S4E408 - Transcript
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S4E408 — “A Problem for Future Me: Cancer and the Worries That Can Wait”
[Cody — sponsor read] Dying to Tell You is supported by the Iliff Death Care Collective. We'll share more about them and their educational offerings later in the episode.
Kimberly: Part of my peace is just that I really trust myself and my future self to handle things that I can't handle today. I couldn't handle prognosis data day one — six months in, I could. There are things my current self cannot handle, but they're not happening to me right now. I know they may one day, but I don't have to carry that burden today. It's not happening to me today.
That's quite literally someone else's problem, and that someone else is me — just not me today. It's my future self. And she will be able to handle it. I know that she will.
[Cody — narration] Ten years ago, Kimberly was tired. She was 25 years old with two young children, starting a business — of course she was tired. But it seemed to her she was more tired than other people in similar situations. When she went to the doctor to ask if something was wrong, she was told to take a nap.
She says she half-heartedly tried to get help a couple of times, and when she was dismissed, she wondered if she was just being a wimp who needed to try harder. About two years ago, red flags appeared that were harder to ignore. She'd started running to build fitness, but instead of improving, she got worse — trouble breathing, terrible headaches after every run — until she had to stop entirely.
The fatigue kept getting worse. Eventually her friends noticed how bad she looked and told her she needed to see a doctor. So she did.
Her bloodwork showed low iron and low hemoglobin. At first her doctor suspected it was related to her menstrual cycle and wanted to schedule a uterine ablation. But after GI pain and blood in her stool, she went in for a colonoscopy — just to rule out cancer before moving forward with the ablation.
She went into that colonoscopy assuming it would find nothing. As she put it: cancer is something that happens to other people.
When she woke up, her life and her perspective changed quickly.
This is Dying to Tell You.
Cody: Take me back to waking up from the colonoscopy.
Kimberly: I woke up very confused that my husband was there, because he hadn't dropped me off — apparently I asked him seventeen times how he'd gotten there. That tells you how out of it I was; I couldn't fathom how he'd located me. It felt like magic. Then the doctor came in.
Cody: They'd called him?
Kimberly: He was already there — he was always going to pick me up, I just wasn't tracking it. So that's the mental state I was in when I was told I probably had cancer. I'm told the doctor looked very alarmed; I have no memory of that. He told us, very somberly, that he couldn't finish the scope — the tumor was so large he couldn't get through. That made it an emergency: if it was already that blocked, it could be even more blocked further down, which could turn dangerous fast. He said we'd check for cancer, and he'd call. Between now and then, I needed to see a surgeon almost immediately — because a full blockage could kill me. He sent me for a CT scan. I had the colonoscopy on a Monday, got the CT in for that Friday — shockingly fast — and saw the surgeon the following Monday.
Cody: What were those days like, between Monday and Friday?
Kimberly: Weird and disorienting. I know better than to Google, so I didn't.
Cody: Amazing self-control.
Kimberly: I know better. I wasn't going to do that to myself — I do now, but not then. I didn't want to invent seventeen different scenarios before I knew the actual situation. So I refrained from Googling and tried to act normal. Our son sort of knew something wasn't great. Our daughter was out of town, completely oblivious. They were about twelve or thirteen and fourteen at the time.
Cody: Their ages.
Kimberly: Right. So it was just surreal — heading back to work, trying to act normal, knowing your life is about to change without knowing how. I was mostly bracing for surgery — I'm very afraid of surgery — and assuming surgery would be curative and quick.
Cody: Did they tell you whether it might not be cancer at all — that it could just be removed and you'd go back to normal? Did they get into what the outcome might look like?
Kimberly: They didn't get into outcomes at all. The doctor said, don't go to oncology yet, just go straight to the surgeon — this is an emergency. In my head I was like, oncology, what? — not even fully processing that. As far as I was taking it in: you'll have surgery, and then it'll be okay. Chemo wasn't in my mind at all. No one in my family has had cancer, so I had zero context.
Cody: That week of anxiety, between the colonoscopy and Friday's surgery — it was all about the surgery itself?
Kimberly: All about the surgery. I'd never had one, never stayed in a hospital except for my kids' births, never had a CT scan. So plenty of anxiety about all of that. Maybe some underlying anxiety about cancer too, but mostly — it'll be fine, obviously. Cancer happens to other people. I wasn't living in reality, I guess.
