By Liam Ryan (another inspirational man for Movember!)
In 2002 I diagnosed with cancer. Not just any cancer. Oncologists have been delighted to tell me ever since that it was one of the worst cases of Head & Neck cancer ever seen, anywhere in the world. I simply had no chance. My initial consultant in the Regional Hospital in Limerick told me I was the second worse case he had ever seen. The worst case was dead in a month. That was all he had down for me too.
Eventually I was referred to a regional Head & Neck cancer treatment centre in Liverpool but even there, nobody really believed I would make it. I had a massive, stage 4 tumor in the middle of my face running around my eye to my brain stem and aside from the severity of the cancer itself, the intensely complex treatment required to remove it was likely to put me in the grave before the tumor even got the chance to. It was as big as surgery comes and everything was at risk, my sight, my speech, my hearing and because the tumor was so close to my brain and spine, my physical ability and my mental capacity too.
But impressed by my acceptance and fighting spirit, they wanted to give me a chance. Success would be survival of any kind and they constantly kept me prepared for the possibility of a very poor outcome. If I was still alive after the surgery it was likely that I would be mentally impaired, physically disabled, blind, deaf, dumb or most likely of all, some combination of all 5. But none of that mattered to me then. I just wanted to be alive. If I was alive I was winning and cancer was losing.
All of that was now a remarkable 15 years ago. And it is the incredible recovery I have made in that time that has made this story as big as it is. I get emails, most days, from all over the world and the great ones say “I was giving up, until I heard your story. These are the 10 key lessons I have learned in my journey that I would like to pass on to all those coming behind me.
1. DRAW A LINE
When you are diagnosed with cancer, or indeed handed any crisis in your life, the first thing you do is draw a line. Now is not the time to go backwards into “why me” or “poor me” territory. It is too late for that now. Your life has now been divided into two very distinctive categories, life before cancer and life after cancer. There is no point in trying to spend time in the former, when you have already been told you have enrolled in the latter. Any trawl back through the “whys” and “wherefores” only takes you back into what I regard as minus territory. You can only start to take on what is in front of you when you get yourself back to zero. You simply draw a line, and there is only one direction to go from there.
2. RUN WHAT YOU SEE
A narrow focus keeps you strong. You can only climb the part of the mountain that is under your foot. When I would run badly I used to adopt a strategy of “run what you see”. I would tell myself that all I needed to do was run the stretch of road in front of me. Just get myself over the top of the next hill or around the next bend, and so on. If I kept doing that the finish line would come to me rather than I run to it. I broke the run down into much smaller components to keep myself strong.
I applied exactly the same tactic to a long and difficult cancer survival and recovery. Now was not the time to worry about when I would go to a wedding, or to a football game or back to work. All I needed to focus on today was the physiotherapist was coming to see me at 3 and I was having a colonoscopy at 5. It was my job to do those two things to the very best of my ability. And that was my only job. Concentrate on the inches. They will make the mile.
3. DON’T EVER GIVE UP
My case has become the ultimate proof that nothing is for certain. I should have died many times in 2002 and there would appear to be no logical reason why I did not. My survival was a complete jigsaw and if any piece was missing I simply would not be here today. But one of those essential pieces was that I always kept myself in a position to survive. I never gave up. The fight became more important to me than whatever the end result could have been. If I was to go down, I was going down in the ring with my gloves on. That was the duty I imposed on myself. So I put myself on the team too and gave myself the role of being the best patient I could possibly be.
Not giving up won’t necessarily guarantee success. But you won’t succeed without it. And the right mindset will open the most unimaginable doors. My case, by itself, puts the onus on everybody coming behind me to never give up.
4. MEDICAL PEOPLE DO GREAT WORK
Before I got sick I knew nothing about the medical world. It simply never came up on my radar. Now, I am embarrassed about how little I knew then. In all my time in hospital I did not meet one person who was not brilliant. They were all there because I was there. My amazing surgeon, Simon Rogers, spent 12 hours in the middle of my head. For much of that time he was within millimeters of both my brain and spine. Everything was just as critical in the last hour as it was in the first. He told me at the end, the entire team was exhausted. The miraculous, fully functioning human being I am today, 15 years later, is thanks to everybody in the room that day.
If I have a bad day my design for a house doesn’t work out. If Simon Rogers has a bad day somebody dies. It just doesn’t get any bigger than saving or improving people’s lives. All medical people do the ultimate work of all. If it wasn’t for people like them, there wouldn’t be people like me.
5. PEOPLE MAKE THE WORLD GO ROUND
Cancer makes you evaluate your life sooner than you may have been expecting to. No matter what the outcome, it will prompt a lookback over your life just as you would do at the point of your death. The results of this little premature evaluation may not be what you expected them to be. When I looked over my life the major milestones that appeared above the horizon were not material possessions, career achievements or even great moments of personal happiness. And yet they had been the milestones I was directing my life towards to that point.
When I assessed the life I had lived the only thing that really appeared was the people who had been in it. Family and friends initially, but soon just about everybody who had connected with me along the way came into view. It was only then I began to realize the value they all held. It was them I was going to miss most of all. Now I will never let myself lose sight of their value ever again. I hug people regularly these days. It’s as if I want them to know what their value is, just in case I don’t get the chance to tell them again. People are the most precious commodity of all. We are all far greater than anything we own ever will be.
6. PERSPECTIVE IS THE ANTIDOTE TO EVERYTHING
None of us have to look too far to find somebody worse off than we are. Perspective makes you strong. If you are bankrupt you look at the person in the wheelchair. If you are in a wheelchair you look at the person with depression. If you have depression you look at the person living in the war zone. If you live in a war zone you look at the person in prison. If you are in prison you look at the person who is suicidal because they are bankrupt.
