In recent years, cancer has become more and more youthful. In 2020, a paper published in the Journal of Clinical Oncology clearly pointed to this trend. The results of the study of young people aged 15-39 showed that the incidence of cancer among young people of all ages increased in the decade from 2007 to 2016.
Many young people have to "bring cancer to work". The complex and brutal reality is that they are burdened with the boulder of cancer treatment costs, and many patients are old and young, and their responsibilities to themselves and their families are entangled, making them dare not stop.
They are unable to shrink their world and be disconnected from society to a certain extent, as they do in older patients. They must squeeze out space in the workplace.
What obstacles and invisible discrimination may a young person suffering from cancer suffer in the workplace, how will their interpersonal connections change in life, and how can they overcome the long period of loneliness and shame?
More essentially, cancer cells are like a bomb hidden in the body, changing the scale of life and changing the way a person sees the world.
"Health News Consultation" chatted with three young cancer patients. Here are their stories:
"Sooner or later, we have to succumb to reality"
Like his peers, Chen Chen went through a difficult job search period. Being a cancer patient has added a lot of difficulties to her.
Last summer, she graduated from a major university in Beijing. Many of her classmates have moved into the cubicles of financial institutions and Internet giants with resumes full of names from large companies.
Chen Chen didn't have this stepping stone. At the age of 18, she was diagnosed with breast cancer and had a total right mammectomy. During her years in college, her time was cut off by going to school, seeing doctors, and tutoring. She also followed the trend to go to a big factory to Xi, and resigned after not long. The reason is very simple, the actual Xi salary of a large factory is 100 a day, and the salary of a tutor is 14 for an hour. Her classmates persuaded her that Xi was actually to accumulate experience. The cost of treatment was pressed on her body, and she thought, what is the experience, what I want is money.
But she also can't do it as "rolling" as many of her peers do - the body can't bear it. Not working overtime is the most important thing for her when looking for a job. After graduating, she worked for a well-known consulting firm. Overtime is a daily routine, and the difference is only in the number of points it can be added to. Occasionally, if she takes a leave of absence due to physical reasons, she will definitely be called by the manager the next day to talk about it, and her performance will be given a low score.
After working overtime until 1 a.m. for many days, it was the middle of the night, Chen Chen walked out of the company under the manager's angry glare, and soon proposed to resign. Now she works for a Japanese company, and the culture of a Japanese company is more humane, even if it is only superficial. With a monthly salary of several thousand yuan, she is quite satisfied, as long as she finds a job, as long as she has money.
After all, the current job search season can be called "hellish" for people suffering from cancer. When cancer hits, many doors in the workplace are closed.
The first thing that is certain is that the "iron rice bowl" will not be served. Article 8 of the "Standards for Physical Examination for Civil Servant Recruitment" clearly stipulates that malignant tumors are not qualified. For most companies, discrimination against cancer has become the default rule, and recruiters and candidates alike are aware of it.
For normal people, it is just a formality, but it is an insurmountable obstacle for cancer patients. Chen Chen revealed that in desperation, some patients went online to buy fake physical examination reports, and some people rushed to the institutions that organized physical examinations.
In recent years, more and more young people have been hit by cancer. A paper published in the Journal of Clinical Oncology pointed out that cancer is trending at a younger age. The results of the study showed that from 2007 to 2016, the incidence of cancer in all age groups under the age of 40 continued to increase.
The suffering of illness does not discriminate at any age. But unlike older patients, young people are not able to leave society even if they have cancer. They have a longer life, more complex and realistic pressures, and must squeeze out the cracks in the workplace.
People with different work qualifications encounter different difficulties. Chen Chen wanted to pry open the closed door of the workplace. More patients are diagnosed with cancer while working. Some of them have accumulated years of work experience, are team leaders, and are executives. When they return to the company after treatment, they have to deal with a huge gap in the workplace environment before and after they get sick.
Zhou Lu, who was diagnosed with rectal cancer four years ago, is an accountant. After working for many years, her business ability has been recognized by the company, and she has also been entrusted with a lot of transactional work. At the end of the two-year treatment period, she hurried back to the company, only to find that she had suddenly become idle. The leader was very polite, but every word of care for her body seemed to imply that she had little hope of being promoted in the future.
