On All, Nothing, and In Between

One evening I forgot to put the dinner leftovers (which were cooling on the counter) into  the fridge before I went to bed. The next morning I dragged myself to the kitchen to start the kettle for tea and found the spoiled food.

As I angrily threw the leftovers away, my brain quickly churned out two competing theories about this problem. Either: a) I’m a terrible person who messed up and now has wasted all the time spent shopping for and preparing that food (which would have provide us another meal), and I am stupid and lazy and forgetful, or b) I’m very busy in my personal and professional lives, so the leftovers slipped my mind, which is a completely understandable mistake, and I should just let it go and not let it stress me out.


Of course other, less extreme options than self-abuse or self-absolution also are possible. Maybe I’m a busy person who should have set a reminder alert on my iPhone, and perhaps I should be less inclined to emotional self-flagellation but was justified in feeling disappointment at the waste of my time and efforts.

I know better than to think in terms of either/or, but I do it frequently. Therapists call this “black and white thinking” and urge people to avoid it. It makes us miserable, and rarely does it lead to truth or good decisions.

Like most long-term cancer survivors with late effects (and others with chronic illnesses and disabilities), I live in the middle between well and sick; I manage my pain and cope with being an amputee as best I can. It’s neither consistently perfect nor perfectly horrible.

Ironically, I teach students to resist such either/or reasoning because it blocks critical thinking. Imagine that I asked you to quickly give me the opposite to the following terms:










I’m pretty confident that you said black, bad, false, left (or wrong), fiction, east, soft, woman, and lose. How do I know? Because Western society, particularly the English language, trains us to think in terms of opposites, to see only two instead of a huge range of possibilities. No matter the course I teach—public speaking, gender and sexuality, interpersonal communication—my students learn about resisting binaries (also called dualisms or dichotomies). Binaries are opposites—mutually exclusive, paired terms, such as tall and short or big and small.

This way of thinking also underlies the dominant cancer narrative—triumph or tragedy. You fight the cancer battle as hard as you can, and then you either triumph over cancer with a cure, or you tragically die. But long-term cancer survivors live in the middle between triumph and tragedy. We survived cancer—sometimes more than once—but most of us live with late effects, that is, chronic illnesses and conditions left over after cancer treatment. We are healthy and ill, recovered and suffering, happy and sad.

I know this. Yet I get sucked into binary thinking over and over again. I swing wildly back and forth in judging my actions and others’ as awesome or useless, mean-spirited or innocent, healthy or unhealthy (and conservative or liberal). I forget that the truth is rarely in the default setting of black or white and far more likely to be in some of the many shades of gray in between extremes.

I have asked myself how I end up defaulting to binary thinking so often for someone who not only rejects it philosophically and ethically but also teaches about its limitations for understanding communication theory and practice. Habits, stress, and cultural reinforcement are part of the answer; I just don’t know is the rest.

What I do know is that when we move from either/or to more nuanced understandings of ourselves and our world, we better solve problems on the micro level (I now set a timer if I am responsible for putting cooling leftovers away) and on the macro level (establishing humane healthcare policies and programs).

Caught between a rock and a hard drink


“Would you like a Diet Coke or some water? That’s all I keep in my office fridge,” I offer, smiling at my friend and colleague with whom I am having a brief organizational meeting.

“No, thanks. I never drink that stuff,” she replies, tilting her head toward the Diet Coke can in my hand and giving it a faintly disapproving glance. “And I brought my water bottle.” I shrug off my defensiveness and smile cheerfully, popping open my Diet Coke and settling in for our discussion.

Cracking open an icy cold can of Diet Coke is how I punctuate meetings, classes, or most any other event. I never did learn to like coffee, and while I do enjoy hot tea, it causes me to have major hot flashes, so I only drink it before my morning shower.

Diet Coke never lets me down; it is my go-to source of caffeine. I love the fizz, the taste, and coolness of it slipping down my throat. It is energy, it is comfort, it is tasty. But does it count as self-care or self-harm?

Any number of students, friends, family members, and colleagues have made gentle and not-so-subtle references to the idea that Diet Coke is not good for one’s health, at least at high levels of consumption. Aspartame (the artificial sweetener) has been blamed for everything from head aches and dizziness to diabetes and depression. One memorable student cried in my office as she warned me that aspartame would turn into formaldehyde in my body and poison me. And more than a few students have teased me about the irony of me teaching them about health communication while drinking my favorite (unhealthy) beverage.

I admit that drinking several cans a day of Diet Coke is probably not the healthiest option, and yet I feel caught in an impossible bind. I drink so much Diet Coke because the daily dose of neuropathic pain medications necessary to control (most of) my phantom limb pain leaves me feeling chronically sleepy and unfocused. I feel more alert after drinking (caffeinated) Diet Coke, and it is a convenient and readily accessible product. Yet I also feel embarrassed and defensive about how much of it I drink.

For the record, significant bodies of research have failed to demonstrate that aspartame has negative effects, except for people with a genetic disorder that makes them unable to process one of the compounds in aspartame. The FDA continues to approve its use. That doesn’t mean that aspartame can’t have long-term negative effects for which we do not have evidence, of course.

When people suggest—implicitly or explicitly—that I should not drink so much soda, I feel a complex blend of emotions: resentment and frustration, mixed with sadness, shame, and defensiveness. I don’t know how else to break out of the mental fog and stay awake. I typically explain that I am so tired that I could lay down on conference table or the floor (or whatever is handy to where I am at the time) and take a nap right at that moment. And drinking Diet Coke helps me stay alert and focused.

