I can’t decide what is the most apt metaphor for cancer. Currently, I have two ideas at the top of the list. One likens having cancer to living on an island in the middle of a vast ocean, an island that can only support one person. People can visit you, they can send supplies, they can wave at you from boats. But no one else can live on that island but you. That’s one idea. It is good at describing the emotional state of a cancer patient but it doesn’t communicate all of the collateral damage.

Cancer doesn’t happen to one person, one time. It is a thing that happens over and over and over again. The effects are life-long and are not confined to only the cancer patient. The island metaphor works but isn’t great. I woke up in the middle of the night last night with an idea, another metaphor. I scribbled it on one of the index cards I keep on my bedside table and I went back to sleep. And then, the idea came again, in the early morning and got me out of bed.

Cancer is like a car accident, but not any accident. It is like one of those epic chain reaction car accidents on the interstate which leaves traffic paralyzed for hours. It makes headlines. It is the kind of thing almost any person who lives in a developed nation has experienced on some level.

There is the instigating incident, the first accident, someone hits their brakes or does a too quick lane change and boom, there it is. It’s ugly, horrible, maybe a semi-truck is involved. That wreck, that first one, the lives of those people will never be the same. That’s the person with cancer.

The secondary wrecks begin, every car around the first wreck, they break to avoid the first and bumpers start crunching. Air bags deploy. There are some hard hits. Some of those people, their cars are totaled, maybe they wear a neck brace for months. Those are the people closest to the cancer patient. The people that love them the most. They witnessed the horrible accident and could do nothing to avoid it. They suffer because of the accident. But they are going to walk away from it.

As the waves of disaster move out from that first, possibly fatal wreck, to the third and fourth levels, the damage begins to lessen. The damage gets less severe. Those people, they can see the wrecks, they can see the horribleness. Maybe they run to see if they can help. They know it is bad. After the adrenaline dissipates, they may think about the delay in their schedule, how this other thing is going to negatively impact their day. But they wouldn’t run over to the bodies laying in the road and complain to them about the inconvenience.

There are the responders, the police, the first ones there, trying to manage the scene. Who is alive and who is not? The firefighters and the EMT’s, the ambulance drivers. The guys who have to wash the blood off the pavement. All of those people have trained for the job. They see something like it often. It doesn’t mean the images won’t stay with them the rest of their lives. It doesn’t mean they won’t always remember the name of the victim they cut out of the car. The ER staff, they will work hard and sometimes they will know, even as they are working, that it is a futile situation. But it doesn’t mean you don’t try.

And it keeps moving out like that, the chaos and the damage, until it gets out to the driver, stuck on the interstate, between exits, with nowhere to go. It keeps moving until it gets to the asshole who can’t see any damage, doesn’t know what’s going on. All they know is they are late to a meeting and they have to pee and if they are stuck in traffic for an hour, there had better be a dead fucking body up there and not just a bunch of assholes rubbernecking.

The metaphor can go on and on and on and on. But that is the nut of it.

In that long, long, long, trail of chaos, no one person had the same experience of that accident as any other person. It effected each person in a unique way. But it effected no one the way it did the person at the center, who, if they live through it, can only stare out the window of the ambulance, awed at their own survival and look at all the ruin and hope no one hates them too much for ruining their day.