Transforming my Perception of Vulnerability: How Cancer Shattered my Stoic Beliefs

The tears were unstoppable.

After being diagnosed with pancreatic cancer five and a half months ago, undergoing seven chemotherapy infusions, and recovering from major surgery for four days, the doctor deemed it suitable to discharge me from the hospital.

I only needed to pass a bowel movement to confirm that my digestive system was functioning properly. That evening, I found myself alone in my hospital room with a nurse who was Iranian-born and 37 years old, the same age as my son. Despite our religious differences – he being Muslim and me being Jewish – we had developed a friendly rapport, sharing stories about our childhoods, careers, and children.

While he was updating my medical records on the computer, I suddenly burst into tears. After months of suppressing my emotions, this was the moment when I finally allowed myself to let it all out. The nurse quickly rushed to my bedside, offering his support. He would later return with a suppository, ensuring that my bowel movement catharsis was just as important.

I believed I could take on cancer alone

It's not just because I'm a man, but rather a trait inherited from my parents. They always summoned inner strength to overcome their own hardships. My mother, in particular, had no other option. Her father, an immigrant from Russia, deserted the family just before the Great Depression hit. To add to her struggles, her mother gradually lost her vision to glaucoma and eventually her hearing as well. Following such a harrowing upbringing, my mother developed a strong sense of independence, never relying on anyone for help.

My father, although soft-spoken, possessed a strength of character that surpassed any physical toughness. With an unwavering work ethic, he silently endured and never uttered a complaint. He instilled in me the belief that it is the duty of the strong to protect the vulnerable, and despite his limited financial resources, he wholeheartedly embraced this responsibility.

Eryn's first day out of the hospital after her liver transplant in February 2022. She was hospitalized for about one month.

Courtesy Eryn Mathewson

Undergoing a transplant made me realize the importance of organ donors. Reflecting on my family history while battling cancer, I never considered myself someone who would require assistance. I believed my extraordinary abilities would conquer the debilitating consequences of chemotherapy, experienced by others. However, I was mistaken. The preoperative chemotherapy inflicted continuous nausea, diarrhea, dehydration-induced fatigue, hair loss, persistent hiccups, blood-tinged mucus, and agonizing tingling whenever I came into contact with something cold.

Being a patient, vulnerable, and dependent would eventually reveal its true significance to me: I would not only benefit from the skills of my caregivers, but also from their unwavering faithfulness. I would come to understand a profound connection, similar to many men who learn it gradually through experience.

I hesitated to embrace any assistance.

Initially, I had hesitated to assume the role of a patient, mainly because my early diagnosis brought positive news. Upon receiving the results of the CT scan which unveiled the presence of the pancreatic tumor, my primary care physician, in fact, opened the conversation by stating, "This is fantastic news!"

In comparison, to some extent, he was correct. The tumor was categorized as stage I and showed no contact with adjacent blood vessels. Furthermore, there was no indication of metastasis. While I felt a sense of unease, I never experienced any anxiety regarding my treatment.

My wife, Ellen, of four decades, was far from composed. She envisioned my return from the hospital akin to a zombie, adorned with tubes seeping a slimy substance as crimson as fruit punch. This catastrophic scenario sprang forth after her encounters with Dr. Google, enlightening her about the alarming fatality rate associated with pancreatic cancer (which happened to be true). Additionally, she stumbled upon exaggerated descriptions of the surgical procedure that would apparently eviscerate me like a fish (obvious hyperbole). Her certainty reached its peak as she believed I would necessitate extensive care not only from her, but also from an army of friends, neighbors, cooks, visiting nurses, and physical therapists.

Segal married Ellen Mazer in 1982. His cancer diagnosis four decades later strained their relationship, generating enough friction that they tried couples therapy.

courtesy Andy Segal

But I was determined to have no involvement with any of them. I intended to manage my own meals, exercise, and what experts refer to as "activities of daily living."

According to my friend, psychologist Avrum Weiss, my mind was simply following societal norms in processing thoughts and emotions. Weiss, the author of "Hidden in Plain Sight: How Men's Fears of Women Shape Their Intimate Relationships," explained that men often see masculinity as a constant standard that they must earn and prove.

My playbook didn't perform well at home.

Ellen and I engaged in a disagreement regarding where she would wait during my surgery. It seemed illogical for her to travel to the hospital at 5:15 a.m. and wait uncomfortably for several hours until the surgery was completed. I believed it would be better for her to arrive later, well-rested, when I would be ready to leave the recovery room. However, this reasoning was deeply hurtful to Ellen. (The surgeon resolved the issue by stating that Ellen should be present.)

Our conflicting predictions resulted in a state of animosity known as a cold war. Beneath the facade of scowls and sulking lay the core issue of control, or rather, the absence of it. Ellen found herself facing a double blow: both the cancer and her power to influence how I handled it were beyond her grasp.

These ongoing conflicts created a sufficient amount of tension for us to seek couples counseling. Regrettably, our attempts were fruitless. Following four sessions, the psychologist decided to terminate our therapy, deeming it unnecessary to spend our time and money listening to our constant quarrels.

