Unbelievably.... I made it.... last week.

On Wednesday afternoon I had the best call of my life. The nurse from my medical oncologist office called me: no chemo this week.

My brain couldn’t register. “No more chemo? I’m done? “ as I sat in my car at the pick up line, waiting for my youngest son to come out from his camp.

That’s right. They reduced the dose last week to 50% and my doctor decided that the benefit of another half dose of chemo was not worth the risk of worsening (and potentially causing permanent) nerve damage. My nurse said —and I am surmising here that this is because I am receiving chemotherapy after my mastectomy— that usually 10 doses is sufficient to reducing future risk of one of my subtype of breast cancer (ER/PR+, HER2+).

The nurse told me I would still have to go in the next day and get the targeted HER2+ treatment (herceptin/ kanjenti), which I will start going in for infusions every three weeks for a year. It is not a chemo drug so doesn’t have the same side effects.

I eagerly asked, “And I’ll get to ring the bell?”

And she laughed and said she hoped I would ring the hell out of that bell and ring it as many times as I wanted.

I had shared with her through MyChart all of my side effects after last week’s chemo: no energy and mostly stayed in bed Friday ~ Sunday, low appetite, a nose bleed, muscle fatigue, tight skin (realized from dehydration also), and persistent spreading nerve numbness throughout all of my finger tips and cheeks. I tried to dispel my worry by writing that the numbness wasn’t preventing any functioning, but my intuition sensed this wasn’t good.

A jumble of emotions erupted from my body with this news. Riding the current last week, I crossed the finish line and didn’t even know it!! With the news, I could practically feel every cell of my body release in relief knowing they would not be doused in poison the next day. Another part of me felt a little deflated that I had finished chemo without knowing it.

But I knew this was to be celebrated!

So, after my youngest son clamored into the car, I told him the great news that my chemotherapy treatments were done! We needed to celebrate, so we went to Paris Baguette and bought a gorgeous rainbow cake for dinner that night.

The next day, my dear friend Christen, who sat with me during my first two initial marathon length infusions, picked me up. I had seen a blue butterfly where my breasts had been in a dream, and I bought a butterfly dress for this very moment of completion and emergence. If that day was not the day to also wear a crown of butterflies, what other day ever would be?

I grinned and smiled as I fluttered past the parking attendants and security guards at the hospital, giving out small fabric butterflies and clipping them onto people who had ushered me through these past 13 weeks. I was particularly grateful to the infusion nurses who took such incredible care of me.

While the 11th infusion was my last chemo infusion, the 12th was the completion. I asked if I could ring the bell first to signal the ending of my chemotherapy from last week, before settling in for the herceptin infusion.

By far, out of all the treatments I have now experienced for breast cancer, from lumpectomy, full breast radiation, and bilateral mastectomy, chemotherapy has been the hardest to endure. And there are sisters that get an additional chemo drug called “the red devil” which I did not get.

My friend, who is a Hawaiian shaman, sent me a mele, a sacred song, to carry me through these past three months and the waters of chemotherapy.

At the start of this week, I listened to this recording of thousands of people in 2019 singing this mele on the sacred mountain, Mauna Kea on the Big Island, to protect her against the excesses of development, yet another telescope to be built on her:

E HO MAI

(na Edith Kanaka'ole)

E hó mai ka 'ike mai luna mai

O nā mea huna no'eau o nā mele ē

E hõ mai, e hõ mai, e hõ mai ē (x3)

Grant us knowledge,

Grant us strength

Grant us intelligence,

Grant us understanding

Grant us insight,

Grant us power.

Knowing this week would be the end of this voyage through chemo, tears exploded and my body shook, and the sacred Korean bells I held in my hand sang.

The tears were a release, a recognition that this part of the voyage was almost over and soon I would be home. And it was this coming home that also brought the tears, because it has been such a tough voyage, and there were times I didn’t know if I would make it. But I kept showing up, and this week I could see the shores of my home and knew soon I would arrive to my homecoming.

I am home.

I am home.

I am home.

I am almost home.

This song carried me over those tough waters of initiation. It has been the voices of thousands who have sent me messages, gifts, light, healing intentions and prayers, who fed me and my family, cared for me, and who sat with me week after week, who carried me home.

Through this voyage, parts of my body have been sacrificed, but I have gained all parts of my soul.

And I know why. For Love. For Life. For the love of my children, that they may know my presence. For the love of myself, that I had abandoned and forgotten. For the love of humanity, that we might re•member we are Love. For the love of the Great Earth, who sustains us despite our excesses and abuse.

And, this has been so very hard.

If you would like to celebrate the completion of this milestone with me and “Life after Chemo: Supporting Others through Cancer”, I have set up a GoFundMe. (https://www.gofundme.com/f/celebrating-life-after-chemo-join-my-continuing-voyage)

These funds will be used to support me in writing and publishing the wisdom I have gathered over the past six years traversing breast cancer twice —especially those who share my lived experience who are adopted, Asian/ BIPOC, or lack access to family medical history, or healing deep ancestral wounds— and explore ways I can further support others finding their way through cancer.

Other ways to continue to support as I move back into Living:

--Read my Substack (you are!). Social media algorithms may not show my post or maybe you aren’t on a platform. Substack is where I am going to be sharing most of my writing. You can subscribe for free and you will get an email when I post stories and send updates just to subscribers: https://holleemcginnis.substack.com

--Help with appointments. I will be continuing now with herceptin infusions (about 2 hours) and appreciate anyone who can come and drive and keep me company during them, which will typically be Thursdays every three weeks for a year. Sign up if you are free to help using this calendar: https://calendar.app.google/tEQHas3R4sh7NKPA8

Be well.

Be love.

And deepest gratitude for all I have received and been given.

I was afraid as I sat in the plastic chair of my infusion “cubical”, which has felt like coming into “work” once a week, that the nurse would come back and tell me to go home.

I knew my ego was chomping at the bit ~ push! Push! Push! Get to the finish line at any cost! I also knew if I followed the will of my ego, I could get hurt.

Fortunately, my mindfulness practices have expanded my awareness beyond the chattering of my ego and understood that the ego often can only see a small part of the whole.

Yes, I want to be finished with chemo, and I don’t want any permanent damage to my nerves. I am still numb enough across my chest from my mastectomy.

I told the infusion nurse that the numbing I had felt around my lips and tongue since Sunday had spread to my cheeks that morning. She seemed concerned. She didn’t like that the numbing, which had waxed and waned around my fingers and toes since the previous week, was taking up residence in new areas of my body.

I wrote a message in MyChart to my medical oncologist about the numbing early this week, especially since the lips and tongue areas were new. I knew to tell them about any numbing and tingling around my feet and fingers because they had scared me: the only way we can know if you are experiencing nerve damage is if you tell us!

Since the peripheral neuropathy can permanently damage the nerves, they will skip a dose or otherwise change protocol to prevent this. The infusion nurses told me about people who told them too late and lost functioning in their hands and feet (not able to button a shirt, difficulty walking).

They had already reduced my dose of taxol when they switched me to the abraxane version of the chemo drug. When I chatted with my medical oncology nurse, she said my doctor was reluctant to reduce it more. They prescribed me gabapetin to help manage any nerve pain, but this would not prevent any damage.

I am grateful for the infusion nurse’s forceful concern. They decided to reduce the dose of taxol this week and so we were able to go ahead with my 11th infusion, the second to last and final dose. I was grateful to share this moment with a soul sister Lindsey Green and celebrated with some beautiful flowers.

This week I entered into a new phase of this voyage. It was a felt sense of simply falling into oneness with the current. Not against it, not surfing on top, not efforting to avoid where I was, just simply the sensation of letting myself lean back and into the life current and letting it carry me over these final days to the other shore.

I only floated down a river once. It was the Amazon River after we had rafted over and splashed our way over rocks and rapids on our honeymoon. The stillness of the water provided a sense of safety (as did the life vest), to lean my head back and allow my body to simply be carried by the river’s current to the end of the journey.

It was an active surrender. I both released my body into the energy of the river’s current and actively brought my full awareness to this surrender, to this letting go. I still had to navigate over small protruding rocks (that my bum hit on occasion) and stay on course, but the effort was taken care of by the current.

This is how I feel now. I am surrendering to the flow with full awareness of the currents of life force energy through me, around me, in me, and as me.

Just as I felt the fortitude, steadiness, and groundedness of a mountain at the beginning of my breast cancer treatments, now I am feeling what it is to feel aligned with and one with the energy of life itself.

This releasing into the current of life that flows through my body feels so loving and easeful. Yet it takes effort of full awareness, too: the embodiment of an Eastern principle of wu-wei, effortless effort.

Every particle and cell simply wants to slow down in this moment. I can see the fast pace around me and I am feeling the sweet luxury to move exactly as I am.

Yet just as the river flows, this moment is not to cling onto, either. So I release the grasping. Remind myself to breathe slowly and embody this fully. And I am told to re•member: the current is your life and all that is.

All of my doctors told me that the chemotherapy would accumulate, but I had no idea what that would feel like. As I approach the closure of this final leg of this voyage, I see how each part has been quite different.

After last week’s chemo (number 9), I hit what I call the chemo wall. There had been signs all week up to my treatment that my body was crumbling: I had a scratchy throat, low energy that I kept pushing through, I began to be less consistent with ensuring I drank enough water, took my supplements, ate whole nutritious food (lot more processed chips and sugary snacks). I could see old mind patterns return, and the ones that were keeping me in the present moment ~ like “everything is happening for my highest good” ~ had slipped away without my awareness. I felt crappy.

It wasn’t from a lack of will, though. It was simply a truth that the body can only sustain so much before she reaches a tipping point. And that tipping point came down really hard last Saturday.

As soon as I woke up I knew it was going to be a PJ day, but I had never felt that level of exhaustion before and for so long in my life. My body literally shut down. Every small exertion I made, was responded by a tripling exhausting effect. So I simply stayed in bed and tried not to move. I experienced the worse abdominal pain, lost appetite, diarrhea, and fatigue out of all of the 9 weeks of this whole experience. Despite the cold compression, I also was feeling some numbing in my fingers.

I also noticed swelling in my fingers that made them feel like sausages ~ literally my body telling me she couldn’t move fluids out. As the week progressed I also noticed when I tried to read my vision was more blurry. Astonishingly, my nurse practioner told me during our check-in this week that these are chemo/taxol related side effects. So we discussed whether we would pull back on the dosage this week, and we decided that since it mostly resolved, we would go through with the full dose.

