When I first found out I had cancer, I did what I think a lot of people do when something scary and unfamiliar happens.

I went online.

Everything was happening so fast - in 2.5 weeks I had been diagnosed, met with a surgeon, was prepping for a wide leg excision and lymph node retrieval, was referred to an oncologist and was told my situation required immediate attention by all doctors on all fronts.

My head was spinning.

I had surgery coming. I was about to meet an oncologist for the first time. I had no idea what treatment was going to look like, what questions I was supposed to ask, what any of the terminology meant or, frankly, what was going to happen to me. I wanted information and answers, and I wanted someone, somewhere, to explain what the hell was happening.

Because I had never had cancer before and had made the decision to not tell anyone (at all!) about it until I had my surgical results and a plan in place, the internet seemed like the obvious place for my research to start. Now, in retrospect, was both incredibly useful and a terrible idea, but it’s what I knew and it’s what I did.

And of course, to no ones surprise, the internet did what the internet does… it learned that I had cancer & it started giving me cancer.

Not literally, obviously. But suddenly my social media feeds were filled with cancer stories, cancer treatments, cancer survivors, cancer warnings, cancer conspiracies, cancer diets, cancer influencers and people who were absolutely certain that whatever treatment they had chosen was the only treatment anyone should ever choose. I was bombarded with advice and treatments and fear and hope.

• You should juice.

• You should do coffee enemas two times a day.

• You should never eat sugar.

• You will die if you have chemotherapy.

• You will die if you have immunotherapy.

• You will die if you don’t have immunotherapy.

• Juicing is a miracle.

• Juicing is nonsense.

• Colonoscopies are a scam.

• Doctors don’t know anything. Never trust science.

• Doctors know everything. Always trust science.

• Take this supplement.

• Don’t take that supplement.

• Move to Mexico and detox.

And then there were the stories… so many stories.

People who were diagnosed and were doing great. People who were diagnosed and were not doing great. People who had the same type of cancer I had but were five years ahead of me. People who had a completely different cancer but whose stories were somehow being served to me anyway.

In my already overwhelmed mind, it was a complete jumble of information, opinions, fear, hope and very, very opinionated strangers.

I think part of what was happening was that I was trying to avoid the reality of what was happening to me by consuming information about what was happening to other people. I convinced myself that if I was researching, I wasn’t sitting there thinking about the fact that I had cancer, surgery, or anything else I was nervous about.

If I was scrolling or reading someone’s story, I didn’t have to sit quite so intently inside my own story and experience.

So I was spending hours scrolling on my phone, getting fed all the content and thinking I was doing something meaningful. Except, it wasn’t actually helping. It was making everything worse.

I started to realize that I wasn’t gaining clarity. I was gaining noise.

I am naturally a researcher. I love learning. I like understanding how things work. I am genuinely interested in hearing different perspectives, including perspectives that are outside the mainstream. Genuinely, I don’t need everyone to agree with me, and I don’t automatically dismiss an idea simply because it is unconventional.

Normally, I would consider that one of my strengths, but during those first few months of cancer, it became a liability because I didn’t have enough information to know what information mattered. I didn’t yet have a framework for understanding what I was being told.

For one of the first times in my life, I wasn’t able to quickly and easily pick out which sources were credible, which experiences were relevant to me, which opinions were based on actual evidence, and which ones were simply very confidently delivered by someone with a pretty face, a ring light and a personal anecdote.

Perhaps, though, most importantly, I didn’t yet know what my position was. I was still figuring out what I thought and all that online noise was making it awfully difficult to make up my own mind.

So I did something that, for me, was surprisingly difficult. I stopped living online.

I deleted TikTok.

I deleted Instagram.

I made it deliberately difficult for myself to get sucked back into them. I kept a couple of other social platforms, mostly because they were tied to my work accounts, but for the most part I stepped away from the social part of the internet.

And it was one of the best things I could have done for myself.

Not because social media is inherently terrible (it is and it isn’t), and not because there isn’t useful information online.

But at this time, and in this moment, I needed to be able to learn for myself without being constantly told what to think.

It’s something I think we all know inherently but don’t really want to admit. There is something very different about deliberately seeking information when you are ready for it and having information relentlessly pushed at you because an algorithm has decided that you are interested in it.

I work in digital media and I know how an algorithm works. It learns about you - through your searches and content that you actively and passively consume. It then figures out what content you’re likely to connect with and consume more of, and it pushes that content into your feed. The goal of an algorithm is to keep you engaged and on an app. It doesn’t matter if the content is truthful or even real - it matters that it captures your attention and keeps your attention again, and again, and again.

Yes, I knew how social media works more intimately than most, but when you’re already overwhelmed and need to make real life decisions that are completely out of your wheelhouse, all that doesn’t seem to matter.

So, quitting social media seemed like the only viable option.

For the first time in months, I wasn’t waking up and immediately being confronted with someone else’s cancer story, their treatment miracles, absorbing their own fears and mistakes, or comparing my experience to someone else.

I could think.

That sounds incredibly basic, but when you’re overwhelmed, the ability to think clearly can feel like a luxury. And I think that was the real gift of going offline because it gave me some mental real estate back.

I could have a conversation and actually listen. I was slowly able to make decisions based on what was happening to me, rather than whatever terrifying story I had read the night before. And, most important, I could have moments where I wasn’t thinking about cancer at all.

There is a strange pressure when you are diagnosed with something serious to become a full-time patient. Suddenly there are appointments, bloodwork, scans, pathology reports, medications, treatment decisions and an endless stream of information to process and it can become very easy to let the illness occupy every available inch of your brain.

Social media made that even easier for me because it created the illusion that I was doing something productive. But I wasn’t. And with my social media break, eventually I realized that I didn’t need more information. I needed to hear myself think. I needed to remember that I was a person who happened to have cancer, rather than a cancer patient whose entire life had suddenly become about cancer.

So I gave myself permission to step out of the conversation.

And I think there is something here that applies far beyond cancer.

We live in a time when we are almost never required to simply sit with our own thoughts. There is always something available to consume, and because we have access to all of it, we can convince ourselves that consuming more information will eventually make us feel more certain.

Sometimes it does.

Sometimes it just makes us more confused.

What I found, quite by necessity more than any specific theory or hypothesis out there, is that there are moments when the healthiest thing you can do is deliberately remove yourself from the conversation just long enough to figure out what you actually think.

I eventually allowed myself back online, but my relationship with social media looks very different now. I don’t use TikTok at all and I check Instagram maybe once a week, sometimes twice. Facebook has remained in my life mostly because, as someone who works in digital advertising, apparently I am professionally obligated to understand the ecosystem I occasionally wish would disappear. But I don’t feel the same need to be everywhere anymore and learn everything that people have ever thought, felt, or experienced. And I, weirdly, really like that.

Cancer taught me a lot of things I never wanted to learn, but one weird little shred of goodness that came out of this uncertainty and overwhelm is finding out that I like knowing that my thoughts have room to be my own. Sometimes protecting yourself and your peace isn’t about adding another healthy habit to your life, but about taking something away.

For me, it was the noise. I’m glad I made the move to cut it all out.

For a while, I needed the quiet. It gave me some space to think, some room to breathe, and, eventually, a clearer view of what came next.

I don’t mean in some grand, Dear Future Sarah, I hope you’re living your best life kind of way. I’m genuinely curious about what it will feel like for me to read these words when enough time has passed that the things I’m writing about now feel less immediate. I mean, that was actually one of the reasons I started Pause for Cancer in the first place.

I wanted a space to document what was happening, obviously. The diagnosis, the treatment, the hospitalization, the recovery, all of the things that happened to my body and my life that I knew I wouldn’t want to forget. But I also wanted to document what was happening around the cancer.

I knew enough right from the start to know that life was going to continue, despite my pause, so I wanted a place for everything to live. The decisions I was making, the things I was questioning, the parts of my life that suddenly looked different. Maybe more importantly, a place to hash out the things I thought I wanted, what I realized I didn’t want, and all the things in between that I was thinking about. A life for the strange little observations that seemed insignificant at the time but somehow felt important enough to write down.

I wanted to remember what it felt like to be me while all of this was happening.

To be fair, I thought I would have figured a lot more out by now…

When I started writing, I know I had an expectation that there would eventually be a point where everything clicked. I would emerge from the experience with my post-cancer glasses firmly in place, suddenly able to see my life and myself with perfect clarity. I’d know exactly what mattered, what I wanted to do next. I’d have some sort of epiphany. I’d understand what cancer had “taught” me. I fully expected there to be a before and an after, and the after would be noticeably better because I would now possess the wisdom that comes from having gone through something terrible.

It has not quite worked out that way. I am still figuring things out.

In some ways, I am still exactly the same person I was before cancer. I still have days where I feel completely certain about what I want and other days where I wonder whether I’ve made everything up. I have not had the dramatic career epiphany I thought I might have - I actually haven’t had any epiphanies of any kind. I don’t wake up every morning with an overwhelming sense of gratitude that I am alive or a fearlessness to walk into any room and feel like I belong.

I guess life doesn’t necessarily hand you a new personality when you survive something difficult. How rude.

But, I’m glad past-Sarah had the foresight to start this space, because the further away I get from the worst parts of the last year, the harder they are to remember properly.

Not that I forget that they happened, but it’s pretty easy, I’m learning, to start forgetting the texture of events. For example, exactly how it felt to wait for a blood test result, or to open MyChart and see a collection of numbers that looked completely foreign to me.

I’m forgetting how much time I spent lying around feeling awful, how long a day could feel when I had nothing to do except recover and how strange it was to watch the rest of the world carry on while my own life felt completely suspended.

I’m not sure if it’s a me-thing or if this is normal (feel free to weigh in on that!). Maybe that’s what our brains are supposed to do. Eventually, as is life in general, sharp edges soften and the things that once occupied every available inch of your brain become a smaller part of the landscape.

Maybe (probably?) it’s a good thing.

But there are somethings I don’t want to lose in the process of entering this new chapter.

I want to remember who I was while I was going through it.

I want to remember what I thought was important.

I want to remember what I was afraid of.

I want to remember what I wanted.

I want to remember the version of myself who was sitting in a hospital bed thinking about what she would do if she got the chance to go home and live normally again.

And I think that’s why writing has become more important to me than I expected. This isn’t just a substack (I still call it a blog!) for me anymore.

It’s becoming a slightly messy, occasionally contradictory, sometimes funny and sometimes very serious record of a particular period of my life. Something for me to look back on and say - hey, look how far you have come and look at what you did to get there!

I said right away that I didn’t want Pause for Cancer to become a collection of lessons or a cancer diary full of only updates on my health.

I deeply want it to capture the process of figuring things out and talk about decisions, questions, moments, opportunities before I know whether they were good ones.

Maybe someday I’ll read all of this and laugh at how seriously I took certain things. If I’ve learned anything from being online for the past 17 years, I probably will one day cringe at my content and want to bury it far, far away. May I be so lucky to get there!

But I do hope I leave a little paper trail back to myself, so that five years from now, or ten years from now, when I’m living some completely different version of my life, I can come back here and meet the person I was. A snapshot into what I got wrong, what I got right, and everything in between.

I think I would like that, because the future version of me is going to forget some of this, and this is the important stuff I just don’t want to totally and completely forget.

It’s an incredibly kind question, but I’ve realized over the past few months that it’s surprisingly difficult to answer. Not because I don’t know how I’m doing, but because the answer depends entirely on which part of me you’re asking about. There is the medical answer, which is (thankfully!) straightforward, and then there is the emotional answer, which seems to change depending on the day, the weather, and whether my next set of scans is close enough to appear on the calendar without scrolling.

Medically, things are about as good as I could have hoped for.

It’s now been over a year since I was diagnosed with Stage 3b melanoma. Looking back, it’s remarkable how quickly life can divide itself into a “before” and an “after.”

In May 2025, I heard the words no one expects to hear. A month later, surgery revealed that the cancer had spread to my nearest lymph nodes, changing the path ahead. At that point, I hadn’t told anyone about the diagnosis because I had hoped it would turn out to be nothing more than an initial mole removal. But, that was not to be.

I began immunotherapy in August expecting, like anyone would, that I would quietly work my way through a year of treatment before gradually returning to normal life.Instead, after only three rounds of treatment, my immune system decided it had other plans. What followed was one of the scariest months of my life.