Cody: You were living strictly in your reality — and in your reality, cancer had never happened to you or anyone in your family, so it wasn't on your radar. You only knew what you'd been told. I've never met anyone who refused to Google the way you did. That's honestly blowing my mind.
Kimberly: My husband was Googling — he knew things. I made it very clear: don't tell me anything. Doctors will tell me what I need to know. I don't want to know more.
Cody: So — the CT scan.
Kimberly: I got the CT five days after he called and told me it was cancer. I'd been expecting it — when the actual doctor called instead of a nurse, I knew before he said a word. But we still knew nothing beyond "it's cancerous." I got the disc — someone had told me to always ask for the disc — and saw the surgeon that Monday. He looked at it and said, look, this is on your right side, relatively easy surgery, you won't need an ostomy bag, quick recovery, it's going to be great. We were laughing, joking, having a good time. Then I mentioned I had the CT scan disc if he wanted to look. He said sure, left the room — jolly — came back deathly white and clearly distressed. He said, I can't operate on you.
Cody: That brought the room down.
Kimberly: Read the room, bro. He described — I don't remember the exact phrasing — something like nets all over my liver, using this motion to show me. He said if he operated, it would "blossom" — such a nice word for something horrible — so he wasn't going to operate, and I needed to see an oncologist immediately. We said, we were told to see you immediately because this was an emergency. He said, it still is — and if I ever went a day without a bowel movement, I needed to go straight to the ER for emergency surgery, which would be nothing like the easy surgery we'd just been discussing. We left not fully grasping how dire it was — we didn't know yet that liver involvement was a much bigger deal than a single spot. As we were checking out, bracing for the usual weeks-long wait for an oncology referral, he stepped into the hallway on his cell phone and said, I'm on the phone with your oncologist right now, the one I've picked for you — we're getting you in. That had never happened with any doctor we'd seen. It was the first real hint of how serious this was.
We got in with her quickly. She's wonderful, and she said right away: we're starting treatment, you need a port placed in your chest, and we begin right after. That was the first time I cried in a doctor's office — not at the cancer news, not at "I can't operate on you." It was the port. That felt scary in a different way. I cried, got the port placed, and started chemo the next day.
Cody: Chemo the day after the port went in?
Kimberly: Fresh and bloody, next-day chemo — which was itself a sign, because people had told me you usually get a two- or three-week break to let the port heal. They said, no, you start tomorrow.
Cody: Did it dawn on you then how serious this was?
Kimberly: Not at all.
Cody: Did your oncologist let on how serious it was — or looking back, do you think she was signaling it and you just weren't picking it up?
Kimberly: She didn't. She's very skilled at reading what information someone wants. Looking back, I can see her putting out feelers — testing whether I wanted to talk about it — and I was clearly giving off "I don't want to talk about that" energy. So she didn't, until I finally asked, about six months later.
Cody: She kept putting out feelers the whole time?
Kimberly: She did — with me, and separately with my husband and my mother-in-law, who comes to every appointment. By then my husband had Googled everything and knew the full situation. He'd ask me, if I know something you don't that might matter, do you want to know? And I'd say, nope, I do not. I need to have hope. If you come at me with math and numbers and percentages, I don't want any of it.
Cody: Did he or your mother-in-law ever talk to the doctor separately, without you?
Kimberly: They thought about it, but no, they never did. He'd Googled and already knew what he needed to. The one thing I asked the oncologist was: she said we'd start with FOLFIRINOX plus Bevacizumab, do four rounds, then scan again. I asked, what are we hoping this scan shows? In my mind, we were aiming for "cured after four rounds." She gave me a look — one of the moments she was really reading how much I wanted to know — and said, "significant improvement." I said, great, that's all I needed.
Cody: Did you want to know what "significant improvement" actually meant?
Kimberly: Didn't need to know. I didn't even know it was an if — that this might not work at all. I didn't know chemo sometimes doesn't work first-line. Eventually I learned it stops working for some people, or never works for others whose cancer is too far progressed. I just thought: I'll significantly improve in four rounds, then get surgery, then be good. That is not what was happening.