The complete collapse of my body last Saturday gave me a lot to reflect on. One part chided me: you “should” have been resting more throughout these two months! What were you thinking trying to work so much? You “should” have been resting in the bed more!

But the deep lesson I learned from my first round with breast cancer is that judgement and internal criticism does not heal: only unconditional love and self-compassion does. So I have a mental flag when I hear the word “should” and a saying: don’t “should” on yourself.

What last Saturday gave me was an invitation to reset for these final chemo sessions. At the beginning of the week I looked at my calendar and began clearing out appointments and due dates. I realized I have to be as intentional about rest as I am about my work appointments. I realized I have to take as seriously and place value on what nourishes and nurtures me (time and conversations with my family and friends) as I do with “work” and that rest IS work.

Noticing what had fallen away the previous week, I intentionally reset the ones that had been so supportive to my well being over the course of this voyage. At last week’s chemo I was in such an old pattern of “It doesn’t matter! Who knows if this is helping!” That I didn’t use the light patches my acupuncturist Effective Wisdom gave me to place on acupuncture points for nausea and appetite. Was that why I felt more nauseous and lost my appetite two days later?

Who knows for sure because in life there is rarely a single causal effect, but from what I observed, I wasn’t going to chance it again and made sure I used them this week during my infusion! I also intentionally rested the day after chemo which was easy since it was part of the Fourth of July holiday. Always wanting to be social (people pleasing?), I also declined a Fourth of July party. My hope was that by intentionally resting, my body would not completely collapse this time after treatment. So far, so good, but I am still bone tired yet nothing like last Saturday.

I also gave myself a generous dose of grace and compassion, because I also saw I simply did not have enough energy, either, to do what I did in the early weeks of treatment when my body had no accumulation of the chemo in it. So if I didn’t take my vitamins and supplements everyday, I didn’t judge it.

I also returned to a practice that would keep me in the present moment and not have my mind run too far into the future, because I can only get to the future if I attend to the present moment.

As an advanced reiki practitioner, there is a beautiful centering mantra that goes like this, which I have slightly modified:

“Just for today, do not worry. Just for today, do not anger. Just for today, do work with integrity. Just for today, let it be just for today.”

When the body is overwhelmed, effort takes everything out of you. So I have been grateful for the gifts that required little effort. A box of Oma seaweed soup that is nourishing and only requires I add hot water (thank you Ann), healthy nourishing salad made by a friend (thank you Alexis), chats with friends, and friends who have taken time out of their days, like Kim Sue Stevens who drive down from NoVa to take me to chemo this week.

What does it feel like to be at the end of a voyage? It means you carry all the accumulated burden and fatigue with you as you cross the finish line. Sure, we love the image of the runner with their arms above their head crossing the finish line in victory. But in truth, especially in the long distances we most often travel - the longest distance being the very course of our life itself - it is simply being able to cross finish lines at all, that is the victory.

When I was experiencing massive writer’s block as a doctoral student, I joined a writer’s group. The facilitator shared a story of how hikers who had climbed summits, often collapse on their descent when they are within miles of making it home. The message: the last mile, when the finish line is in sight, is often the hardest to navigate in a journey.

This week has felt like that collapse. I’m so close, and yet not there, yet.

Last week I noticed the areas where my breast once were ached in a familiar way, like before I got my period. “But I have no boobs!” I laughed as I shared this with my husband. Then I realized: my body was reawakening.

The tight band of numbness that stretched like a taunt wire ~ “iron bra” is how it is described by survivors ~ the plowed flat band where the rolling hills of my bosoms once stood, has begun to return to life!.

Feeling the vitality and aliveness return to areas of my body that have been numb and lifeless for four months, made my ego soar into dreams of when these treatments will be over. As this week rolled around, I found myself fighting the edges of a cold and noticed I had stopped eating nutritiously. Thinking too much about the future caused me to neglect the present. But I can only get to that future by taking care of the present.

These are some of the reasons the last mile is the hardest. The exhaustion has set in, the accumulated weight of the past weeks makes any effort heavier, and the wily mind gets ever more impatient with anticipation of the future. The end is near, but we only can get there through the present moment. So, even if it feels like I am moving at the speed of a sloth, it is still movement. It is movement that is honoring the truth of the present: that near the end of a long journey, we are bone TIRED.

6 of 12 CHEMOS DONE - 6 MORE TO GO ~ MIDWAY HOORAY 🌸! When I began this chemo voyage a month and a half ago, reaching this midway point felt unfathomable, let alone completing the course. What a joy to celebrate this milestone with my fellow adoptee, Also-Known-As, Inc. leader & VP, and great friend Ann McKinnon who traveled down from northern VA to be with me, gave me gorgeous flowers 💐, and celebrated after at a New York Jewish deli ~ perfect for two New Yorkers!

The first three weeks were truly rough waters as my body did not take well to the chemo drug (taxol). The side effects of having to take double the amount of premeds to dampen my body’s reaction (antihistamine and steroids) caused Benadryl like exhaustion and steroid induced hyperactivity that truly were miserable.

The last two sessions (4 and 5) were actually the hardest in the voyage because I felt neither at the beginning nor any closer to the other shore. It felt like I was sitting in still waters, no wind catching the sails. The worry caused by the delay in treatment for a week because of insurance, experimenting with the different version of chemo (abraxane), and my eldest son’s graduation helped to distract me from this deadness that made me feel like I was making no progress in the voyage.

But I was all along!

Now, as extended family left over the weekend and I settled back into the rhythm of treatment, I have found myself at this midway point. Six done. Six more to go. How many times are we carried to such moments in our lives, unaware? We just keep showing up and behold, we are drifting along incrementally without effort. Showing up is the effort.

What got me through to this point? Living in the moment, seeking beauty even with my worries, not dispute of them, and finding points of agency that helped me transmute losses into opportunities to grow and laugh.

Most of all, what has helped me is to hold the knowing that life is not a journey with a beginning, middle, and an end, but rather a voyage of discovery through which we encounter many storms, glorious vistas, strange and miraculous lands, riding each wave as they arrive, bobbing up and down the sea of life.

I felt like it was a race to get through all 12 infusions even though when the nurse first explained the protocol she emphasized that it did not translate to 12 weeks of treatment, more like 14 to 15 weeks. My doctor also assured me that because we are not doing the chemotherapy to shrink any tumors as is the case when chemo is given prior to surgery, we have a bit more breathing space for treatment which really helped me to let go of my sense of urgency.

As though to affirm that everything is unfolding for my highest good and alignment with the universe, I saw my magical number ~~ double 3’s ~ ~ show up as I got my coffee and enjoyed time with my friends who were going to take me to chemo today, getting to enjoy each other’s company in a cozy cafe instead of the infusion room.

I would still like to complete my chemotherapy by July, but now it may be more toward the end of July or early August at the latest. With this new attitude, though, I feel I may skip chemo the week that my eldest son is to graduate from high school. After all, what are all these treatments for if they aren’t to live life? We cannot wait to live this beautiful life, because life is being lived at every moment. And these flowers, gifted to myself and given to me by my friend, remind me that we are always invited to step into the beauty, especially when things are difficult. May you walk in beauty, each and every day.

I have arrived, three months post-double mastectomy surgery and my third of twelve chemotherapy treatments completed this week.

Physically my body has healed very well from the double breast amputation. The week before my first chemotherapy I had been in New York City to see family and friends, and celebrate the 30th anniversary of an organization I started for adult intercountry adoptees, Also-Known-As, Inc.

My body was still very much hurting that week. I really wondered how I would handle chemo when my body was still healing from the surgery. But then the next week I found a full flowering in my body of strength. Like a child taking off their training wheels from their bicycle, my tissues and nerves no longer needed compression to hold them. I could wear shirts with nothing underneath: no bra, no compression. And it felt amazing!

I hadn’t even noticed that I had been carrying my body in a protective contraction, shoulders slightly hunched, only moving to the limits of my range, not beyond, since the surgery. Then my OT said she wasn’t giving me exercises because I had practices like yoga and tai chi ~ but I realized I wasn’t doing them. So I confessed to her that I wasn’t in fact moving my body and that I needed some exercises to slowly guide my body into a sense of safety to move again. And my body responded.

As aspects of what my body could do before the surgery returned ~ yoga, tai chi, deep breathing ~ I felt a sense of return, not to where I was before the surgery, but a great re•turn to being embodied and strong in a new body that has been put through the wringer. A new body that I am slowly beginning to fall in love with in a way that I had never loved the old.

The body is just amazing. Give her all that she needs: nutritious food, good sleep, rest, follow her needs, micronutrients, and she does this: heal. But you have to be patient. And you have to discern whether the guidance is coming from your body or your ego.

Those energies of being with family, friends, and community in New York City blissfully carried me through the days leading up to my first chemo treatment. But as the day approached, panic set in as I faced into the unknown. It felt so overwhelming I couldn’t think straight about what I would need to bring with me.

Friends who had gone through chemo gave wonderful suggestions: Trader Joe’s green tea mints for when they flush the port to chase away the metallic taste, peppermint oil to sniff for nausea, ginger candies to suck on, chew on ice and drink water during the infusion, never skip the pre-meds, and take the warm blanket!

At the same time, I found myself asking my body what would take care of her. As I wandered around the grocery store getting food to eat during the infusion, I found myself reaching for a lot of fruit (Hawaiian papaya, pineapple, cantaloupe, berries), potatoes (Korean sweet potatoes, Okinawa purple potatoes), fresh ginger and peppermint, dark leafy greens, okra, Greek yogurt, rice pudding. and bone broth.

For dinners, my body wanted to eat food from my motherland, Korean bulgogi and my homemade kimchi, hot pot filled with veggies and mushrooms, and grounding Korean radish (mu) soup with doenjang (fermented soy bean paste).

The night before my first infusion, my youngest son decided he wanted to make “power balls” ~ treats filled with oats, rolled in peanut butter and mini chocolate chips, coated in sesame seeds. I am convinced in his subconscious he knew that these would be the perfect sources of extra protein for me. I tucked these power balls into my lunch box, along with berries, greek yogurt, prunes, and a thermos of bone broth.

The nurses had told me to drink a lot of water. I had a handout on how to manage all of the side effects of the taxol chemotherapy (nausea, diarrhea, constipation, fatigue, immune suppression, leg swelling, mouth sores, brittle nails, loss of hair) . I knew that for 48 hours after the infusion I would have to use a separate toilet to keep my family safe. No open mouth kissing either for 48 hours because trace amounts of the taxol could be in the saliva.