I developed what my medical team believes was a severe (allergic?) reaction to the immunotherapy that sent me into organ failure and had me rushed to the hospital with a week-long stay pumping me full of drugs and introducing me to parts of the medical system I didn’t know existed. Even now, there isn’t complete certainty about why it happened. Medicine, I have learned, doesn’t always offer neat explanations, which is both realistic and maddening at the same time.

What every specialist I have seen since does agree on, though, is that the reaction was serious enough that I will not be eligible to receive immunotherapy again. And that, because of what happened, there are other treatments my oncology teams are (understandably) reluctant to use in the future as well.

That knowledge sits quietly in the background of my life now. It isn’t something I dwell on every day, but it is part of the landscape. Like many things after cancer, it has become something I carry rather than something I constantly think about.

The good news is that my body has recovered far better than anyone initially expected. After weeks of extraordinarily high doses of prednisone and enough medications to make my bathroom counter resemble a small pharmacy, my blood work slowly began making its way back to normal. If you’ve never spent months compulsively opening MyChart every time a notification appears, it’s difficult to explain the strange relationship you develop with your own lab results. Numbers that once meant nothing suddenly begin dictating the emotional tone of your entire afternoon.

For months, mine seemed to exist almost entirely outside the normal range. Liver numbers climbed. Inflammatory markers bounced around unpredictably. Nearly every test contained something highlighted in red and worth flagging to the team, and over time I became strangely fluent in blood test results I had never heard of before. I hyper-focused on diet (fibre was my friend!) and walking, because I read studies that showed some favourable results for previous patients in my situation.

The first time everything came back normal again, it was March 2026 - almost a year since my initial diagnosis - and it was actually quite jarring. There they were. Ordinary numbers. Nothing remarkable. Nothing urgent. Nothing alarming. Uneventful in the absolute best way…

The only lasting casualty of the entire experience turned out to be my gallbladder. It never fully recovered from everything my body had gone through, and after a couple of particularly memorable gallbladder attacks, it was removed this June.

RIP

I have to admit, I don’t miss it. In fact, I feel better now than I have in a very long time.

After my surgery, my medical team essentially told me something I had been waiting over a year to hear. Go live your life.

There were no restrictions. No long list of things I should avoid. No instructions beyond the same common sense advice most people receive. Travel. Exercise. Take supplements or don’t. Work (or don’t). Make plans. Eat whatever you feel like. Enjoy yourself.

It felt great to walk out of the doctor’s office with zero to focus on. A year of having to worry about everything little thing and then.. nothing.

What I hadn’t anticipated was how much responsibility I would suddenly feel, knowing that my only marching orders were to “live my life”.

When you’re actively in treatment, your job is surprisingly clear. You go to appointments, take the medication, recover from the medication, wait for scans, repeat. Your world becomes incredibly focused because it has to be - there isn’t much room to think about the future when you’re busy trying to get through Tuesday.

Then, almost without warning, the appointments begin disappearing from your calendar and your life is handed back to you.

Suddenly the question is no longer “how do I get through this?”

The question becomes “Now what?”

I’ve realized over the last few months that I have started putting enormous pressure on myself to answer that question well. I have convinced myself that the worst year of my life should produce something extraordinary.

Surely I should travel more. Write more. Take bigger risks. Worry less. Become the person cancer was apparently trying to reveal all along.

Some days that feels exciting. Other days, if I’m being honest, it feels like I’ve simply replaced one source of pressure with another.

Before cancer, I put pressure on myself to build a successful career, be productive, and achieve enough. During cancer, the pressure shifted to surviving treatment. Now, on the other side, I’ve somehow managed to create an entirely new pressure, which is making sure I don’t “waste” the time I have now. It’s remarkable how quickly my brain finds something new to worry about.

So I’m trying, clumsily, to not confuse intention with pressure. I don’t need to earn my “second chance”. I simply want to live in a way that feels a little more awake than I did before.

That probably doesn’t mean selling everything I own and moving to a vineyard in Italy (question mark??). It probably looks much smaller than that. It looks like writing the essays that have been sitting in my head for years. Or saying yes to opportunities that scare me a little. Even more, saying no to opportunities that I know I really don’t want but feel like are the right thing to do. Maybe it’s spending less time worrying about whether anyone likes me and more time building a lifestyle that actually feels like mine.

November will bring another set of scans, and with them, I’m sure, another round of scanxiety. I don’t imagine that part ever disappears completely. But today, as I write this, there is no evidence of cancer and my blood work is (finally!) normal. My skin checks are clear and my gallbladder has officially retired for good. Despite everything my body has been through over the past year, it has found its way back to something that looks shockingly like health (with a bit of additional prednisone-induced weight to boot).

A year ago, I wasn’t sure I would ever feel this ordinary again. Turns out ordinary was exactly what I was hoping for.

So if you’re wondering how I’m doing now, I guess you have your answer. I’m doing medically well, emotionally stable(ish), and physically scarred but getting back to me. The new version of me, that is - the one the at is rebuilding and relearning life with a different lens and a lot of hope that this next chapter will be a great one.

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When I took a medical leave from my VP role at a media company after being diagnosed with stage 3b melanoma, I was incredibly fortunate. I’m Canadian and, because of where I live and the type of job I had, I had access to employment insurance that allowed me to step away from work while I was going through surgeries, immunotherapy, an immunotherapy reaction that landed me in hospital, and months of recovering on prednisone. Of course, as you might expect, the money wasn’t exactly my salary, but it was enough.

I know not everyone gets that privilege, and I don’t take it lightly.

But, by the time six months had passed along (full of really hard and really good times), I knew I was ready to return to work. Initially, following my diagnosis, I had been shouting from the rooftops that I was never going to return to the stress-filled, rat-race that was ‘corporate canada’, and I held true to that for the first half of my leave. I started this substack, I had lunches and coffee, I took naps and walked 8km a day, and worked on pausing my propensity for productivity.

As time does though, I started to grow weary of my days. I missed having somewhere to be, something to stimulate my brain, a problem to solve, using made-up acronyms like KPI, ROI, CAC(!), or a mid-day chit-chat with a co-worker. I missed being part of big business decisions and the small ones too. I missed thinking!!

I think I also missed… myself? I missed Sarah pre-cancer and the way I moved through my day, week, month, year.

I thought a return to work would give me back all that (and more!), and in lots of ways it did. But it also taught me something I hadn’t foreseen: returning to work isn’t actually returning. So what was returning really like?

Here’s the first surprise I faced: I don’t think anyone prepares you for the fact that life keeps happening while you’re gone.

Of course it does. Duh!

It’s not as if ‘corporate canada’ collectively got together and decided to close their laptops and let their pens run dry until Sarah was ready to come back to work. That’s not how it works - despite the fact that my ego would love it to.

So, when you return to work, you are faced with the fact that people adapt. In my case, they redistribute responsibilities, form new go-to relationships, and new people step into leadership roles. There’s new ways of working that you are no longer privy to, and unspoken understandings that you might never quite get the hang of.

Work continues. Even without you there.

And when you return, you might not be returning to the work place, systems, people, or places you were used to. There are tables you used to sit at that won’t ask you back, or don’t even exist anymore. Finding a new seat - if there’s one to find - might be your greatest task.

The second surprise was how people treated me.

Now, I’m not saying that I worked at the worst workplace ever, but we all know (or can guess) about the corporate machine. It can chew you up and spit you out at the best of times. But I found that my return to work saw people treating me… differently. Gently, carefully, kindly(?) even. And of course that sounds lovely until you’re the person being “handled”.

For months after my return to the workplace, I felt as though everyone had collectively decided not to give me anything too important. And again, I get it. I had been gone, things had changed, and they had no idea what version of Sarah they were getting back after my time off.

But when you’ve spent years building an identity around being extremely capable, high performing, and deeply involved in all facets of the business, protection can feel eerily similar to exclusion.

I wanted responsibility, with a capital R. They wanted to make sure I wasn’t overwhelmed and could handle re-integration.

Neither of us was wrong. We were simply solving different problems.

The third and hardest surprise for me came much later.

To be frank, I had assumed I’d regain the influence I’d had before I left without missing a beat. I mean sure, the business had to make due while I was gone, but surely my insight and experience was deeply missed and needed.

Wrong :)

Before cancer, I’d been a significant voice with a strong POV and listening ears (theirs and mine). When I returned, it was different. As I noted, people had stepped up, learned new skills, and built their own ways of doing things. The rhythm was different and decisions that used to hinge on my input no longer did.

Growth is so good - it’s needed - and new systems and adaptations are exciting, expect when you just can’t get the hang of it to join back in. My brain didn’t feel as sharp, the industry had grown and changed in a way that was causing me to feel behind. I knew I had value but it just felt different. Different bad/different good, I couldn’t be sure.

The final surprise was all about me. Remember how I told you that I swore I would never return to corporate when I initially went on leave? I still kinda feel that way because I know that I returned a very different person.

And that’s the surprise - I’m not me. At least not the me that left.

Sure, I’m still smart and capable and all the things that made me good at my job pre-diagnosis, but there’s an awareness and reality that I walk around with. I suppose it’s more of a subtraction than anything else. I used to thrive in piling on more and more and more, but now I’m looking for a lot less. Not worse (actually I think I want the best of the best life has to offer me now) but less.

Less stress, less responsibility, fewer meetings, less unnecessary discussion and quick huddles. Less optimization and circling back. I don’t want to prepare a 15-page power point convincing you of the right way to do things and I certainly don’t feel the need to prove myself in the way I did previously.

I used to live in the eye of the storm, and now I value calm.

I’m not sure if it’s strange for anyone but me at my workplace - I certainly haven’t asked - but I know I’m not the same. And I think that’s ok.

All those surprises I listed above, they’re real and I wish someone had prepared me for them. But I know the biggest one for me is having to re-introduce myself as a slightly different model than the one I was used to.

I don’t regret going back to work just like I don’t regret taking time off. Both were needed and both were healing. Work gave me structure when I felt untethered and reminded me that my brain wasn’t (entirely) mush {thanks in no part to my newfound TikTok addiction while off on leave}. Sure, it was an unused muscle, but muscles adapt and my brain did it with relative speed and ease.

Eventually, over the past few months, I have built new routines and made new & old connections. I found a rhythm that wasn’t my previous one but is a rhythm nonetheless. I started to feel more at ease in my own power and skin, though still slightly unfamiliar.

I’ve rested on the fact, after going around in circles in my mind, that work might never feel the same again. Heck, I might not be the right fit for a corporate executive role anymore.

But for now I’m grateful for this transition “back to work” time. It’s a time where I can learn who I am now, what I need & want, and re-learn how to confidently show up for myself and others every day.

I know not everyone has the privilege or overall positive experience that I’ve had, but I suspect regardless of the reason, we all might understand how it feels to be a bit of an “outside looking in” person at one time or another - and fingers crossed we all come out the end a little better and wiser for it.

So, given that my first thought was one of what do I do to cause this? it will be no surprise to find out that I spent a lot of time pre, during and post-treatment trying to figure out what caused my cancer.

Not medically. Morally.

I wasn’t looking for the answer in my pathology report, I was looking for the mistake. The thing I had done wrong that would finally explain how I ended up here, because surely there had to be something I had done to either cause this cancer - or not done - to prevent it.

For most of my life, I had been a pretty responsible person when it came to my health. I exercised, I ate (reasonably) well, I wasn’t a chronic smoker, I didn’t use drugs and didn’t drink nearly enough to make me a “drinker”. Even though I’m a parent (x2), I tried really hard to prioritize sleep when I could, and I tried to manage stress (although if you’ve ever met me, you know that one has always been a work in progress).

I wasn’t perfect, obviously. I have never met a doughnut I didn’t want to be friends with and I used tanning beds occasionally in the early 2000s because GTL (gym, tan, laundry for all you non-Jersey Shore watchers) was all the rage.

But on the whole, I was “good”. And I still ended up with an aggressive melanoma tumor that changed the trajectory of my life.

I found this incredibly difficult to reconcile. Not just because I had cancer -obviously that part was difficult - but because, somewhere deep inside me, I had believed that if I followed the rules, life would follow them too. And that is a much harder belief to let go of.

