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I’ve spent most of the past four days in bed with a virus. I’ve been too fatigued to do much of anything. My appetite disappeared. My body has felt weak. And the mental clarity I usually take for granted hasn’t been there. Even writing has felt like too much. And this has only been four days. As I lay here, I find myself thinking about the people I work with and write for who live with exhaustion, weakness, brain fog, nausea, pain, loss of appetite, and countless other effects of cancer and its treatment—not for only four days, but week after week, month after month, often with no real opportunity to recover before the next treatment begins. I would never pretend that being sick for a few days tells me what that experience is like. It can't. But this week has reminded me, in a very small and personal way, of something that's easy to understand intellectually and much harder to appreciate physically: Being sick is work. Sometimes getting through the day is the work. And if that’s where you are right now, I get it a little more than I did last week. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

"I just want everything to go back to the way it was before cancer." I hear this from almost every patient I sit with during their cancer experience and beyond. I understand this desire. Human beings are most comfortable in routine. Therefore, it's normal that you would want to seek what you knew before. Familiarity breeds comfort. And when we're comfortable, we know what to expect; when we know what to expect, we feel we can handle what comes our way because we're prepared. But there’s something that can make returning to the way things were especially difficult: you may no longer feel entirely like the person you were before. That feeling makes sense. You’ve lived through something that changes you. It changes your relationship with time, your body, and often with others. You become much more aware of what's more meaningful to you, including some relationships. You begin to reflect on what you really want to do with your life. How you want to spend your time and your energy. How you really want to spend yourself moving forward. So even though you might have a desire to return to the way things were before cancer, it's almost an impossible task to do so completely. You may return to familiar routines and discover they don't feel quite as familiar anymore. You might find yourself wanting to spend your time differently. Some relationships may feel different. Things you once tolerated may suddenly feel more costly than you're willing to give. You might want to redraw boundaries, spend yourself differently, and focus your attention on things and people who previously received less of it from you. And this is hard to do. It's uncomfortable to say, Yeah, that's the way things used to be, but now they have to be a little different moving forward. So you can feel a lot of emotional discomfort as you try to navigate this new terrain as it unfolds. And in all of this, you’re having to familiarize yourself with who you’re evolving into. I hear my patients notice things like: I don't want to spend my time that way anymore. That matters more to me than I realized. I can't—or don't want to—push my body the way I used to. Why does something I used to enjoy no longer feel the same? Who am I now? You may seek a return to a life that looks familiar, only to discover you no longer fit into it in quite the same way. And that’s uncomfortable, because changing how you participate in your own life can create friction. Other people knew the previous version of you. You knew the previous version of you. There was a script. Now some of the lines are being rewritten, even though nobody asked for a rewrite. There’s a particular kind of discomfort in getting to know someone you once knew differently. Especially when that someone is you. Maybe the discomfort isn't a sign that you're failing at this. Maybe some of it comes from learning how to inhabit a life that has changed—and discovering, a little bit at a time, how you want to live inside it. Here’s the thing: you don't have to figure that out immediately. You may not recognize yourself completely yet. That doesn't mean you're lost. You may simply still be getting acquainted. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

“Everybody is a story,” Rachel Naomi Remen writes in Kitchen Table Wisdom. This quote often comes to mind as I sit with people whose lives have been changed by cancer. One of the most common things I hear in the therapy room is, “I don't want people to know I have cancer.” I've often wondered what sits underneath that decision. You may be willing to share your diagnosis with a few close family members and friends. That's understandable. We all want support when we find ourselves in a frightening situation with an illness that threatens our lives. It’s reasonable that you might not want to share your diagnosis with acquaintances, coworkers, or even your bosses. The fear of being treated differently is a real human worry. You might worry about not being invited to places because your friends assume you won't have the energy to come along. You might fear you won't be given the same responsibilities at work because your bosses worry you won't be able to fulfill them. That's a genuine concern. I understand those worries. I wonder if they only scratch the surface of not wanting to disclose your cancer diagnosis to very many people. As I reflect on life and on Remen’s quote, I'm reminded that there were many chapters in a life before cancer entered it. Perhaps decades of them: chapters about becoming skilled and valued at your work, building a business, raising a family, becoming the friend people could depend on. Chapters about things you love and value, mistakes you've made, the places you've traveled, how you’ve come to understand others and the person you've become. Then cancer enters the story around page 187 or 352. And perhaps one of the fears that comes with telling other people is that they'll start reading the entire story through this newest chapter. I wonder if that's where “I don't want everyone to know I have cancer” comes from. Could it mean more than simply wanting privacy? Could it also be about not wanting one chapter to consume your entire story? Maybe it’s even more. Maybe it’s about retaining some authorship of the story that's still being written. That is a powerful desire when cancer has seemingly taken so much away from