I bought the Imodium and miralax, but for now I am opting for more bananas and prunes, using light patches on acupuncture points, drinking and eating a lot pre and probiotics to maintain my gut health, which is so important for immune function. I will hit the over counter medicines when needed.

While I am feeding my body, I am also choosing to do a 14 hour intermittent fast each day, not eating after 8pm and breaking my fast at 10 am. I had read about clinical trials on the efficacy of a fast-mimicking diet during chemotherapy. During fasting, healthy cells slow down their metabolism and not take up as much of the chemotherapy drugs. Cancer cells don’t moderate their metabolism, so end up taking up more of the chemo drugs. During the trials, researchers found that fasting or a fast-mimicking diet was associated with better outcomes, reducing cancer tumor size and side effects [Valter Longo, “Fasting Cancer”, 2025; https://clinic.createcures.org/].

Unfortunately, I do not have a functional integrative health oncologist to guide me in these fast-mimicking diet protocols during chemotherapy. While my allopathic medical oncologist was supportive, it’s not standard practice at all, because the evidence is emerging. As a cancer patient, though, you don’t care as much of the strength of the evidence. You want to do whatever you can to maximize results. So I am running this experiment on myself. I have done intermittent fasting in the past, so doing it during chemo does not feel like a burden. But I absolutely will listen to my body and change as necessary.

Still, all the knowing is nothing like stepping in and doing it. During the first chemotherapy treatment, the infusion nurse told me it would take about four hours, but it ended up being six because my body kept reacting to the taxol. I was so grateful for the company and energy of my friend who sat with me, gave me space to nap, snacked with me (and allowed me to steal her baby cucumbers and homemade hummus), chatted with me, and walked with me to the rest room when I needed.

In Zen Buddhism, we are called to return to the beginner’s mind. The beginner’s mind is a fresh mind, one not tainted by past experiences. This was my first infusion. It was blissful because I did not know anything when I entered in. Now I have some knowing.

At the start of week two, I found my body recoiling in anticipation of the next infusion, not mentally, but some other deeper primal part of me. It was that instinctual survival part within all humans, the animal programming to survive. My body knows, now, this is poison and does not want to step back into the trap. But she will have to step in, 12 times.

Intellectually, I knew it was going to be intense. Now I know it in my body. Others who have gone through this before me tell me I will get into a habit and a routine with it. For me, each week has felt like a moving target. This may fall into a pattern and lessen some of the intensity I feel right now, but I think the healthier mind set is to accept I won’t know. I won’t be able to predict how my body will show up that day. Or my mind and emotions. No one talks to cancer patients about the mental game ~ the mind-field ~ needed to sustain such a physical onslaught for such a long and grueling ultra marathon. Yet, so many of us have. And I will, too.

The pace of weekly infusions gives my body little time to recoup herself. The infusions have been on Thursdays, wiping me out until Sunday. I am both exhausted and revved up by the pre-med steroids meant to suppress my body’s reaction to the taxol, but also disrupt my sleep. By the time Sunday arrives, my ego realizes he only has three days to get sh*t done before we are back in the hopper and out of commission. And I just can’t get every thing done.

After the second infusion took 7 hours because I had another reaction to the taxol requiring them to stop, clear my system, and start again with a lower titration, I had set my mind to this is how long my infusions will take.

The third infusion felt different in a couple of ways. First, another friend took me to the chemotherapy. As though to mark this change, I was also placed in a different “cubicle” than the one I was in for the first two sessions. The new cubicle was wider than my other one, but it didn’t offer any of the little comforts of the smaller space. There was no little table to set my lunch, so I had to stuff my lunch box beside me in my chair. The recliner chair operated differently, no handle on the side to lift the foot rest, rather you had to push the back of the seat to get the foot rest to extend.

The nurses’ energy had shifted, too. They didn’t offer me a second warm blanket, or a pillow. They asked if I needed anything, but it was clear I would have to ask specifically for what I needed. They were still friendly and attentive, but it was clear I wasn’t a new patient anymore. They didn’t explain everything as thoroughly.

The third infusion took five hours (not 7!) but that was still longer than the typical 3 to 4 hours. I still had a reaction after getting the pre-meds but I was able to handle more of the regular dose before my body reacted (heaviness in my chest, dizziness, headache). But I don’t think my body wanted faster because when I got home, I felt worse than the previous times. Maybe it was the accumulating effects, but maybe my body needs a slower pace to digest the medicine.

At the end of the session my nurse told me my medical oncologist will be talking with me before my fourth infusion about changing to a different taxane. Taxol is wrapped in a solvent that is known to cause reactions (hence the pre-meds). This other taxane, called abraxane, has a protein coating and isn’t as reactive (no need for pre-meds to suppress a reaction), but it’s more expensive than taxol so insurance won’t cover it unless there is a problem with the cheaper taxol.

I know I am at a turning point, entering the long middle phase of this chemo voyage, where the shore we left recedes ever further, and the shore we hope to reach is nowhere in sight. My friend said infusions 3 to 5 were the hardest for her. I was also told after the second or third infusions your hair begins to fall out. As though on cue, when I got home after my third infusion and took a shower, I wondered what was entangling my fingers as I shampooed my hair. As I opened my eyes I was shocked to see huge clumps of hair in my fist and the shower drain. The time had arrived, and once again, knowing I would lose my hair was far different from experiencing it.

There will be a tipping point, I know, somewhere in the middle, where I might feel like I will not be able to endure anymore, a point where I have set out too far out and there is no return, only moving through. That point will feel hopeless, despairing, and at that very darkest moment, I will see a glimmer of the destined shore. I will look up to see the many people all around me, cheering me on, stretching out a supportive hand. They cannot paddle my boat for me, but they have been riding with me, the whole time.

How do I know? Because I have crossed such waters many other times, in different circumstances before. At those other times, I did not have the awareness of what was happening, the bigger picture. When you are deep in the voyage, you can only see what is in front of your nose. You feel like a tiny person alone on a tiny boat, a victim, being thrashed about by forces far greater than you. But after every voyage, I always arrived to the other shore. We always do. We just lose trust that we will when we are in the middle of it.

We arrive battered, yes. Torn apart, yes. But also put tougher and stronger than before so that we have more to bring on the next voyage. And there is always a next voyage. Mother Nature is not cruel. Even in the greatest storm there is a beginning, middle, and an end. And then, a new storm arises again.

In the Facebook support groups I am in for “flatties”, people share photos of their AFT reconstruction to help us “see” what our bodies may look like flat after breast removal because most of us have no place to begin to imagine what this looks like. Breast implants are far more accessible imagery, as most women in the US are likely to have been exposed to the idea of breast augmentation (enlargement or reduction).

It was extremely helpful to see these images of women who had AFT so that I could begin to prepare my mind for what it would see when I looked down at my chest. In the support group there is a lot of chat on how AFT looks, like how smooth a chest a plastic surgeon can achieve, the need for revision of “dogears”, extra skin left on the sides of the body (showing that aesthetic flat is reconstruction surgery, not just sewing up after breast removal).

The website and advocacy group to support and educate about the option of aesthetic flat closure , notputtingonashirt.org, also provides images that helped me see clearly what being denied flat looks like. Meeting and seeing the work of a local tattoo artist @amyblack tattoos, who specializes in mastecomy and trans tatooing, also helped me see the beauty of a flat chest.

But it was very hard to find on the internet people talking about what it feels like to live in a body post mastecomy. Hints were suggested in language describing  mastecomy as “breast amputation”, with experiences of phantom sensations similar to people who experience limbs amputation post-mastecomy. Studies tell of breast cancer survivors being equally satisfied post-mastecomy with their decision for reconstruction or aesthetic flat closure. And physicians and surgeons the least likely to talk about what it feels like to live in a new body after a mastectomy. This is probably because for every person, it is unique to them.

In the flattie support group I observed there were  a number of people who did not choose aesthetic flat closure first, but rather came to it after having implants that made them (unknowingly at the time) sick for years, or who were not candidates for breast reconstruction. For some of them, the feeling of breast implants felt like cold objects in their body or never felt like a part of their body. In a DEIP-Flap support group, I read many being happy about the natural feel of their reconstruction, and some lamenting complications.

My conversations with fellow adoptee cancer survivors helped me the most  to imagine what living in a post-mastectomy body might feel like, particularly the loss of sensation where your breasts once were, in that space where we offer the warmth of a hug and embrace.  This is what convinced me to push for the nerve grafting despite my insurance’s denial of the procedure.

When I woke up after surgery, I can only recollect asking my husband to itch my nose, giggling, waking up again and hearing that I was all wrapped up in blankets around my head, giggling, and passing out again.

At another point an entourage of doctors came in, some of whom were students who wanted to check my incision. Before they took off the surgical bra I knew I wanted to have the first peek at my flat chest. I had read on the support groups some people took weeks before they had the courage to look down at their new flat chest.

I could see how I could have closed my eyes as the doctors examined me. But I forced myself to keep my eyes open and take a peek, even though I was scared, plus I was still filled with drugs so there was little impulse control. What I saw was what I had prepared myself to see (and my husband) from pictures on the internet. There was no surprise. Yup, flat.

The past two months have been survival and recovery mode, not embodiment. I have examined my body with the emotional distance of a surgeon and scientist, checking on the physical healing and fascinated by what I observed as I marveled at the body’s ability to heal.

As I begin the third month post-mastecomy I am beginning to embody this post-mastectomy body more and the felt sense of what it feels to live in it. So much of what it has felt like to this point has been pain as my rearranged insides have tried to reattach themselves to chest walls, to nerves, to fascia, to broken blood vessels, to each other.

I felt mostly like my body has been broken into pieces and taped back together. I have tight bands of scar tissue along the side of my body that limit my arm mobility. Across my chest running along my suture is a tight band that feels like I am wearing a really tight “iron bra”. I experience nerve sensations that feel like sore breasts, milk letting down for breast feeding, and charlie-horse like cramping.

The true magic though is our body’s ability to heal from such a traumatic injury. How could there not be scars after such an ordeal?  I know much of what I feel now I will not feel in a year or two or five. But the scars we heal from are not only physical. They are mental and emotional as well. As my body has been rearranged physically, so too does the mind and heart. Unless we resist.

This week I was feeling particularly  exhausted physically and emotionally depressed (physical and emotional energies often move with each other). I wandered into the bathroom to get ready to take a shower and for the first time I looked at my hollowed chest and missed my breasts. I just missed their fullness where now skin lies sunken into shallow depressions, where once my soft bosoms rose.  Now my sternum is the highest peak on my chest.

