Ruminate

Cancer is not a clean thought. It doesn’t come in with a headline and a bullet-pointed list of lessons. It’s a static hum. It’s background noise that turns foreground. It’s the constant, uninvited narrator of my life now. And it won’t shut up.

I ruminate. All the time. Not in the charming, introspective way that looks good in a memoir. More like pacing a house with no doors, retracing every possible cause and missed sign and bad decision that maybe—probably—got me here.

I think about food. Every bite I ever ate. Every cigarette I didn’t finish. The drinks I used to call medicine. The night I stood in the kitchen pouring sugar into coffee and said, out loud, “Who cares.” Like that was some kind of act of rebellion instead of slow suicide. I think about inflammation like it’s a houseguest I let in too many times. I think about the meat I didn’t eat and now eat obsessively. I think about fiber. About fasting. About how I’m pretty sure kale was never going to save me, but maybe not drinking wine for dinner would have helped.

I ruminate on whether I did this to myself. Whether my body is punishing me for not paying attention. Whether trauma calcified into something cellular. Whether every therapist who said “You carry too much” was talking about my rectum.

I ruminate about telling people. The tone in my voice when I say, “I have cancer.” The too-bright smile I flash after, like I’m auditioning for the role of the Well-Adjusted Sick Person. I worry that I make people uncomfortable. I worry I’m too comfortable with their discomfort.

I ruminate about my parents. About the fact that neither of them made it. One dead by a fast act of defiance at 55, the other a slow crumble into madness—dementia at 73. About how I watched my father rot in a memory care unit while they fed him pudding and told me to prepare myself. About my mother’s suicide and whether that grief fermented into something in me. Whether sadness can become genetic. Whether I’ve always been dying, just slower than her.

I ruminate about my ex. About New York. About how I thought I loved him, but maybe I just loved the way he made me forget about dying. I ruminate about current love. About whether this man I’m with now will stay. Whether I’m lovable in this state. Whether he’s staying because of me or because he’s the kind of man who doesn’t leave sick people. Whether that’s love or pity or duty or something I don’t want to look too closely at.

I ruminate about money. I have cancer and no savings. I ruminate about that sentence every time I have to explain why I can’t afford over the counter anything, or why I skipped the last test, or why I have to do chemo without freezing my eggs or getting cold capping to prevent hair loss because it’s not covered by Medicaid. I ruminate about GoFundMe, about shame, about asking people for things when I’ve spent my whole life trying to prove I don’t need anything.

I ruminate about dying. Not in a poetic way. In a Google search way. In a waking-up-at-3 a.m. and feeling your stomach harden way. I ruminate about pain. About what “quality of life” actually means. About how many more months I’ll be able to take stairs. I ruminate about what to do with my dog if I go.

I ruminate about what to wear if I’m cremated.

I ruminate about legacy. About whether anything I’ve written will outlast me. Whether people will talk about me at dinner or just scroll past my name when someone posts the announcement. I ruminate about whether my story will be turned into inspiration porn by people who barely knew me.

I ruminate about hope. Not because I have a lot of it, but because I can’t seem to stop looking for it in places it doesn’t belong. Like Instagram. Or doctors. Or a single good day where I can take a walk without thinking about how many I have left.

I ruminate because I’m still here. And being here, while knowing you might not be for long, is its own kind of madness. I live in limbo. I exist inside a question mark. Every plan I make comes with a silent footnote: unless I die first.

So I ruminate. I loop. I stew. I breathe in thoughts I don’t want and exhale ones I can’t keep.

There’s no bow on this. No clean finish.

Just me, awake again, wondering:

Was it the wine?

Was it the grief?

Was it already written?

And if so, what now?

A blog post by Rachel Smak on grief, loss, and lessons from stage 3C rectal cancer