In psychology there is actually a name for this tendency: the Just-World Belief, a concept first coined by Dr. Melvin Lerner, a social psychologist (and sometimes called the “Just-World Hypothesis” or “Just-World Fallacy”). It refers to our very human tendency to believe that the world is fundamentally fair, people generally get what they deserve -good and bad, and that outcomes in any situation can usually be explained by someone’s actions, choices, or character.

It makes sense why our brains do this. A world where good choices lead to good outcomes feels safer than a world where random things happen to random people. But, if the world is fair and you get what you deserve, then we can control our destiny by “doing the right thing” and “being a good person”.

The truth is that I think most of us believe in some version of this. We might not say it out loud, but we carry around quiet assumptions about how life works - I know I certainly have. For example, you might assume, with really no internal pushback, that people who are successful must have worked harder, people who are struggling must have made poor choices, and people who get sick must have done something wrong.

And if I’m being honest, before cancer, I was guilty of this too. I can think of moments where I quietly created explanations because explanations felt easier than uncertainty. It’s such a subtle human tendency that sometimes we don’t even realize we’re doing it. We are constantly trying to connect dots, even when there are no dots to connect.

Of course that happened…

Of course there was a reason…

Of course they must have...

Cancer forced me to confront that in a very personal way. And I realized there is no magic formula and certainly no guarantees. Of course we should always try to do what we think is the best thing with the information we have at that time, but there are things we can control and things we cannot.

And that is a profoundly uncomfortable place to live… (in fact, I’d suggest you might be feeling a little uncomfortable right now reading this).

So, I guess one of the stranger side effects of cancer is that it has made me much slower to explain other people’s lives, because, before all of this, I think I believed in a version of the Just-World Belief without ever knowing it had a name. There were moments when I’d hear someone had lost a job, gone through a divorce, or become seriously ill, and somewhere in the back of my mind I’d quietly start building a story that made it make sense. It made me less uncomfortable, to be honest, to work from an assumption that you did something - or didn’t do something - to earn what is happening to you. And I felt better believing that if there was a reason it happened to them, then maybe there was a way to make sure it would never happen to me.

Now, I’m certainly not perfect and still catch myself being judgmental and making assumptions because, unfortunately, becoming slightly more self-aware does not immediately turn you into a person who never has an unkind thought… but I’d like to think I notice them sooner.

And I still do the things that tilt the odds in my favour - hello coconut kefir in the morning and raw celery, cucumber, and carrot juice before bed - but I believe those choices matter. I believe taking care of ourselves matters. I’m just getting better at not asking those choices to do something they were never capable of doing in the first place.

They can’t shape my life, but they cannot tell my future or guarantee my outcomes.

And, for the record, I still believe we can (sometimes) reap what we sow.

I just no longer believe every harvest is ours to explain.

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“Are you afraid of the sun now?”

It’s one of the questions I’ve been asked most often since being diagnosed with advanced melanoma (skin cancer).

Sometimes people ask if I still sit outside. Sometimes they ask whether I wear sunscreen every day. Occasionally someone will mention something they’ve read online suggesting sunscreen is actually the problem and wonder whether I’m afraid of that too. More recently, and unrelated to the sun, people have started asking about sugar and if I eat it since cancer feeds off it, usually in a slightly apologetic tone, as though they’re worried they’re about to ask something insensitive.

I understand why people ask.

Truthfully, I probably would have asked the same questions once.

Most of us don’t know many people who’ve survived cancer, and if we do, we usually only know them before or after. We rarely get invited into the middle, where life is less inspirational than expected and considerably more ordinary. We fill in the gaps with whatever stories we’ve been given. Some come from people we know, some come from social media, some come from movies where surviving cancer seems to involve climbing mountains, quitting your job, repairing every broken relationship you’ve ever had, and suddenly becoming the sort of person who watches every sunrise AND sunset as though you’ve personally discovered daylight.

But since I was someone who got to live this in real time, I cans say that real life, I’ve discovered, is a little quieter than that. Maybe “quieter” isn’t the right word: less obvious - that’s it.

The honest answer is no, I’m not afraid of the sun.

As I write this, I’m sitting outside on my back deck. I’ve got sunscreen on. The sun is warm. The birds are making far more noise than seems necessary for this time of the morning, and my coffee has already gone cold because I’ve become distracted writing this paragraph.

For the record, I’m not particularly afraid of sunscreen either. Despite the internet’s occasional enthusiasm for convincing us that everything we thought we knew is wrong, sunscreen remains one of the most well studied tools we have for protecting our skin from UV damage. The same goes for sugar. Cancer is far more complicated than a single ingredient we can eliminate from our lives. I wish it were that simple.

What has surprised me isn’t that cancer made me afraid of the sun, because it didn’t. What surprised me was how quietly it rearranged almost everything else I worry about.

Before all of this, I spent an astonishing amount of my mental energy worrying about things that now seem strangely optional. I worried about whether people liked me or whether I was getting ahead quickly enough at work. I worried about conversations I’d had three days (who am I kidding, three years!) earlier and emails I’d already sent. I thought relentlessly about whether I was doing enough, earning enough, achieving enough, engaging with friends and hobbies enough, and whether everyone else had somehow received the handbook explaining how life was supposed to work while mine had been lost in the mail.

I’m still me, so those thoughts haven’t disappeared completely. I don’t think surviving something difficult rewires your personality quite as dramatically as we’d like to believe. I’m still ambitious. I still overthink things. I still enjoy a personality assessment (Enneagram 3!!) far more than any grown person probably should. But those worries don’t seem quite so convincing anymore.

Instead, I find myself worrying about entirely different things.

I can no longer spend an ounce of my brain power worrying about people who wouldn’t spend much time thinking about me if our positions were reversed. I worry about staying in environments and places long after I’ve outgrown it simply because it’s familiar. I worry about talking myself out of opportunities because they feel impractical or inconvenient, forgetting that there was once a version of me who would have given almost anything for the privilege of worrying about inconvenient opportunities.

I think a lot about becoming too careful. Not medically careful (that’s different), I’m talking about becoming careful with my life.

Careful about trying something new because I might fail, about writing the thing because someone might not like it, about changing direction because other people have become comfortable with the version of me they already know. The list could go on and on.

What I worry about most, though, is something so ordinary it almost feels ridiculous to admit. I worry that I’ll forget.

When you’re sick, every scan feels monumental and every blood test feels important. The MyChart app becomes the most used app on your phone and every uneventful Tuesday feels like borrowed time. You notice everything because everything feels fragile.

Then, if you’re lucky, you get better. Life slowly begins asking ordinary things of you again. In fact, these ordinary things never stopped when you were sick, there were just bigger fish for your brain to fry. So once that emergency of active cancer diagnosis and treatment start to lessen, your brain naturally goes back to the things that once occupied it: groceries, meetings, laundry, unanswered emails that you really, really do mean to get to! Before you know it, you’re standing in Costco debating whether the giant jar of almonds is actually a good deal while wondering if you’ve remembered to switch the laundry over because you’re washing your favourite sheets. Normal life returns so gradually that you hardly notice it’s happening.

And, of course!, I’m grateful for that. But alongside that gratefulness is another feeling I think a lot of recovering cancer patients come to know: the worry that I’ll slowly drift back into living without really noticing I’m doing it.

Wake up.

Work.

Eat.

Sleep.

Repeat.

Not because it’s a bad life. Quite the opposite, it’s a wonderful life that so many people could only dream of living on a daily basis. But I just don’t want to sleepwalk through it or drilldown my focus on things that don’t actually matter to me.

So when people ask about sun or sunscreen (or sugar, haha) what I think people are really broaching is if cancer changed me.

The answer is yes.

Just probably not in the ways they expect.

It didn’t make me fearless or full of gratitude when my eyes flutter open each day. I’m not above complaining about the slow driver in front of me who absolutely could have made that yellow light or the lady in Costco who stopped her cart and blocked my path without even a glance in my direction (I just got back from Costco, so you all know what an adventure I must have had there!).

But what I think has happened is that the hierarchy of my fears has been quietly rewritten. The sun isn’t on the list, neither is sunscreen nor sugar. What scares me now is something far less dramatic.

I’m afraid that one day, years from now, I’ll look back and realize I slowly returned to the life I had before without bringing any of the perspective with me. That I’ll forget I can start over or change my mind. I’ll slip back into focusing on people and places who wouldn’t ever focus on me and not remember there are people to meet, places to see, work worth doing, risks worth taking, and stories still waiting to be written simply because I became comfortable enough to stop looking.

I’m not sure what this perspective looks like long term - maybe it’s only a temporary blip or maybe it’s my new normal. But if I had to sum it up, I’d say there are things that no longer get or deserve my fear, worry or brain space. And there are new things that have skyrocketed up to the top. Things that might have always lived there but in the hubub of daily life got shoved down and pushed aside.

Maybe that’s the strangest gift cancer gave me. Not the fearlessness or zen-like endless gratitude I’d seen in the movies. Not a completely transformed life where I wake up every morning knowing exactly what matters and never get annoyed by Costco traffic again… ahem.

Just a quieter awareness that my time and attention are actually mine to spend with people and in places that I want to be.

One day, I published a blog post about being left out.

Within a few hours, two people contacted me - furious. They were both convinced it was about them.

The funny part is it wasn’t about either of them. It wasn’t even really about me either, although I had written it in first person like I did with everything back then, which probably didn’t help my case. It was one of those posts that comes out of a story you overhear when you’re out and about in the world, listening as I do to peoples experiences and tales. It was written in that very specific early-blogging era when you assumed the internet was a slightly bigger version of your diary and not, in fact, a permanent record of your emotional states. So, yes, I wrote a story about being left out that wasn’t really about me at all but it was a good story and I was a writer.

Anyway, two separate people reached out thinking I had written the (not very flattering) story about them. One of them accepted that it wasn’t about her. The other did not.

DID. NOT.

She was furious in a very focused way, the kind of fury that has structure and stamina. She called me to explain this to me directly, which is still wild when I think about it now, but what makes it even more surreal is that she called to chew me out while I was driving to my grandmother’s funeral. Read that again. It helps give context and weight to how mad she was that I wrote about her, and something negative to boot.

I remember glancing at the phone and thinking, not now, of all moments, and then answering anyway because at that point in life I still believed I could manage everything gracefully. I mean, I was telling the truth after all!

What followed was a conversation I will never forget not because it resolved anything, but because it didn’t. She wasn’t interested in clarifying what I had written or even my claim that it wasn’t about her. She was interested in being right about what she had already decided I meant and to make sure I learned whatever lesson she was trying to teach me, and when I didn’t bend in her direction something in her hardened instead. Over time, she made it her mission to ensure I understood exactly my place(?) which included, as these things sometimes do, recruiting other people into the story she had decided was true.

Something had shifted for me, too, that had very little to do with her or even with that post; it was that I had accidentally learned what it feels like to be misunderstood in public and, more importantly, to be believed less about your own intention than someone else’s interpretation.

A few things happened after that.

First, I found out that two people I genuinely liked had read the post and privately assumed it was about them. Yikes.

Second, I started to censor myself.

This was more like a quiet internal editing system that began to run in the background. Remember, at this time I was writing for a living. But looking back, I know I stopped writing certain things. I softened edges I didn’t even realize I had. I became more aware of who might be reading in my real life - which was actually a pretty small percentage of my readership audience - and less aware of why I was writing in the first place.

It also made me start to fixate on something that had happened years before that. I had another early encounter with this same dynamic, although I didn’t have the language for it at the time. Someone who knew me in real life used to leave anonymous, very critical, and sometimes downright mean comments on my blog (remember this is 2009 folks!). The catch? I, of course, was the administrator of the blog and could see all the non-anonymous information about this person in the backend… something they were totally unaware of.

The internet, I learned, has never been as private as people hope it is and people have never been as anonymous as they assume.

What I didn’t fully understand then, but understand much more clearly now, is that writing has a strange way of becoming a kind of projection screen. People read your words and (intentionally or not) begin to locate themselves inside them. Sometimes that is generous and connective. Sometimes it is not. And sometimes it has almost nothing to do with you at all. It has to do with whatever they are already carrying when they read it.