Cody: I've always believed you need information to make an informed decision — and it's hard for someone to agree to a treatment that isn't going to cure them if they think it will, and still call that informed consent.
Kimberly: That's fair.
Cody: I still think that. And I also hear the wisdom in you knowing yourself and being willing to say, I don't need that — and it worked out.
Kimberly: It was the right decision for me.
Cody: Right — because if you'd had the full picture, the incurable label, the percentages, the reality that this treatment might not cure you and might not even work — it wouldn't have changed your course.
Kimberly: No. This was first-line treatment — wherever I'd gone, it would have been the same first-line regimen. It just would have crushed me. It was already so much to process at 35.
Cody: So the outcome wouldn't have changed, only how you carried it.
Kimberly: I couldn't have carried it. At some point I did Google survival rate — saw it, thought, well, there's nuance here, closed the tab, never looked again. There's no "100% of the time," and every case is different, so I decided I wasn't going to live my life inside that percentage.
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Cody: Do you generally have anxiety? Do you worry?
Kimberly: For anyone who knows me, that's the funniest question you could ask. Yes — historically I've been a very anxious person, struggled with depression, dealt with mental health issues most of my life.
Cody: Where did that come from?
Kimberly: I've had anxiety for so long that I know exactly what my mind does and how it spirals, so I already knew what I needed to do to get ahead of it — what I was capable of handling, what would prevent a panic attack. That's been most of my life. But honestly, I'm less anxious now than I used to be — partly because I have iron in my body now, and partly because I have cancer. I can always tell when my iron drops, because chemo takes iron too, and the anxiety ramps right back up. It makes me wonder how many of those ten years I wouldn't have spent anxious if I'd just gotten iron sooner. That annoys me more than the cancer diagnosis does — that I could've been a lot happier with a simple supplement.
Cody: Are you familiar with Stoicism — the idea of knowing what's in your control and what isn't, and putting your mental and emotional energy toward what is?
Kimberly: Not really, no.
Cody: I think you may be practicing a version of that already — whether through therapy or your own reading, learning to tell the difference between what's in your control and what isn't, and where to put your energy.
Kimberly: Yeah, that's a big part of it. I'm using so much energy just to get through the day on chemo — I can't also carry anxiety about what happens years from now. I just can't.
Cody: So walk me through how you came to understand the reality of your situation. What did that look like?
Kimberly: First, I got more comfortable with "this is what's happening." I also had an insanely good response. Before starting, at chemo class, I asked how soon the pain I was in every day would go away after treatment started. They graciously didn't tell me it might not work at all — they said it could take weeks or months. I needed to hear that, because I'm the kind of person who assumes instant relief, and when it doesn't come, that crushes me. So I braced for the pain to take a couple of months to fade. It went away in five days after my first treatment — which I now know is unusual. That helped me start processing: okay, I know this is working. I got scans that showed significant shrinkage. I became more comfortable saying "I have cancer," which took a minute.
We went beyond the original four rounds — she said normal first-line is twelve, so we were aiming for twelve, then maybe dropping one near the end. I thought: twelve rounds, then surgery, there's a pathway, I'll follow it. Then, in one appointment, I asked about surgery timing, and she said — since you're stage four and it's incurable, some people don't get surgery at all because there's no benefit.
Cody: That was a lot to hear in one sentence.
Kimberly: One little sentence. I looked at my mother-in-law, who comes to almost every appointment with me — we were both like, what? I said, back up, you said incurable — what does that mean? I assumed it must be a medical term I was misreading. She said, well, you've Googled, right? I said, no, I haven't. She said, you haven't? I said, I only know what you've told me, personally. So she laid out everything I'd been avoiding. I cried, my mother-in-law cried — she hadn't fully processed it either, even though I'm sure she'd Googled. We both left in tears. I remember thinking, how do I even tell my husband this. When I did, he said, yeah, I know — which explained a strange tension I'd noticed in him for a while. It made sense.
I spent two or three weeks trying to process it — is there a death date, that kind of thing — and nothing about how I tried to sit with it felt right. So I decided it didn't apply, for better or worse. I made a little joke about it online: like that scene where a guy keeps getting told no and finally says, "so you're saying there's a chance." That's me. There's a small percentage of people no one can explain who beat this. There's a chance. I'm going to find the chance. That's the life I'm living now.
