Halfway through chemo, Jessica was annoyed with me.
The Architecture of Showing Up
“This would suck less if we did it together.”
2009. We’d each had our third child in 2007, and I wanted my body back. My sister, an extraordinary athletic trainer and entrepreneur, told me that I needed a combination of high-intensity cardio with lifting heavy weights to make my body strong, resilient, and (hopefully) closer to my pre-pregnancy dimensions. I’m active, but I don’t love working out. Doing it as my dedicated time with my best girlfriend three times a week would ensure I did the work AND had fun. Jessica agreed to join me, and so a three-mornings-per-week routine was born.
We track everything to measure progress and share with our amazing remote trainer (from Tracey’s FIT business), who programs for us to achieve our goals, rehab our aging parts, and push us. She always had a heavier back squat. I always had a heavier bench press. Even mid-chemo, I could still out-deadlift her. Mighty Mouse, she’d called me for years. It was, she told me, maddening.
What she didn’t know at the time was that the lifts were doing more than building muscle. They were improving my odds on many dimensions.
A Friendship of Diagnostics
Jessica Rosenbaum is my best friend for 25 years. A licensed clinical psychologist. I met her in a parenting prep class twenty-some years ago, when we were both seven months pregnant with our first kids. We just clicked. We’ve been each other’s person ever since.
When I was diagnosed with triple-negative breast cancer, she didn’t ask what I needed. She claimed her role.
She set up the meal coordination, but didn’t cook.
She built the driver sign-up, but didn’t drive me to chemo.
She set up the CaringBridge, but mostly laughed as I wrote about being the secret shopper at my cancer center.
She’d been watching me long enough to know the patient ends up doing logistics weather-watching for everyone else’s well-meaning help. So she became the air traffic controller. She kept her workout slot but adjusted the time and location to help me. The workouts, it turned out, were critical.
I didn’t know she was watching me. Or rather, I knew, the way you know any friend who loves you keeps an eye on you. I didn’t know I was being read. The grip going slack would tell her. The setup rituals, shortening or lengthening, would tell her. The exact pace of the breath between reps. She was running diagnostics three mornings a week, and the cover story was that we were just getting our workouts in.
It took me about a year after treatment to fully understand what had happened. There’s something deeply tender about being known well enough that someone can read you under a heavy bar. There’s also something destabilizing about it. The protection of I’m fine was off the menu. You couldn’t perform fine for the person standing six feet away, watching your glutes.
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The Research and the Reality
The research suggests this is a feature, not a bug.
Social Support: The largest meta-analysis to date on social support and cancer outcomes, which summarized 87 studies by Pinquart and Duberstein, found that high levels of perceived social support were associated with a 25% reduction in mortality risk among cancer patients. Larger social networks contributed another 20%.
Exercise: The 2019 ACSM consensus guidelines on exercise for cancer survivors, drawing on more than 2,500 randomized controlled trials, confirm that exercise during treatment is among the most evidence-based interventions a patient can use to manage side effects and improve outcomes.
My doctor cleared me to keep lifting. The lifting turned out to be therapy and surveillance in the same hour.
Cancer caregivers themselves bear measurable costs. The National Cancer Institute reports significant rates of chronic depressive symptoms among caregivers, and a recent survey found that more than 75% reported that caregiving had negatively affected their own well-being.
Jessica’s quiet response, before she ever said it out loud to me, was to gather her own people. She told her own friends (informed them, didn’t ask) that they were her people during this time. There was a network around me, and there was a network around her. She built both.
That’s the part of this kind of support I think most of us underestimate. The architecture has to include the architect.
Building Community Before You Need It
The conventional advice to ask what someone needs assumes the person in crisis is the right focus. They’re not. It’s the people with enduring relationships who can identify what is needed and when. A relationship that goes back 25 years has stored an enormous amount of information about what works, what doesn’t, what’s said, what isn’t, and where the soft spots are. Jessica wasn’t guessing when she chose the workout role or the logistics coordinator. She was deploying the dividend of two decades of paid attention.
By the time you need help, the relationships that will help you have already been mostly built or mostly not. That’s an uncomfortable implication because it pushes the work of being well supported earlier than we like to think about it. What does it actually take to be ready when a friend gets the call? Most of it happens before. Jessica’s own answer, when I asked her at the end of our conversation what she’d tell someone facing cancer or any other curveball, was straightforward: build community before you need it. From the get-go. Not because you might need help, but because it makes your life happier, healthier, and purposeful.
Pick someone you love. Not the obvious one. The second person you thought of. Do you know them well enough to design their role if they got the call? Do they know yours?
The Bye-Bye Boobies Party did happen, eventually. Four months later, the night before the same surgery, this time with a different prognosis. We wore T-shirts. We laughed. I was clinically cancer-free. The attendees were old and new friends. Build community before you need it and never stop building it.
I remember thinking that night that the party was almost beside the point. The point was that people showed up to laugh, support me, and be exactly what they knew I needed them to be.
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