature. With practice, they say, we can learn to let go of our attachment to one outcome over another.
. . .
Statistics and Luck and Magic
Here, I would like to wrap it up with some all-encompassing point, some formula for how it really works. But of course, there isn’t one—at least one that everyone can agree on—and that’s why we’re always looking. And by “we,” I mean humanity: scholars, sages, scientists, priests, and—as Kermit the Frog put it—the lovers, the dreamers . . . and me. We’re all addicted to causality. We’re all yearning for some control over our lives. So we look for meaning in the patterns—in the stars, the atoms, the numbers, and the tea leaves. And if there is none, we impose it.
People with HNPCC make up between 3 and 5 percent of those diagnosed with colon cancer. I am part of that small percentage.
Of people initially diagnosed with stage 3C colon cancer, 44 percent survive for five years. Again, I am part of that number.
At the Dana-Farber Institute, a study of 850 people who had Stage 3 colon cancer found that those who exercised most had a 55 percent higher survival rate than those who exercised least. Needless to say, I exercise.
A study of health insurance statistics of over two thousand people practicing meditation over a five-year period revealed that meditators had fewer incidents of illness in seventeen medical treatment categories, including 55 percent less for cancer. So I meditate.
I also drink freshly made vegetable juices, eat certain foods and not others, abstain from alcohol, take enzyme tablets, and occasionally sing affirmations under my breath. For reasons statistical or anecdotal, I have chosen to do all these things. In some cases, I have forgotten what my original reasons were for doing them, but I continue to do them.
My understanding of statistics has improved little since eleventh grade. I can quote numbers, but I don’t really know how being “X percent less likely to get cancer than people who don’t meditate, or exercise, or eat broccoli” factors into “80 percent more likely to get cancer than the general population.”
Maybe I don’t want to know.
Maybe that’s because I like my illusion of control.
But there is more than that.
Not always, but sometimes, these rituals—originally performed out of fear of one outcome and desire for another—do actually transcend their original purpose. Some days I count my pills like prayer beads, stir my organic veggies with an awareness that I am honoring some connection between the universe and myself. The Buddhists might say I am coming closer to my true nature. Paul just says he’s always known I’m a hippie.
I have even had fleeting moments of peace—a taste of what it would be like to let go of my attachment to outcome. Paradoxically, these brief moments do not lessen my resolve to beat the odds, but give me something else, a feeling that everything’s going to be okay. And for a while after, I rest in my belief—that I can be one of the lucky ones.
About the Author
Barrington Smith-Seetachitt is currently enrolled in the screenwriting mfa program at University of Southern California. Her short stories have been published in Sycamore Review and Colorado Review. “Luck, Magic, Statistics” is her first published essay from a collection-in-progress about the experience of cancer.