Using scientific research as a springboard for discussion, CKN is distilling this research into practical narratives that will improve the quality of life for patients and offer deeper understanding and connection for physicians. Please join this Doctor-Patient conversation about Tattoo Therapy.
by Anne Marie Cerato, Living with Cancer, CKN Young Adult Section Editor
There are a few words I thought I’d never utter together, tattoos and therapy are an example, mind you “I have cancer” is another! You might wonder how inflicting pain on one’s self could be seen as therapeutic, but I swear to you it is. The pain is temporary, what stays behind is a permanent reminder, much like a scar. Before actually getting tattooed, I did try conventional therapy, it worked for a while, but was somewhat unsatisfying, but I’m jumping the gun!! We really should start at the beginning.
My name is Anne Marie and I am living with stage 4 Lung Cancer, my story starts in 2009 when I was diagnosed with stage 3a Adenocarcinoma of the right lung. This was a shocker because at the time I was a healthy 30 year old that had never smoked!! I received treatment almost immediately (Chemo-radiation, surgery, followed by high dose chemo); six months later I was done. All this seemed to have worked until 2011 when it was determined that like the cat, the cancer came back. This time, it was in both lungs and in multiple lobes and my options were far fewer, so how did I deal? Tattoos!! Let me explain.
During treatment I was so focused on just staying alive and getting through it, I never gave any thought to how I would be affected by the after effects of treatment, including surgery. After my Lobectomy, I was left with a large red J shaped scar on my back and side, it looked like a zipper if you included the staple marks, and I hated it! It reminded me of all the crap and fear that I was feeling. I hated it because when people saw it they’d ask me to re-live the story behind it, I got tired of explaining, tired of the question “did you smoke?” and tired of lying that I was “fine” when really I was a mess. All I really wanted to do was bury what had happened.
As treatment ended, the emotional fallout began and I slowly became a highly functioning basket case. To look at me I was normal, but inside I was an unmitigated mess, barely holding it together, and I was becoming exhausted keeping up the front. The more the Doctors told me I was fine, the worse my anxiety got, until it happened. The other shoe dropped and the news I was afraid of was true; the cancer was back. The knowledge of which was both terrifying and liberating at the same time. Liberating in that accepting my mortality allowed me to choose not to comply with societal expectations of normalcy since I would never be normal again. I thought to hell with conventional beauty, I’m doing what I want, and so began my tattoo odyssey. It started at the wrists, then the shoulder, lower back and hip, all the while I was dying to tattoo over my scar. I still hated it! I would hide it, and cover it up; I would make it something beautiful!
The strange thing was that as time passed, I continued to tattoo, but I held off on that piece, I’m not sure what I was waiting for. Maybe I was waiting for acceptance, that this thing was part of me and shouldn’t be covered. Maybe If I covered my scar, it would be like denying what happened, the good and bad…but a lot of what I found was goodness, yes cancer sucks, I can’t deny that. I wish no one ever had to get that news, but we do, and it stinks! Without it though, I wouldn’t have met some of the most amazing and inspiring people, or have realized that life is so much more than what I was living! As that realization washed over me, I found that I could deal with my reality; the thing was I didn’t even know that I had realized it yet! Until one day I found myself talking to my tattoo artist about my back piece and how I wanted it to be, describing the image I wanted painted and then I said it, “you have creative license, but don’t cover the scar!” What!? Had I lost my marbles!
It’s strange that people will say “you’ve scarred me” or “I’m scarred” because it always has such a negative connotation. I’ll admit to buying into the negativity, after all it’s something that happens to you. No one really chooses to become scarred.
It wasn’t until I was having coffee with a dear friend and fellow cancer ass kicker that the catharsis hit me in its entirety. We began talking about tattoos and how they could tell a story, I was explaining how I felt about my scars, when he told me about his, and I couldn’t believe it, he was a virtual road map of surgical storytelling. Knowing about his story, where he had been and what he had gone through to survive made his scars beautiful! Mine too.