This is one of the more complicated parts of writing in public that no one really prepares you for and was a big reason I hesitated in starting this platform after sunsetting my previous blog and brand. It isn’t just that people will disagree with you, I can (shockingly!) handle that part with relative ease. It is that people will sometimes believe they are in the story when they are not or believe they are being described when they are not, or believe something is a message when it was never meant as one.

And then, sometimes when you least expect it, act accordingly.

Even now, years later, I still catch myself in that tension. Wanting to be honest, but also wanting to be accurate in a way that doesn’t accidentally become something it was never meant to be in someone else’s mind. Because what I learned from that early blog post, and from the phone call on the way to my grandma’s funeral, and from the anonymous comments, and from all the small moments of misunderstanding that followed, is that writing in public is never just about what you say.

It is also about what people hear.

And sometimes those two things are not even in the same conversation. Which is probably why, even now, if you ever read something I’ve written and think it might be about you…

It probably isn’t.

But I suppose I now understand why you might wonder anyway.

I gained thirty-five pounds in less than a month.

Thirty-five.

Even writing that number now feels aggressive.

The speed of it was honestly impressive. If I had been trying to gain thirty five pounds intentionally, it probably would have taken years of dedication, commitment, and weekly use of my (expensive and is it really worth it?) Costco membership. Prednisone, however, approached the task with the kind of efficiency of my Amazon Prime deliveries.

To be truthful I knew VERY little about the drug before I started taking it. Here’s what I knew: it was a steroid, it was supposed to reduce inflammation & calm down my immune system that had suddenly decided to take on a life of its own, it was pretty much the only thing that could save my life in a dire situation, and that people had been taking it safely for decades. All good and all very, very necessary in my situation.

What I did not know was that it would quietly move into my body, rearrange the furniture, and start making decisions without consulting me.

What I learned is: prednisone can increase your appetite, cause your body to retain fluid, change where fat is stored, make it difficult to sleep, leave you feeling strangely wired while simultaneously exhausted, and produce the delightfully whimsical sounding side effect known as “moon face.”

Moon face. Whoever named that deserves a strongly worded email.

It sounds charming. Magical, even. Like something that happens to a Disney princess after making a wish under unusually favorable lunar conditions.

I am here to tell you that it, my friends, is not charming. It is opening your front facing camera and taking 30 seconds for your brain to compute that this is, in fact, you and not Jabba the Hutt. It is catching your reflection in a store window and briefly thinking hm, that woman looks familiar before realizing with some alarm that the woman is you and that the mirrored reflection is not, in fact, stretched beyond recognition.

What’s weirder, though, is that I didn’t feel different in my body. Sure, none of my clothes fit over my abdomen and my facial swelling got so bad at times that I could literally feel the fluid moving under my {is this even doing anything} gua sha. But I still felt like me so it was literally startling every single time I caught another glimpse of myself. There is something profoundly strange about feeling exactly like yourself on the inside while looking increasingly unfamiliar on the outside. Every morning, I would wake up expecting to see the face I’d been carrying around for the previous forty-five years. Every morning I was introduced to a slightly newer version, one that seemed to be expanding with remarkable confidence.

Sure, I’m vain. I hated seeing myself in such a state. But more so, I wanted to recognize myself. That felt like a surprisingly modest request that just couldn’t be answered no matter how much I asked for it.

Meanwhile, my appetite had developed ambitions of its own. People often describe prednisone as making you hungry, but I don’t think hungry quite captures it. Hungry is forgetting to eat lunch and looking forward to dinner or smelling fresh bread and deciding you might have room for another slice loaf.

Prednisone hunger feels much more like your body has appointed a full time employee whose only responsibility is to remind you that food exists…constantly. I remember standing in the kitchen one afternoon eating crackers straight from the box while simultaneously trying to decide what I should have for lunch. It wasn’t that I was enjoying the crackers all that much. It was simply that the act of eating had somehow become the background music to my day. My stomach behaved as though it had never once been fed in its entire life, despite overwhelming evidence to the contrary.

The internet, as it turns out, is filled with people looking for reassurance that they are not the only ones experiencing this. Search for Prednisone and before long you’ll find yourself reading message boards - if that’s what they’re still called? - and Reddit threads full of strangers asking whether the weight comes off, whether moon face goes away, whether they will ever look like themselves again. Hey, at least I wasn’t alone. In fact, between cancer and then Prednisone, me and message boards became virtual BFFs.

Cancer has a funny way of rearranging your priorities. There were days when doctors were discussing scans and treatment plans and blood work, and somehow, in the middle of all of that, I was standing in my bathroom wondering if my stomach would ever fit back into pants with a button on them.

Oh ya, while dissecting every inch of my 35lbs weight gain, I was also still dealing with cancer. Insert my largest eye roll For months, I was contemplating mortality at ten o’clock and mourning my jawline by lunchtime. For a while I felt guilty about that. It was soooo shallow. Surely I should have been focused on bigger things, but I don’t think that’s how life works now that I’ve lived it.

The big things and the little things insist on occupying the same space. You can be deeply grateful to be receiving medication that is helping your body while simultaneously wishing it wasn’t making your cheeks and stomach arrive in the room several seconds before the rest of you.

Both things get to be true.

Eventually I stopped studying every photograph. I stopped the Prednisone and the weight, ever so slowly, month by month, started coming off. The swelling retreated. My face, for the most part, returned to negotiations with gravity under its usual terms. Somewhat. A little worse for wear and definitely looking older than ever, but back to (mostly) normal.

Every now and then a picture from that time still pops up in my camera roll.

For a split second I have exactly the same reaction.

Who is that?

Then I remember… oh, right, that was me. It’s funny how quickly I’ve forgotten what she looked like. Because at the time I was convinced I’d never look like anything else again.

Not because they’re bad phrases, necessarily. Most of them are perfectly harmless. Some are probably even useful in the right context. But every so often a phrase escapes the confines of whatever leadership book, coaching program, or podcast birthed it and begins reproducing uncontrollably in the wild.

“Say more” is one of those phrases. Shiver

Recently, I started working with a superior in my corporate job who responded to almost everything with it.

You’d explain an idea.

Say more

You’d raise a concern.

Say more

You’d share an observation.

Say more

It was delivered with a thoughtful nod that suggested she was either deeply curious, completely in over her head, or sneak-watching an old episode of Real Housewives while conducting one of 18 meetings she’d run that day. To this day, I’m honestly not sure which is more accurate.

I knew immediately why she used the phrase though - it made her (so she was told? so she thought?) appear to be an exceptional listener who was connected to learning and growing. Except I realized almost immediately, she wasn’t really listening or connecting at all. She was listening the way people listen when they’ve recently discovered executive coaching and are trying very hard to become the kind of leader who asks thoughtful questions.

You know the type.

The people who refer to problems as opportunities. The people who don’t have conversations, they “hold space.” The people who somehow manage to turn ordering lunch into a lesson about abundance and alignment.

I don’t think what bothers me is the language itself. What bothers me is the performance of it. The desire to sound wise instead of being present, and to appear self-aware instead of actually doing the messy work of self-awareness. She was adopting the language of insight before the insight itself has arrived. Call her Mel Robbins or Tim Ferris. Say More just fills in the blank when they either don’t understand, or don’t care to do the work of understanding.

Maybe that’s unfair? Actually, it probably is because, if I’m being truthful, I’ve spent a good portion of my own life doing exactly the same thing. Not with “say more” (shiver) specifically, thank goodness, but I’m not without my self-help hooks from time to time.

I’ve always been drawn to ideas. Frameworks. Systems. Books that promise to explain why people do what they do and how to do it better. Podcasts that make you think new thoughts and enhance your neural pathways (?). Give me a personality assessment, a communication model, a productivity system, or an acronym to follow about becoming a better version of myself and I’m there! All in, totally interested!

Let’s face it, there’s something deeply comforting about the idea that life can be understood. That if we gather enough information, learn enough lessons, and become sufficiently self-aware, we can stay one step ahead of whatever comes next.

I think that’s why self-help is a billion-dollar industry. Uncertainty is uncomfortable, and certainty sells. Everywhere you look, someone is offering a framework for a better life.

A better morning routine.

A better mindset.

A better way to communicate.

A better way to lead.

A better way to parent.

I, like probably everyone else reading this, did believe that enough learning could prepare me for life, and if I paid attention, did the work, stayed curious, and accumulated enough wisdom along the way, I would and could overcome my many personal faults and become the kind of person who handled things well, the kind of person and parent that had their stuff together at all times - woke up ready to go and conquer the world and laid my head down at night in the exact same manner.

Then life did what life does. Not all at once. Life is rarely that considerate, hey? A few disappointments here, a few losses there, some plans that didn’t work out, some surprises I didn’t see coming. And eventually a few things so far outside my frame of reference that no podcast, framework, leadership principle, or communication technique had anything useful to say about them.

That’s the funny / not so funny thing about real uncertainty when it’s plopped in your lap, it doesn’t care how prepared you are, what your EQ is, how many books you’ve read, or if you’re an Enneagram 3 (which I am by the way, and if you know me in real life every single part of it will ring true for me!). When something genuinely unexpected arrives, all the tools you’ve carefully cultivated and collected suddenly starts looking and feeling a little flimsy.

At some point in life, probably when you least expect it because isn’t that the way?, there isn’t going to be a perfect mindset for what was happening. No lesson to learn in advance that would allow me to skip the experience itself. I would have loved one, truly. I am exactly the kind of person who would have downloaded the worksheet and put pen to paper immediately to skip the hard.

Instead, there was just the thing itself. The uncertainty, waiting. The not knowing.

Eventually I started noticing that the thing I trusted and learned from the most in my time of great and unfathomable uncertainty most wasn’t necessarily prettily packaged advice that gave a simple problem/solution response for me to immediately plug into my own experience.

Nope, instead, it was sitting in the hard, resisting the urge to turn every experience into a lesson. No framework. No strategy. No say more.

Just presence.

Which, frankly, is a terrible business model. Nobody wants to hear that the answer is “I don’t know” when looking for answers to unanswerable questions. No one is signing multi-million dollar deals with Spotify for launching a podcast called Let’s Sit Here and Feel Uncomfortable for a While and Never Really Come To Any Clear Conclusions.

And yet, that’s probably the closest I’ve come to wisdom in the past few months. Just the slow realization that some experiences insist on being lived rather than solved. And don’t get me wrong at all, I still love ideas and learning and want to optimize every facet of my life (especially if there’s a fun tagline included that I get to write on a steamed up mirror after a shower!), but I don’t believe anymore that I can learn my way around every hard thing before it arrives.

Which is probably why say more still gives me the ick. Because every time I hear it, I think of all the things in life that don’t get more.

They just are.

And you stand there with them anyway.

Before we dive in…it’s been a while (I know I’ve used those words before!).

For a long time, it felt too hard to put words out into the world and then sit with whatever came back. Responses. Questions. Concern. Advice. Hope. All of it. When you’re very sick, even the kindest feedback can feel like one more thing to carry.

Thankfully, I’m doing better now.

What many people don’t know is that I never stopped writing. I stopped publishing, but I never stopped writing. The words kept coming even when I wasn’t sharing them.

Over the last few months, I’ve been revisiting those notebooks and documents and voice notes. Reading them feels a little like opening a time capsule from someone I know intimately and barely recognize at the same time.

So this is my way back. I’ll try to post every week.

Some of what I share was written months ago. Some of it feels as true today as it did then. Some of it doesn’t. That’s the funny thing about surviving difficult seasons: by the time you have the strength to tell the story, you’ve already changed.

As you read these essays, keep in mind that many were written in the middle of things, not at the end. They come from moments when I didn’t know what would happen next.

And while cancer may be the backdrop, these aren’t really stories about cancer. Not entirely.

They’re stories about being a real person in a real world, and about the plans that fall apart, the identities we lose and rebuild. About disappointment and fear and resilience and acceptance and all the other things that quietly shape us.

I hope your life is never interrupted by cancer.

Truly.

But all of us eventually meet something, and when that happens, something shifts. Maybe only slightly. Maybe forever. Either way, pretending it didn’t happen is no longer an option.

This space was always meant to be a place where we could talk honestly about those moments.

So let’s begin…

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I have been thinking a lot lately about lemons.