Cody: You said earlier you didn't want the information because you needed hope to get through this. This sounds like a version of that — needing to believe there's a chance you could be cured, even knowing what you have is classified as incurable.
Kimberly: I know the reality. It's a choice.
Cody: How do you actually do that? I'd genuinely like to know, for myself — how do you make yourself believe something impossible could happen?
Kimberly: I don't have a tidy answer. I can tell you what it feels like: instead of spending time Googling every reason things are terrible — and there are plenty — I spend my time reading the reasons things could go right. I've spent most of my life bracing for the worst, even before cancer, because a lot of the worst has happened to me. Now I try to frame it as, what if the best happens? What if I'm one of the one-to-fourteen percent — I don't track the exact number — that nobody can explain? If my mind is going to spiral anyway, I try to steer the spiral toward something good. It doesn't always work, but it works more often than not. And it lets me approach my reality without living in constant anxiety. There are certain times I choose to dive into the data and the research, because I need to figure out what care I want — my situation is one where the doctors genuinely don't know what to expect. But I'm not doing that from a place of terror or grasping at straws. I can see multiple pathways where I survive this, and I pick one to try. If it doesn't work, I pick another.
That's carried over into how I think about recurrence, too. I've read about people who've had a recurrence and gone right back to no evidence of disease — several times over. I used to be terrified of recurrence; now I know it's not the end of the world if it happens, because there's still a pathway forward. That's all I need to hold onto.
Cody: I've heard people say you can spend all your energy worrying about what could go wrong, or spend it wondering what could go right — but getting there takes a lot of work.
Kimberly: It's exhausting. Not anymore, but it was — lying in bed in pain from chemo, alone while my husband's at work and my kids are at school. That took a lot of mental effort to build. But it's what I needed to survive.
Cody: I imagine there are still hard moments, when you're worried.
Kimberly: Of course. But even then, I tell myself: this is a bad day, tomorrow's going to be okay, and I'll make sure of it. I sit with how crappy today feels without letting it feel permanent. Over the past year — I was diagnosed just over a year ago — I've actually become comfortable with uncertainty, which is new. People who ask how I'm doing often want a certain answer. When I stopped wearing a mask, because I'm on maintenance now and my white blood cells are holding, people assumed that meant "you're done." I'm not done. People want to slap "survivor" on me because that feels certain. We want certainty so badly — but not having a cancer diagnosis just makes it easier to live inside the illusion that you have it. None of us actually do.
I'm okay with there not being certainty. Today's a bad day, or a good day, whatever it is — it's just today. I don't need certainty about the next thing. When my mind spirals into "what if this happens," I try to find a happy pathway through that too, because that's who I am. I'm okay with the uncertainty, because it's never going to be certain again — and I find some potential good in everything.
Cody: "It's never going to be certain again" made me laugh, because it never actually was. I think that's what unsettles people around you — it highlights the uncertainty, and the danger, that was always there.
Kimberly: But now I know it.
Cody: And when people want to slap a "survivor" label on you, or want you to be "done," they're really wanting things to feel certain and safe again. When the uncertainty is right in their face, it's uncomfortable — even offensive to some people.
Kimberly: There's one thing I say that makes people very uncomfortable, but I try to be honest with people about the reality of right now — because otherwise they assume I'm done, and I'm not. Saying "chemo for life" usually gets that across. But people closer to me will ask when I'll be finished, and — in every happy pathway I can currently see, based on where science is today, there isn't one that leads back to a normal life. That part's pretty certain. The one curative option that technically exists is a liver transplant, and that's not an easy, normal life either — you're on immunosuppressants for the rest of your life, still vulnerable to all kinds of things.
Cody: And neither is living with someone else's liver for fifty years, exactly "normal."
Kimberly: None of it is easy or carefree. I've accepted that that version of life is over — maybe science advances and I get back there someday, but I'm not spending much time on that. I've made peace with the uncertainty, and I think that peace is what stands out to the healthy people I talk to, who are so uncomfortable with uncertainty. They'll say, "but you're smiling while you say all this."
Cody: You might as well be. Though — what even is normal?
Kimberly: Not getting stabbed with a needle six times a week would be nice.
Cody: Sure — but right now, your normal includes that, and you've made peace with it.