you. Everybody is a story. When cancer enters your life, it adds another chapter to your story, while reminding you that you are not always the sole author of your life. That doesn’t mean you have to surrender the pen. There is still more to be written. And there are parts of that story that you still get to write. When cancer takes away so much from you — control, certainty, your relationship with time, your schedule, your priorities — it challenges your identity and agency. One thing that can still belong to you is deciding what you want to share about this chapter, who gets to read it, and when. “I don’t want people to know I have cancer.” Perhaps what I’m hearing is not only a wish for privacy. Perhaps I’m hearing someone holding on to the pen. Cancer entered the story without your permission. It’s even written pages you would never have chosen. But who gets to read those pages, and when, can still belong to you. Maybe sometimes saying, “I don’t want people to know I have cancer,” is another way of saying: Some parts of the story are still mine to tell. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

The scan results are encouraging. The treatment appears to be working. The tumor has shrunk. Things are moving in the direction everyone hoped they would. Relief appears. And then, almost before it has fully arrived, a thought steps in front of it. “Well, let’s see what happens next.” I hear versions of this often. Not because people don’t appreciate good news, and not because they doubt the results. It’s something more protective. Cancer introduces you to a kind of uncertainty you may never have known before. You learn that plans can change. That expectations can change. That entire futures can change, sometimes in the space of a single sentence in a single appointment. It makes sense, after that, to approach hope more cautiously than you once did. “I don’t want to get my hopes up.” It’s one of the most understandable things a person living alongside cancer can say, and there is nothing wrong with saying it. Cancer earns this caution honestly. No one arrives at this thought because they’re being weak or negative. They arrive at it by paying attention, by living through the ups and the downs and learning, the hard way, that good news and hard news can trade places quickly. The wariness is not a flaw. It is wisdom, doing its job. And still. The longer I sit with these moments, the more I notice what the caution costs. Because the same instinct that braces us against tomorrow can also keep us from fully receiving today. Relief arrives, and we usher it back out before we’ve let ourselves feel it. Encouragement arrives, and we hold it at a careful distance. Just close enough to see it. Not close enough to trust it. I’ve come to believe this isn't a story specific to cancer. It’s a story that stretches across the human experience, and cancer simply turns the lights on so we can finally see it. Think, for a moment, about how the mind actually works. Have you ever caught yourself saying, I’ll be happy when? I’ll be happy when this project is finished. When the school year ends. When we move. When things settle down. And then the thing arrives, and you are happy, for a moment, and almost immediately the mind goes looking again. Now I’ll be happy when. There is always a next condition. The finish line moves the moment we reach it. This is not a personal failing. It is how the mind is built. Part of the mind exists to scan the road ahead, to prepare, to keep us safe. It is forever leaning into the future, whether through worry, bracing for what might go wrong, or through hope, reaching for something better still to come. For all their differences, the worry and the wish carry us to the same place. Away from the present. Fear lives in the future. So does longing. And while the mind is up ahead, scouting for thorns or reaching for a better rose, the roses that are actually open, right now, go unsmelled beside us. Cancer doesn't create this pattern. Every human mind already runs it. What cancer does is make the stakes impossible to ignore. Others do it over far less—small uncertainties that may never amount to anything, futures they have the luxury of assuming they’ll reach. A person living alongside cancer is doing the same thing the mind has always done, only now under a real and present weight. Which means they may understand something others have not yet had to learn. We need to be honest about the fear underneath all of this, because it’s bigger than the word disappointment can hold. When someone holds good news at arm’s length, they are rarely protecting themselves against a mild letdown. They are protecting themselves against devastation. The logic runs like this: if I let myself fully feel this, and then the next scan turns, the fall will be so much steeper for how high I climbed. Better, then, not to climb. I understand that logic completely. But I’m not sure it does what we hope it does. If hard news comes, it will hurt enormously, whether or not you let yourself be happy this afternoon. The grief, when grief comes, is about the thing itself—not made worse by the joy that came before it, not made smaller by the joy we refused. So the bargain, trade today’s happiness for protection from tomorrow’s pain, does not actually pay out. We hand over the joy, and the hard news still comes if it is going to come. The only thing the arm’s-length stance reliably accomplishes is to subtract the good from the days that were genuinely good. There’s an older, more magical version of this kind of fear: that joy might jinx it, that to celebrate is to tempt fate. Let me say this plainly: It does not work that way. Your relief today does not reach forward and change the next scan. Joy is not a provocation, nor a down payment on future pain. It is simply yours, and it belongs to today. So, what if the goal was never to become certain before we allowed ourselves to feel? What if hope and uncertainty were never meant to take turns? This is the perspective I most want to offer. The two of them can occupy the same space. At the same time. In the same set of hands. The part of you watching the next scan and the part of you reveling in the good news are not in competition. You do not have to evict one to make room for the other. The uncertainty can stay in the room, exactly as real as it is, and you can still let yourself be fully glad. That is what living alongside has meant all along. Cancer is here. And so are you. Both occupy the same space. The fear