I was missing seeing what was familiar and known. I was feeling weary from having to adjust to a new body that was still unfamiliar to me. Missing what one has seen regularly is a very normal response to loss. When the people we love die, it is seeing them in the flesh that we miss. The memories we will always have, but that hug, that tender look on their eye, the resonance of their voice, these we know are what is lost once the body passes and continue to long for after the period of deep grief softens.

The next night I chose to were a compression top that had a breast mound. I allowed the familiarity of seeing this shape of my body fill me with joy and I was reminded that I have a choice. I can “foob” (fake boobs) or be flat and either feels natural and true to me. It seems for many “flatties” it can take time to embrace flat full-time (and for many others no time at all!), with some choosing to foob on the daily and others loving being flat and braless (and topless!).  I can imagine I will likely fall somewhere in between.

Last week I was at the Boston Musuem of Fine Arts and I found myself lingering at a larger than life statue of Kwan Yin (Kwan Um in Korean, Kannon in Japanese). Her image has been an archetype for me  before I understood, drawn to an image of a divine being who looked like me, female and Asian.

As I slowly walked around and inspected her image, I became aware that her chest was carved flat like mine, with the artist’s rendering of cloth folding softly over her chest. An excitement arose as I said to my husband, “Kwan Yin is flat like me.”

Kwan Yin  is a bodhisattva (enlightened being who chooses to remain in the world to help others reach enlightenment) of compassion whose name means “she who hears the cries of the world”. The mirroring of an ancient being who looks like me was a comfort for my ego who has hungered for most of her life to see such mirrors.

In adoption research the notion of “genealogical bewilderment” (Sants, 1964) acknowledges the bewilderment of being cut off and denied knowledge of one’s biological roots and “mirror hunger” (Partridge, 1991) among adoptees to see someone who resembles them.  The image also helped me connect to a  lineage from my ancestry, a lineage that celebrates breastless ~ perhaps androgynous ~ female divine forms.

Before my mastectomy the image of a blue butterfly came to me in a dream and I knew this was an archetypical symbol to help me make meaning of this transformation of my physical form. This week as I took a walk around my neighborhood, trying to fight off my melancholy, I asked for a sign. I didn’t even articulate why, it was just my heart’s exhausted lament to the universe. Within moments, a female eastern tiger swallowtail arrived. Jung would call this synchronicity.

She sat for a long time on some newly emerged spring leaves. As I approached she did not fly off as I feared. She allowed me to get quite close as though she was inviting me to listen closely to the lesson she had to show me. She sat quietly and lifted her wings slowly, like a breath, up and down, not fully closing the wings  so as to allow the full sun radiate her wings. I thought, “You must be one of the first butterflies to emerge this spring.”

I had imagined that after my surgery I would emerge out of it like a butterfly from her chrysalis ready to fly right away. What she showed me was, no. After she emerges from her cocoon, a butterfly rests. She allows her wings to unfurl slowly, she lifts them slowly so they dry and get strong, so that when she is ready to lift she flies with strength.

And she said to me:

Be strong. Have faith. Trust the process. Better times are coming. You are being guided. You are not alone. You are allowed to falter. It is the human condition. Love this part and all parts of the experience. This is what it is to be alive!

It is hard to believe this is seven weeks post bilateral mastectomy to aesthetic flat closure. Week three was physically and emotionally the hardest as the drugs from the surgery wore off, I tried too soon to taper off of my the pain medications, and my new body woke up trying to figure out how to reconnect the parts that had been severed and rearranged.

Week four I realized the real challenge for me was to manage my emotions and mind. When you are in physical pain your emotions and thinking tank right along with the pain. So I began to be more conscious about trying to go outside for a walk, not only to get my body moving again, but also to lift my spirits. This effort got dampened when my youngest son came down with the flu and my husband had to take care of him and I.

Week five my husband’s immune system finally was overwhelmed from the stress of the past weeks and extra caring for our youngest son (and exposure to the flu) that he came down with a viral infection. By that week I was able to move about with more ease and needed less help.

Last week, six weeks out, was a real turning point in my healing. I was able to see my physical therapist who gave me permission to start to raise my arms above my head and drive, warning me to go “low and slow”. I felt liberated getting to drive again and do daily chores like loading dishes and doing laundry.

Patience toward my body, listening to my body, honoring her pace, and being rightfully corrected (by pain or exhaustion) have been my teachers these past weeks. It has left me truly humbled by the wisdom our bodies have to heal if we are patient and provide our bodies with the nutrients and nourishment to do so.

Here are some reflections on choices I made that felt true for me that likely helped me to heal over this period (I have no comparison other than what I did). I also respect choices that other people have made who also healed well from those decisions. But this is my experience.

First, I tried to give my body nutrients it would need to heal. I took a wound supplement (Juven which has been researched) once a day before surgery (about 10 days before) and after. It’s expensive and I am so grateful for those who gifted this to me. I took in extra protein (Core Protein shakes are very delicious and I love adding the vanilla flavored one to make a protein latte) because your body needs proteins to build everything. I also ate a bowl of fresh pineapples a day with cottage cheese (more protein!) because bromelain in pineapples is potent for skin healing. I wish I had started sooner, but I also took Arnica (oral pills) to help heal the bruising. Now that most of my sutures have dissolved I am using silica gel to limit scarring.

Second, I tried to listen to my body, but it was so hard! When I started to feel my energy return, my ego•mind would rejoice and think I was “back” which would inevitably mean I over did something. At the end of week three the weather was particularly warm and I was having cabin fever, so I set out and did a six mile walk and paid for it the next two days with utter exhaustion. I didn’t seem to learn my lesson, because the next week I thought I could do a three mile walk to the pharmacy in my neighborhood, and came back exhausted again! Unfortunately, it is trying to do too much too soon is what can really set back our healing.

Finally, my risk of infection and other complications post surgery was reduced because I chose not to reconstruct a breast mound (several nurses reiterated this). Even at seven weeks I find I am playing at the edges of what my body can do and the energy I actually have now to do other things, given that most of my body’s energy is still going to healing. I can imagine how an infection would have set back this healing.

As I face chemotherapy treatment I wish I had a bit more time to let my body heal from this phase of treatment, but that just doesn’t seem to be the pace of treatment. If I did have breast reconstruction I would be looking at another surgery in the fall, barely time to recover much from chemo side effects.

Last week I asked my medical oncologist how long we could wait before we started chemotherapy and she said no longer than three months after the surgery. I wanted to attend Also-Known-As, Inc. 30th Anniversary so she permitted me to begin my first infusion on April 23.

My meeting with my medical oncologist was a fire hose of information, but it was less stressful than other meetings. I think because this time while I started to go down the rabbit hole of information, I ended up stopping myself. When the report of the oncotype of the larger HER2- tumor came back I said, “I am going to let her tell me what it means,” of course only after I tried to make sense of it.

There was something liberating to allow my doctor be the expert that she is. It also speaks to the limitations of trying to interpret single datapoints without the unique context of your situation. In my meeting, my doctor was able to explain that there were two reasons they wanted to give me adjunctive chemotherapy.

First, was what I understood: HER2+ is more aggressive with a 20% chance of recurrence within 10 years. This falls to 2 to 3% chance of recurrence with treatment (combination chemotherapy drug taxol and targeted HER2 therapy drug herceptin).

The second reason was that in my pathology they noted lymphovascular invasion near my tumors which is a high risk feature. This means that while my lymph nodes were clear of any cancer, some cancerous cells could have migrated out of my breast through this vascular structure. Chemotherapy will help kill any cancer cells that might have hitched a ride to another part of my body.

I opted for the treatment that has the strongest evidence base. This will involve 12 infusions of chemotherapy administered weekly. So approximately three months of treatment, but the time may be longer because infusions are dependent on your blood work, so they may skip an infusion one week if my white blood cell count is too low.

I will start the HER2 targeted therapy at the same time as the chemo and then will have to continue this treatment for a year, getting a dose once every three weeks. I have opted to get a port placed after talking to some fellow breast cancer survivor friends. This will save me from getting weekly IVs for the infusions which run the risk of crapping out (my technical medical term) your veins, limits the risk of the chemo pulling out into the neighboring tissue, and allows me to get up and go to the bathroom during the infusion which typically runs a couple of hours.

The other option would have been to use a newer combination of a different chemo drug (tedium) and HER2 targeted therapy (herceptin) together for a year. The upside to this regimen is that the side effect of this chemo drug does not have you lose your hair. But all of the other chemo side effects, such as compromised immune system, fatigue, risk of neuropathy, remain. For a whole year.

I realized that I did not feel terribly attached to my hair, even though I love the new cut. I thought maybe I feel this way because after losing both my breasts, losing my hair does not feel as big of a deal. I chatted with a friend of mine who was receiving treatment for lung cancer and she shared how devastated she was when she started to lose her hair. We giggled together in shared misery. I realized that what “it” is for a person with cancer ~ losing one’s hair, breast, surgery ~ will be individual, but for many of us there is simply a moment(s) where it all just feels too much.

Then my doctor clarified: you lose ALL of your hair on your body.

“You mean, like your eye brows and lashes?” I squeaked.

“Yes, and leg hair and arm hairs.”

Losing leg and arm pit hair did not seem too terrible especially since most of my treatment will be over the summer. But imagining my face without eyebrows was new. Later that week I was up in Northern Virginia and made sure to stop at an Asian store to get some good makeup to draw in my brows.

My medical oncologist informed me that the first two chemo infusions will let us know how well my body will tolerate the medicine and that my hair will start to fall after the second dose or so. I thought I would get ahead of it and shave my hair before my first infusion, but then my college friend suggested, “Why don’t you wait?” Maybe I won’t lose my hair. Maybe I could hang onto my cute haircut for a week or two longer. When I shared that I would lose my hair with my sons their eyes got round and they said I would look like a monk. Monk Mom. I certainly think I will.

I am keenly aware that this next phase of treatment is a marathon, not a sprint. My treatment is considered chemo “light” because the dose isn’t very heavy each week and because the oncology score on HER- tumor did not warrant being treated with chemo as well. However, the side effects of the chemo will accumulate over treatment so by the final weeks I will likely feel the most exhausted. The only side effects of the HER2 targeted therapy are risks to my heart so my hair will grow back and my immunity will come back once I end the chemotherapy.

