Eaten by a bear

A bear ate Big Plop.  I do not mean a symbolic metaphysical beast representing disease and tragedy; a meat and potatoes, muscle, fur and fang, 10-foot-tall mammal, devoured him.  Big Plop finished gnawing on a rib of caribou with side of wild yam, which took a while because he had only three teeth, and then he hobbled away from the fire, his 23-year-old leg bent from a snake bite when he was three, walked behind a tree to relieve himself, modesty just becoming the norm, along with his fashionable loin cloth, and wham-o.  Big Plop was eaten by a bear.

Now, I never met Big Plop, there being 12,400 or so years between his birth and mine, although I do suspect one of my wife’s relatives to be a direct descendent, but I have considered his hasty fate.  Wake up, feeling fine, have a gourmet meal with family, head to el banjo and you are gone.  No doctors, hospitals, anxiety, planning, insurance battles, precertification, crippling bills, Internet searches, family dysfunction or prolonged suffering.  A simple end, which did not even require hospice.  Did this “primitive” man know something we do not?

The average man will have his terminal disease for three years, the average woman five. The 20th Century saw a dramatic transformation from short life, short disease, quick death, to longer life, but years of chronic illness.  In 1900 we died of childbirth, trauma or sudden infection; now we linger with heart disease, degenerative conditions, degrading dementias and of course the dread illness, cancer.  It strikes me that while the physical science of medicine has undergone a revolution, mentally we are still wearing deerskin, shivering in the darkness and expecting, at any moment, to be consumed.

The psychology of fight, flight or dinner is very different from the downward cycle of disease, heal, relapse, complication, new disease, partially heal, complication, rehab, etcetera.  In the old world, you could be assured that if you felt healthy, you were.  If there was not something actively chewing on your foot, then all was good.  Sure, there could be another battle, just around then bend, but for now you were fine.

In the modern era, a cancer “survivor”, or a patient with any chronic or potentially relapsing illness, must find a way to cope with the constant burden of the disease’s cold shadow.  This is not a natural human instinct, reared as we were for thousands of years on a crisis model.  Because we do not cope well with the continued presence of the bear’s paw on our shoulder, this can lead to a range of dysfunction including depression, anger, confusion, social isolation, loss of hope and debilitating labile anxiety which flares whenever there the slightest suggestion of physical malfunction.  Even a bug bite, a simple cold or a sprained ankle, releases the fear that the disease may have returned.

There are myriad ways in which we adjust to the “beast in the room.”  We fight hard to regain strength and health.  We become experts in “our” illness and get the finest care.  We distract ourselves with work, friends, family and good deeds.  We take up hobbies, travel, learning, teaching, giving or reading.  Nonetheless, at other times we malfunction and take up drugs, booze, fractured relationships, failed jobs, poly-pharmacy, over-testing, overtreatment and may become overwhelmed by the specter of disease.  Mentally designed for sudden battle, we may be depleted by drawn out war.

I strikes me that perhaps the most important lesson is to be aware that no matter how hard you try, it can be very difficult to cope with threatening or chronic illness. This is natural. You are not nuts or weak or at fault.  We are not mentally designed to survive, but we do.  Therefore, sometimes, things are going to emotionally fall apart.  Take a deep breath.  Give yourself a break. It will pass.

You have the strength to rebuild and find hope, happiness and laughter.  While you are at times frail, you can be incredibly strong.  You can handle the bear because you are simply human.


  • Dr. your writing is really soaring lately! Your words are inspirational and you totally rock. I will think about this essay for a long while. Happy Easter to you, dear sir.
    • James Salwitz, MD
      Thank you very much. I am honored. jcs
  • I just take the view that when it's time it's time, I felt the same before cancer and after and, so far, I am doing fine. My perfectly healthy husband collapsed and died seven years ago for, apparently no other reason than he fainted at the top of the stairs. The fall killed him, massive skull fracture, but no cause for his sudden collapse was found at PM. I developed lung cancer three years later and am convinced the stress of his sudden death, my immune system collapsed for months, was the cause. Since then I have believed we are all date stamped, just can't see it. I don't worry about the cancer, if it comes back I will deal with it then but three and a half years later so far so good.
  • Ray
    Be calm, carry on
  • And aren't we lucky that we have those extra years of "chronic disease" to get our lives and our relationships in order, to do the things we always wanted to do but didn't have time for, and to prepare ourselves psychologically for the end. This is an important gift of modern medicine, if the patient can appreciate it.
    • D Someya Reed
      Interesting point of view and one that I've never considered.
  • D Someya Reed
    Not sure I understand how you can say "Mentally designed for sudden battle, we may be depleted by drawn out war" (though I get your meaning in context) then follow it with "We are not mentally designed to survive, but we do" which is somewhat contradictory. I presume that you meant "mentally" here because your next sentence, "Therefore, sometimes, things are going to emotionally fall apart" refers to a mental state. Physically, we are neither designed to survive (chronic illness without medical intervention) nor are we immortal. Mentally and instinctively, though, we are all about survival. Your wrap-up speaks of finding mental (not physical) strength to endure and overcome the challenges of chronic illness. So, I understand your ultimate conclusion but I still don't agree that we are NOT mentally designed for survival as that is the way that most, if not all of us, do indeed survive (and overcome the physical limitations placed upon us by illness). Sorry to be so picayune but you know how much of a difference the choice of a single word can make at times. I don't know why but that one sentence, one word practically jumped off the page and smacked me across the face. Our seven, small dogs, now known as "The Minions" (a nod to the film, 'Despicable Me' and so appropriate for them) must have thought I'd put in the DVD again when I exclaimed, "What?!" It was amazing how quickly they understood the command, "Minions assemble!" Guess you had to (will have to) see the movie to understand. The youngest of our seven is transfixed by it for reasons unknown to either me or the other six. If only she could speak.

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