Writing this, I continue to feel defensive. I want to explain that other decisions I make are more clearly health sustaining: I eat in a fairly healthy manner and engage in regular, moderate exercise on an exercise bike, both of which help to keep me feeling as well as possible. I drink at least 8 glasses of water per day. Granted, eating less chocolate than I do would be a good idea, but that’s unlikely to happen, and anyway, dark chocolate has antioxidants and other good nutrients.

At this point, Diet Coke remains the best—albeit imperfect—solution that I have found to coping with one of the worst side effects of my medications. It would be so nice if health decisions were clearly right or wrong, healthy or unhealthy, but in real life, coping is almost always more complicated than that.

Must I always be nice?

I’m travelling a lot this fall, and while I enjoy visiting other cities, I am also running a little low on patience. I feel equal parts guilty and gratified about what I did in the airport a few weeks ago.

I had a connecting flight in Minneapolis, an airport with an efficient system of electric carts to transport people with disabilities from gate to gate. Aboard one such vehicle with a friendly driver and a woman with crutches whose right leg was encased in a large black brace, we made slow progress through a crowded terminal. People either didn’t know or didn’t care that our cart was trying to pass them.

charlotte-airport-electric-shuttle-cart_mediumPausing yet again because the masses of people swimming upstream did not respond to her repeated calls of “Excuse me!” the driver shook her head. As we stalled, a tall, white man with curly brown hair walked toward us. He spread his arms wide and leaned over in front of me, violating my personal space.

“Hey, hey, how do I get in on this?” he asked with a snarky smile, waving his hand to indicate the cart. Tired and in pain, I snapped. “Cut off your leg,” I said flatly, looking him in the eye. “That’s what I did.” Then the driver broke through the crowd and I lost sight of the man just as his face registered surprise.

I swear I didn’t plan to say that. It just slipped out. And I feel bad about it… but also good.

I believe that educating uniformed and insensitive people is a far better tactic than sinking to the level of those who think they are clever when they make such unfunny “jokes.” And I typically do try to offer a constructive comment or (if I can manage it) a bit of self-deprecating humor. Whether I want to or not, I represent the identity category of people with disabilities, and I hope to leave a positive impression with strangers, even when I am annoyed or hurt by their insensitivity.

And yet I can’t bring myself to regret my quip. The man was out of line. While I was rude, the insult was fairly mild, and my statement was also accurate (I am an above-knee amputee). I didn’t say anything obscene or make any crude hand gestures. Instead, I asserted myself to indicate that I didn’t appreciate his humor.

I shared this story with a number of friends, all of whom thought my response was spot on. But it nags at me, sparking feelings of guilt over my sharp reply and the possibility that I angered the man, leaving him with a negative view of disabled people. Moreover, I can’t help but consider the gender dynamics of the situation and ask whether he would have felt entitled to make such a “joke” to cart full of men. I seriously doubt it.

I’ve tried to conjure an appropriate response to his intrusive, thoughtless statement, made on the fly, necessitating super-quick decision making. I suppose the defenders of civility would point out that he probably didn’t intend to be unkind or to make fun of my need for a ride. But he clearly meant to call attention to the cart. To what end?

I can’t know what he intended. But I know how his actions made me feel—embarrassed, annoyed, resentful—and then just a little bit proud of myself for pushing back.

The Stress of Pain and the Pain of Stress

Trying not to fidget in my chair, I looked around the table at the other attendees of the committee meeting. My fellow faculty looked at their notes, at the proposed wording of a recommendation to our provost projected on the screen at the far end of the conference room, or at the woman currently speaking. They all appeared to be fine.

I was not fine. My phantom pain had kicked into gear and it felt like a hot needle was stabbing me in my (absent) right big toe, while the top of my (absent) foot felt like it had been badly burned. I concentrated on not gasping or wincing every time the pain spiked, which it did every 15 seconds or so, then relaxed my shoulders gratefully as it receded.


Side note: I always feel strange describing phantom pain to other people, whether out loud or in writing. I’ve never had someone actually heat up a needle and plunge it into my big toe, nor have I ever had the top of my foot badly burned, nor any of the other bizarre comparisons I reach for—like a really bad sunburn that someone slapped, like an electrical current shooting up my leg, like a knife stabbing the muscle in my calf, etc. So I’m describing things that have never happened in order to explain current pain in a limb that quite obviously no longer exists, and that’s so weird it makes me feel crazy.

Anyway, the phantom pain made it difficult for me to concentrate on or contribute to the meeting, which made me feel self-conscious, frustrated, tired, and more than a little stressed out. I could have left (and no one would have criticized me for doing so), but leaving wouldn’t have made the pain subside, and if I left every activity in which I engaged while in pain, I wouldn’t do much. So I tried to hang in there.

At the same time that phantom pain makes me feel stressed out, I also have detected over the years a definite correlation between being stressed out (by whatever) and an increase in phantom pain. So impending publication deadlines, big stacks of grading, monstrous to-do lists, an argument with my spouse or a friend, and updates on tragedies—from the recent Las Vegas massacre to the ongoing Syrian refugee crisis to the U.S. school-to-prison pipeline—all cause me to be in more pain.

Anyone who lives with chronic pain knows, and probably some others will correctly deduce, that being stressed by pain and pained by stress fosters a terrible spiral of pain that is difficult to stop and incredibly depressing. I feel grateful that medications control my pain as well as they do, so that most of the time my pain is manageable.

In the end, the best I can do is to try to manage stress through moderate exercise, escaping into a book, cat cuddles, and of course some less healthy strategies as well (think binge-watching on Netflix and simple carbs). Or I could always watch The Princess Bride yet again—“To the pain!”