Li Yang's once meticulous career plan was also disrupted by cancer. She worked as an HR at the head office of a bank, and before she was diagnosed with breast cancer, she managed a large team. After the treatment, she went to several Internet companies for interviews, but every time she reached the final link, she "couldn't take this leg" because she knew that she had so-called pre-existing conditions and it was difficult to pass the physical examination. She hasn't updated her resume for a long time, and her imagination of life in Dachang has become a distant memory.
Not only that, but she had to face a boss who became more demanding. The work I used to do is now often picky, "I don't have enough of this, and I don't have enough detail." She doubted her abilities because of this, and finally realized a cruel truth: the leader knew that there was no way back for her.
A series of events that followed confirmed her judgment. The company adjusted its structure, and the leaders added a large piece of work to Li Yang, but did not send her additional manpower. When the reserve cadres were selected, she was unexpectedly defeated. The low score in the performance appraisal at the end of last year was another blow.
She remembered the moment when she "saw the poor dagger". During a meeting, she took leave early because she was unwell. Listening to a colleague, as soon as she walked out, the leader said, "Sooner or later, you have to succumb to reality." ”
No one knows better than cancer patients how cruel the workplace can be. They have been unwilling, and most of them have had a strong desire to leave. But in the end, they can only convince themselves to accept the status quo.
Don't dare not work
Even if there are many unfairness in the workplace, cancer patients must hold on to this straw. The first and most important reason is that the cost of cancer treatment is too heavy.
A relative once advised Chen Chen not to work and to take care of his body at home. She felt funny and helpless: if she didn't work, where would she get the money to support her body?
In the face of this boulder, not every patient has financially sound families who can provide support. Chen Chen grew up in a single-parent family and lived with his mother. During the treatment, the medical expenses alone cost 150,000 yuan, and the mother's savings in the family were just enough. In addition, there is a large cost of living. Her mother traveled from her hometown to Beijing to accompany her to see a doctor, and the rent was close to 5,000 a month.
In those two years, Chen Chen worked almost every day, and even went during chemotherapy, "because he was really short of money."
Even if you have worked for many years, have a stable income and a savings, once you are diagnosed with cancer, your life will be turned upside down in an instant.
36-year-old Zhou Lu sometimes wonders how life has come to this point. After getting cancer, she didn't dare to work a lot, and the biggest thing she didn't dare was not to work. Her husband's income is not high, and her parents are retired and living on pensions. She can't get rid of the financial burden of her family.
She didn't dare to think about how much money she had spent since she got sick, and the basic treatment fee was hundreds of thousands, not to mention the cost of nutrition and nutrition injections. She didn't dare to think about how much it would cost her afterward. The doctor said that based on her current condition, she may need to use a targeted drug in the future, at least 10,000 or 20,000 a month.
She didn't even dare to think about her age. Her peers around her are working hard to earn money, and she spends money like running water, in the words of a friend, she worked so hard before, and all the money she earned was handed over to the hospital. At the same time, there is no hope of promotion, and salaries hit the ceiling. Every time she thought about it, her pressure increased dramatically.
And when a person has children, the burden on his shoulders becomes more concrete, and he is even more afraid to stop.
Zhou Lu originally had a loose personality, but the birth of her daughter completely changed her. She suddenly realized that she was a mother and that she had to take responsibility. Over the years, Zhou Lu has taken care of her children while working, and has also done a small business with her friends, and she will not sleep until 12 o'clock at night every day, all year round, even during confinement.
The moment she learned that she had rectal cancer, Zhou Lu "couldn't cry when she cried" and was stunned. But sometimes, she looks at her children and feels that life doesn't seem to have changed much. She takes care of the children's food, clothing, daily life, tutors homework, and is still busy. The so-called Meng's mother moved three times, she always wanted to give her children a better educational environment, so she needed a house with a better location. She can't think about this problem, she is anxious when she thinks about it, she is anxious that she does not have enough savings, and she is also anxious that she can't afford the mortgage, how can she stop with the capital?