I realized as well that it will likely take several months for those chemo side-effects to wear off and for my hair to grow back, which will take me well into autumn. Still, I feel good about concentrating the chemotherapy in the next three months. It is my hope my chemotherapy will be done by August so I can focus on helping my eldest son launch as a freshman in college.

For those who feel called to support me in this upcoming grueling marathon, all of my earlier suggestions still apply. However, these are two areas where I can use the most support in the upcoming months:

-Help with appointments. I would especially appreciate anyone who can come and drive and keep me company during my chemo treatment (about 3-4 hours) which will typically be Thursdays. Sign up if you are free to help using this calendar: https://calendar.app.google/tEQHas3R4sh7NKPA8

-Provide financial support. As a professor of social work, culturally we find it hard to give money to help. We have built social welfare to provide goods and services, but not cash which empowers a person to have agency to meet their own needs. Even with health insurance, we face steep and on going medical costs. I am working in a consulting capacity without benefits. A financial gift in any amount is welcome, and you can tell me what you hope we would use it for. I have decided to set up a GoFUndMe for ease which I will post later. I also use Venmo (https://venmo.com/u/Hollee-McGinnis), or Zelle, or check.

Today marks three weeks since my surgery. It feels like a transition point. And for some reason I feel more vulnerable than when I was probably more vulnerable ~ at least physically ~ immediately following the surgery.

I had thought the surgery was the threshold, but this moment feels more like it.

I can see now that I can’t actually remember very much of the first two weeks of my recovery. I am sure some of it was the wearing off of the anesthesia and nerve blocker, my own body’s adrenaline and the body’s coping with such a physical trauma by shutting down unnecessary things like memory.

All of my resources were going to heal my physical body and there was no energy left for deep thinking and feeling. But both were building up.

This week is a time of transition back to a new normal. One that I do not know my way yet. One in which I feel quite wobbly and nothing feels quite right. Because it isn’t normal yet.

I could only imagine how this moment would feel like the weeks before my surgery, the weeks agonizing about what direction I would take that would reshape my body. And now that moment has arrived.

One that has been clouded by the fact I will need another treatment for the cancer. The dreaded chemo.

The official news came last Thursday, but I suspected on Monday when I opened MyChart and saw a new “FISH” pathology result. I thought it was a mistake because this same pathology had been done in November showing the biopsy of the first large tumor was HER2 protein negative.

The date though was on my surgery so I decided I would check it out.

It turns out you can have two different subtypes of breast cancer in one breast. Apparently the larger (1 cm) tumor that was biopsied in November was negative for HER2 proteins. But the other tumor (5 mm) is HER2 positive.

When the biopsies of the other suspicious spots came back at the beginning of December as cancer, we didn’t bother to send them for further pathology because we knew the line of surgical treatment was clear: we had to remove the breast because the cancer was multifocal.

While we knew the larger tumor was estrogen and progesterone positive(or hormone receptor positive, HR+) because of earlier staining of the biopsy, we knew nothing of the other three tumors that were removed during the mastectomy that the pathology report indicated were all cancerous.

When my breast surgeon called me she did not have the pathology of the HER2 protein for these three other cancers, only that they were all hormone receptor positive (HR+). She likely presumed that the result for the HER2 protein would be the same as the test in November which would have supported her assertion that I did not need any further treatment.

The least aggressive subtype of breast cancer is HR+ HER2- though this alone does not determine prognosis. The age of onset, size of the lump and advanced stage of cancer, meaning the cancer had spread to the lymphs or other places in the body, is still potentially more lethal regardless of subtype.

So my happy dance after the pathology results I got from my breast surgeon that the surgery had successfully removed the cancer (margins clear!) and that my lymphs were also clear of any cancer was absolutely worth dancing about. It means it is the lowest staging possible (stage I) for an invasive cancer and means my prognosis is very good.

What I regretted was that I over reached in hoping that I would need no more cancer treatments. This was my hope. This is what I wanted to hear. But we didn’t have all the data, yet. And at that moment, it was reasonable to assume the results of the earlier pathology for the HER2 protein.

But, I am a unicorn. It’s not common, my medical oncologist told me, to have two different subtypes of breast cancer, but she has seen more than enough of her share of it.

I had already had radiation on my left breast. I knew what that felt like. I now knew what it felt like to lose my breasts. I was already on an estrogen blocker to help starve what we knew of this new cancer. I really didn’t want to have to experience chemotherapy.

But, I do.

Breast cancer subtypes is a real advancement in treatment because they have made targeted treatments possible, rather than just trying to throw the kitchen sink at the problem. Knowing that the subtype of breast cancer “feeds” or grows from estrogen and progesterone hormones (HR+) means there are hormone blockers that can be taken to “starve” these cancers from growing.

The most lethal subtype of breast cancer is triple negative. One reason it is so lethal is because the targeted therapies don’t work on them. The triple negative subtype means the cancer has no hormone receptors or HER2 protein receptors to target. The other subtype that is more aggressive is HER2+. So I have both hormone receptor positive HER2- and hormone receptor positive HER2+ positive (triple positive) subtypes.

Since my cancer is very early stage we are not trying to kill any known cancer with chemotherapy, we are trying to slow any potential growth that might crop up. I will also need to take another medication that blocks the HER2 protein as well as continue the hormone blocker I am currently on. For HER2- subtype, my medical oncologist said she needed another test to get the oncotype score to see how much the DNA has mutated; depending on the oncotype score this will be factored into the chemo cocktail that will be part of treatment.

Even when I was dancing over the initial news of my pathology, I wrote to friends saying I know that this may not be the end of the story, but that this was something to celebrate no matter what came down the line next. I knew from my first cancer that there were likely be other twists in the road.

But when the next bit of news arrived so soon, I was really deflated. I wanted to feel like I put cancer in the rear view mirror, even though I knew that very notion is a mirage for every cancer survivor. I was already starting to feel a bit more energy and was thinking of starting back to do some work. But after the news, the clarity of that future got hazy again.

I know it is only temporary. I know that the chemotherapy plus the targeted HER2 and hormone therapy offers me excellent prognosis for treating the cancer that will likely keep it at bay for a long time. I know I am fortunate to have a relatively common kind of cancer for which there is much research and treatments.

And yet, there are days where it just feels like too much. These are the long lingering weeks and months after the acute phase of treatment that are the hardest to not fall into despair. Where the physical body is weakened and the heart and mind begins to spiral. Where your friend who “had” cancer still feels very much like she or he still has it. Where your loved one who “had” cancer looks down at a body they cannot recognize anymore because of all the “treatments” it has been put through. Where the cancer survivor who had endured incredible pain wavers in their resolve.

We live in a culture that cherishes the notion that we can be “cured” and “bounce” back into our lives as though nothing had interrupted it in the first place, rather than honoring as sacred what we have been through and show the scars we carry. When the body heals, there is always a scar. Sure, it may fade, but its mark will still be there.

Now as the physical body heals, the emotional and mental bodies must also have their time to heal. This healing is less bounded and predictable than the physical healing, and may take the rest of a life.

I drop huge tears with my husband. Huge tears ~ not over what my body looks like now or even the upcoming treatments ~ but over what life I am going to live into now, for which I have put my body through so much to live for. How can I go back to resuming my “old” life after all that I have been through? Because no matter what, I am changed. The first cancer had already changed me. This second cancer feels like there is no going back. Yet, I do not yet know, yet, what is forward.

And maybe, I am not supposed to.

This means I do not need any more cancer treatments (no radiation or chemo) just my oncology med (estrogen blocker) and healing up from my bilateral mastectomy 🥰! This is my limited arm happy dance with my one and only Miriam as backup 😂😂😂!!

Life is precious, life is beautiful, life is worth every effort to live each moment as it is imperfectly perfect! 🌸🌈🦋✨🌸✨

It will be another two weeks before the pathology reports will done. That will determine whether I will need other treatments like radiation or chemo. I am already taking onc meds which thankfully have not given me terrible side effects.

See you on the other side 🥰🌈🦋.

This has been a very hard week.

It has reminded how much fear is biologically programmed. We cannot be fearless. If someone says they are fearless, they are likely lying. They are likely coping with the fear through denial, numbing, rationalization, armoring up, inflating the ego.

They are likely masking the fear, but the fear is there. It’s in all of us. It is a biological program in our cells to protect and survive. Fear is not our enemy. It is our protector.

Fear shows up, wearing many faces: depression, anxiety, worry, need to control. Fear is the response to a perceived danger. In these modern times this danger may show up as purposelessness, a news story, a text that goes unanswered, thoughts of the past and the future.

We are at risk of living our entire lives only through our fear responses. When a fear response gets stuck, therapeutically we call this post traumatic stress disorder (ptsd), which essentially is the body being stuck in the fear response (fight, flight, freeze, fawn).

Yet, the body was not designed to just fear. It was also designed to relax. Within our autonomic nervous system there are two complimentary systems: the sympathetic (fight/ flight) and parasympathetic (rest/ digest) nervous systems. And the bridge between the two, that is within our conscious control, is our breath. This is why in many Eastern mindfulness practices we are encouraged to return to the breath.

The autonomic nervous system is exactly that, automatic, involuntary, outside of the control of our mind. And that is a good thing. We would not want to have to think about our lungs breathing, heart beating, our stomach and intestines digesting.

I feel fortunate is some ways for the first cancer in 2020 because it set me on a path and deepening of Eastern practices (yoga, meditation, qigong, tai chi, reiki) that are very helpful for this moment. These practices have helped train my body to know how to breath deeply, to cultivate my awareness, develop a loving relationship to the self, and discernment. Still, fear will always arise.

It hit hard on Monday, as the stretch of the week felt infinite, and last night when the weight of the week finally crashed on me.

On Monday I had my pre-operation meeting with my plastic surgeon in the morning. My mind was all set to drive myself and I told my husband the night before. This was also helpful given my kids had asynchronous school at home because of the ice and snow conditions from the storm.

When I woke up and began getting ready for my morning appointment, I became aware that my entire body felt frozen and that my mind was disconnecting, or disassociating, from my body. Even as I commanded my body to get dressed, I could feel my mind was actually detaching itself. In that present moment, I realized it was not safe for me to drive in such a state. So I asked my husband to drive me.

My old self that only knew how to react and was programmed to survive, would have done what she always had done: she would have pushed the body’s fear signals down and driven herself to the appointment.

I am grateful that I have cultivated an awareness where I can now see my body’s signals and honor them rather than judge and fight them. I am also grateful that my situation right now allows me the space to honor them and that I have resources available that can support me to respond. I know many do not have this kind of space or resources, and must stuff feelings and take care of things. I have been there, too. Now aware of how I have largely responded to fear in all of its guises by stuffing it and soldiering on, I know the great cost and toll of this on the body, mind, and heart.