is real, and the joy is allowed, and neither one cancels the other. You are not protecting yourself by minimizing the good news. You are only losing the part you could have had. The encouraging scan does not guarantee the next one. The shrinking tumor does not settle the future. The good news is incomplete. And it is still good news. It is still true. You are still allowed to hold it. And here is the thing we somehow forget: we have never once had certainty. Not before cancer, not after. Cancer didn’t take our certainty away. It only removed the comfortable illusion that we ever had it in the first place. And we have gone on living anyway. We always have. The good afternoon. The treatment that seems to be working. The relief. Not because tomorrow has been promised, but because this moment is real, and this moment is ours, and this is the only place a life has ever actually been lived. Life never asked you to be certain. It only ever asked you to receive what each day gave you—to hold it with open hands, fully, for as long as it’s yours to hold. And today, it gave you this. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond. 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A Reflection on the Weight of Being Called Strong It's said with the best intentions. It's meant to provide encouragement. Sometimes it's said from not knowing what else to say in the presence of something so frightening. But somewhere inside you, when you hear the words "You are so strong," you close just a little. Because there are at least two ways you are so strong can be felt, and both place something heavy in your hands without knowing it. The first is encouragement — you are so strong, I know you'll get through this — as if what you're living through is something your will alone can carry. The second is admiration — you are so strong, you're such an inspiration — which lifts you into a symbol from which others draw meaning, which adds its own kind of lonely pressure when the usual steadiness of your world has just fallen out from under you. In both cases, what you're actually experiencing gets overlooked or glossed over. What you’re living through is not simply a test of character. Cancer treatment saps everything you have within you. It devastates the body's ability to carry you as it once did. The fatigue that comes with chemotherapy and radiation is not tiredness that determination can push through. It lives in the bones and dismantles your identity in the world. Your mind can't help but worry about the future: Will the treatment you're enduring work? How long do you have to live? How do you show up for everyone else when you can barely show up for yourself? What will happen to your loved ones if you can no longer provide as you have been, or even worse, die? "I don't know who I am anymore," people tell me. And how could you? When the body that once carried you through your life no longer feels like your own, and you are emotionally tapped out from mental and emotional exhaustion. No amount of inner resolve or positive attitude lifts it. To be told how strong you are in the middle of that can feel profoundly unseen. Yet you make every attempt to hold the image up. Because you've always been the strong one, the one others leaned on and who held things together. Cancer hasn't changed what people see when they look at you, even if it's changed everything about how you feel inside. So you smile, show up to work, play with the kids and walk the dogs, help others solve their problems, and try not to complain or look concerned. Until… The accumulation of treatment begins to weigh so heavily on your body that every day feels like you're walking through quicksand, wearing a sheet of lead across your body. When taking a shower exhausts all the physical energy you have for the day. When the next scan shows the treatment isn't shrinking the tumors, or there's a new spot that could be metastases. And you begin worrying so much about the future that you can't possibly focus on what's in front of you today. These are very real weights that a person living alongside cancer has to hold every day. It becomes exhausting, both physically and emotionally. You cannot be expected to use sheer will to steamroll through days of treatment as you did before cancer entered your life. One thing cancer teaches us is that strength looks different from what we thought. The strength people praised was only ever one version of it, and maybe not the fullest one: the showing up, the holding together. There is grace in being cared for instead of always being the one who cares. Courage in honoring your body's new pace, and choosing how to spend the limited energy you have. Strength in simply surviving a day that asked everything of you. So if you have been wondering why you can't be strong the way everyone insists you are: you haven't failed at being strong. You were only measuring yourself against a definition far too narrow to hold what you’re actually doing. You are allowed to come undone, to set the whole heavy image down, and to trust that you are no less strong for having done so. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

A Reflection About Holding On When I ask patients how they've been doing since our last appointment, they often answer with a small, tired laugh, "It's been a roller coaster." I've come to believe that is exactly the right description because it's true in ways that most metaphors aren't. The roller coaster doesn't just describe the ups and downs of your life after cancer enters it. It illuminates it. Let's stay with the image for a moment. A roller coaster has two essential elements: the car and the track. The car carries you and all you've brought with you. The track is everything else. It is the path laid out before you, designed by forces outside your control, visible only a little ways ahead before it disappears into the next curve or the next drop. You didn't choose the track. You can’t alter it. And you can’t get off. When you’re living through cancer treatment, the track is relentless and unpredictable. There’s the fatigue — not ordinary tiredness, but the kind that sits in the body like heavy lead, occasionally lifting just long enough to offer hope between treatments, before settling back in. There is nausea that comes and goes on its own schedule. There is neuropathy, that painful tingling and numbness in the hands and feet, a side effect that reminds you, even on good days, that you’re fighting a serious illness. These are the physical