Several of Zhou Lujia's patients are mostly women, and many of them are mothers. When they encourage each other, the most common thing they say is, "You must be strong, you must be strong to protect your children." ”
"It is the age of the old and the young, and you can't be decadent. Zhou Lu emphasized, "It's all responsibility." ”
Two bombs: recurrence and shame
Bringing cancer to work is like carrying a bomb with you. The first is the recurrence and metastasis of cancer.
The end of treatment is not the same as a cure. The former only means that the cancer at the lesion site has been removed, the condition has been relieved and controlled, and it is in a relatively stable state. The criteria for clinical cure are much higher, requiring patients to survive for more than five years after treatment without any signs of recurrence. Even if a patient survives for five years, it does not mean that they can rest easy. Recurrence and metastasis are like a sword of Damocles, hanging over the head of cancer patients all day long, making them panic.
So far, Zhou Lu has been hit three times by this bomb. The first time was the hardest. A test just two months after the surgery showed that the tumor had metastasized to the liver and had grown four. When she learned the news, Zhou Lu was almost desperate. She asked the doctor why, the lymph nodes were not cleaned during the operation, and the doctor could not give an answer.
Two more metastases followed. In the past two years, every time she heard that the indicators were not good, her heart hung up. It's been four years since I was diagnosed, and the cancer can't be broken again and again, like a monster that can't be finished and can't be done, just after being beaten away, life finally regained a little calm, and it came again. Zhou Lu was exhausted.
Zhou Lu is being treated.
There is also a bomb that is shameful, silent, but just as unignorant.
Living in a small city, Zhou Lu felt as if she had a "cancer" word on her face, and the eyes of others looking at her became different. Acquaintances will always ask her more when they see her, how is her health recently, and she feels uncomfortable when she hears it, "I talk about cancer every day, and that word is very scary." ”
When she first returned to the unit, Zhou Lu couldn't sleep all night, often had panic attacks, became irritable, and lost a lot of hair. When she went to the hospital, she found out that she was suffering from anxiety.
A significant source of anxiety was in her – she lost her anus. When she was first diagnosed, the doctor told her that the tumor was very close to the anus and that she was considering removing the anus. She tried preservation and increased the number of chemoradiotherapy to do so, which was followed by a rapid weight loss and severe pain that was barely relieved by taking a lot of painkillers.
But the anus didn't save it in the end. Before the operation, the doctor asked her to choose by herself, to save her anus or to save her life. On the other side of the balance is life, and she can only give up her anus. The doctor pulled out a section of bowel and sewed it into her abdominal wall, leaving her with a permanent stoma on the left side of her belly button and a daily stoma bag to collect excrement.
There is an extra stoma on her body, and Zhou Lu's nerves are tense all the time. She didn't dare to exert herself, so she stopped carrying heavy loads. She was also afraid of squeezing into the stoma, so she never wore tight clothes again.
To make matters worse, her bowel movements became irregular, and she couldn't control the time and place. She may be in a meeting, she may be giving a presentation, she may be eating, and she may be having a bowel movement at the same time. Although the number of times a day is not particularly much, there are times when she does not handle it well, and it will leak air or smell. She felt inferior and depressed, but she didn't know who to talk to.
There are also people who actively choose not to be "invisible". Many breast cancer patients do breast reconstruction after treatment, but Chen Chen does not, and she can't find a reason to do so. This is not an easy decision to make. Everyone advised her: do breast reconstruction, it is for your good, your quality of life will be higher, and you will be more confident. The family said so, the lover said so, and the attending doctor said so.
Chen Chen was not shaken. The mutilation of the body may seem terrible in the eyes of others, but she doesn't care about it herself. She didn't live for others to see.
Solitary, invisible
The most hurtful thing is often not institutional discrimination, but the incomprehension of those around you. It is difficult for healthy people to truly empathize with all kinds of pain after illness.
After getting sick, Li Yang only took three months of sick leave. She considered quitting her job to support her body, but her parents strongly objected when they heard it, how could she not go to work, and what if she didn't have social security. Her parents both work in the system and think traditionally, and in their eyes, Li Yang's bank head office is synonymous with stability and decency, and such a good unit can be retained.