What I discovered was that I never gave myself credit for enduring, because I was always thinking there was someone worse off. I was ashamed that I had come through fairly unscathed compared to others, I felt guilty. As my scars faded, I think the guilt did too. I have to admit that I’m a bit sad they have faded, and maybe now I’m afraid that they’ll disappear completely. Its strange loving and hating something at the same time, except I don’t hate them anymore, if anything I’m proud of them and of my story.
It was this conversation and this catharsis that inspired what my friends and I are trying to do with These Are My Scars. We all have a story to tell, if we can share our journeys and our scars whether they are physical or emotional, we can help each other deal with what they represent. For me it was the emotional scars that cut me deeper than the physical ones, once I opened up about my guilt, my fears and anxieties, I was able to embrace my physical scars and appreciate them for the beauty and strength they represented.
So how did tattooing help? Well, it allowed me to reclaim my body, to exert some kind of control over it. I know it’s a strange way to exert control, but when everything is out of control on the inside, being able to make a choice on how the outside looks is empowering! It has also acted as a permanent reminder that life is short, and if we are not present in the moment, we tend to miss them. I don’t want to miss moments!
Anne Marie is a 36 year old lung cancer survivor. Originally diagnosed at the age of 30, she put her career as an educator on hold for treatment. After experiencing a recurrence at 32 she was forced to face what it meant to be incurable. Since then, she has become a patient advocate for both the young adult and lung cancer communities. She has spoken internationally about her experience as a young adult living with lung cancer in the hopes of changing the public’s perception of the disease. Anne Marie currently volunteers as a peer supporter and is a sitting board member of Lung Cancer Canada. “My goal as CKN’s Young Adult Editor is to represent the whole cancer experience and the range of challenges young adults face at all stages of the cancer journey, from diagnosis to remission to end of life.”
A note from Dr. Gordon Buduhan
As a surgeon, a necessary aftermath of my handiwork is a scar. I routinely try to minimize the physical appearance of the scar – by making small “keyhole” incisions, hiding the incision within a skin wrinkle, etc. However, it is the emotional scars following a cancer operation that are often all too slow to heal. While the physical incision may be innocuous, it also acts as a permanent reminder of the silent entity that has invaded someone’s body and taken over their life.
One of the most difficult aspects of dealing with a new cancer diagnosis is the loss of control. The unseen pariah that has overcome the body often leaves the cancer patient feeling helpless. As in all aspects of life however, the one element we can control is our willingness to fight, to overcome despair, and to see beauty in the triumph of human spirit over the cruel randomness of fate.
Regardless of the reasons a person chooses to obtain a tattoo, the common ideal is that of a permanent statement reflective of the individual. Whether it reflects a true love, a daughter’s birth, an unyielding philosophy, or a humorous cultural reference, a tattoo reflects a person’s life experiences, both the triumphs and the tragedies.
This patient’s tattoo is an enduring symbol of the victory of spirit over the unrelenting foe. Certainly it may convey a wide variety of emotions: elation, anger, catharsis, defiance, acceptance, or maybe a degree of all of the above. But above all else, I believe the act of decorating one’s body for this individual represents regaining some semblance of control. This tattoo – representing the storm of emotions associated with her cancer journey – is an enduring reminder of what the human spirit can endure and overcome.
Most people hope that their surgical scars eventually fade over time, and with it, the memory of the often traumatic experience. I think it is admirable that one would choose to create a permanent physical memento of their cancer experience. Whether the battle was ultimately victorious or not, I see their tattoo as a bold and enduring declaration to their cancer:
I am still in control here. You do not dictate my feelings. I choose to fight, to live, to laugh, to cry. I am not my cancer. This is who I am – and this will never fade.
Dr. Gordon Buduhan, Assistant Professor of Surgery, Section of Thoracic Surgery, University of Manitoba / Health Sciences Centre, Winnipeg, Manitoba Program Director Thoracic Surgery Residency Program, University of Manitoba