turns of the track, the dips and climbs the body navigates, whether it is ready or not. Then there are the scans. Scan results are their own particular feature of the track. Sharp, defined moments that send the car soaring or plunging or, perhaps most disorienting of all, holding steady in a way that feels neither safe nor resolved. Stability is, objectively, good news. But it lands differently than people expect. It doesn't return you to the life before. It just gives you more track. It can feel like being held at the top of a loop, waiting to find out what comes next. And then there is the scan result that says: we see something small, we're not sure what it is, we're going to do more testing. That result doesn't give you bad news to process. It gives you uncertainty, which is harder. Uncertainty means the track ahead is not just unseen — it’s not yet built. All of this is the track. The shifting symptoms, the scheduled scans, the results that clarify and the results that confuse. The disrupted rhythms of your body. The calendar reorganized around appointments and recovery windows. None of it is chosen. All of it must be ridden. And through it all, through every plunge and climb and nauseating curve, there is the car. The car is not just you. The car is your life, and it’s full. There’s a partner in the seat alongside, or a parent, or a child who doesn't entirely understand what’s happening but feels every lurch nonetheless. There are friendships that have drawn closer and some that have pulled away. There are roles you still hold — parent, spouse, worker, friend — that don't pause because treatment has begun. There are dreams and plans that have been set aside, with the hopes of returning to them later. All of this is in the car, along the ride with you. And everyone in that car is holding on. That’s what I think of when patients say, “It’s been a roller coaster.” Not the vague sense of ups and downs, but the specific image of hands gripping the bar — white-knuckled, determined, exhausted. You grip because the track demands it, because the people next to you are gripping too, and there is something in that shared effort that holds the car together. You grip out of the sheer effort of staying present on a ride you did not choose and cannot stop. Holding on is not passive. It is an intentional choice that the track cannot take from you. What strikes me, after years of sitting with people in the middle of this ride, is how rarely the roller coaster metaphor gets its due. It tends to be brushed past, as if it were a cliché rather than a genuine experience. Yet, it's reached for because it names something true about what you’re living: that the sensations — physical and emotional alike — come from the track twisting and rising beneath you. That the fear and the relief and the suspended feeling of stability are not signs of not coping well. They are appropriate responses to a track that keeps shifting. While you’re on this ride, there is something validating about simply naming it. Cancer is a roller coaster ride. The track is hard, and you didn't choose to ride it. And here's the thing: you are holding on, the best you can, so as not to fall out of the car that holds everything that matters to you. And that is everything. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

A Reflection on Cancer as a Chronic Condition You know the feeling. Getting up every Monday for work. Weekly laundry that's never done for good. Driving in rush hour traffic. Mentally managing the daily stressors that arrive, whether you are ready for them or not. Most people learn to live with these returning demands. They make peace with them, even if they don’t like them. But there is a particular kind of weariness reserved for the demands that accompany a body that requires ongoing medical care. And a particular weight reserved for those whose care continues for as long as their lives go on. When your cancer is being treated as a chronic condition, the rhythm of treatment becomes the rhythm of your life, indefinitely. Which means: on day seven of every cycle, you face the same moment. A week, more or less, since your last treatment. And as expected, the fog is beginning to lift a little. You can feel a small return of something — energy, focus, the body remembering itself. Normally, a moment like this would feel like progress. You would think: I can begin again. I can do something today. And on a finite course with the end of treatment visible somewhere down the line, that thought might come easily. Each return of energy is a step closer to the other side. But your treatment doesn't end. It continues indefinitely. Alongside the gratitude for the research that has developed this life-saving treatment, another private thought arises. One your friends and family don't hear, because you don't say it out loud: Why bother? This isn't how I want to live. Feeling almost normal for a couple of weeks, and then back in that chair, and the next ten days will disappear into the fog again. Why get up at all? And almost immediately, the answer rises behind it: What choice do I have, if I want to live? You want to live. You've chosen this many times over. And still, on day seven, you’re tired in a way that goes beyond the physical. You're tired of having to choose it yet again. For some people, cancer is an event with a beginning, a middle, and an end. Treatment runs its course. The body recovers. Life resumes in some altered form. For others, cancer is not an event. It is a condition. Treatment doesn't run a course — it cycles. And the cycling continues for as long as the cancer needs to be managed, which may be a long time. Possibly the rest of your life. This is a unique experience, and it doesn't have the language other cancer experiences have. You're not in an acute crisis you will get through. You're not a survivor on the other side of treatment. You're somewhere else — someone for whom treatment is the recurring rhythm of your life. Like a never-ending cha-cha. Two steps forward, one step back. Two weeks up, ten days down. Infusion, recovery, return, infusion again. The calendar is shaped around treatment and recovery. In this dance, you partner with cancer. It leads some of the steps. You're leading others. Living alongside cancer means learning to step to the rhythm of this particular dance. The hardest part is not any single cycle. You know, all too well, what to expect from the chair, from the days after, from the slow climb back toward yourself. The hardest part is