We cannot be fearless. But what I have learned over these past six years is that we can fear•less.

In the West and modern society generally, we are conditioned to constantly be on the go and never rest. We are conditioned to think that rest and digest is being “lazy”. As a result we do not know how to relax and rest in ways that truly restore the body, mind, and spirit.

In the East and indigenous cultures generally, practices cultivated over 5,000 years have continued to be practiced and remembered to this present day. Wisdom that had been carried by the wisdom keepers is now easily available and accessible to the general public.

But if you do not practice with the intensity of a monk, do not fool yourself that you will be able to use these tools of mindfulness, yoga, mediation to ohm yourself out of fear. Fear is your body protecting itself. You are simply cultivating a relationship to that fear so that fear won’t run the show.

In fact, mindfulness practices were not designed to escape from our fear. They were designed to help you be in the present moment. If the present moment is loving or fearful, mindfulness practices are meant for you to be present to that love or fear, rather than run away or numb out of that present moment.

Yet, even for the venerable monks who are Walking for Peace, who have cultivated incredible mindfulness practices that they can walk 2,300 miles, they cannot escape their biology and bodies. Many in this final stretch to D.C. are coming down with the flu or sniffing with head colds. And their response? Is to take care of the present moment. They are taking care of their bodies with medicine and acupuncture, they are taking longer rests, walking a little slower, yet they still walk. They are present to the moment and therefore can take care of the present moment. This also makes them fear•less. They did not stop walking because of worry about snow or sickness or hardship; they simply met them as they arose in the present moment.

Realizing I could not talk or breathe my body into relaxing, I was grateful to my past self for having booked an acupuncture and massage appointment on Tuesday. When our bodies are stuck, often we can only move out of it with the help of another. We need someone else to help the body regulate, especially when the body is deeply stuck or frozen in fear. This is also why the monks walk in community, with a sangha.

Co-regulation with another is also deep in our biology. Our understanding of this comes from attachment theory. I was struck by new neuroscience research showing that children save their hardest feelings for their mothers because their nervous system physically changes in her presence. In brain scans, the stress circuits in a child’s brain deactivates five time faster when reunited with their mom than with anyone else.

This means that for all the Moms out there if it feels like you get the brunt of your child’s emotions it’s because they are seeking regulation from you and they instinctively know this. They just can’t tell you except through their behaviors which reflects their hurt, not their need for help. This also means that we also can regulate (though slower) with anyone.

On Friday I tried to self-regulate. After my appointments on Tuesday the cells of my body began to soften. By Wednesday I began all of the pre-op cleansing procedures and that night I was able to finally get a good night sleep. On Thursday I had shifted enough into rest and relax that I had a little space to finally do a little yoga and a short meditation. I was fully present to the joy in getting my hair cut and how the short hair changed my look.

By Friday, the stress of anticipating the surgery got compounded when I was told that insurance denied the nerve grafting procedure and the peer-to-peer request by my doctors, essentially a day before my surgery.

Nerve grafting is not new, but is new as a procedure for mastectomy. To have chest sensation, even a little bit, is a safety issue (think of the fire in the movie “Mrs. Doubtfire” - my breast surgeon told me this has actually happened to her mastectomy patients), as well as quality of life. We have decided we will pay for this out of pocket and bear the financial burden. But it’s not right.

I could feel the stress load on my body but I was fully operating from my well trained survival mode. I pushed through the rest of Friday with work I felt I had to complete before I would go under on Monday. I responded to a bunch of emails. I could see myself getting crankier and less patient, but I wasn’t aware enough to shift. Then after dinner my husband said something minor and I found myself furious and upset, wanting him to just take care of it.

I was aware but couldn’t stop it except to hold it in. I did not want to have an outburst in front of him or my sons. So I froze. I looked at my phone. I fell asleep briefly on the sofa. Then I just stomped off to shower and do my pre-op cleansing. I wanted him to know I needed help because I could not tell him. Of course, he didn’t know.

I finished my shower and still upset at him, I stomped to bed, not letting him or my sons know I was going to sleep. As soon as my head hit the pillow, I burst into tears, and the words finally arose, “It’s too much! It’s just too much!” My entire body mind heart system was overwhelmed and it was all just too much.

My Mom told me after I arrived from South Korea at the age of three-in-a-half and could speak English, I would similarly break down and bawl my eyes out, shaking my head, crying out, “Too much! Too much”. This would happen before dinner or other moments that were for some reason too stimulating and overwhelming to my little toddler self. She would respond by removing me until I calmed down.

I was not functioning from my prefrontal cortex (executive function) which was why I could not ask for help. I was completely in my limbic system (emotional/ survival brain) and could only express my need and overwhelm through acting out and crying. Children’s prefrontal cortex do not fully develop until late adolescence. So young children only have their limbic brain to process which is why they are “so emotional”.

The tears were a release, giving me just enough space for my executive functioning to work again. I realized I forgot to do the pre-op cleansing of my mouth and teeth. By this time, my husband had come up to get ready for bed and was in the bathroom. I had been lying, faced away so he could not see me or my tears on the bed.

As I stirred and walked into the bathroom to do the cleansing, I told myself to show him my tears. I came to him for a hug and was finally able to say the words out loud to him that I couldn’t earlier, “It’s too much. It’s too much.” And I was able to tell him how overwhelming and stressed I was feeling.

He held me tight, and said to me, “You don’t have to do this alone.” And my entire body melted into his as I could finally let go of the fear that held me captive. My executive functioning mind knows I am not alone. But my freaked out limbic system? That toddler needs reminders all the time that she is safe, that she is loved, that she is enough. Otherwise, she will have a tantrum.

Indeed, none of us have to do life alone and we are not wired for that kind of life. If you feel alone, let this be a message that there is someone who sees you and wants to walk with you. It might not be the people we expect to support us, either.

So do not be disappointed if your co-regulator is not a parent or partner. Perhaps your co-regulator is your four legged friend, a tree, a river. But as humans, our biology was designed for co-regulation with another human. We were designed to go out and face the dangers of the forest or jungle and return to rest and reset with our village, our people. In the safety and love of our community is where we can be most fear•less.

People have asked how they can support me and my family as we move through the next few months of recovery from the acute phase of my 8 hour double mastectomy and aesthetic flat closure procedure on Feb 9, potential other cancer treatments, and long term health recovery.

This is a time of great turmoil and suffering in the world. I am grateful for any and all acts of kindness.

This is not a request for support, just guidance on how to provide support if this feels right for you (and is not a checklist 🥰). Feel free to share or use it as a template for yourself or others:

- Take care of yourself first. Give from you abundance, not your burn out. Eat well, take a walk in nature, do something that rests the body•mind, fills the heart, calms the soul.

- Prioritize your giving. There are great needs in the world, and I have support. Discern what is in your capacity and priority to give.

- Give anything from your heart. Send a text, mail a card, leave me a voice message, give a thumbs up on a social media post; these are signals to me that you are present, and it is your presence that is the gift. I may not respond, but please know what ever action you do is not small, it is received and appreciated.

- Share anything uplifting, motivating, inspiring, awe awakening, playlists, music, movies. Sometimes you need something to help lift your emotions and spirit.

- Read my Substack. Social media algorithms may not show my post or maybe you aren’t on a platform. Substack is where I am sharing how I am truly feeling and doing. You can subscribe for free and you will get an email when I post stories and send updates just to subscribers: https://holleemcginnis.substack.com

- Provide financial support. As a professor of social work, culturally we find it hard to give money to help. We have built social welfare to provide goods and services, but not cash which empowers a person to have agency to meet their own needs. Even with health insurance, we face steep and on going medical costs, as well as financial burden for services that are not covered by insurance but are helpful for wellness (e.g. therapeutic  massage, acupuncture, future tattoo, a pedicure). A financial gift  in any amount is welcome, and you can tell me what you hope we would use it for. Platforms like GoFUndMe take a cut. So I would prefer to  just use Venmo (https://venmo.com/u/Hollee-McGinnis), or Zelle, or check.

- Nourish us. We decided rather than a meal train we will sign up for the meal prep service Gobble. We welcome any support for this service. You can buy gift cards to send us here https://feast.gobble.com/offers/gift-cards

- Share a gift. This could be something you do as a hobby or offering. Or could be a card for Amazon, Costco, Target, Grubhub, DoorDash, Kroger, Wegmans. Gifts for my whole family are appreciated. Please text me if you are sending me something because notes don’t always come with deliveries and I want to know who is being generous. I have a gift registry of items pre and post mastecomy on Amazon here: https://www.amazon.com/registries/gl/guest-view/33WGNRVC0VIHZ?ref_=cm_sw_r_apin_ggr-subnav-share_9KHZ7AAQDPB1RR0TPF1K&language=en-US

- Come visit or chat. I will use Calendly to show what days and times are open for chats. Sign up and then I’ll know when to expect a  call. https://calendly.com/hollee-mcginnis/conversation-connection

How do you live fully knowing you will die?

Most of us cope with our mortality as we would any traumatic event: fight, flight, freeze, or fawn.

This makes sense since our biological system is programmed for survival: To survive the traumatic event of a tiger leaping out of the jungle ready to devour us.

How might these trauma coping show up in our lives?

We fight death by keeping our body pristine ~ eating, exercising in ways to keep the body alive. These are healthy. Where coping gets unhealthy is when we only fixate on keeping our body looking youthful and fight and judge when cracks and wrinkles begin to appear.

We take flight from death mentally by denying death will come for us, detaching or disassociating emotionally or mentally when someone is sick or dying, procrastinating getting the will done or setting our affairs in order. Where this becomes problematic is when our flight makes us impulsive and we take unnecessary risks, or never get our affairs in order.

We freeze in the specter of death when someone is sick or hurt and we don’t know what to say, we don’t know what to do. We freeze when we stop living expansively and live small and safe, unwilling to try anything new or unknown.

We fawn and plead through our appeals to death, hoping our prayers or even a morbid fascination or befriending with death may help prevent death coming to our door.

What, then, does it look like to truly be alive while knowing your body is on a journey of decay?

For this is the fate of all living things, but it is unique to humanity that we occupy as much of our living to our fear of dying, usually unconsciously.