When I was diagnosed and looked as if I was about to die at the age of 40, cancer suddenly allowed me to see people I had never seen before. I saw the 3 year old who had just been diagnosed with leukemia. I saw the 17 year old who just had a horrific accident on their motorcycle. I saw the 20 year olds, all over the world, who leave home every day only to never return again.
And it wasn’t just the people who die young. I saw people who would live twice as long as me but who would never have anything like the life I had. The child soldier. The oppressed factory worker. The many people in the world whose entire lives are blighted by illness or violence or poverty. Perspective gives you perspective. It can turn a frightening negative into an extraordinary positive. If I was to die my overriding emotion at that point was an immense gratitude for having lived so well, for so long. That made me incredibly strong.
7. TOMORROW MIGHT NEVER COME
We should be careful about all the things we put on the long finger of life. The chance to address them may not come at the time we have appointed. A major illness is an expert at showing us the difference between unfounded calculation and mortal reality.
A good exercise is just to tell yourself you will not be here this time tomorrow and see what comes up. What are the issues in your life that would disappoint you most if you suddenly didn’t get the opportunity to resolve them. I suspect that most of them again will be people related. You won’t regret that you didn’t buy that beach house you looked at 6 months ago. But you might regret that you haven’t popped down to see your Mom in over a year. Or that you and your brother haven’t made up since that silly argument at Christmas. Cancer prompts you to put your right priorities, in the right order. It tells you to do it now when you know you still can. Tomorrow may never arrive. It gives you the opportunity to have less regrets when your time eventually does come.
8. WE ARE ALL GOING TO DIE
One thing I like about cancer is it calls our bluff. For all of our advancement, most of us choose to turn a blind eye to one of the greatest certainties of all. Many people do not consider the possibility that their death will occur before the age of at least 70. And yet we read in our newspapers every day about people all over the world who die at every age from 0 to 70. Life is a lottery, we all know that. Cancer not only forces us to see that there is an elephant in the room, it lifts him up and plonks him on our lap.
We should all just deal with the fact that we are going to die, put it away, and get on with making sure we live every day of our lives until then. When I did this, in the middle of my treatment, I gained huge strength from it. I plucked the only card cancer held over me, out of its hand. I was untouchable after that. If you are not afraid to die there is nothing left to be afraid of. It was a huge turning point in my fight. My cancer knew it was going to be dragged all the way, kicking and screaming, from there. And in a nice twist, by not being afraid to die, I lived.
My death has already revealed itself to me so there will be no surprise when it comes back for real. I will not be afraid then either. And until that day comes I intend to spend every day of this amazing life I have been given savoring the wonderful part of my glass that is half full, rather than living in fear of the part that is half empty.
9. DON’T EVER FORGET WHERE YOU WERE
Nobody should come through a life threatening illness or any kind of a major crisis without it also having a positive impact on the remainder of their lives. Cancer takes a broom to your life and clears out a lot of clutter you previously thought was important. It also illuminates many other things you had previously taken for granted. It shows you that they are actually the most important things of all. I didn’t appreciate all of the amazing things my two hands and ten fingers did every day until I was lying in intensive care without the use of them. And they were only the simple things like scratching my nose, brushing my teeth or lifting a cup of coffee to my lips. Up to then I barely acknowledged I had two hands and my only concern was that my cappuccino was too cold. Illness makes you appreciate all the amazing things your body does every day by taking them away for a while.
Now I will never let myself forget ever again. I make a space each day to remind myself that this is yet another day I was not supposed to have. I make myself see clouds in the sky, birds in the trees, people on the street. I will never let myself lose sight again of the amazing gift it is to be alive and well. I love every single day that I am still here to be a part of this wonderful planet. Life is simply awesome when you make yourself see it properly. I now see more with one eye than I ever did before with two.
10. THERE SIMPLY HAS TO BE MORE
It is impossible to go to the very edge of your life without wondering what happens next. Is this it! Am I just to die and be buried to feed the worms? Or is there something more. Will I return next week as a tree, or a table or a dog. Is there a heaven and a hell, and if so, which one has been told to prepare for my imminent arrival. The likelihood of your demise takes you to parts of your mind you rarely visit.
We can only really know the world we have so when I faced that point I just looked at everything around me in a very practical way. I saw the earth and all its wonderful complexities of mountains and oceans and stars and volcanoes. Then I saw the sun and the moon and galaxies far away that we probably haven’t even discovered yet. And pretty soon I came to very simple, personal conclusion.
We can’t have made all this.
We can barely make good coffee let alone put something like this together. There simply has to be something more.
As it turns out the more I believe in pretty much falls in with what I naturally believe to be right. Try and be a good person. Try and do the best you can. Try and do good rather than bad. Try to love everyone and everything you can. Nobody can fault those aspirations. Love and happiness seem to be the true, genuine qualities that unite all of us equally, no matter who we are.
There are so many things in this world that don’t make sense and we seem to be incapable of making sense of them here. I don’t know why children die. Or why people seem to suffer needlessly. Or why we have wars and famine and disaster.
But a day must come when everything will make sense. We are far too complex and too advanced for that not to be so. In all our hearts we would want injustice and pain and violence and suffering to be gone. And love and happiness and the world as we all know it could be to prevail.
But if we don’t know the beginning, why should we know the end. If I had any doubts that this is just the very early stage of a far greater journey before cancer, I certainly don’t have any now. I don’t know why very few of us are truly happy for any great length of time.
From everything I see, I was never more certain that a day will come when everything must make perfect sense. The last will be first and the first will be last.
Or perhaps we all just be wonderfully, beautifully, equal.
Liam Ryan running in November