the cumulative weight. The years adding up. The energy that never fully returns to where it once was before all this entered your life. The feeling of being tethered to an endless rhythm you never chose. And the mental work of getting up again and again on day seven. Because by the time you have done this five times, or ten, or thirty, getting up is no longer just a matter of waiting for the body to recover. It's trying to coax your mind back into the world again. And by the time you've coaxed it back, you're only a week or two away from the next infusion, when you'll lose the ground you just regained. So an understandable question arises: What kind of life am I fighting for, if this is what the fighting buys me? Treatment to treatment. A few decent weeks between. Year after year. It's a fair question. It deserves to be honored, not argued with. Here is something worth noticing. You have always lived inside rhythms you did not choose. Day and night. The seasons. The body's need for sleep. You did not select any of these. You learned to live inside them, and within them you built your life. No one stands at the threshold of winter and says, "Why bother?" Winter arrives, and you retreat inside. You attend to what needs you there. You gather in smaller circles by lamplight. You rest more — because all of life does this. Trees pull their resources inward. Animals hibernate. Fields lie fallow. The resting is not absence. It is part of how living things keep living. Then spring arrives, and you feel something return. The first warm afternoon. The birds building nests. The smell of flowers blooming. Then summer, with its travel, its long evenings, the large gatherings of family and friends. Then fall, which slows you down and asks you to prepare for winter again. The rhythm of the seasons has always been the rhythm of life. You've adjusted to it so thoroughly that you simply stopped noticing it. Cancer has a way of illuminating what you had neglected or rarely noticed before. The rhythm was already here. Living alongside cancer asks you to join it — intentionally. Cancer didn't introduce rhythm into a life that was previously without it. It changed its proportion, its visibility, its name. The skill is asked of you again, in a harder form. You already have it. You’re being asked to apply it differently now. The rhythm continues. The infusions come. And you, on day seven, choose again. You are not living between treatments. You are living the rhythm — not as endurance, not as resignation, but as the form your life has taken. Not the form you would have chosen. But yours, still. Day by day. Choice by choice. The work of being here, in this life, in this rhythm — and making it your own. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

A Test of Patience Impatience is a feeling most of us know well. Stuck in traffic when you need to be somewhere. Waiting in a long line when you have other things to do. Watching the phone for an important call that hasn’t come yet. The wanting of something to happen faster than it is. Most of us learn to live with these moments. They soon pass. But when cancer enters your life, impatience rises to a level few have experienced before. There's an alien threat inside your body that shouldn’t be there. Every part of you wants it gone, now! And understandably, a cry arises from deep inside: I want it out! I’ve heard it a thousand times. I wish they could just cut it out. I wish the tumor was shrinking faster. Why can’t they tell me more? How much longer? What’s taking so long? This doesn’t come from weakness. It’s wisdom from a nervous system that evolved over hundreds of thousands of years to respond to threat by acting immediately. Fight. Flee. Restore safety. That’s the design. The urgency you feel is the urgency of a survival system doing what it was built to do. But cancer treatment doesn’t move at the speed the system wants. It requires the exact opposite. Where the nervous system says move, treatment says wait. Where the body says now, treatment says when the next step is ready. Where every cell says do something now, treatment offers the slow work of biopsies, staging, rounds of medicine that come weeks apart, scans that measure response, decisions about what comes next. The nervous system is designed for immediate action. Cancer treatment requires sustained inaction. These two systems are fundamentally incompatible. And you’re caught between them. So, your sleep becomes disrupted. You wake at three in the morning, and your first thought is the cancer. You try to read, to work, to be with the people you love — and your attention keeps returning to the same place. The threat is still inside you. The system that registered it is still sounding alarms. This is understandable. Your nervous system isn’t malfunctioning. It’s doing what it has always done when something is wrong inside. The signal continues because the threat continues. What you have little power to do is act on the urgency. The next step of treatment is the only thing that’s possible — and the next step is often nothing immediate. Only more waiting. This is what is meant by a test of patience. Not the small patience that is tested while waiting for traffic to clear, or a line to move, or a call to eventually come. That patience is easier by comparison because what you’re waiting for isn’t life-threatening and resolves after a short while. This is patience at a level you’ve not been asked for before. The thing you are waiting for isn’t small. The system that wants to act quickly can’t be quieted. The waiting isn’t days but months, and possibly years. You’ve waited through other uncertainties in your life. You’ve stayed with things that took longer than you wanted. You already know something about how to wait, even when the body and mind protest. Cancer is asking that capacity to show up in a harder form than ever before. Patience in this situation, when it can be brought, is often built from trust. Trust in the willingness to lean on something while you wait. Trust in the process that moves slower than you’d like, but is moving toward what you can’t move toward alone. Each step generates the information the next step requires. Trust in the people on your team. They’ve spent careers learning to read cancer and how to treat it. You can’t possibly predict every outcome and know what to plan next. Your job is to show up for the steps that have been planned. Their job is to know what those steps are. Trust in your faith, if you hold it. Some find a larger framework that holds them through uncertainty. Others do not. Neither is required. And trust in yourself. The patience you’ve brought to other moments of waiting in your life is real. It’s a skill that’s part of you. It doesn’t disappear because the waiting is harder now. This is what patience looks like in this moment. You show up for the biopsy, wait for the results, and begin the first round of treatment. You return for the next one, and the one after that. You walk into the scan when it's scheduled. You hear the report, absorb whatever it contains, and move toward whatever comes next. And inside all of it, the wanting continues. The system still signals. The body still says move. The cry still rises in the private moments. And still, you wait. You carry what you can. You lean on what holds you. Through the process. Step by step. Breath by breath. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