In fact, in my doctoral class I introduce my students to Terror Management Theory (TMT) developed by Jeff Greenberg and Tom Pyszczynski in the 1980s that posits that most of human behavior is driven by our unconscious fear of our mortality:

“According to TMT, the uniquely human awareness of death gives rise to potentially paralyzing terror that is assuaged by embracing cultural worldviews and meeting or exceeding the standards of value associated with them (i.e., self-esteem) in pursuit of literal and/or symbolic immortality (Pyszczynski, Solomon, Greenberg, 2015).”

What is key in this research is that we tend to cope with this fear of death by bolstering our self-esteem by asserting the dominance of our worldview over others, that can fuel bias, prejudice and discrimination. This need to assert a dominant worldview to cope is one of many factors that contribute to global conflicts.

An upside to being aware of this existential fear is that you can consciously choose to take steps (rather than reacting to fear) toward finding meaning in your life that is not driven by this fear. So in my course I give my students an assignment to write their obituary as an exercise to make meaning about the life they want to live rather than living in unconscious fear of their life’s end.

It is not an easy assignment.

Today is 10 days before my double mastectomy and aesthetic flat closure surgery. The rationale logical mind knows that I am safe. This is the miracle of modern Western medicine that I will go into a surgery for 8 hours, have my chest cut open, body parts removed, and wake up to live and tell the tale.

The ego-mind that seeks to protect at all costs, that anticipates and scans the environment for all possible risk of mortal harm, pokes his head and squeaks: but, I could die.

A friend reflected this truth to me after my lumpectomy five years ago, the first time I had gone under the knife: surgery is a controlled death.

The true risks of what I am about to embark on came home yesterday when I met with the pre-op team who gave me all of the guidances to prepare for the surgery. First, I had to immediately do breathing exercises to make sure my lungs are cleared.

Starting next Wednesday, five days before the surgery, I have to wash my body, mouth and nostrils with antiseptic to remove as much potential pathogens that might be carried in with me into the surgery. These are the true ancient killers to any major bodily wound.

I can’t shave ~ and by extension I am extrapolating to be careful of any cuts and punctures ~ because the nurse told me they are potential doorways for pathogens to enter the body. Infection after the surgery is the greatest threat during recovery.

I also met with the lymphedema specialist this week who explained my risk of lymphedema. I did not know, but having had radiation on my left breast also increases my risk for lymphedema because the radiation scars stiffens the elasticity of the lymph tubes, lowering its capacity to clear fluids.

I knew I was also at risk because I will have some sentinel nodes removed under my right arm during surgery to assess if the cancer had spread into the lymphatic system. If the cancer had spread there it means a new cancer could show up again anywhere in the body.

I feel like I am getting crash courses on the lymphatic system, human anatomy, breast tissue, and cancer. I am doing a lot of self study on all of these topics including nutrition and fascia. It takes a lot of discernment to know at what point this is healthy and helpful, or tips into unhealthy and obsessive.

I think because during my first cancer much of my healing came from confronting my relationship with my body and facing my mortality, I am in a different space now. I realized cancer can be an invitation to form a new relationship with your body. But I now see this new relationship has also been built on fear: the fear of cancer returning.

My British friend shared in the dry dark humor of one who has lived it, that when her husband’s cancer returned they joked: Well, we no longer have to wonder whether it will come back.

I don’t either. This is why if you speak to anyone who had cancer, we know we are never done. There is no endgame for cancer. The hope for everyone is to be with no evidence of disease (NED), but every cancer survivor knows that NED is always temporary. It is only NED for this moment, because who knows the next.

And maybe that is the gift of death: to remind us that all we ever have to live for is in the precious moment before us. We may lament the past or dream the future, but what we actually have hold of is the present moment we are standing breathing walking in.

In so living, every moment becomes a lifetime.

Last night, as I allowed the fear of my mortality run through my body, heart, mind, and spirit, my youngest son seemed to sense it and asked to cuddle in bed with me. So I gathered him in my bed and then my eldest son came wandering into the bedroom to say good-night. So I invited him to cuddle on my other side. Both of their heads were tucked on my chest as I wrapped each of my arms around them and hugged them, snuggled under the warm blankets.

And I spoke the words of truth. That I will be safe and that if anything happened to me, I would still always be by their side: that their mother’s love will always be with them, surrounding them, holding them, protecting them, embedded in their heart and every cell of their bodies, guiding them. I told them I was proud of them and how much I love them, and that we should never wait to tell someone how much we love them.

Finally, as they headed to their bedrooms and I settled to rest, I whispered to my husband: take good care of them. He said, I will. And I know he will, because he already has.

Follow the story on Substack: https://holleemcginnis.substack.comr

I have been savoring the gift of stillness. But I know this time is coming to an end.

I close my eyes and an image behind the dark curtains of my eyes reveals, stillness. Walking slowly, in deep snow banks. Each booted step sinking quietly into the powdery diamond flecks of snow.

Stillness of a new fallen snow. Stillness within a breeze that gently caresses a chilled cheek. Stillness of sunlight sparkles. I step forward. But I do not know where I go. Do we ever know?

Only when we arrive.

When do we arrive?

We arrive with every thought, with each step, within every breath.

In the stillness, you hear softness. You feel gentleness. You sense breath before it arises. The earth, sighing. The birds, calling. Of a life, returning. However, for life to return, we must take the next step.

What we only really know is that there is a next step, for change and evolution is the experience, not stasis. So we are guided to take the next step forward.

Whether I am ready or not, the next step awaits. This means it is time to move out of this stillness and respite it has offered.

It is now two weeks until my mastectomy. My pre-op appointment that was scheduled for yesterday was cancelled because of the snow and ice storm, and will now be next Monday, one week before the surgery.

After intense weeks in November and early December, I was offered a gift of more time. My ego-mind had clung to the words of my breast surgeon who said my surgery would likely be “early early January”. I began to align all my thoughts and actions towards this time, compressed by this deadline.

Then on Dec. 18 a message appeared in MyChart for a pre-operation appointment and surgery instructions for Feb. 9. Despite the note stating that someone left a message, I had not received or gotten a voice message.

In a panic that I had missed something -- because when you are operating from a traumatized brain you always think it’s your fault or their fault -- I wrote back via MyChart asking if I had missed some information and that I had never received a voice message. And no one responded.

So how I found out I was scheduled for surgery was it simply appeared as an appointment in MyChart. Similar appointments continued to appear in MyChart without any communication about them.

An appointment with my medical oncologist physician assistant to start an aromatase inhibitor, to block estrogen that my cancer feeds on, appeared in MyChart for early January. This did not make sense to me. It would be almost two months from diagnosis before I would have my surgery, so why not start immediately in mid December?

So, I advocated to move the appointment up and started on the estrogen inhibitor over the Christmas holidays. I was given anastrozole (for menopausal women) and thankfully I have had minimal side effects from it, unlike when I tried tamoxifen (for pre-menopausal women) five years ago with the first cancer, and felt like there was glass cutting under my skin. The pain was so great and at that point in my treatments the quality of my life was more important, so I decided not to continue.

I was not thrilled at this appointment to learn that long term use of these estrogen inhibitors increases your risks for osteoporosis. So I had to get a base line bone density test which came back with mild bone loss. To counter the bone loss while on this estrogen blocker for cancer, you need to take another medication weekly or a shot every 6 months, to maintain bone health.

And thus the yoyo of medications that are both the benefit and problem of western medicines: they are so potent on what they are designed to target, but end up throwing other systems out of wack. Are the benefits worth the new problems? It is up to each person undergoing treatment to decide.

Last week I got a notice from CVS that my medications were ready to be picked up. I had not received a call about any prescriptions, had not seen a doctor about any prescriptions, and saw nothing in MyChart about a prescription. So I ignored the first message. Then the second.

On the third I figured I should find out what these cryptic medications were. Only because a breast cancer survivor friend tipped me off that I would likely need an antiseptic body wash pre-surgery did I understand what the prescriptions were for. So then I went and got them. But it would have been nice to have known those prescriptions were coming in and why.

Thankfully I have friends who are medical professionals who could explain to me what would likely be the nature of these appointments. I have never had a major surgery like the one I am to face. I will likely get all of the instructions at the pre-op appointment that has been rescheduled a week before surgery, but I had so much more time that I could have been informed in order to prepare.

I wish the medical establishment could understand that while this is all routine for those working in the system, for patients it’s like trying to navigate a foreign planet knowing your life is at stake. Having information provides the faintest map for the mind to understand, at least vaguely, the terrain ahead.

While I could have remained in a state of anxiety and worry about having to wait two months before I could have my surgery to remove the breast cancer, I chose to be grateful for the time I was given.

I staved off the impulsive conditioning to cram a bunch of work in January, and instead chose to listen to my body, which really wanted to rest and conserve energy. I began physical therapy and nutritional supplements I saw on breast cancer support groups that people said were helpful.

I have been donated a mastectomy pillow I can wear to protect my chest, ParkPuff to protect my chest from the seatbelt, mesh belts to hold the drains while I shower, shirts and pj’s with drain pockets, triangular pillows for my bed to sleep upright.

I savored the quiet time with my family, moving with presence and love towards this body that has been mine for 54 years, that has carried me through this life and provided me so many experiences. I spoke with kindness to her and wishes of forgiveness for all the times I had judged and criticized her.

It has been a time of a long and cherished farewell. It has been a time to experience the steadiness offered by stillness.

I now know I can return to this stillness anytime because it has been re•membered in my body. I had only forgotten that I carry the stillness of the mountains within.

And so I breath in the cool crisp fresh air of the snowy mountain peaks and smile softly. I will come back. I can always come back. But now I must return.

“Love letter”

(c) 2026, Hollee McGinnis

After psychologically and emotionally agonizing chaotic disruptive unmooring weeks, I have come through to a space of stillness, quiet, fortitude.

I began to observe the stillness last week as I found my ego-mind quiet. The chaos, the constant chattering, was gone. I could simply see the tasks and there was no anxious tension constantly asking was it right or was it wrong. Doubt had fled. Confusion had settled. Clarity presided.

I became conscious of this new inner stillness enough that I was able to reflect on it with a friend. I felt so grounded, I said. An inner stillness where there had been a constant chaotic energy that had no inner core or anchor to tether itself.

As a child, my inner compass had oriented herself outwards, rather than inwards. My sense of self, carved by inconsistent attention of multiple caregivers, had gotten disoriented by the mixed signals I received from the outer world which then shaped my inner self.

When the outer world, through consistent caregivers, responds to the cry of an infant, the infant learns both about the world and themselves: that the world is safe because their needs will be met and that they are a someone for whom the world will respond.

