The Survivor Mindset

By way of introduction, I conduct in-depth research into emerging therapies where the standard-of-care offers little hope of recovery and a quality life. My primary techniques are interviews of leading medical researchers and the use of AI to research trials and emerging cures. If the widely practiced standard-of-care offers the real promise of a quality life, and reasonable longevity, I’m probably of little use. Increasingly the standard-of-care offers real hope. In 2000, the five-year survival rate for cancer patients was around 63.5%. It is now approximately 70%. Similar trends exist in most other serious diseases.

In those cases where the standard-of-care offers little hope of a quality life, the first question someone on the receiving end of a dire diagnosis needs to ask themselves is, “Do I really want to live? Do I enjoy life?” The cancer journey can be hard. Partially, it is the disease itself. Partially it is the treatments. Chemo, surgery and radiation are hard on the body and on one’s mental attitude. Your friends and family can sympathize with you but not fully relate to or understand what you are going through. So it can be lonely. It is completely natural for someone recently diagnosed with a serious illness to contemplate an unfinished life and sink into self-pity over the dreams that will never be accomplished. The grandchildren (or children) you won’t hug and see grow up.

For the first few days after my first diagnosis, a terminal one, advanced non-Hodgkin’s lymphoma, I fell into a kind of daze. I saw life in a way I had not encountered before. I remember driving with my father to a bookstore to get some books on cancer, and looking out the car window thinking, “This is what life looks like when it is floating away. I wonder how many more times I’ll see this scene.” After a serious diagnosis, give yourself a few days to reflect on life, on its impermanence, and then decide how badly you want to live.

An athlete has to have deep drive to win. A business person needs a deep drive to succeed. In all of the big, important things in life, there is struggle. Surrender is fine. I’m not saying everyone has to go on the journey, has to want to sacrifice in order to survive. An oncologist once told me that he sometimes feels it necessary to say to patients, “If I want you to survive more than you do, we have a problem.” And, he said to me, he encounters a surprising number of people who, deep down, don’t really enjoy life that much and who don’t, as a result, really want to live. Or put effort into surviving.

If you decide to embark on the survival journey you need to know that setbacks will be encountered. Discouragement is a part of every journey that involves getting off the couch and going for it. Failure is always a possibility. Generally speaking, in fact, statistically, failure is the most likely outcome with the clients I work with. It certainly was my first diagnosis thirty-five years ago. Cancer patients either decide to put that possibility in their back pocket, or they decide to surrender. Doing the kind of work I do, putting my heart and soul into someone’s survival, I need a client who deep down wants to live.

Please allow me an analogy that many will find far-fetched, possibly even irrelevant. I have a background in wilderness survival. I see a commonality in the mindset that must be adopted by someone who encounters extreme adversity on a long wilderness trip, and someone on the cancer journey. It is the same mindset that is cultivated by athletes participating in extreme professional sports – boxing, professional football – and the mindset of special forces soldiers. That mindset is one of, “Come hell or high water, I am going to survive.”

Getting back to the wilderness example, imagine you are on a four hundred mile solo canoe trip down a remote, seldom traveled river. While the river is mostly flat, there are some rapids. Those rapids are rated as class II or III – generally within the skill level of an accomplished paddler such as yourself. However, at roughly the halfway point, you wrap your canoe around a big rock in the middle of the river and, as you swim for shore, notice your food bag disappear around a bend in the river.

On shore you collect your thoughts. Getting angry won’t help. Feeling sorry for yourself won’t help. You need to think one thing: survival. You need to cultivate and enhance, in any way possible, your relationship with your inner world, with your inner strength. That relationship will be profoundly shaped by the decisions you make over the next few hours.

As you start to look around, you notice something bob up and down in an eddy a hundred feet downriver – your lunch bag. You wade out and grab it. You return to shore and analyze your situation. In your lunch backpack is maybe three days of food. You are about two hundred miles upriver from your takeout – a place where the river intersects a road. Two hundred miles of moderately rough terrain is about twenty days of walking. In other words, seventeen days with no food. You can eat one day in six. Or, better, a sixth of a full ration each day.

As the crow flies though, you are a hundred miles from a road – a hundred miles of lakes, muskeg, mosquitos and black flies. You contemplate that option -- walking to the nearest road. You’ve lost your GPS and your compass. As an experienced wilderness traveler, you know that moss grows thickest on the north side of trees, and the prevailing winds in this area are from the north, so the treetops have a slight bias, a slight lean, toward the south. While setting off hoping to find the road, a hundred miles to the north in a straight line, may work, it also is risky. As anyone knows who has lost their way in the woods – and I have hundreds of times (I’m a daydreamer) – every time you step in one direction or another, for instance to get around a tree or boulder, you get slightly off course. Cumulatively, those minor changes add up to major course misdirection. You tend to end up going in a big circle. The lakes you need to walk around will not only add many miles to your hike out, but will probably throw you off course.

Equally important, if you stick to the river, you may come across your food pack. Or your tent and sleeping bag pack. Without those, bugs will consume a chunk of your physical and mental corpus. Sleep will be difficult. Your mental attitude will at times suffer because you will be suffering. On the other hand, there is a slight chance, walking along the river, that you may find both your food bag and your tent and sleeping bag pack. That would be extreme good fortune, somewhat akin to winning the lottery. Extremely unlikely, but possible. So you decide to stick to the river. The challenge there is that the trees, scrub and rocks may make sticking close to the river difficult, so you’ll need to constantly check, when you can’t see or hear the river, that you haven’t wandered away from it. If you do, death from starvation will likely result.

You think of something an old Inuit once told you – the translation of their word for hunting is “a long walk on an empty stomach.” That’s what you’ve embarked upon – a hunt for survival. I also remember something arctic explorer Helen Thayer once told me. On her solo walk to the North Pole, in the middle of the night, an extreme arctic blizzard blew away most of her food. She had a couple of bags of nuts left, nothing else. No radio to call for extraction. She was scared, knew the odds of her survival were greatly diminished. But on another level she told me, she was excited, almost euphoric. A little voice inside whispered, “When the chips are down, that’s when you shine. That’s where you excel.” Now is the time to nurture that little voice. That’s the voice that is going to get you through this.

So you collect your thoughts, grab your lunch pack, and set off. If you start to encounter extreme fatigue, or get overly discouraged, you stop, rest and maybe soak in the river a little to assuage your bug bites. Then you get up and walk.

Above all else, your mental attitude must be protected and preserved. Eyes on the prize: survival.