ideas | sarah catherine cotterill

Things don’t happen for a reason: My life in remission

Cancer cells.
Cancer cells.Shutterstock / Jovan Vitanovski/jovan vitanovski

“Sarah, it’s good.”

For two weeks, I’d lain in my post-op bed, waiting to hear these words from my surgical oncologist. Kidney cancer does not respond to chemotherapy. Typically, the only curative treatment is surgery: If doctors cannot literally cut your cancer out of your body, they can rarely return you to good health. The illness, for all intents and purposes, is terminal. With my surgeon’s call, I was on the fortunate side of this morose equation.

I remember little else from that conversation, but I do recall that in the first few days of my remission it seemed as if gratitude would eternally flow through my veins. I would never feel more alive than I felt post-cancer, I thought.


The irony would come only with hindsight. I am a psychologist by training. My dissertation has focused, in part, on the intuitive appeal of believing that “things happen for a reason.” My remission suddenly left me my own best subject, desperately clinging to the same ideological beliefs I’d spent my young career trying to understand. Yet for all its palliative allure, it was difficult to convince myself that my life was orchestrated such that I would get cancer at 26 — that this unfortunate turn of events was part of some broader plan that would reveal itself in time. As far as I could tell, there was no reason for my cancer other than some unfortunate mutations written in my genetic code.

Slowly, the bottom seemed to drop out from under me. Treatment had been a darkly magical experience, marked not just with appointments and scans and hospitalizations, but also with love that boiled over, drowning out the pain and unease. In its place, the eerie quiet of my remission haunted me.

Humans are notoriously bad at predicting emotional reactions to events, good or bad, and indeed, I suddenly found myself living a forecasting error of sorts — how I imagined remission would feel seemed to starkly contrast with my lived experience. My work suddenly felt meaningless, and yet I didn’t know who I was without it. I no longer identified with my friends’ professional ambitions. They didn’t identify with my dark sentimentality. There was an urgency with which I told them I loved them. They responded in turn, and yet looked at me with unease, unsure how to handle the emotional gravity of it all.


Then there was the prescriptive question of how to spend my time. I vacillated between anxiety and disillusionment: Why push my dissertation forward, I wondered, if I might not live to go on the job market? Focus on your relationships, I told myself, the rest is ephemeral anyway. I repeated that mantra until a pang of anxiety set in: Maybe I will manage to outrun my cancer after all, only to be left without a fulfilling career. I’d binge on work until the guilt of neglecting my friends and family resurfaced. And so on and so forth.

In fact, that I struggled in itself provoked in me a sense of guilt. The cancer narrative dictates that a survivor should cherish every day as if it was her last. By that metric, it was as if I had learned nothing from losing an organ and confronting my mortality. And although my surgical scars faded, thanks to the brilliance and deft artistry of my oncologist, each follow-up scan tore open the psychological wound, unleashing raw terror and vulnerability.


With time, however, I began to see that I was simply running along life’s hedonic treadmill — while major positive events might make us momentarily happy, and major negative events might make us momentarily sad, research shows we eventually tend to return to some sort of personal “happiness stasis.” My initial diagnosis had not broken me, nor had the subsequent news of my remission immunized me from sadness, anger, and the like.

I began to notice stable changes in my psychology, though less dramatic than the societal cliches would have it. I wasn’t immune from the strain of the 20-something rat race. But I could more easily disengage from it. Cancer forced my inner circle to prematurely grapple with fear that shook the walls of social norms. When they fell, my friends and family found license to have conversations that might otherwise have been awkward or taboo. Eventually those conversations transcended cancer all together. Cherishing every day might be a tall order, we decided, but that didn’t mean we couldn’t share a renewed collective commitment to “enjoy every sandwich” — as Warren Zevon put it, following his own cancer diagnosis.

While there will always be a psychological gulf between those who have faced cancer and those who haven’t, in the end my struggle seemed to have breathed — of all things — new life into my relationships. And I had emerged from a great internal psychological study with newfound evidence for resilience I never knew I had. And here’s where things more starkly departed from the dominant narrative: That cancer strengthened, not weakened, the human experience seemed quite miraculous in itself, without needing to invent a literal story for how the cancer came about in the first place.


To be sure, given the choice, I would not have traded my left kidney for some hard-fought wisdom and a force-fed dose of perspective. But in the face of existential uncertainty, something else had become paradoxically clear: Accepting, as a scientist, the randomness of my cancer is not mutually exclusive with finding meaning in the disease. I can abandon delusions of predestination, while still gleaning value from the pain. My faith in the human spirit carries me through.

Sarah Catherine Cotterill is a PhD candidate in psychology at Harvard University.