Scanxiety
Tips for Riding the Roller Coaster of Test Anxiety
I adjust my shirt as I strut with brisk—no officious—steps from the parking lot to the radiology office for my first Pet scan since the breast cancer treatments, like a professional late for a business meeting. It’s the end of 2019 and a long battle with a recurrence. As I shove the door to the building, a flashback to another door reactivates, the door to the Tarzana Hospital where I am about to have my first breast biopsy in 2002. That defiant door depression, fueled by the impression I am wasting the doctor’s time, has an air of invincibility. My brain gathers up other pictures from the “denial” folder before I realize what’s happening: My snappy stride belies anxiety and fear. The body knows something the head denies.
We’ve all experienced the roller coaster of test anxiety, and medical tests are no exception, though perhaps more nerve-wracking and serious. “Scanxiety” births two unhealthy offspring: to control or be controlled, denial or acquiescence. A healthier outcome is needed. Switching to a clothing metaphor, denial is dressing for success in business attire, which confers control and empowerment. This coping strategy is the fruit of hardship, and it has its rewards, if not taken too far. I’m keeping life normal and exercising control over what I can manage. I decide there will be plenty of time to deal with bleak news, so why ruin my fun now? I carry on confidently until my anxiety pushes through, like a mouth revealing contempt. This is what happens in 2002 when I receive my first dose of a chemo “cocktail”—the Red Devil (Adriamycin)— and I faint. My anxiety breaks through the mental dam. It’s scary to lose control of your resolve to keep things calm. The downside of denial is a stoic disconnect from the self where the emotions find an unconscious release. That’s when I need a change of clothing.
Another option is putting on dark funeral attire by imagining the worst-case scenario and immersing oneself in what ifs. People whose default mode is acquiescence may be more honest and connected to their emotions, but they are also more noticeably controlled by fear. A month before the Pet Scan, I undergo a different scan for colon cancer due to persistent intestinal issues. As I ponder the dark possibility of two primary cancers, I consider the things I would miss: the smell of rain on a dust-caked path, my granddaughter lifting up her arms to be held, fast cars and motorcycles, the family at Thanksgiving, velvet pants, a thousand pleasures of this embodied life. These thoughts make me so depressed that I change back to business attire. I can’t dwell in the land of what ifs very long. Thankfully, this time both scans are negative, and I have a new lease on life.
What’s a better way of riding the roller coaster of test anxiety? Every year, when my youngest son, Nate, was still in school, we would celebrate the end of the year at Six Flags Magic Mountain, roller coaster heaven. The annoyance of hour-long waits vanished after the adrenaline rush of 30 seconds of raw thrill, a perfect price to pay for epinephrine saturation. I felt intensely alive during those seconds. There’s a trick to riding a roller coaster: go with the flow and scream. You can’t be rigid. You have to ride it and scream to release the fear—and increase the delight. Fear is a close cousin of delight.
The trick to riding test anxiety is similar, surrender and scream, trust and feel. It’s an intense ride. I remember the first time read bad test results from a biopsy. My world became those words, which cut through my denial and stripped off petty concerns. Priorities came into sharp focus in an instant. There’s an intense focus, a clarity, a grounding— like some people feel when they help in crises and emergencies. The focus stays with you for a long time, and you don’t want to lose it. It helps you surrender.
I learn more about surrender from Brittany, a 29-year-old former student familiar with test anxiety. I feature her story of her second bone marrow transplant in my blog post “Even Then” https://lifeafterwhy.com/blog/even-then-inspiration-on-911-from-a-young-woman-facing-her-second-bone-marrow-transplant. Her descriptions sting, but her wisdom as a roller coaster rider heals:
“I’ve always had test anxiety, especially with standardized tests in school. I’ve taken my SATs and LSATs more than once because of it. I’m sure everyone does to some extent, but medical exams are their own beast. Worst case scenario for a standardized test is an F or retake. Worst case on a medical exam could point to literal death. I don’t say that to be dramatic (although if you ask my husband, I generally am). I say that to really give perspective on how this type of fear is so different from other kinds.