Not actual lemons, although if you had seen the state of my refrigerator sometime around February you would have found at least six of them rolling around - shriveled beyond use and wondering, I’m sure, what in the heck they did to deserve this lack of care and respect from the person who bought them in the first place - in the produce drawer, purchased during one of my overly ambitious periods of healthy eating. They sat there for weeks, slowly hardening into little yellow reminders of intentions that never quite materialized. Every time I opened the fridge, I would see them and think, I should really do something with those and, quite frankly, those thoughts would quickly turn to annoyance at the sight of them still there. STILL THERE. Taunting me. Reminding me that I’d bought them with a purpose and then left them to shrink, shrivel, and rot. That I’d wasted the opportunity…

Now that I think about it, this is probably the closest I’ve come to understanding the famous saying: When life gives you lemons, make lemonade.

It is one of those expressions that sounds wonderfully wise right up until life actually gives you lemons. Then it starts to feel a little like being handed a flat-pack bookshelf, three missing screws, and a set of instructions written in half-pictures and half-words, and being told to embrace the opportunity.

The phrase is everywhere. We say it to kids. We write it in Facebook comments. We post it on social media over photographs of sunsets with a light script that suggests the words are joyous and hold no weight - easy and breezy. It has become one of those pieces of cultural wisdom that everyone accepts without ever stopping to examine too closely. Of course you should make lemonade. Of course you should make the best of things. Of course you should find the silver lining and squeeze an opportunity out of every last thing that enters your life.

And yet, I have discovered, that there are entire stretches of life during which the last thing you want is a silver lining.

You want your old life back.

Or at least I do.

Not all of it, of course. There are plenty of things about my old life that deserved questioning. I spent too much time worrying about work, too much time sitting at my computer, too much time assuming that my energy, health, and plans were permanent fixtures rather than temporary privileges. Moping over people who would never mope over me. Focusing on past events that I didn’t handle the way I wish I could now but I can’t go back to fix no matter how much I want to.

But there is a particular kind of innocence that exists before something difficult happens to you, and once it is gone, it never quite returns.

I remember sitting in my kitchen one afternoon after an appointment, staring out the window at absolutely nothing. It was winter (of course, it’s always winter here, don’t you think?). The dog was asleep. The dishwasher was running. One of my sons had left a pile of old school papers that had been crammed in the bottom of his bag in the middle of the floor despite years of evidence suggesting that old crusty papers do not, in fact, belong in the middle of the floor.

Everything was completely normal.

And everything was completely different. That duality - and the ease with which it exists - has surprised me more than almost anything else.

Before all of this, I imagined that major life events announced themselves more dramatically. I thought there would be a clear dividing line between Before and After, that everyone around me would somehow recognize that I had crossed into a different country altogether. Instead, life remains stubbornly ordinary.

People still need dinner.

Laundry still accumulates and waits for me to magically know it needs to be done.

The dog still wants to be walked whether you’ve spent the entire night contemplating your mortality or not (I cannot overstate how little interest a Labrador has in an existential crisis!).

The world continues at its usual pace while your internal landscape is being completely rearranged, and there is something both comforting and maddening about that reality.

For a long time I resisted it. I thought my job was to understand what was happening. To find the lesson. To become a better person because of it. To emerge with wisdom neatly packaged and ready for sharing. To be ready with a book, a 45 minute motivational speech, a podcast, and a community of thousands as soon as I “wasn’t sick” anymore.

There is a tremendous amount of pressure, particularly in our culture, to transform suffering into content. We love stories of adversity, provided they arrive with a satisfying ending. We admire resilience, provided it looks graceful. We celebrate personal growth, provided it can be summarized in a quote and printed on a coffee mug. I’ll raise my hand for being a person who loves a good come back story - you went against all odds and made it out? Sign. Me. Up!

What we (the collective we, myself included) are less comfortable with is the middle.

The long, boring, repetitive, frustrating middle. The months where there are no revelations. The days when your greatest accomplishment is getting through the day and the periods where growth looks suspiciously like lying on the couch wondering why everything suddenly feels so hard.

I suspect this is true whether the challenge is cancer or divorce or grief or unemployment or caring for aging parents or simply reaching a point in your life where the story you expected to be living is no longer the story unfolding in front of you. Eventually every one of us is handed something we didn’t order. And when that happens, there is often a gap between what is happening and what we are able to accept.

I have spent a surprising amount of energy inside that gap.

Because acceptance, I’m learning, isn’t a single moment. It isn’t a profound realization that arrives one Tuesday afternoon and permanently changes everything. It is a practice. It is something you do over and over again.

You wake up, remember, adjust. You wake up the next day, remember again, adjust again. And so on, and so forth. And somewhere in that repetition, life quietly continues.

Not the life you expected, perhaps. Not the life I expected.

Not the life you would have chosen. Not the life I would have chosen - especially not in this current state.

But life nonetheless.

Which, admittedly, is not nearly as catchy as lemonade. It’s kinda boring and on repeat. It’s not ready for a wrap up with a neat little bow. It’s not sweet, sugary lemonade at all (at least not yet).

Still, I suspect it’s closer to the truth.

But after what happened in October with my body rejecting the treatment and the long, complicated medical response that followed (and is still ongoing), I realized I do not currently have updates to give that are not medical. I am tapering off very heavy medication and the process has been… arduous.

While I did share some details about the medical incident that happened to me post-treatment here on this Substack, I also kept out a number of details and have not felt comfortable sharing any more on the internet. What I will say is that the road since early October has been challenging and surprising. Now that we are at the end of November, I do not have significant updates or reflections to offer that aren’t private or related to me medically.

So for now, I am putting a pause on writing here. Maybe I will return in 2026 and perhaps I won’t. I’m staying extra non-committal and keeping all options open :) Nothing’s off the table.

If you know me in real life, or if you are even connected to me via social media, I’m always happy to give you updates or answer questions - never hesitate to reach out to me! I really mean it. One of the weirder parts of this (it has now been 6 months since my diagnosis!) has been hearing nothing from people I thought would have reached out. This is a learning for me too, as someone who doesn’t always reach out first: silence can feel strange and disappointing, so say something or ask something at least once in a while.

And hey, please don’t be discouraged if you message and do not get a response right away. Many messages have arrived at times while I was in the hospital or dealing with something medical and I simply could not reply. I promise I will get back to you, even if it takes me a while. Sometimes more than a month... :)

Thank you for reading, for caring, and for giving me the space to be honest. I hope to be back when I have something real and grounded to share that is not only about the medical side of things.

Until then, consider this a pause on the Pause ❤️

I’ve always been the kind of person who can’t do things halfway.

If I’m in, I’m all in. Moderation has never really been my strong suit. Apparently, my immune system decided to take up that trait.

I was fine one minute. Standing in my bathroom, about to get in the shower. And then within moments, seconds even, I wasn’t fine at all.

An all-encompassing pressure started radiating through my upper abdomen. It was unlike anything I’ve ever felt before and I’m still struggling to explain it properly - it was harsh and warm, gripping my insides and moving like a wall through my body toward my shoulders. I was buckled over in half and felt every single organ pulsing in a way I don’t think they’re meant to pulse.

My face started to swell - starting with my eyes then moving to my ears and nose until they were completely shut off and unable to function. My throat and tongue became tight. My breathing turned shallow. Within minutes, I could feel my body shutting down.

I could have sworn I was screaming at the top of my lungs but apparently (according to everyone in my house at the time) I was pretty calm and just telling them that something was wrong over and over again. Thankfully my facial swelling made it impossible for anyone to ignore that something was, in fact, very wrong.

My husband called 911.

By the time the ambulance arrived, my face was swollen beyond recognition. It took three epinephrine shots, two doses of Benadryl, and a hefty amount of IV steroids before the swelling even began to subside remotely.

They couldn’t find a vein for the IV (they never can) during hospital transport, and I was moved to the trauma bay at the ER for about 36 hours, heading to the ICU before they were able to get things under control enough that the doctors felt comfortable sending me to a medical ward instead. I ended up spending five days on the oncology ward being closely monitored and mostly in an isolation room.

It was surreal and completely out of the blue.

Once the initial chaos settled, the medical detective work began. After days of tests & consultations, a working theory has emerged - with a lot of discovery still to be made:

A Delayed Hypersensitivity Reaction

In plain terms, a rare, severe immune response that sometimes occurs with immunotherapy (specifically pembrolizumab, which is the immunotherapy drug that I was being given).

Normally, this medication stimulates the immune system to attack cancer cells. In my case, my immune system got a little overzealous… let’s say “classic overachiever” energy. Instead of calmly targeting what it was supposed to, it decided to go big and attack my own tissues.

The reaction likely involved a Type III or IV delayed immune response, where the body produces antibodies or activated T-cells that mistakenly turn against itself days or even weeks after exposure.

In my case, that meant:

• Allergic-type symptoms: full-body hives, facial swelling, airway inflammation

• Organ involvement: inflammation in the liver and other systems/organs

• A coordinated immune flare: overactive cells triggered inflammation in multiple places at once

Because the reaction occurred about seven days after my infusion, it is not a typical immediate allergy but rather a delayed systemic immune event, something sometimes referred to as a serum sickness–like reaction. Essentially, the same overactive T-cells and cytokines that inflamed my liver also inflamed my skin and airways.

These kinds of delayed immune events are extremely rare. My doctors have suggested that less than 1% of patients worldwide experience anything even remotely similar. And yet, here we are.

Thankfully, I am home now. I wish I could give everyone a great update, but honestly we’re in a period of watchful waiting. My bloodwork is still wildly off the charts, I’m on a really heavy dose of steroids to stave off any new attacks, and we are testing, re-testing, and trying to determine how to move through this rare event and get back to baseline.

There are no clear answers yet. No plan. Just questions and data points and a lot of gratitude that I stabilized when I did.

The hardest part is the uncertainty. I had just started to find my footing with treatment and now, the map has changed again.

But as I’ve learned over the past 5 months (more times than I’d like to admit), sometimes life doesn’t ask whether you’re ready to change direction. It just does.

I keep laughing, in a darkly ironic way, about the fact that even here, in cancer treatment, I couldn’t just do things the straightforward way. No, I had to have the rare reaction, the “you might see this on a medical exam but never in real life” reaction. Classic.

But it’s also a reminder for me to accept that, at least in these moments and days, control is an illusion and the only thing I can really do is show up, listen, and keep moving forward.

So that’s what I’m doing. Slowly. Carefully. One breath, one blood test, one conversation at a time.

I don’t know what the next chapter looks like yet. But I do know this: I’m still here. I’m still me. And apparently, even my immune system refuses to do anything halfway.

Cancer has made me live by two clocks I didn’t know could co-exist: the one that ticks too slowly and the one that eats entire months in a single gulp.

On one hand, time feels irrelevant. There are moments where I’ll lie down just to rest my eyes and wake up to find the day already gone, my kids home from school, and dinner a last-minute scramble. Sitting in the chemo room sends time stretching into eternities, with the slow drip of medication, the scurry of nurses, the shuffle of volunteers and patients up and down the halls, and the hum of fluorescent lights.

Fifteen minutes waiting for my name to be called for bloodwork can feel like a true lifetime. And yet, somehow, July and August completely disappeared in the blink of an eye. In fact, the whole summer season seems to have slipped past while I wasn’t looking.

I sometimes think of it as fake time. Everyone else is living a real life with school, sports, deadlines, dinner reservations, and vacation plans. Meanwhile my life isn’t really happening, or at the very least it’s on hold, quieter, slower, and strangely fake-feeling even though I’m still doing very real things.

On the other hand, there are moments when time matters deeply and will suddenly sharpen into clarity. I notice the number of mismatched tiles on the floor of the long cancer ward hallway or how quickly the leaves are turning from green to orange on the maple tree I pass every day on my walk. I can tell you the date of my diagnosis without hesitation and exactly what my doctor was wearing when I found out - we (oddly?) dress alike and that day she and I had on almost identical olive green sweaters & baggy jeans.

And I’m super aware that I’m not the first to notice how illness warps time.

Years ago, when I initially read Suleika Jaouad’s memoir Between Two Kingdoms, she described the years of her cancer treatment as “life in suspension”. While her friends’ lives marched forward in milestones & movement, hers became a strange cocoon of waiting rooms and hospital gowns. Everyone had the same hours but vastly different experiences with time.