Kimberly: These things don't only happen to other people. Some people get diabetes at two and deal with needles their whole life. Sometimes life just isn't fair. Might as well be okay with that.
Cody: It's hard for a lot of us with comfortable lives to accept that something might not stay perfect. Nobody wants to believe that.
Kimberly: Right.
Cody: I want to talk about your bad days. I've been thinking a lot about zooming in and zooming out — and what you've described sounds a lot like zooming out. I worked with someone for a long time who framed it this way: if the moment is hard, you zoom out; if the whole situation is hard, you zoom in. When a bad day hits, zooming out means not denying that it's bad, but reminding yourself that tomorrow will likely be better, that life hasn't always been like this and probably won't stay this way. When you're stuck in a hard situation — say, living with cancer — zooming in means turning toward something good right in front of you: family, a friend, a moment worth appreciating. Moving between the two, and staying grateful for what's there, tends to help. Does that match what you do on a bad day?
Kimberly: Yeah, for the random bad days, for sure — they sneak up on you without a clear reason. I could have every single day be a bad one, but usually there's not new bad news I need to process on any given day. I've already done the biggest piece of the work: this is my reality, I live here, and it's fine.
There are rhythms to my bad days that I've learned to get ahead of. I get chemo every other week — hooked up on Monday, carrying a bag for fifty hours, unhooked Wednesday. Wednesday is physically the hardest day, since that's when I have the most chemo in my system, but my brain clears up enough that I can work — I skip work Monday and Tuesday because my brain's too foggy. Thursday and Friday are more normal. But Thursdays are emotionally brutal — every single time, without fail, I crash. So I started strategizing: what do I need in place to soften that Thursday crash? It still comes — I still feel sadness on Thursdays I don't feel other days, because of the heaviness of feeling awful six days out of every month, and not great for half of the rest of my life. That's a lot to sit with. It's more real on a Thursday than on a good day like today, when I haven't had chemo in a while and can almost forget I have cancer.
So I've built things into my chemo schedule to give myself something to look forward to instead of dreading it. On chemo days, I get to work on a Lego set with my husband, or go to a particular lake with a friend who walks with me while I'm carrying my chemo bag — it's hard to walk while you're actively being poisoned, but she does it with me anyway. That gives me something to hold onto, and it softens Thursday. I try to pair a good rhythm with a bad one — not to pretend it's okay, because it's not, but to remind myself I can hold both at once. It can be a terrible day and a good day simultaneously: I'm in constant pain, exhausted, foggy, my fingers are numb — and my friend's there, and we're having a good time doing Legos. Both, at once. So for the days I know are coming, I plan ahead — make sure I get outside, get some sunshine — and afterward I take a step back and ask whether it was just a random bad day, or something tied to the schedule. If I know Thursday's likely to be rough, I plan around it so it doesn't bleed into Friday and Saturday.
Cody: Have you thought about how you'd find hope if you had a recurrence — if you didn't get a continued response?
Kimberly: I think part of what looks like denial, without actually being denial, is asking myself whether this is sustainable — this works today, but would it work if something went wrong? I think it would, for a long time. I know that eventually, for most people who don't survive, it becomes clear it's a matter of time. And then I think I'd just transition into believing that's going to be okay too.
I think about dying a lot more than I used to. But I don't think about the actual process of dying — that's none of my business right now, and it's too much. I don't think dwelling on it now would make my life better, now or later. I don't feel unprepared, exactly, but I also don't feel like there's more mental preparation I need to do. I haven't fully accepted that it's going to be sad if it happens — but I trust I'll be able to handle it when it comes. I've learned this past year that I can handle a lot more than I thought. Part of my peace is trusting myself, and my future self, to handle what my current self can't. I couldn't handle prognosis data on day one; six months later, I could. There are things my current self can't handle that aren't happening to me right now. If they happen, my future self will handle it. I don't need to handle something today that isn't happening to me today.
Cody: You're trusting the pattern — you've handled everything up to this point, and you'll keep handling it.
Kimberly: I really do believe that. I think I'll be all right, and able to handle it if the time comes. If it's happening, it's going to be okay.
Cody: I'll tell you — from sitting with hundreds of people who are dying, or who have died — that is true. It becomes okay, at some point. As the situation changes and we get our minds around whatever the new reality is, the hope changes with it. When reality outgrows the old hope, you find a new one.