On the Grief of Cancer You’ve just realized that something you can’t imagine living without is gone. Unexpectedly vanished, and you may never be able to replace it. Your heart lifts and drops at the same time. Racing and falling into a dark pit you didn’t know you had inside you. You start frantically searching. Reversing the last hours in your mind. Trying to remember when you last saw it, when it was still yours. Your world narrows until there is only it. What if I never find it? What if it doesn’t come back? What will I do if this is gone for good? Underneath, a deep ache begins to fester. Not fully present yet. Bubbling. While you search, and worry, and long for the return of what is lost. This is what loss does when it arrives. It fills every part of you. It draws your entire attention to it. It refuses to be set aside. Even a small loss can completely occupy you until it’s resolved. But when the loss is significant, when what you have lost can’t be so easily found or replaced, you stay fully focused on what’s lost for a long time. Pondering. Mourning. Hoping. Significant loss stays. It changes the shape of your days, refusing to release you when you would like it to. Some losses arrive and then dissipate with time. Others arrive and keep arriving. This is what happens when a cancer diagnosis enters your life. Not one loss, but many: body, future, self. At once, or in slow succession. Each one insisting on your attention. Each one refusing to be set aside easily. The loss of the body you once were able to count upon, the future you had assumed you would have, the person you once were, or thought you were. And underneath all of them, the possibility of more loss. A scan on the horizon and a treatment decision that could go either way. A symptom you can’t quite make sense of. A treatment side-effect that takes more from you — another loss not of your doing. The demand on your attention is your mind doing what minds do. Trying to protect you from what might be coming. It won’t stop scanning, because the loss keeps arriving, and there might be more of it. So you’re inside two things at once. An anxious searching that will not quiet. Turning the loss over. Preparing for the next loss. Trying to find some ground. And a heaviness that settles beneath it. The weight of what has already happened pressing down. The ache of what has already been taken. Despair over what may never be retrieved. Both are present. Both are real. Neither lets you rest long from attending to the loss or threat of more to come. This is what people mean when they say they feel lost in cancer. Lost as in pulled between two forces that will not resolve. Lost as in unable to find yourself in the space you used to inhabit. And here is something worth saying about the shape of this loss. The loss of a person you love leaves a hole in your heart that is carried forward through memory. The person will not come back. What you keep of them is only what you remember. Cancer-loss is not always one shape. Some of what has been lost is final in the way a death is final. The pre-diagnosis confidence in your body. The untroubled future. The version of yourself who had not yet been asked to hold this. Yet some of what’s been lost can be met differently. The energy you had for hikes may be missing, but you could still sit outside and watch the light change. The strength you had for wrestling with your children may be in hiding, but you could still play games with them at the table. The plans you had for the year ahead may not be possible, but new plans, simpler ones, may still find their way. This isn’t a bright side to hold onto. It’s not a lesson to learn. It’s the honest observation that cancer-loss comes in different shapes, and some shapes can be met, and some cannot. You’re grieving both kinds at once. This is why the grief is so complicated. You’re asked to accept some losses as final while continuing to search for what can be met differently. Two griefs at once, each with its own shape. One of the unrecognized consequences of profound loss is that it can become difficult to notice anything that is not loss. While so much of your attention is drawn toward what has been taken and what may yet be taken, life continues rearranging itself in other ways. These shifts are easy to overlook while loss is asking so much of you. Relationships that become closer than you imagined possible. A keener awareness of time. Certain kinds of clarity that were harder to see before. Noticing these changes does not lessen what has been lost. Nor do you have to feel grateful for them or try to make meaning of them. They are simply another way life can be rearranged. You are inside a shape of loss that few people have language for. Anxious and heavy. Searching and pressed down. Grieving what has changed and preparing for what might change more. This is what loss does to you. It occupies. It fills the space that is you. It draws the whole self toward it. And it leaves too little of you to notice the part that has been holding it all. The part that has felt the loss. The part that has done the searching. The part that has ached under the weight of what has been taken. That part is you. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