Those words rang true then, but I suppose since this is my first brush with any serious illness involving myself, the enormity of time and its weirdness has become crystal clear to me. My lived experience is seemingly a bit more jagged and jarring, with blurred lines where there used to be a lot of clarity. My two lives - maybe even two new life timelines - unfolding at once, overlapping but not quite touching.

As I write this, it is about to be the four-month anniversary of my diagnosis. It feels like years and mere seconds have passed, all at once.

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Instead of trying to make sense of time, perhaps I should be focused on integrating milestones and benchmarks. Key cornerstones to anchor memories and measure time against.

Or, maybe pausing for cancer forces me to see time differently going forward. Not as something I can manage, optimize, or plan into submission, but as something alive and unpredictable, that demands to be noticed.

And it might not just be cancer time. Maybe time has always been this weird but I’ve just refused to stand up and take notice? It could be a gift, a curse, or something in between.

I’m not sure what the lesson here is or really how time will continue to evolve and change for me… But what I do know is that time keeps teaching me, like it or not.

So for now, I can say with certainty: time gets weird. And maybe one day I’ll see that was the point all along.

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When I started sharing about melanoma and immunotherapy a few weeks ago, I quickly realized people had a lot of questions. Heck, me too! Some were practical, some were thoughtful, and some were the kind of thing you only ask once you’ve had a few glasses of wine :)

But listen, we’re all human and we’re all curious. And honestly I don’t mind answering because I’m learning a million new things every day about myself, my body, and cancer, so no one should feel weird about their questions with me. Consider me your safe space :)

But in the spirit of wanting you to get the information you want and need, here’s my most commonly asked questions with some honest answers about what treatment looks like, how it feels, and what life is like in the middle of it. It’s a bit long so might be more of a skimmer than a deep read :)

Q: How do they give you immunotherapy?
A: It’s given through an IV. On therapy weeks I have two appointments, one of Wednesday for blood work and a check in with my oncologist, and one on Friday where I receive the immunotherapy. It is given through an IV in my arm (no chemo port needed), and the drug drips in over about an hour.

In my particular case, I don’t have great veins. And because my veins aren’t nearly as plump and robust as nurses would like, I start treatment with a warm towel wrapped around my arms to help prep the veins. I also get an extra bag of saline that helps slightly dilute the meds as they’re administered, which makes my veins a little more compliant.

The IV process takes about an hour and a half from start to finish and then I’m free to go.

Q: Where do you go to get it?
A: At the cancer centre in my local hospital. The infusion room is full of big reclining chairs, IV poles, and people. Honestly the sheer number of people in the room is something that really took me off guard on my first visit. There are some private rooms, but mostly everyone is lumped into a large common area.

I’ve sat in both the private and common rooms, but I prefer the common room as it lets me people watch and eavesdrop on the nurses (my favourite thing to do). Makes the time go by so much faster! In the room, some people read or nap, some watch TV, and others just rest and people watch - I’m in the last category.

You can have one person sit with you in a hard plastic chair and patients are allowed to eat and drink as they please during treatment. Because patients have varying durations of treatment, some people bring in tons of snacks and last week someone even had their spouse go and get them a footlong sub and coke because they were starving. Volunteers also will bring patients ginger ale or water if they need it. Since my treatment is on the shorter side, I don’t eat anything but I do bring a water with me.

Q: How does it feel afterward?
A: That really varies. I personally can feel the medicine entering my veins for the full duration but I know lots of people don’t feel anything. Generally I leave feeling completely normal but fatigue sets in pretty quickly for me. I try to take a big long nap when I get home and that tends to help a lot. For the next few days, there can be aches, digestive issues, or other side effects depending on how my immune system reacts. I’ve only had a few treatments so far but it really seems to be a bit different every time.

After my first infusion I had an awful migraine and digestive issues, alongside flu-like symptoms. However, the next infusion just resulted in tiredness that felt like REALLY bad jet-lag for a few days. I suspect each time the reaction and symptoms will be a little different.

Q: How do you even get checked for melanoma?
A: Great questions because I didn’t know. Keep in mind I’m not a doctor and I definitely can’t look at your mole and tell you if it looks weird :) But, from my experience and from speaking with both my dermatologist and oncologist, if you have fair skin and a European (Irish, English, Scottish specifically) or East Asian background you fall into a higher risk category and should be getting your skin checked yearly.

During an annual skin check, a dermatologist will examine your skin from head to toe with a dermatoscope (a little magnifying light that reminds me of what doctors use to look in your ears). If anything on your body looks suspicious or has changed, they take a biopsy or cut it off completely. That tiny skin sample will give them a fuller picture of whether the mole/growth/freckle/etc is melanoma and how serious it is.

There are definitely recommendations regarding checking from home, and you should follow them, but in my case my melanoma didn’t hit any of the “watch outs” and I would have ignored it with a home check, so having a yearly dermatologist visit is really your best and safest bet if you fall into the higher risk category.

Q: Why did you get it?
A: Great question! Melanoma doesn’t have one clear cause. Risk factors include fair skin, history of sunburns, tanning beds, and genetics. In my case, I have always worn sunscreen but I had a deep love for tanning beds in my early 20s. I suspect that’s the root cause; melanoma doesn’t run in my family so it wasn’t really on my radar of things to watch out for.

An interesting thing I’ve learned is that melanoma can show up anywhere, not just sun-exposed spots. So while I got this melanoma on my left leg in a pretty covered up/non-tanned area, it could have originated from a sunburn somewhere else on my body.

As I’ve mentioned before, there’s a lot of emerging evidence that stress can be a factor in getting melanoma and the severity of it. I think you’d be hard-pressed to convince me that stress didn’t play a factor in my melanoma journey.

Q: Do you lose your hair with immunotherapy?
A: No. Immunotherapy isn’t as harsh or hard on the body as chemotherapy. It works by training the immune system to recognize and attack cancer cells, so it doesn’t usually cause hair loss. That’s one thing I haven’t had to worry about.

Q: How long is the treatment?
A: Treatments happen every 2-3 weeks, and the full course for me will be 17-20 treatments (about an entire year). It’s a steady rhythm that is now becoming part of my calendar and will be the basis of all planning for the next 12 months.

At the half-way mark, I’ll redo all the tests I did at the start of this journey to see if there are any changes happening within. All the tests at the onset provided a baseline of “normal” for me, and will be the yardstick by which everything else is measured.

In case you’re curious (I would be), I have passed all my blood tests and scans with flying colours to date.

Q: What’s the weirdest side effect?
A: Immunotherapy side effects can be surprising. Because it works by stimulating the immune system, sometimes the body gets a little overzealous and inflames healthy tissue. That can mean anything from headaches, rashes, thyroid issues, joint pain, or digestive problems.

For me, the weirdest symptom (and sorry if this is TMI) has been that my period has been thrown completely out of whack. I now get my period with no warning, and it can last anywhere between 3 days to THREE WEEKS(!!!). They also start at full force - kinda like someone turns on a tap at full blast - usually in the middle of the night. It’s not really normal for me, but the care team monitors all of this closely of course and assure me that while this symptoms sucks, it’s not abnormal or too worrisome for them.

Q: How do you talk about it with your kids?
A: With honesty and openness. My kids are teenagers, so they know the basics of what’s going on. I share the facts with them, let them ask questions, and admit when I don’t know the answer. They get to see me being strong, but also human, which I think matters.

They also have a strong base understanding of what cancer is as it’s part of the health curriculum at school so they were immediately more informed than I was (I knew nothing, if I’m being honest) and took the news, and continue to deal with it all, really well.

Q: What helps the most right now?
A: Personally, not working has been the best decision I ever made for this particular time period. While I hope no one reading this ever finds themselves in this position, I would advocate for taking a break from work 10/10 times. Clearing mental space is key to making good, informed decisions at a time where everything feels like a big jumbled mess.

In terms of help from others, I don’t really need anything in particular but I do appreciate the quick check-ins that don’t require a reply, or friends who keep me active with walks and laughter. I’ve had some really lovely gifts arrive on my door step/ inbox that have made it clear that people know me and the things I like :) While not expected, those have really lifted my spirits!

I said this in my first post but I’ll say it again, I don’t expect anything from anyone. Everyone deals with this kind of situation differently and in their own way. But honestly, just knowing you’re on the heart of a few people has been so helpful to me.

Q: What’s one thing you wish people knew about melanoma?
A: That it’s serious.

Melanoma isn’t “just skin cancer”, it can spread quickly and it is considered to be one of the worst cancers to get in terms of spread (you’ve heard me refer to it as wildfire and that’s truly what it is like).

Q: Anything really annoying you?

A: Very well-meaning (I’m sure!) people have said things like:

you look fine/you don’t look sick OR

it’s a common cancer and you don’t need to be worried OR

regale me with stories of someone they know who got a worse cancer than me and lived...

And I get it. I do look good for someone going through treatment and it is a more common cancer with positive outcomes for many people. But while I’m sure people are just trying to be positive, it’s reductive and feels like a brush off. In some cases, depending on the day I guess, it makes me feel kinda embarrassed to have ever talked about my diagnosis and like I’m overreacting to something that isn’t that deep. Silly, right?

I actually didn’t understand the toxic positivity culture that surrounds cancer treatment (more on that another time??) but honestly it is the only thing that has truly annoyed me about this journey to date.

That’s my FAQ for now! Writing this down reminds me how much I’ve learned in a short time, and how grateful I am for the support around me.

If you have other questions, please ask. Cancer is overwhelming but no question is silly, too personal, or off-limits. Sometimes asking is the best way to turn something scary into something we can actually talk about.

And that, weirdly, was its own milestone. Because if there’s one thing I’ve been too good at in this life, it’s never skipping. Never not producing. If there isn’t already a box to check, I’ll invent one just for the satisfaction of ticking it off in Sharpie. Productivity has been my oxygen, my love language, my entire identity in so many areas of my life and in so many big and small ways.

Have you ever watched the show Intervention? It became my nightly watch when I was recovering post-surgery and couldn’t get out of bed or walk around. It’s sad, engaging, informative, and hopeful all at once. It sheds light on how easy it is to slip into a lifestyle that you never even meant to slip into, and how hard you have to work (and want it!) to get yourself out.

So when cancer came calling in May, it came with its own bunch of problems, insights, and eye-openers. But, it turns out, it has also been one hell of a productivity intervention for me.

The first time I walked into the cancer room, I felt like the new kid in school. Except instead of lockers and backpacks, there were recliners, IV poles, and the quiet hum of machines. Most of the people around me were decades older, at least 60 years old+++.

And then there was me. Mid-forties. Sneakers and wide-leg jeans on in an attempt to still be kinda relevant in my clothing. Stanley water bottle in hand (thanks to a sweet care basket that my employees sent to me!). I like to think that if this were a reality show, I’d be the hot new bombshell entering the villa. I could almost hear the reality show voiceover: She’s younger, feistier, and she’s here to stir things up…

Of course, the truth is much less glamorous. I sat down, tried not to make too much eye contact, and immediately pulled out my notebook because what else would a productivity addict do?

If I couldn’t work, at least I could plan.

Make lists.

Capture insights.

By the time the nurse hooked me up, I was already halfway through mapping out a “healing project plan,” complete with bullet points and deadlines.

But in looking around I saw patients in the same spot I was, doing things that I quite frankly didn’t even think to do.

No notebook. No phone. No distractions. Just sitting there, letting it all happen.

Breathing.

Existing.

Napping.

Being.

And I realized: I didn’t even know how to do that.

My family doctor warned me this might be my biggest challenge before treatment even began. She looked me straight in the eye and said: What if, instead of trying to be a hero and push through, you just focused on yourself? You don’t know how you’ll feel so what if you just took a time-out from all your obligations?

She’s in her mid-late 30s, cute as a button and a really progressive thinker as far as medical professionals go. I feel lucky that she’s on my team, but that suggestion hit me like an alien language. Focus on… me? On my health? Take a (unpaid, for the record) leave of absence from work?

What does that even mean when your brain is wired to prove your worth through output?

But I listened to her. I told work I’d be back when I’m ready (and they were great about it!). I have the most supportive family who honestly seems quite unfased by lack of productivity and kinda on board with my need to rest a heck of a lot more than I ever have in my life (go figure).