It’s not something I wish on anybody. The fear. The despair. The waiting what feels like forever to actually be told the results. The dreaming up of the worst-case scenario while trying to bargain with God, promising Him you’ll be more X or do more Y if He just makes the results positive. All of these negative thoughts and emotions swirling in your brain, while also trying to remain as upbeat and positive as possible. While also trying to go about your “regular day,” if any semblance of regular even exists in your life anymore.
Talk about exhausting! So how do I deal with it every few months?
It is by no means easy, but I find peace in the surrender. Truly accepting that my situation is out of my control and, most importantly, was not caused by me. I think cancer patients often blame themselves for getting cancer in the first place. ‘If I had just eaten less sugar or worked out a little more consistently, maybe I could have avoided it.’
The reality is, a lot of cancers are genetic, or the cause is unknown. I could drive myself crazy always trying to figure out what caused the cancer. For goodness sake, there are THOUSANDS of scientists who dedicate their entire life's work to just trying to figure out what causes a singular type of cancer and I'm sitting over here trying to Google my way to an answer?
I believe in being a positive person, but I think it's equally as important to allow myself to really feel the hurt - feel the upset and to know that those feelings are valid and okay. If someone asks how I am doing, I’m not afraid to say, ‘You know, not great but I’m okay with it.’ It’s okay to feel the negative feelings as long as you don’t let them consume you completely.
Cancer has given me numerous bad things. And yet, it's also given me some great joys I might not have experienced otherwise. It's connected me to old friends and new ones. It’s shown me relationships not worth putting my time into anymore. It's given me another support group living in a city away from my hometown. It's given me the encouragement to be more understanding of others and to help out in any way possible.
It’s reaffirmed what I believe spiritually. I don’t know how people go through this type of life event without the presence of spirituality in their lives. It reminds me of Proverbs 16:9, ‘In his heart a man plans his course, but the Lord determines his steps’ and Psalm 37:23-24 ‘The Lord makes firm the steps of the one who delights in Him; though he may stumble, he will not fall, for the Lord upholds him with His hand.’
You can’t find peace by excessively planning or trying to control this thing or how it will affect your future. Trying to control the uncontrollable is a form of disbelief. Allowing your mind to make multiple plans is a recipe for disaster when something takes those plans even slightly off course. Just when you think you’ve made a roadmap for every possible scenario, something unexpected occurs and brings all of the confusion on again. By bringing God all of my hopes and fears, I can turn from a path of planning to a path of peace (although I’m only human and will still make plans in my head).”
Surrender orders Brittany’s anxiety like raked rocks in a Zen garden. This is the balancing act of faith and fear.
Brittany writes this as she awaits test results from her second bone marrow transplant to be delivered on Christmas Eve. Christmas is her favorite time of year. She is buoyed by the decorations and parties, but she can’t silence the background groan of the terrible. Her Advent anguish pierces my heart.
On December 27, this email greets me: “Merry Christmas! I have great news! My 100-day scan was completely clear! HUGE relief.” She has a new lease on life. Five months later she’s enrolled in an MBA program, gets a puppy, and buys a house. She’s now clothed in a princess dress and tiara.
Fast forward to the Corona virus shutdown of medical procedures deemed elective. Brittany waits two months for her second belated scan and has to wait even longer now. Each scan is like a Chinese college entrance exam with only one chance, only much worse. High stakes. I tell her I’m posting the reflections she generously shared on test anxiety next week. She is struggling to find surrender again. She rereads her own words and is helped, but fear is a mosquito bite craving another scratch.
Fears, halts, stops, starts, celebrations, dreams, decisions, fears, halts, stops, waits. Lots of waiting. Lots of clothing changes. It never leaves, the anxiety, the fear.