We’ve all said some version of it before. “I love you, but you drive me crazy.” “I’m grateful, but I wish things were different.” “I’m excited, but I’m terrified.” Read those again. Where did the weight of your attention go? If you’re like most of us, your mind probably settled almost immediately on whatever came after the word but. I’ve long wondered why that is. It’s only three letters. Yet somehow, this tiny word has a significant influence on the way we experience our lives. Part of the answer may lie in the remarkable way language works. We tend to think words simply communicate what we’re thinking. But language does much more than that. It helps organize how we experience the world. Words carry more than dictionary definitions. They also carry the meanings, memories, emotions, and associations we’ve attached to them over a lifetime. Language doesn’t only express our experience. It directs our attention within it. Think about it. The moment someone says the word but, you’re already waiting for what comes next. You’ve learned that but often introduces an exception, a contradiction, or something that qualifies what came before it. Without realizing it, your attention begins to shift. The first half of the sentence starts to recede. The second half comes into sharper focus. Part of that shift reflects the magnificent way our minds are designed. The mind is first and foremost protective. Given the choice between noticing what’s safe and scanning for what could go wrong, it naturally leans toward protection. From an evolutionary perspective, that makes perfect sense. Missing a genuine threat has always carried greater consequences than overlooking a moment of comfort. So gratitude gives way to worry. Relief becomes overshadowed by uncertainty. Love gets eclipsed by the part that drives us crazy. The mind also longs for resolution to make sense of the world and settle the tension of holding two seemingly competing truths. It wants to know which story is the real one. Which feeling deserves our attention. Which truth should carry the most weight. The difficulty is that, in trying to protect us from tomorrow, the mind sometimes makes it harder for us to fully receive what is true for today. I see this every day in conversations with people living alongside cancer. “I’m grateful the treatment is working, but these side effects are awful.” “This scan is good news, but I still worry about what the next one will tell us.” “I feel thankful, but I wish things were different.” None of those statements need correcting. They’re deeply human. Yet notice what happens within each statement. The gratitude remains… but becomes quieter. The relief remains… but feels smaller. The hope remains… but somehow seems less believable than the fear. Then I began wondering what would happen if we changed only one word. “I’m grateful the treatment is working, and these side effects are awful.” “This scan is good news, and I still worry about what the next one will tell us.” “I feel thankful, and I wish things were different.” The circumstances and emotions haven’t changed. Only our relationship to them has. The word but asks us to choose between two truths. The word and invites us to step back just enough that both truths have room to exist. Sometimes wisdom is found in three small letters. As I found myself reflecting on this, my mind wandered to the yin-yang. It’s one of the most recognizable symbols in the world, yet I realized I’d rarely stopped to really look at it. We often think of it as representing two opposites. Light and dark. Joy and sorrow. Hope and fear. But that’s only part of what it reveals. Look more closely. The light side contains a small circle of darkness and the dark side contains a small circle of light. Each side carries something of the other. And the line separating them isn’t straight. It bends. It flows. It refuses to divide life into rigid halves. Instead, it suggests that these seemingly opposite realities exist in relationship with one another, sharing the same space in continual movement. Perhaps that’s why the symbol has endured for centuries. What if our work isn’t deciding which side is true? Our work may be learning to find our equilibrium within their continual movement, allowing both to exist without asking either one to disappear. Holding two truths that seem to conflict asks more of us. It requires us to live with tension rather than resolve it. Cancer asks this of us every day. We can celebrate a good scan… and still fear the next one. We can be deeply grateful for treatment… and wish none of this had ever happened. We can feel stronger than we did last month… and grieve the life we once knew. I’ve come to believe this isn’t simply the work of living alongside cancer. This has always been the work of being human. To be changed… and still recognize ourselves. Life has rarely asked us to decide which truth is real. More often, it asks us to make room for both. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

"I don’t know why I cried." A patient said this to me not long ago. She described an afternoon sitting outside with her family, watching the children play. Nothing remarkable had happened. It was one of those ordinary afternoons that unexpectedly become beautiful while we’re living them. Without warning, tears came to her eyes. A family member noticed and asked what was wrong. "I don’t know," she replied. "I just want more moments like this." Her family knew she had recently finished treatment, so they assumed she was worried the cancer would return. That she was afraid she might not live long enough to have more afternoons like this. So they tried consoling her, telling her not to think that way. That the cancer was behind her and she’d have many more days with the family. In trying to reassure her, they unintentionally dismissed that afternoon as just one of many ordinary days still to come. They didn’t see what she was seeing. She tried to explain that she wasn’t worrying about the future or grieving the past. She found herself emotional in the middle of an ordinary afternoon and couldn’t understand why. When she came to see me, that became her question. "Why did I feel that way?" Have you ever been surprised by your own emotional response to an otherwise ordinary moment? One moment you’re watching life unfold as usual. The next, your eyes begin to fill with tears, and if someone asks why, you’re not quite sure what to tell them. Our first instinct is to search for an explanation. Did something remind me of the past? Am I worried about the future? Much of our emotional life unfolds in those two directions. Our attention drifts backward into memory or forward into anticipation, and our emotions often follow. But sometimes neither explanation seems to fit. Sometimes our attention hasn’t wandered at all — it has settled more deeply into the present. That was what