However, I’ll be honest: I’m not good at it. Not yet. I still set weird “rest goals” for myself, as if healing can be optimized like a quarterly KPI. Walk 10,000 steps a day? Great! But what if I also tracked my monthly kilometers? And added weights to my walk? And turned it into a spreadsheet with a line graph so I could see progress in real time?

And because my brain never met a syllabus it didn’t want to write, I even started building a learning curriculum for myself. Finally, I’d catch up on all the topics I never had time for. I made assignments. Deadlines. Reading lists. I gave myself homework. (You can’t make this up.) Spoiler: I had to have a little heart to heart with myself and put my beautifully (with the help of ChatGPT) created learning plan aside.

Because part of learning to take care of myself is unlearning this obsession with achieving. It’s absurd when you think about it. I’m having to ease myself into reading books for fun, not for learning, not for “enrichment,” not because I could later reference them in conversation. Just for fun. Do you know how revolutionary that feels when you’ve spent your life trying to squeeze productivity out of every minute?

The more I reflect on it, the clearer it becomes: I was running on fumes long before the diagnosis. My life was structured around producing: at work, at home, in every corner of my day. The more I achieved, the more I wanted to achieve. It was like chasing a finish line that always moved a little further away.

And while I can’t say with certainty that this way of living caused my cancer, I can’t ignore the likelihood that it contributed to the perfect storm. My body was waving red flags for years, and instead of slowing down, I found ways to sprint harder.

Now the brakes have been slammed for me, like it or not.

That’s the part no one tells you: cancer isn’t just a fight in your body, it’s also a rewiring of your brain. For me at least, I can’t keep living at the same unsustainable pace, but stepping off the hamster wheel feels unnatural and even threatening. Who am I if I’m not producing? Where is my value if not in what I create, achieve, check off, or hustle for?

Right now, I don’t have a perfect answer. Some days, I’m still bargaining with myself and obviously sneaking productivity into my healing like contraband (I have kept my walking goals but I ditched the spread sheet in case you were wondering…). Other days, I catch a glimpse of what it means to just be without doing, and it feels both terrifying and freeing.

So this is where I am: not climbing the metaphorical production mountain, not acing the imaginary curriculum, not giving it my all and running on all cylinders. Just sitting in the villa, IV drip in hand, trying to practice the messy, uncomfortable art of being instead of doing.

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My surgeon warned me at our first meeting that surgery alone wouldn’t be enough. I’d need treatment that would be decided upon based on if/when any new active tumours were discovered via surgery and post-surgery scans (PET, MRI, bone scat, CAT, etc).

As he ran through the menu of treatment options that I may receive, it was the first time I heard of immunotherapy as an option for treatment.

If you had asked me a year ago what immunotherapy was, I would have guessed something vague about vitamins (maybe one of those fancy vitamin drips people get after a rough weekend in Vegas?). Possibly a spa treatment? Maybe a new smoothie?

The truth is, I had absolutely no idea. And fair enough, why would I? Unless cancer has crashed into your life (or the life of someone you love), it’s not the kind of thing you ever have reason to look up or learn about.

But now I know. Oh, do I know.

Immunotherapy is a type of cancer treatment that doesn’t blast your body with chemo or zap you with radiation. Instead, it uses your own immune system, your body’s built-in defence force, and gives it a wake-up call. Think of it like turning the lights on and yelling “Hey, over here!” so your immune cells can spot and attack cancer cells they’ve been ignoring.

And because it doesn’t poison cancer cells directly like chemo, it essentially rallies your own immune system through training so it will recognize cancer cells as intruders and attack them.

For melanoma, this approach has been a game-changer. Even five years ago people with my diagnosis would have surgery to remove the cancer (as much as possible) and then be left to hope and pray that it didn’t come back. But immunotherapy has literally changed the game. People with advanced stages have the chance to live longer and lessen the chance of reoccurrence or further metastasis in their body (remember melanoma loves to hide and then attach itself to major organs when no one is looking!). It’s why I’m doing it - because the payoff could literally be my life.

The kind I’ll be on is given through an IV at the cancer centre. I shouldn’t lose my hair and it’s unlikely that I’ll get the sunken cheeks or other physical markers people associate with cancer treatment. On the surface, I should look mostly fine. That’s good news, but it has also made this harder to explain. Because I don’t look sick, some people can’t quite grasp that I’m in treatment. They picture chemo and all its accompaniments, not this.

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The side effects from immunotherapy are there though. When you supercharge the immune system, it can get a little…enthusiastic. It might attack healthy cells, not just the cancer ones. Extreme fatigue, skin irritation and rashes, significant diarrhea that isn’t helped by just popping an Immodium, joint pain, inflammation - the list is long and unpredictable. This is why sitting in a chair, IV in my arm, feels like crossing an invisible line. I’ll officially be someone in treatment, even if you can’t see it from the outside.

Because I tend not to be a passive person and I need to feel like I’m actively part of something that’s happening to me, I’m also making some changes in my own day to day life. Most of these are just tweaks to how I already live but they are tweaks with great intention - things that are now non-negotiable and essential to my well-being.

There’s a lot of new and science-backed lifestyle recommendations that can make a significant difference in how a patient reacts to and receives immunotherapy. While a lot of the research is still relatively new (done within the last 5 years - I’ve linked a few articles below if you’re interested), I’m excited to know there are things I can do in the process that might improve my outcome. They include:

• Mediterranean-style eating - plant-forward eating with lots of veggies, legumes, whole grains, olive oil, fish, nuts, and herbs

• Boosting daily fibre - there is emerging evidence that fibre-rich foods aide in the performance of immunotherapy. I’m aiming for 30-40 g a day from natural sources like berries, leafy greens, beans, lentils, and chia seeds (this is hard though, I can’t lie!)

• Avoiding probiotic supplements - letting my gut microbiome flourish naturally from whole foods.

• Hydrating like it’s my job - water, herbal teas, and fresh-pressed veggie juices every day (my current juice is carrot, celery, and cucumber and I CRAVE it from the moment my eyes open).

• Moving daily - long walks with and without my dog (I’m aiming for 8-10km per day), stretching, and lower-impact movement to keep energy and circulation strong.

• Protecting my sleep - aiming for 8+ hours, even if it means adjusting my evening routine, which is hard for someone like me who has never been a sleeper. I’m trying to get into napping, but so far I’m not great at it.

• Stress management - removing myself from a high-stress work environment for the next few months, carving out quiet solo time each day, saying no to unnecessary commitments (or ones that won’t contribute to my peace!), and figuring out how to move forward with less stress overall are just a few of the actions I’m taking here. Consider this a huge work in progress. Again, there’s a lot of emerging evidence that stress plays a role in the emergence of melanoma in someone who is already predisposed to it.

• Limiting sugar and removing any alcohol - keeping my immune system focused on the fight.

So the treatment plan is relatively new as far as drug therapies are concerned, a bit unproven, but makes me feel hopeful.

I’ll be on immunotherapy treatment for a year, after which we’ll assess where we are at and what (if any) treatment needs to be undertaken. It’s wild to think that this is my new reality.

This is so, so, so real now.

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💡 Quick Facts: Immunotherapy 101

• What it is: A cancer treatment that boosts your immune system to recognize and attack cancer cells.

• How it works: Turns your immune system into a more active cancer-fighting force.

• How it’s given: Through an IV infusion at a cancer centre.

• Major side effects: Fatigue, skin rashes, joint pain, inflammation because the immune system can overreact.

• Why it matters for melanoma: It has dramatically improved survival rates for advanced melanoma and offers real chances at remission or cure.

• What makes it different from chemo: You typically won’t lose your hair or have the same physical markers, which means you might look fine while you’re still in very real treatment.

Actually, I barely told anyone at all.

Not my colleagues. Not friends. Not family members. Not even my own kids.

At the time, it felt easier to keep things moving like nothing had changed. I was scheduled for a surgery to remove additional tissue and lymph nodes, but I still showed up to meetings, kept deadlines, and responded to emails like everything was normal. I still went to every basketball practice, dragged my kids out of bed at 6am for school, and just kept life moving along without breathing a word to anyone but my husband.

Looking back, I can see that I told myself a few different stories about why I was keeping it quiet. I’m still not sure if it was the right or wrong thing to do, but it was what I felt I had to do at the time to keep myself straight during this time.

First: I didn’t want it to be real.

Not saying it out loud made it feel like maybe it wasn’t that serious. Maybe this would be one of those one-and-done things; a bump in the road. I’d get through the surgery, get the all-clear, and get back to life.

No reason to sound the alarm or make people worry. No reason to burden anyone else with something that might not even be a thing.

I figured I’d just quietly recover, tell people later (or never), and carry on.

Except, as you know, it was a thing. It became a bigger thing. And then an even bigger thing after that. Pretending otherwise didn’t make it any smaller but honestly it made it a lot easier on me. Not having anyone but my spouse know kept this thing ignorable and tolerable, which I suppose in hindsight was exactly what I needed it to be as I worked through my own emotions and tried to “plan” (haha famous last words) how I could make this all work out in my current busy life schedule.

Second (and a lot harder to swallow, but honestly quite plausible): What if people didn’t care?

That one hit - and continues to hit - a little deeper.

It’s a strange thing to admit, especially as a grown woman who has spent decades in leadership roles and has no shortage of confidence in most areas of life. But there’s a vulnerability that comes with illness; not just physically, but emotionally. When you tell people you have cancer, you’re inviting them into a very uncertain, very uncomfortable space. And the truth is, not everyone knows what to do once they’re in there. I sure didn’t.

And I’ve seen it play out in a few different ways before.

Years ago, I worked with a woman who had cancer and didn’t tell a soul at work. I found out one day when she joined a meeting with me with her camera on by accident and saw firsthand the effects that chemo was having on her. I never said a word to her or anyone else as I knew she would say something if she had wanted to, so I stayed quiet. And if I’m being honest, she had been a really difficult co-worker so at least this (secret) knowledge that I had made her attitude at least make some sense. A few months after I left, she passed away and no one knew she’d even been sick. Her current and former colleagues were stunned and overwhelmed with questions. So many people said they would have rallied around her if they’d had the chance, but she hadn’t given them that choice. Maybe she knew that people say they care but she also wasn’t sure if they really did?

However, on the flip side, I also saw someone go public with their diagnosis right away. She was also a work colleague (different workplace) and although she got the initial “so sorry, reach out if you need anything”, I watched as people quietly turned to resent how much time she took off, how she was still getting paid, how it seemed like she wasn’t really sick. There were whispers that she was using her diagnosis to get special treatment and even after she was in remission and returned to full-time work people treated her drastically differently. She didn’t do anything wrong and, in fact, she was exceptionally sick and had no choice but to work through her treatment as a single mom but honestly, her telling everyone made things way worse than they needed to be.

The truth is, I didn’t want to be either of those women.

I didn’t want to disappear silently. And I definitely didn’t want to be accused of overplaying it.

So I stayed quiet.

I kept working. I played it cool. I told myself I was just being “professional” and not burdening anyone with my secret and my troubles.

But really, I was scared.

Because what if I told people, and they didn’t care? Or worse, and this brings me to my final story…

Third: What if people felt annoyed?

What if they rolled their eyes when I took a half day for a CT, or whispered that I “seemed fine” while I was waiting on pathology reports? What if they felt I was using this to get special treatment or to steal the focus from someone else? What if they didn’t like me enough to have this even register on their emotional radar? Or the absolute nightmare (for me), what if someone downplayed my diagnosis or treatment, making me question myself for ever opening my mouth?

I was a writer and blogger for many years, and I loved it. BUT I distinctly remember having people in my life, people who I thought liked me and were my friends, confront me from time to time about things I had written. In some cases, a few less-savvy internet users even anonymously commented nasty things on a few of my online pieces. In the end, a big part of why I stopped writing online was because people in my real life started assuming that things I wrote were about them and/or tried to guess who was involved in stories that I told. It got embarrassing and felt downright awful to realize that people I loved were probably not talking great behind my back and were making assumptions that just weren’t true. That sharing my life through my online writing was annoying to them.

So what if the same thing happened here. What if I realized that I was an annoyance, a frustration, or (gulp) not actually someone they consider a friend.

So what has the reality been like so far? It’s been a mixed bag.