For work, she quarreled with her parents many times. Earlier this year, after another heated argument, her father asked her to go to the mental health department. She went, did a full set of psychometric tests, and the results showed that everything was fine. Li Yang can only slowly practice Xi isolating his parents' voices, "They are people with a strong desire to control, there is no way." ”
What makes cancer patients even more chilling is the disgusting gaze of family and friends. In the feudal concept, if a person suffers from cancer, it is considered to be contaminated with bad luck and becomes a symbol of bad luck.
Chen Chen's grandmother cared about her, but since she fell ill, a thorn has grown in her grandmother's heart. She felt that Chen Chen had lost her face, dragged down the family, made her look down on her neighbors, and made her unable to show off in front of her friends in her life.
There is also a good friend she has known since childhood, knowing that her attitude has changed greatly after she is sick, and she lives in one place, but "she can't call it out". Years of friendship have cooled down. She understands in her heart that people nowadays are all upward socializing, and if you are sick, people will think that you are a useless person.
Disliked by his family and alienated by his friends, Chen Chen would "pull inside" at first and couldn't think about it. Cancer is not an infectious disease, and she is not sick because she has done something bad, so why should she be treated like this?
Later, she realized that unless she had a similar experience, it was difficult for others to empathize with the pain of cancer. This year, the father of a friend of hers was diagnosed with stomach cancer, and after the friend was busy alone, he felt the great pain that his father endured when he was sick, and later sighed to her, and now I know that it is not easy for her, and it is so difficult to fight cancer.
Sometimes, social discrimination against cancer is wrapped in a "good for you" veneer.
In his junior year, Chen Chen got the qualification for the insurance research institute. The counselor advised her to give up, citing the pressure of graduate school and not for her. She wanted to ask rhetorically, if she was not suitable for graduate school, would she be suitable for the life of 996? But she didn't want to make an ugly fuss, after all, the counselor had helped her a lot in the four years of college. In the end, she signed a letter of commitment to give up the insurance research.
This "care" permeates the daily lives of most patients. When the medical history is known to others, they are sympathized and pitied, and at the same time, they are also isolated from normal human life.
In order to be considered normal, patients must first adjust their self-perception. Some patients will have a "glass heart" after returning to work, and take it for granted that they should be taken care of, Li Yang does not agree with this mentality, after all, the company will not lag the progress of the business because of caring for individual employees. After returning to the unit, she doubted her own ability, but she saw that she could do what other colleagues could do, and she could do it well, and her self-confidence gradually recovered.
A colleague from the company said that he would try his best to take care of Li Yang, who returned to the unit.
The desire to return to the normal world makes the disease a secret. In Chen Chen's company, no one knew that she was sick. The routine prescription of medication once a month was a nuisance, and every time she asked for leave, she had to rack her brains to make up reasons, and the thought of this gave her a headache.
Keep this secret because it is "not necessary" and because it is "useless". "After all, you have to climb out on your own in the end. Chen Chen said.
When life can't be planned
After cancer treatment, most patients need to have a follow-up examination every six months. The scale of life has since changed.
Long-term career planning is no longer realistic, and has been replaced by a sense of worry. Li Yang gave up his plan to switch jobs to a major Internet company, but banking is not a sunrise industry.
Li Yang knew in his heart that he had to find a way back for himself. She had posted several blog posts about treatment on Xiaohongshu, but she didn't expect to receive many likes. She realized there was room for money. In the past two years, she has passed the third-level public dietitian certificate, learned to operate, practice copywriting, and make up for various professional knowledge.
It's not a good road, but at least she's on the road. Li Yang calculated that if she retired and went home one day, she still had a skill that could support herself and her children.
The disease has also changed the concept of money. Influenced by the female elders in the family, Li Yang's biggest hobby is buying clothes. After getting sick, she took out all her clothes and told herself, that's all, she can only throw them away if she really wears them out and washes them.
Whether it's trying to save money or having fun in time, more people are swinging between the two options.