intrigued me about my patient’s question. She wasn’t looking backward into memory. She wasn’t looking forward with fear. Which left me wondering whether her attention had settled somewhere else entirely. Have you ever noticed what happens when you finally slow down enough to fully attend to the moment in front of you? You notice details you might otherwise miss. The children’s laughter screeching through bright, open smiles. Their bodies tumbling across the grass with an almost naive abandon. The warm grip of another’s hand in yours, holding on as if to say you’re not alone. The way afternoon light settles across a familiar room, illuminating its parts differently as the shifting angle of the light passes through. Nothing about the moment has changed, yet somehow your experience of it has. Perhaps that’s because attention doesn’t merely help us notice more. It allows us to receive more. The moment itself hasn’t become richer. Our participation in it has. And sometimes, when we participate that fully, we are moved in ways we can’t immediately explain. Perhaps that was what happened with my patient that afternoon. She slowed down long enough to fully receive an ordinary moment. And in doing so, she experienced its extraordinary meaning. Cancer has a way of bringing certain truths into the foreground. Not new truths. Ancient ones. That time is finite. That nothing is promised. That ordinary days are, in fact, extraordinary. None of these truths began with cancer. They’ve always belonged to life itself. Most of us have the luxury of keeping them in the background. Cancer has a way of rearranging our attention so that certain truths become more difficult to overlook. We speak of "stopping to smell the roses" as though it’s little more than sentimental advice. But it isn’t new advice, or small advice. It’s an old truth we keep forgetting because our attention is always being pulled somewhere else. Ordinary moments are where life is actually happening. We forget to give them the attention that lets their extraordinary nature show itself. Sometimes it takes a profound interruption to remember what we’ve always known. I don’t believe cancer teaches wisdom. No one should have to suffer in order to become wise. But I do believe cancer can reveal truths that ask something of us. The wisdom comes later. It comes from what we do with what those truths reveal. Maybe that’s why some people find themselves unexpectedly moved by an ordinary Tuesday afternoon. Not because they’re worried there might not be other ordinary Tuesdays to come. Not because they’re grieving a past to which they might not return. But because they are fully present to something they might once have hurried past. And perhaps those tears aren’t asking to be explained. Perhaps they’re an invitation—to notice, before something life-altering opens your eyes to it, that the afternoon you’re living now is one of the extraordinary ones. The people beside you. The light in the room. A warm hand in yours. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

A patient recently reminded me of the familiar saying, “When life gives you lemons, make lemonade.” Then he added something I had never considered. “What makes it lemonade is what you add to the lemon.” I had always understood the saying as an invitation to make the best of something difficult. But his words suggested a different way of looking at it. Consider what happens when we make lemonade. Adding sweetness doesn’t erase the lemon’s tartness, and water doesn’t ask the lemon to become something else. Each ingredient joins what is already there, and together they create a different experience of the whole. Cancer can enter a life in a similar way. It arrives unexpectedly, bringing a tartness we didn’t ask for and would never have chosen. A diagnosis, treatment, uncertainty, changes to the body, disruptions to the future we had been imagining. Each can become so powerful that it seems to overwhelm every other flavor in our lives. Our attention understandably turns toward what has arrived. We become aware of what has changed, what may be lost, and what might happen next. It becomes difficult to taste beyond the tartness because an unexpected ingredient has become so strong that, for a while, it’s all we can taste. Maybe this is where what we add begins to matter. Not as an attempt to make cancer sweeter than it is. Nor as a pressured effort to find something positive in an experience that has brought pain, fear, or loss. What we choose to add may just be our return to the beauty, joy, connection, and support that remain accessible to us. These ingredients were always there before cancer came along. Now, we may need to turn to them even more. The tartness remains. We simply remember that it’s not the only thing available to taste. Recently, another patient spoke about the loss cancer had brought into her life. She named the loss of certainty, the loss of energy, the loss of her hair, and the unfamiliarity of seeing a body she no longer recognized in the same way. We stayed with those losses for a while. They deserved to be acknowledged and mourned. Some losses cannot be replaced. They become part of the life we are learning to live. And they don’t have to become its only ingredient. I invited her to consider what she might want to add to the life that was now being rearranged around her. Not because an empty space always has to be filled, but because cancer doesn’t get to make every choice about what her life will contain. What we add will look different for each of us. We might choose to add the presence of someone who can sit beside us without trying to make everything better, or add moments of beauty that ask nothing from us. We may return to music, laughter, creativity, faith, nature, or the people whose love we once counted on without having to think about it. Sometimes what we add is nothing new. It’s something meaningful that has always been part of our lives, now chosen with greater intention. Before the lemon arrived, we may not have thought about these ingredients. They were just always part of the mixture. Cancer changes that. When its tartness begins to dominate our experience, we may need to reach deliberately for the other flavors that once found their way in without effort. We add them not to disguise what has happened, but to keep what has happened from becoming the only thing our lives hold. Reflections on the inner psychological experience of living alongside cancer. Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.