Some people showed up in a way that surprised me and continue to reach out with real, heartfelt support. That meant and means everything. I don’t need constant check-ins at all but knowing that I’m at least on the mind of people here and there is amazing.

And then, of course, there were others who responded with things like “Oh, that’s pretty common” or “At least it’s not XYZ” or “You don’t look sick” (which, fair, I don’t). Or, worse, said nothing at all even though I had thought we were close.

Intellectually, I knew this would happen. I know everyone’s bandwidth is different. I know people mean well, even when they don’t always say the right thing, or are silent (which I certainly have been in the past). But when you’re in the middle of something big and scary to you, I have learned that it’s hard not to wonder what your absence from their text, inbox or meeting calendar actually meant to them.

So, what if all those stories I told myself came true? It turns out… some will. And some won’t. Some people will say the wrong thing. Some will say nothing at all. And some (bless their hearts) will surprise you by showing up exactly when you need them most.

But the bigger shift? Realizing that the caring doesn’t have to come from everyone. Understanding or acceptance isn’t a guarantee. People won’t aways get you and you’ll always kinda be annoying to some… and that’s ok. Your experience is still valid and real - and you accepting you and what you need is actually the greatest gift of all.

That’s the part I’m still working on. But at least now, I’m talking about it.

Life’s Little Joys

An oncology nurse put me on to the idea of “Radical Self-Care” and how potent it can be for patients going through treatment. I’ve been working through what radical self-care might look like for me, but the more I dive into the concept, the more I love it and can see the immediate benefits not just for me and my situation, but anyone navigating a tough road. It is quite a foreign experience for me but as I spend time learning about what makes me feel like a whole and centred person, I’m growing to embrace the concept more and more. There’s a lot of literature out there that you might connect with, but the mantra that has stuck with me the most is: Radical Self-Care is Not Just a Bath. It's a Way of Life.

Take some time this week to think about what radical self-care might look like to you, ok? Don’t wait like I did for something out of left field to make you wake up and take real stock of your own life and well-being.

Although I promised this wasn’t going to be a medical diary, I do know that understanding what happened, when, and what it all means is important context to my on-going story.

So, this is what actually happened.

April 29 – Mole removed
I went to my family doctor about a mole on the top of my left thigh. It had started rubbing against my pants and was annoying me, even though it didn’t look remotely threatening. No asymmetry, no strange borders or colours. It didn’t match any of the typical melanoma warning signs.

Still, we decided to remove it in the office and send it for biopsy just to be safe. Local freezing, a few minutes, and it was gone. I honestly did not give it a second thought until…

May 15 – The call to come in
My doctor’s office called and asked me to come in that day. The urgency made me nervous, but I still didn’t think it would be anything major.

She let me know the biopsy confirmed melanoma. The tumour was deeper than expected, being placed at Clark Level IV. Clark Level refers to how far the melanoma cells have penetrated into the skin layers. Level IV means the cancer has reached the reticular dermis, which significantly increases the risk that it has spread.

Although we had already removed the mole, I was now being referred for surgery to remove additional skin and tissue around the site (this is called a Wide Leg Excision), as well as a sentinel lymph node biopsy to determine whether the melanoma had travelled beyond the original site.

June 4 – Wide Leg Excision and Lymph Node Surgery
Up until this point, I was still treating it like an annoying detour. I took just two days off work (!!), in hindsight a very unrealistic and overly optimistic choice.

The morning of the surgery, I was given a series of nuclear medicine injections around the original mole site. The purpose was to identify the sentinel lymph nodes (the first nodes that drain from the tumour area) so they could be surgically removed and tested for cancer.

What I didn’t expect was the intense pain of the injections. It was easily one of the most physically painful moments of this journey. That was the first time I really understood how serious this was.

I was taken into a surgical room at the hospital and placed under general anaesthesia. When I woke up, I had large, painful incisions in two places, my groin and my upper thigh. It took me about a week to be able to even sit up straight or walk even small distances in my house.

The scars from that surgery are significant. I still see them every day, and it will take about a year for my left to look relatively “normal” again, although the scars will always be there.

Mid-June – Surgical follow-up
Two weeks after the surgery, I returned to the surgeon for results.

The melanoma had spread. Cancer cells were found in the lymph nodes.

That was the moment everything shifted.

Late June – Oncology appointment
I met with my oncologist and his incredible team. We reviewed the results and I was officially staged: Stage 3b metastatic melanoma.

Stage 3b means that melanoma was found not only at the primary skin site but has also spread to nearby lymph nodes. It’s aggressive. It’s unpredictable. It raises the likelihood of recurrence dramatically.

He immediately booked a full series of scans and tests (including a PET scan, which is relatively new to the hospital I’m being treated at) to ensure there were no new tumours forming anywhere else in my body.

July - Preparing for treatment
Here’s what I’ve learned: Melanoma at my stage spreads like wildfire. It moves fast and often invisibly.

Even though we had removed the original tumour and surrounding skin, the fact that it had travelled to my lymph nodes meant we were no longer dealing with something localized. We were now managing a systemic threat.

That’s what Stage 3b means. It doesn’t just stay in one place.

I went from an annoying mole to a cancer patient with a long-term treatment plan (more about that later) in under two months. Skin cancer isn’t always a quick fix. For many, myself now included, it becomes a whole new life.

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It started with a mole. Not a suspicious, terrifying-looking mole. Relatively small and easily ignorable. The kind of thing that looked like it had grown out of an old freckle and honestly might just fall off if I gave it time. It lived quietly on the top of my left thigh. Honestly, not exactly a high-visibility area during February in Canada, but I had planned a trip with my sister to Miami and that meant shorts and bathing suits and that pesky new mole becoming more annoying and much more visible to me than it might have otherwise been.

The only reason I really thought about doing anything to the mole, however, was because it had started to rub against my jeans. Not painfully, just annoyingly. It didn’t look like anything out of the ordinary: no scary shape, no strange colour, nothing that would set off the alarms we’ve all been taught to look for. It didn’t even hit one of the ABCDEs of melanoma.

Not one.

Still, I was annoyed enough to make an appointment to go see my family doctor, and see if she could refer me to a dermatologist or even remove it herself. She wasn’t specifically alarmed either, but thankfully (and I really do mean thankfully) we decided it made sense to just remove it in her office. I went back the next week, quick and easy under local freezing, and the mole was gone with a few stitches left in its place for good luck. I barely noticed it happening and forgot about it almost immediately.

That was in late April.

By mid-May, my life had changed.

It happened on an ordinary weekday. I got a call from my doctor’s office asking if I could come in… that day. I definitely paused and thought, hm, weird. I remember hesitating and stalling while on the phone with the receptionist. I had meetings, a full work calendar, both kids had an orthodontist appointment that afternoon. Just typical things to do. Driving down to the office wasn’t exactly convenient, but something told me to make it work. I moved a few things around and went in.

And I’m so grateful I did.

From the second I arrived, I could tell I was being prioritized. The staff knew I was coming and moved quickly and kindly. I didn’t sit in the waiting room long. My doctor came into the room almost immediately, sat down across from me, looked me in the eye, and told me that the mole had tested positive for melanoma.

It wasn’t shocking exactly, as the urgency of the call to come into the office had made me start to brace for something, but it was still too much to fully take in. I think I had been hoping it would be something smaller, something more abstract, maybe something to monitor or keep an eye on. Not something that required immediate surgical intervention.

My doctor, who I very much like and appreciate more than ever, was calm, clear. and empathetic. She told me she had received the pathology results that day and made it a priority to tell me in person. And, she had already put in a call to a surgeon on the network health team to do a wider excision and assess next steps in order to properly stage the cancer. She had my back and if you continue to follow along with my story, you’ll see she has had my back in multiple ways!

So, of course, I walked out of the office and did what any other sane person would do… I went right back to work.

I drove from my doctor’s office to my desk and straight into a meeting, because the only way I know how to handle things is to just keep moving. I told my husband, but honestly I minimized the whole thing to him and to myself. I brushed it off as a small hiccup, a blip in time, that I’d handle and then move on from.

At the time, I truly didn’t realize that this wasn’t a speed bump. This was a life-altering diagnosis and the beginning of a new road for me - or at the very least a true life detour. It was my pause, even if I couldn’t see it yet.

But in that first moment, I didn’t fall apart. I didn’t cry in the car or scream into a pillow. I put my head down and went back to work, took the kids to their appointment and held a completely normal conversation with the receptionist at the orthodontist office, and then made dinner for the family, holding the enormity of it all at arm’s length.

It has proved to be a really weird space between normal life and not-so-normal life. Throughout the first 6 weeks post-diagnosis, I was still doing school drop-offs and work calls and making dinner, but underneath all of it, my world was shifting and rearranging itself.

If there’s one thing I’ve learned already, it’s this: sometimes the most unremarkable things, like an annoying but otherwise normal mole, are the ones that change everything.

Life’s Little Joys

I thought I’d end my written updates with a quick view into something that is bringing me happiness or joy. This week it is my coveted Crash Out playlist on Spotify. You might have gathered from the above that I don’t really face things with a lot of emotion but this playlist and the long, long, long daily walks I’ve been taking have been uber-helpful in letting my brain process everything that’s going on. Keep in mind this playlist is curated by an elder millennial, so expect to see nothing current :)

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I’m Sarah, and for most of my adult life, I’ve been moving fast. Career climbing. Raising kids. Writing on the side. Working in media. Teaching. Building a company. I used to say things like sleeping is for losers while juggling work, parenting, writing deadlines, carpools and away game scheduling, blocking charts, and meetings with people I never actually met in real life. For years, I built my identity around showing up, moving things forward, and being that person who could always get it done.

I was also one of the original bloggers back when the internet was barely monetized and “influencer” wasn’t a dirty word. My old blog site, Sleeping Is for Losers, was both an accidental brand and my actual lifestyle, tbh. Sleep? Never met her!

I’ve always been high-functioning, living by the motto that to matter you had to show up early, say yes even when you don’t know what you’re doing, push through everything at all costs, and never let them see you falter.

Then, in May 2025, I was diagnosed with cancer.

I wasn’t sick, which is what has made it so disorienting. I had a mole removed off my left leg, routine stuff for someone with fair and freckly skin like mine. And then on May 15th I received an unexpected call to pop into my doctor’s office.

And just like that, I had cancer. Not you’ll need to watch this cancer, but you’ll need surgery followed by serious treatment cancer.

What started as a routine procedure turned into scans, then surgery (wide leg excision and lymph node removal), then news that my cancer was found in my lymph nodes and the words “chemotherapy” and “immunotherapy” being dropped like a lead weight in a room full of specialists - as if I had any clue what they were talking about or any idea what I was in for.

Suddenly, my calendar, once filled with kids basketball games, strategy meetings, and client calls, was wiped clean and replaced with a tentative treatment plan and a slew of tests I’d never heard of before. I went from being a high-functioning executive and mom, to being someone who had to sit still and just…be. And that shift? It has cracked something open in me.

So what is Pause for Cancer?

It’s not a medical diary. It’s not a survival story with a tidy ending (at least not yet). It’s a space to tell the truth about what it means when ambition meets illness. When your life doesn’t stop, but your life - or what you thought you were building toward - has to. When May 15th, 2025 marks the day you go from “What’s the Q3 forecast?” to “What’s my white blood cell count?” overnight.

You can expect stories here. Some emotional, some practical, some probably written while waiting with fear or hope for new test results. I’ll talk about identity, work, health, parenting, loss, grace, hope, fear, and all the weird little moments that make up life in the pause.

If you’ve ever had your life rerouted by something big and uninvited (an illness, a loss, a breakup, a breakdown) this space is for you. And if you’ve followed me since the Sleeping is for Losers days (shoutout to the OG blog crew!!), this might feel like a full-circle moment. Writing was always my way through things. It still is.

I’m not building this Substack to vent or spiral or even to “be inspiring.” I’m building it to make space for myself, for the parts of life that don’t fit into neat timelines, and maybe for you too, if you’re so inclined.

If you’re in a pause of your own, I hope you’ll find something here that makes you feel a little less alone.

For those who’ve followed me for years, welcome back. It means more than you know. And for those who are just landing here for the first time, I’m glad we found each other.

Let’s see what can grow inside the pause.

❤️Sarah