I am not a member of the medical community. I am a patient. I have had a biopsy, lumpectomy, mastectomy, adriamycin chemotherapy, radiation and tamoxifen. You may find me hesitant or losing my train of thought. That's O.K. This is part of the cancer treatment - fatigue. This is why I have written what I want to say.

A few months ago I went with my husband to do the grocery shopping. I was to pay by writing a check. Fatigue had settled down onto me and as I stood before the cashier with the checkbook open and pen in my hand, I could not remember my name. I looked to my husband. He was no help. He was packing the groceries. I felt a twinge of panic. And then, my eyes fell to the upper left hand corner of the check and I realized, ah ha, that's who I am. I am Viola.

A couple of weeks ago I awakened and needed to write down my thoughts. Please allow me to read what I wrote...

Fatigued, tired, overwhelmed are factors of life that all persons contend with. During cancer treatment, fatigue is a matter of survival. They are very real symptoms of the 24 hour a day work of recovery. There is no "time off." The body is using all the energy it can muster to renew and improve on the day before. Never before has it been more important that the body, mind and spirit work together. For if one lags, the others have to take up the slack, and the job becomes more difficult. Listen to your body. Cooperate with your body. This will take time. Be patient.

Yes, cooperate. The causes of treatment fatigue are multiple. The fatigue is very real. Lazy is not part of the equation. The body and spirit have experienced trauma. Our energy goes to heal and rebuild, the same as if we would use energy to chop wood or run a marathon. The body and the energy need to be renewed through firm, gentle, discipline. We must not sink deeper into our beds. Yes, cooperate.

I don't want to take the tamoxifen. But I must, so I do. I don't want to exercise. But I must, so I do. I don't want to eat. But I must, so I do.

We have heard Martha [U-M's cancer nutritionist] speak. Well, let me tell you, Martha doesn't take any "yah buts." Martha says, "Eat kale." I eat kale. Martha says, "Eat one Brazil nut every day," and the owner of my local market stocked Brazil nuts. Martha says, "Show me your hands." Ah ha, no twinge of orange. Martha says, "eat more carrots."

I have an attitude. Anyone who knows me knows this is very true. A doctor whom I respect told me that attitude is 98% healing. I am going to be all right because boy, do I have an attitude
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There is an old Russian proverb that says, "When your boat springs a leak, pray to God and row for shore." I pray and I row. I strive to balance positive attitudes. I do what needs to be done as I can. I do the laundry, meals and paper work. Oh how I hate to pay "late" fees for utilities.

I will not allow myself to wallow in mental stagnation. I read, listen to music, good radio and argue back when I disagree with what I hear. There is very little TV watching in our home.

One of my areas of creative expression is quilt making. My husband approves. Can you even imagine him trying to tell me that I may not? He has said that it keeps me off the corners and out of the bars. This pleases him.

I belong to three guilds. The Ann Arbor guild was 495 strong at one count. They are my support group. The love was there when I appeared at a meeting with a scarf tied around my bald head. I am so very proud to be a member of this guild. We support Safe House in Ann Arbor. When a mother comes with a child, each is given a quilt. My husband said the November meeting is like a religious experience. Women bring their quilt offering to the stage, unfold and show it, then put it down and walk away. When I see the quilts, I wonder how they can part with them. They are beautiful.

As soon as I regained my vision and control of the needle after chemo, I started what have become known as my therapy quilts. I have brought two here this evening. The others I have given away as gifts. Do look at the quilts that I brought. Touch and handle them. Enjoy them.

God guides and provides. When I was not able to make decisions about design or color, the local quilt shop offered a set of instructions on the first of the month. My husband would go to the shop and get a set of instructions each month for six months. You did not know what you were making until the last set of instructions. That's O.K. I didn't know what I was doing anyway. I just followed instructions.

What I am trying to say is that it is important to do something: read, write, crochet, knit, make baskets, garden, bake cookies, make soup (I love to make soup. My husband says I run a soup kitchen) or play cards. But if Old Maid and Solitaire were your games don't try to learn Bridge now. It won't happen. Do anything. But do something. This is the way to grow strong.

And it is only you who are able, and must decide what and how you will do your music, art or whatever it may be. There is no right or wrong, just different. But let it be something. Another thing we need to do is delegate that which we are unable to do. My husband tells me that "delegate" is one of the three things I do really well.

I need to say something about those like my husband, the caregivers, be they husbands, wives, children, neighbors, friends or the mailman. Yes, the mailman. Mine has carried mail and parcels to me from around the world - Australia, New Zealand, China, Wales, Paris and Canada. How did I make contact with all these people??!! God love them. It's trite, but true that at times like these you are shown who your friends are.

I once told the mailman that I was not able to get the mail from the mailbox. He solved that problem. He bundled my mail in order of importance; letters from friends on the top, bills in the middle and junk mail at the bottom. He banded it with a rubber band, then propped it between the inner door and the storm door so that when I opened the inner door the mail dropped to my feet. I later learned that he instructed his substitute as to how my mail was to be delivered.

God must have a special place for all these people. I thank God each day for mine. I have told him so. Mine has stripped drains, given baths, ironed his white shirts, shopped for groceries, scrubbed floors and yes, he does do windows. Whatever it is, if I can't do it, he will. All this after a full day at a very demanding and responsible job. And he still has energy left to hold me when I feel as though I am flying apart with emotional turmoil.

Donald please stand so that I may introduce you.

Now, I know that there must be many here tonight who are the caregivers. I know too that the experience and its toll have been traumatic for those who love us, as it has been for us the patients. It has not been easy to stand by and feel helpless to do something about it. I know that my husband would have given one of his veins when he stood by and watched as they repeatedly failed to find one of mine. I know that he has gone into the bathroom, closed the door and cried.

I know that he is not one lone exception. There are legions of you out there. Please stand so that we may see you and thank you.

You have all been patient with me. You have been kind. Thank you.

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