Cancer Diagnosis is Unexpected and Unforgettable

We have mentioned in 4.1 that non-neutral pattern for age-disclosure contained temporal orientation, which included time relative to the narrator’s life or memorable life events surrounding the event of receiving a cancer diagnosis. We have also mentioned in 4.2 that patient members provided the description of a sense of normalcy about their life prior to the cancer diagnosis. Moreover, they made use of positive descriptors to describe the satisfaction with their lives prior to the cancer diagnosis and emphatic adverbials to describe their counter-expectation of getting a cancer diagnosis. Chou et al. (2011) stated in their study about personal cancer narratives that the presence of temporal orientation and the description of a sense of normalcy in the cancer stories emphasize not only the narrator’s vulnerability and the randomness and disruptive power of caner but also the unexpected nature of the cancer diagnosis. Moreover, these linguistic features frame the receiving of cancer diagnosis as an unforgettable memory. According to this point of view, patient members in cancer board chose to describe a sense of normalcy and satisfaction with their lives prior to cancer diagnosis in self-introduction posting because the diagnosis

was very unexpected and unthinkable for them.

The occurrence of cancer diagnosis was unexpected because their life prior to the cancer diagnosis had gone very smoothly, for example, getting along well with people around and having a chance to study abroad (cf. Examples 5 and 6 in Table 4.6) and being like the dearest daughter of God, having a lot of parties to attend and feeling joyful about going back to hometown for Chinese New Year, (cf. Lines 2, 4 and 5 in Example 3.1). The receiving of cancer diagnosis was a big contrast with the life going smoothly and thus patient members were shocked. Apart from the shock being brought by the diagnosis, it even interrupted their original life. For example, before they got the diagnosis, they had gotten a promising job: ‘working as a software engineer in a foreign company’ (cf.

Example 4 in Table 4.6,) ‘found a job in famous fashion industry in London’ (cf. Line 3 in Example 3.1). However, the occurrence of cancer diagnosis forced them to stop working temporarily or even permanently to undergo operation or treatment. Because of the shock and interruption the cancer diagnosis brought to their lives, the occurrence of cancer diagnosis became a memorable event in their life. Furthermore, the contrast between cancer diagnosis and the normalcy as well as satisfaction with the life prior to cancer diagnosis highlights the difficulties for patient members to face their cancer diagnosis.

Apart from the contrast between cancer diagnosis and the normalcy as well as the satisfaction with the life prior to cancer diagnosis, patient members’ belief that there should be no risk or sign for them to get cancer diagnosis was also the reason for their difficulty in accepting the cancer diagnosis. We have mentioned in 4.2 that a sense of satisfaction with the life prior to the cancer diagnosis that patient members mentioned included healthy lifestyle, good physical condition, a promising job, good life and good educational background. Among them, the description of their previous healthy lifestyle and good physical condition highlighted the contrast between their belief and the fact of diagnosis.

They perceived that there was a low possibility for them to get cancer because they, for example, have no history of consumption of cigarette and betel nut, no use of medical resources (cf. Examples 1 and 2 in Table 4.6) and having been athletic (cf. Examples 3 in Table 4.6). Having healthy lifestyle and good physical condition are normally thought to be free from illness. Khan et al. (2010) also pointed out in their research on the association between certain lifestyle characteristics (e.g. exercise habit, the consumption of alcohol and cigarettes) and the risk of getting cancer that more and more people believe that lifestyle is related to the risk of getting cancer. Their research results also showed that a healthy lifestyle, such as, regular exercise, reduction in alcohol consumption and no use of cigarette helps to reduce the risk of getting cancer. Thus, it is reasonable for the patient members with healthy lifestyles and regular exercise habits to believe that there was no cause for them to get a cancer diagnosis. However, to their surprise, they got cancer diagnosis. The contrast between their belief that they were healthy and the fact of the cancer diagnosis results in their difficulty in accepting the cancer diagnosis.

Besides, good educational background is also the reason for their difficulty in accepting the cancer diagnosis. Eide and Showalter (2011) pointed out in their research on the relation between health and education that many studies have proved the positive association between higher levels of education and better health. Thus, we can presume that those who have a good educational background are normally thought to be distant from getting serious illness. One patient member with a master’s degree (cf. Example 8 in Table 4.6) mentioned that his/her doctor has said that ‘我這年紀跟學經歷得這病很少見 /it is rare for a person in your age and educational background to get this kind of illness.’

Therefore, it was hard for them to accept the cancer diagnosis because of the contrast between their assumed better health and the fact of getting cancer diagnosis.

In addition to a sense of satisfaction with the life prior to the cancer diagnosis, patient

members’ counter-expectation of getting cancer diagnosis also contributes to their difficulty in accepting the cancer diagnosis. People with family history of cancer are normally thought to have higher risk of getting cancer. The association between family history and increased risk of getting cancer diagnosis is also present in medical research.

Ziogas et al. (2011) stated in their study on family history of cancer that it is effective to figure out whether patients have higher risk of getting cancer by evaluating their family histories and those who have family history are suggested to have cancer screening earlier.

Therefore, it is reasonable for people without such a history to assume a lower chance of getting a cancer diagnosis or to hold the belief that they will remain cancer free, as conveyed through Examples 1 to 4 in Table 4.7 and thus, the membership in KDD cancer board turned out to be counter to their expectation (cf. Examples 5 to 8 in Table 4.7).

Because of the lack of family history of cancer and the unthinkable membership in cancer board, the occurrence of cancer diagnosis was unexpected to patient members as shown by the sayings from patient member L. After he/she stated his/her lack of family history of cancer (cf. Example 2 in Table 4.7) and the unthinkable membership in cancer board (cf.

Example 6 in Table 4.7), he/she further stated that ‘ 所 以 ... 這一切都來的好突然 啊!!!/so…everything came so unexpected!!!’ This sudden surprise caused them to have difficulty in accepting the fact of cancer diagnosis.

Maynard’s (2003) research on the news receivers’ responses toward good news and bad news pointed out that cancer patients step into a new world through the event of receiving cancer diagnosis (bad news) and the news disrupts the flow of their normal life.

In this situation, their sensory functions, like perception and retention, are unable to function normally so they cannot coherently integrate the information they receive.

Maynard (2003:12) terms this kind of phenomenon as ‘noetic crisis.’ Noetic crisis causes mainly cognitive disorientation as well as affective arousal from receiving bad news.

Therefore, even though bad news receivers have been introduced to enter into a new world, they may still stay in the previous old world, which thus results in difficulties in the realization of the news. For the patient members in KDD cancer board, the fact of getting cancer is like entering a new world. However, this unexpected bad news disoriented their cognition and thus they retreated to their old world of original normalcy and satisfaction.

Their description of a sense of normalcy and satisfaction was the proof of their retreat to the old world, while not yet wholly entering their new world. It is not easy for them to enter the new world not only because cancer diagnosis is a bad news, but also because it is extremely out of their expectation. The contrast between the new and old world also highlights the difficulties for patient members to face their cancer diagnosis.

The above is our discussion about the unexpected and unforgettable nature of cancer diagnosis for patient members. However, we believe that patient members do not merely have difficulty facing their cancer diagnosis, and some to the extent that they resist acceptance of their diagnosis deep in their mind. In the next section, we will further discuss this pattern from three aspects.