“You’re not sick enough”

When I was diagnosed with chronic cancer last year, a friend of mine said something I found deeply distressing. 

“You’re not sick enough to write about your health,” he intoned. “No one will take you seriously unless you’re close to death.”

I brushed off my friend’s unsolicited “advice” and began to write anyway. But I was nevertheless dogged by his admonition. 

Could he be right? Was my cancer experience – so far at least – too “easy?” After all, during my first round of treatment, I didn’t lose my hair, I never had to be hospitalized, I didn’t spend nights hunched over the toilet overcome by nausea. 

No, that couldn’t be the case. Cancer is cancer, regardless of symptom severity. I must be suffering from “impostor syndrome.”

Impostor syndrome was defined in 1978 by psychologists Pauline Clance and Suzanne Imes, who described it as a feeling of “phoniness in people who believe that they are not intelligent, capable or creative despite evidence of high achievement. [They] live in fear of being ‘found out’ or exposed as frauds.” 

While Clance and Imes were referring mainly to the work environment, impostor syndrome can apply across a wide spectrum of activities – including, it seems, health.

Impostor syndrome is surprisingly common. Harvard Business School professor Ann Cuddy, who wrote an entire book about what she calls “impostorism,” reports that an estimated 80% of Americans will feel they are impostors at work or in life at one time or another. 

In recent years, an increasing number of public figures have come out of the impostor closet. Neil Armstrong, the first man to set foot on the Moon, has said he felt like an impostor, which prompted another Neil – best-selling author Gaiman – to quip that meeting Armstrong made him feel better, “because if Neil Armstrong felt like an impostor, maybe everyone did.”

“Impostorism causes us to overthink and second-guess. It makes us fixate on how we think others are judging us,” writes Cuddy, “then fixate some more on how those judgments might poison our interactions.”

I’ve certainly felt like an impostor periodically in my professional life. My first major career trajectory was producing multimedia CD-ROMs. Back in the early 1990s, the industry was so new, we all were impostors of a sort, applying knowledge we brought from other disciplines and, mostly, making it up as we went along.

The best cure for impostor syndrome is time. The more you do something, the more competent you tend to feel.

When it comes to cancer, though, I’m constantly plunging headfirst into new territory. It was that way when I started chemo. It was that way as I watched my blood scores unexpectedly drop, and as I’ve carefully monitored my body for any alarming changes. 

While I’ve become more comfortable with cancer as my experience with the disease has grown, there’s one area where I feel like a perpetual impostor: death. 

“Are you afraid you won’t be any good at it?” my therapist asked during a recent session.

It seemed like such an odd question. And yet it makes a certain sense: I will never be able to get “better” at death over time. It’s always new, a one-time event with which none of us, by definition, can ever have any familiarity. 

For me, it’s not so much the being dead part – I’m pretty sure once I’m gone, I’ll feel nothing. Rather, it’s the transition, the moment of slipping from one state into an entirely unexplored one, that’s the source of disquietude. 

The only way to get past impostor syndrome around death would be to try it. But how? I’ve seen the movie Flatliners and it doesn’t end well. 

And then, an unusual opportunity – a stand-in experience of a sort – presented itself.

When my PET CT came back showing new tumors, my doctor ordered a biopsy to see what was going on. Because of the location of the tumors, the radiologist had to be exacting. I wouldn’t be allowed to move. The test had to be done under full sedation

As I lay on the hospital bed, IV in arm, a chipper anesthesiologist wished me “good luck,” before turning on the drip. I felt an unexpected warmth spread from my extremities to my lungs and then to my head as my blood carried the medication through my body. The only way I can describe it is as a great wash of yellow. 

As the smoggy haze descended, I felt myself panic. It was an instinct, an uncontrollable response. Despite knowing cognitively that I was just going to sleep for an hour or so, I fought back, as if I were drowning or being suffocated (although with my body paralyzed, there was nothing I could do).

The next thing I remember, I was in the recovery room, startled awake by the sound of what seemed like a thousand ringing cell phones all playing the boisterous opening theme to the evening news at full volume. 

That transition – the yellow haze and panic – is that what dying feels like? Do I now have a tangentially related near-death experience that can help temper my fear? Or, when the time comes, will I hold on with the same furious futility?

I don’t know. Nor will I be able to report back to you (hopefully many years from now). But, at the very least, I feel ever so slightly less like an impostor when it comes to that most unknowable moment in all our lives. 

I first wrote about Impostor Syndrome at The Jerusalem Post.

Poser image thanks to cogdogblog.

Tagged as: Ann Cuddy, Imposter Syndrome, Neil Armstrong, Neil Gaiman, Pauline Clance, Suzanne Imes