When this beautiful dance between self and other, inner and outer worlds, is disrupted and inconsistent, the infant receives mixed messages about the world and themselves: that the world is not safe and their needs won’t be met and that they are a nobody because the world does not see them as a somebody worth responding to.

Not being attended to is a threat to a newborn whose entire existence is dependent on others. In response to this potential annihilation, the infant may turn inwards to cope. To compensate and protect, the infant may withdraw ever deeper within themselves, or act outwards, or freeze and not respond, or desperately cling to anyone because the stress permeates every cell of their little body.

Within the context of traumatic stress studies we call these responses flight, fight, freeze and fawn. Disrupted and inconsistent caregiving ~ or what is known as developmental or attachment trauma ~ deeply chisels the body, mind, and spirit of a newborn child and their infant inner self.

The good news is that every human is wired for attachment because we are wired for relationship. Every infant or child who might have experienced disrupted or inconsistent care can form attachment relationships with a healthy caring adult. We are born to.

Unfortunately, simply the presence of a co-regulating adult cannot remove the internal patterns that an infant or child learned to use to survive. When feeling threatened, we often default first to how we coped when we were children. We might react with an angry outburst or tantrum (fight), we might withhold (flight), we might say nothing (freeze), we may plead (fawn).

My default has been to freeze or to go outward and find external authority who knew more than I did for the answers (fawn). A huge part of my healing has been re•discovering my own inner compass and building trust within and inner authority.

The past few weeks felt like a massive churning up of an old soil bed of emotions, memories, fears, losses, angers, regrets, that had hardened over a lifetime. I had no realization how desperately it needed to be plowed and turned over so something new could grow.

We are so far removed from our relation to the earth that we have forgotten how much effort it takes to plow the soil in order to sow and grow. Once at a Korean folk village I watched an old black and white footage taken mid-century of a farmer struggling behind a cow pulling a large wooden plow to dig up the earth. He wobbled back and forth with weight of the plow, his brow heavy with sweat, his legs sunk deep up to his knees in mud.

We have forgotten that we plow and till the soil so air and water can be better absorbed. We have forgotten that we must plow and the till the soil to create a soft and nutrient rich environment for seedlings to grow.

I needed to make room for something new to bloom. What I didn’t realize is that in order to bloom we must enrich the soil. We must let some things go. Even the trees know this truth when they let the leaves fall, becoming the fertilizer for spring’s blossoming.

I had settled and gained clarity on a path for me: double mastectomy and no breast reconstruction (I will be flat), which provided me with a felt sense of peace, beauty, and freedom.

But there was something else that arose within me after going through the chaotic churning of the past few weeks. It was more than peace or serenity. There was a steadiness. And while it felt peaceful, it felt strong and energetic too, not passive and also not forceful. As I sat to reflect the word arose: fortitude.

According to the Merriam Webster Dictionary definition, fortitude means: “Strength of mind that enables a person to encounter danger or bear pain or adversity with courage.”

Fortitude is forged when we face our hardship, not avoid them. The chaotic upending of the past few weeks were a necessary tilling and plowing up of the soil. It also became a forge, a fire, that burned away what was not me, showng my mind-heart I can face the danger, bear the pain, and adversity with courage.

Fortitude. Steadiness. This is what I feel now that I have gone through the hard work of allowing all the feelings to be felt, all the worries and fears to be heard, all the cries, longings, and wishes to be held. Our hardships aren’t meant to destroy us, nor be easy, but they are meant to remind us we are capable of more than we may believe.

All of these feelings are still a part of the soil of my being and yet because I allowed myself to be present to them, to farm them and till them, I now realize I created a rich soil for the new seeds to blossom and grow.

So I invite you: do not be afraid to till your soil, to feel every tear, to hold every longing, to see deeply into your fears, to know who you are (not who you were told to be), for in doing so we are preparing the nourishment for our becoming who we were born to be.

Yesterday I could feel the depression settle into my body. I could feel the sluggishness take over my body-mind. It’s familiar.

Depression made it hard to move the body when I knew that was exactly what I needed to do to shake its grip. So I did some yoga. I listened to a podcast that I liked. Depression hadn’t settled too deeply but it continued to shroud me.

So I pushed the body to move more. It felt good to set my attention on my eldest son who needed to complete his art portfolio for his college applications. It gave the mind something to focus on but it didn’t shift the depression.

I had wanted to decorate for Christmas but I really couldn’t muster any joy to do so. Even my youngest son who typically is the one most enthusiastic for decorating for the holiday didn’t feel like doing it that day.

The mind’s negative reasoning floated by: it’s so much work. We will have to take them down so soon. It’s such a bother. No one is going to see them (as though bringing joy to us was not important). The effort felt simply too much because I had no joy to push the depressive fog aside.

Finally, the effort to put together the art portfolio was done and I collapsed into the sofa and watched two Japanese anime movies with my youngest son. My husband pulled together a simple and tasty dinner of fried jalapeno cheese sausages, seasoned cucumbers, and cheese plate.

It felt good to allow myself to let go of the effort and sink into the sofa for the rest of the night. It helped to lift the depression because the anime movies were captivating. The movies grabbed my emotions that had been stuck in a depression and could not be shifted through behavior alone.

The movies helped me break free from the depression to reveal what was beneath.

My husband joined us to watch the second movie and I cuddled up with him. Pillows and blankets created a mountain blocking my access to his body so I grabbed his arm and wrapped my body around it, pressing it into my chest like a teddy bear.

Thats when the sorrow arose that had been masked by the depression as the thought floated by, “I am going to miss feeling him.”

I am going to miss feeling my chest. Feeling hugs. Feeling “the girls”, for their annoyances and for their pleasure.

As I laid in bed with my husband the tears finally fell. Sweet gentle rolling tears. Not the sobs of a few days ago. Gentle tears, tears of sorrow. Sorrow for what will be lost that brought joy, like having sensation when pressing my children to my breast to comfort them.

Tears of loss. That when I run my hands over my chest there won’t be two familiar mounds to greet me, even as they grow droopy. Even if they were reconstructed mounds, the sensation and shape would never be like my own. I knew this because with the lumpectomy I never had the same sensation return to my nipple.

And so begins my grieving, a process that flow like tears, yet was being blunted by depression. The depression was the sign that something had to move, yet also became an obstacle to that movement.

Grief is a releasing of all that you loved and will miss now that there is an absence. Grief is not something we do. It is giving ourselves the permission to be and feel.

Other women who have lost other feminine parts ~ hysterectomy and ovaries ~ also shared they had to confront feelings of being “less than” a woman. I have no doubt. Yet these female organs are not as public as breasts. Nor are they organs with the same capacity for sensation. Another female friend said she never had a lot of sensation in her breasts.

But I do.

Grief is about the loss of what we love. For all of my love-hate relationship with my breasts, grieving all that I love about them is essential for my healing and moving with this loss.

This is the first time I will be losing a physical part of me, but I have lost physical presence many times.

From what I know of the first three in a half years of my life in Korea, I lost the physical presence of my Korean mother, father, foster grandmother, paternal grandmother and grandfather, paternal aunt and uncles, foster mother and father and orphanage “siblings”.

When I arrived to my adoptive family in the U.S. I fought and cried and tried to “go home,” but that little toddler never had a chance to grieve all she loved. Her caring adoptive parents tried to console her tantrums, but they didn’t know she was fighting because she was in grief for all she loved that was now lost to her.

And so the grief that could not be named sunk into her body and lost its name. It sunk into her body and was numbed by depression that misguidedly came to protect her, but only ended up numbing her like ice on a frozen mountain stream.

It has taken half a life to help this little girl release her grief. She had carried the grief for so long, it made her body sick. The parts of her body that grew sick embody mothering, nurturing, nourishing, family, and the sustaining milk of life itself. How can we feel anything but love for these beautiful mounds?

Yet, for most of her life she had an antagonistic relationship with them because she had not been able to grieve. The grief had set in too deep for her and was growing out of control. It was too late. Now they must be sacrificed so the whole can live.

Her breasts remind her: even though we will no longer be with you in form, we will always be with you.

She allows this to sink deep within her because this is something her toddler heart could not understand. Her toddler heart only felt the binary: presence and absence. Loss and gain. Have and have not.

As she grew up no one told her, you carry your family with you every day. Your family has not been lost to you. Your culture has not been lost to you. You carry them with you deep in your DNA.

No, it is not the same because those who are raising you are not your blood or culture of origin, but that does not mean it is lost to you. They are alive in you as much as your adoptive parents are alive beside you.

And there is nothing you need to do. You don’t need to prove your culture or search for blood kin (unless you want to) to know who you are. Because all that you have thought you have lost, have always been and will always be in you. And because you love greatly, so do you grieve.

So while I will lose the physical presence of my breasts, just like I lost the physical presence of my family and culture of origin, they will always also be a part of me. Just like unconditonal love. You never lose the love others give you. Every gesture of love is carried within you, imprinted in your heart forever. Grief is paving the way for loving myself fully once more.

Today I hit the breaking point.

Tears arrived, held back by my fear response, which showed up as hyper analysis, over thinking, the whirring of a mind that could not stop for 13 days. A mind that was working overtime to protect me from feeling. But the feelings were always there.

The tears fell like a busted dam, a rushing waterfall of emotions, jumbled and honest thoughts, and lots of snot.

Tears that heaved with my whole body with the wish that I didn’t have to go through this. That I didn’t have cancer again. That I didn’t have to make these decisions.

Tears of trepidation and anxiety of knowing others had taken the same leap, yet wondering whether I can jump the chasm to the other side with them, knowing that when you leap, you leap solo.

And solo is how I have felt most of my life even though I have always had so many people who love me around me. Solo and alone is the felt sense I carried as a child who internalized her grief and pain. A sense of aloneness that cannot be healed simply by the presence of another, but must be excavated, spoken, released.

Tears that unleashed the unspoken worries of not being attractive to my partner, or to myself. Of the ways my body’s beauty had been shaped by the society I grew up in, norms that were not set to see beauty in my Asian form.

Tears that open doors to healing, realizing all the ways I had over compensated to make me “more” attractive, or armored up to “fuck that” norm, two poles that never brought me acceptance, and ability to see the beauty of the body I live in.

Tears that did not have to be shed alone, that could fall and soak the chest of my partner’s blue t-shirt as he held me and listened.

Tears of relief reading words that gave voice to the unspoken in my heart: it’s just too much. Physically, emotionally. Let’s just take one surgery at a time, with truth and honesty. Every option has pros and cons, the calculus of which remains incalculable.