Kimberly: That's why there are certain things I just can't sit with right now. But I think — I think I'd face death with hope. I don't love picturing the dying part, but picturing what comes after brings me peace. I don't know, of course, but I think that's what I'd lean on. And I trust my husband and my kids will be okay. That's what matters.
Cody: What do you picture happens next?
Kimberly: I'm a Christian, so what the Bible says shapes how I think about it. Growing up in church, the afterlife always got described as clouds and vague weirdness, and none of that resonated with me as a kid. Now, when I read about it, it's described as a feast — a world made new. So I picture eating ice cream with my best friend, because that's my favorite feast. I picture exploring the world with my kids, traveling, no pain, no fear, no worrying about budget — going wherever we want. Everything the way it is now, but perfect. I don't know for sure, obviously, but I need something to picture — that's who I am. My mind spirals until it lands on something.
Cody: That's okay.
Kimberly: Ice cream and travel sounds pretty good.
Cody: Favorite flavor?
Kimberly: The limit does not exist. Every flavor is my favorite.
Cody: No go-to?
Kimberly: Nope — whatever I'm vibing with in the moment. I just want ice cream, always. No favorite.
Cody: Last question — how do you want to be remembered?
Kimberly: You told me that was coming, so I've been thinking about it. When I was younger, in my twenties, I think I wanted to make some kind of big splash — or maybe that was just me. I really don't care about that anymore. I don't think I care about being remembered by most people. I hope my kids remember me as a really good mom — that's the most important thing. I hope my husband remembers me as a good wife. I hope my friends remember how much I loved them. If nobody outside the people I love remembers me, I genuinely don't mind. I don't need to have made some impact on the world. I want the people I actually interact with to be a little better for having known me — but if I don't leave a mark on six billion people, that's fine. The people I know, I want them to know how loved they were.
Cody: I like that. I've been thinking a lot about this too — I'm past midlife now, and I don't know if I'm living to forty-two or ninety-two, but I keep coming back to wanting the people I interact with to feel loved, seen, and valued. What more is there, honestly?
Kimberly: Right. My kids know their mom loved them. Good. Done. That's all I needed.
Cody: I'll remember you as someone who changed how I think about whether people need information about their disease and their process — and as someone genuinely skilled at finding hope, in a way that isn't delusional or toxic, but real hope in a real situation. I really appreciate that. Tell people where they can find you.
Kimberly: Thank you — that's kind. You're going to laugh, but it's "Cancer is a joke" everywhere, mostly TikTok, where I post the most. There's also an online support group by the same name. When I finally went looking for support from other people with cancer, it was — I say this through tears — a lot of people crying into a camera. I didn't want that. I don't think that's all there is. There's a lot of fun in this, a lot of funny, a lot of ways to make it easier and better, and that side doesn't get talked about as much. Nine million people wanted to buy me a wig, which I didn't care about — nobody told me the practical stuff, like eat more protein, or that a walk would help. That side was missing. So I went online and started telling jokes about cancer.
Cody: That's actually how we first connected, and I love it. Is the support group separate from the social media, or do people meet elsewhere too?
Kimberly: It's online — an app and a website. You can find it through Cancer is a Joke, or at cancerisajoke.com, under the community tab. It's open to all cancer types, as long as you're there to have a good time — a realistic good time. We complain, we find solutions, and we laugh.
Cody: It's good medicine, I hear.
Kimberly: It is. It's surprising how many healthy people don't want you laughing about your own cancer — but they don't get to decide that. That's kind of where this all started: I'd make a joke and people would send sad-face reactions, and I'd think, but it was funny. Laugh at my joke, gosh darn it. So — come laugh with us.
Cody: That's wild to me. We'll put links in the show notes so people can find it. Thank you so much — this genuinely turned my mood around. This was great.
Kimberly: Thank you for having me.
[Cody — narration] Thank you so much to Kimberly for joining me on the podcast. Her perspective on worry, and the way she's made peace with her anxiety about the future, have stayed with me since we talked. If you'd like to see the video of this interview, you can find it at patreon.com/dyingtotellyou.
This week, may we all leave our future problems to our future selves, and live in the present with intention and purpose. Thank you for listening.
This is Dying to Tell You.