A pivotal moment in my journey to recovery

I valued my privacy and independence greatly. Though I enjoyed being the center of attention as the class clown, I had no interest in starring in my own medical drama. I didn't want others to see me as someone broken. At first, we only confided in our closest circle. However, the tremendous support we received made me understand that my loved ones were aiding me, and not sharing the truth with our friends felt disingenuous. Therefore, we began opening up to more people.

Richard Roth and Samira Jafari in New York in June 2022.

Samira Jafari/CNN

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Sometimes, being open about my situation didn't turn out well. There were a few instances where someone unexpectedly mentioned that their relative had passed away from pancreatic cancer. However, for the most part, the emails and phone calls I received were filled with positivity. A classmate from high school broke a 54-year silence just to offer me words of encouragement. It seemed like my support system was coming together, whether I had asked for it or not.

Friends who had previously battled cancer stepped up to offer me advice, help with grocery shopping, respite care, and rides to doctor appointments. It made me realize that there were people I had neglected to reach out to when they were sick. At the time, I believed I wouldn't make a difference in their lives and didn't want to be an intrusion. I now regret my immaturity and promise that I will never let that happen again.

Connecting with my surgeon

Following chemotherapy, I underwent surgery performed by a surgeon who exudes the confidence of a professional football quarterback and possesses a sufficient level of approachability. According to his estimation, he has successfully performed numerous pancreaticoduodenectomies, commonly referred to as the Whipple procedure, which was developed by Dr. Allen Oldfather Whipple in the mid-1930s. Apart from removing the tumor, the Whipple procedure involves the extraction of sections of the stomach and intestine, as well as the complete removal of the gallbladder. This intricate operation necessitates the creation of new surgical connections between the organs.

After my surgery, the hospital staff and I experienced an instant physical closeness in my hospital room. This was due to various factors such as the ever-changing hospital gown, the presence of a urinary catheter, and the two surgical drains in my abdomen.

Presurgery chemotherapy left Segal with nausea, diarrhea, hair loss and other side effects. He expects to undergo five more chemotherapy sessions after surgery.

courtesy Andy Segal

Everyone I came across, including doctors, nurses, physician assistants, physical therapists, housekeepers, and food servers, showed a deep commitment to my well-being. My friends uplifted my spirits, and Ellen was there overseeing everything. I had no argument whatsoever. Together, they created a nurturing environment for healing, which I initially thought I didn't require.

Soon, my surgeon abandoned the formal address of "Mr. Segal" and began calling me "Segal" instead—a more informal and friendly term. During his rounds on the evening before my discharge, I saw this change as an opportunity to foster a sense of camaraderie by cracking a crude joke about a genie in a magic lantern. After sharing a hearty laugh, he even started using derogatory terms for certain individuals and even dropped the f-bomb.

Ellen's brother, a former critical care physician, generously offered to travel from Annapolis, Maryland to Atlanta to be with me upon my discharge. Although I initially deemed it unnecessary, Ellen appreciated his presence for emotional support and the additional assistance in case any unforeseen emergencies occurred at home.

Segal says that he and his wife, Ellen, have now discovered places where they connect as caregiver and patient.

After leaving the hospital, he entertained us with amusing tales of seeking vengeance on his "enemies," even joking about targeting gender-specific body parts. The conversation was filled with laughter, creating an instant bond. In the days that followed, he transitioned from being a family member to feeling like a close friend.

Longtime friends redefined the concept of "comfort food" by providing meals for both Ellen and me that catered to my restricted diet. Additionally, they showered us with phone calls, texts, and lighthearted get-well cards. One of my friends' husbands even became my walking partner. I had never truly grasped the extent of support from people who had my (and Ellen's) back.

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Finding a bond with my spouse

The prognosis appears promising as per the pathologists' report, indicating that the tumor was completely removed with clear margins by the surgeon. Furthermore, the absence of cancer in the 34 removed lymph nodes suggests minimal likelihood of its spreading.

Despite this, I am willing to undergo five additional chemotherapy sessions to ensure that any hidden cancer cells are eliminated. I am open to any assistance that can aid me in enduring the strenuous 10 weeks ahead.

Thankfully, Ellen and I have become more equipped for this journey. We have found areas where our roles as caregiver and patient align. For instance, when I took my first steps post-surgery, I instinctively and unnecessarily hunched over, fearing abdominal discomfort.

In order to enhance my posture, Ellen adopted a catchphrase from the popular TV show "The Marvelous Mrs. Maisel," which she plans to use again during the challenging final stage of my chemotherapy treatment: "Tits up!" This phrase, rather than the commanding "Stand up straight," not only improves my posture but also uplifts my overall attitude. I sincerely appreciate this support at this stage.

Andy Segal, a former senior producer in CNN's documentary unit, has been honored with prestigious awards including Emmy, Peabody, and DuPont. Presently, he pursues an independent career as a writer, producer, and director based in Atlanta.