For example, Chen Chen. Most of the time, she can save on food and clothing. In Beijing, she didn't want to spend most of her salary on renting, so she found another way to live in a hostel, so that even if she lived in the bustling area of Chaoyang District, she would only need 70 yuan a night. But sometimes she's reluctant. She likes to watch movies, and the price of a movie ticket can range from forty or fifty yuan to eighty or ninety yuan, and she rarely hesitates to pay.
Her small goal is $100,000. As for when it will be realized, Chen Chen decided to "let it be".
Life is a stage full of ambition, and it is not easy to achieve peace when you suddenly encounter a catastrophe.
In order to alleviate anxiety, Li Yang joined several psychological companionship camps, and "energy" became a high-frequency word in her life. Everyone in the WeChat group praises each other, which is called "blessing energy" by the "body, mind and spirit" colleagues. When she meets a new friend, if she finds that the other person's "positive energy" is low, she will take the initiative to reduce contact.
This summer, Li Yangtuo's friend asked the master to calculate a astrolabe and wanted to know when he would be transferred. A simple message was sent from the other side: 2029.
Later, in many moments when she felt anxious, she would think of the astrolabe that heralded the distant future.
She comforted herself, "Anyway, we have to wait until 2029, and now it's all an accumulation period, so there's no hurry." ”
When life lasts for half a year, the important and the unimportant find a new coordinate.
Sometimes thinking of the abrupt end of her career path, Zhou Lu feels discouraged. At such times, she thinks about the countries that have experienced war, where countless women and children have been displaced and even tortured and killed, but she feels that she should be content to live in a country without war.
She taught her daughter that there will be too many accidents in a person's life, and it is already a great ability to live healthy and safe to old age. In the past, she hoped that her daughter would score more than 90 points in all her homework, but now, she will let her daughter exercise more and go out to play.
Zhou Lu and her daughter in the dragon orchard
The same is true for Li Yang, whose focus on children's education has shifted from the pursuit of high grades to the cultivation of a sound personality. She hopes that her son will become a person who can communicate, have a sense of responsibility, and can face life's setbacks correctly.
In the small garden downstairs at home, Li Yang can always see several old people gathering together to cook homely, shaking a fan in summer and wearing a woolen hat in winter, and the topic is nothing more than the dishes cooked today and the TV series he watched last night.
In the past, she would only pass by in a hurry. Now she often stops unconsciously and sighs, this kind of life is really good.
(At the request of the interviewee, Chen Chen, Zhou Lu, and Li Yang are pseudonyms.) ）
Author's postscript:
Cancer invaded Chen Chen's life when she was 18 years old. Inevitably, she thinks more about life and death than before, and is more likely to feel sad. But at the same time, the cruel fate also reshaped the scale of Chen Chen's view of the world, sculpting her into a softer person. This is the real mark of cancer in her life.
I can't forget what Chen Chen said when he first met me. That day, as soon as she sat down, she threw out the question, "What is death to you?"
She quickly asked herself, "For me, death is the smell of a person mixed with potions and body fluids, death is countless CT films and pathology reports, death is a doctor's sigh, death is social discrimination and family incomprehension, death is the end of becoming a person I don't know." ”
"In your world, death may be an abstract, distant concept, but for me, death is so figurative, it follows me like this. ”
She sighed, pointed to the scented candle on the table, and slowed her voice, "My life is like this candle." I knew it was going to burn out, and even what every moment before it burned out, I can imagine. The question is, once a person knows the shape of death, how should he spend the rest of his life?"
How did this girl who calmly talked about death manage to dispel the cruelty of fate, how to be sad but not sad? Those cold eyes and discrimination that have been experienced have tempered a softer heart.
Chen Chen admits that before her illness, she lacked real compassion for the disadvantaged. It's different now. For example, when she walks, she will pay special attention to observe the blind road, and if she notices that there is a problem with the design of the blind road, whether it is a broken road, or if she finds that the blind road is occupied, she will immediately call 12345 to report.
"Only when you become a vulnerable group can you truly understand other vulnerable groups. We are all weak people under the current social structure. Chen Chen said.
It's just that the moment when she pokes her head out to care for the world is like a comet streaking across the night sky, and more often than not, she has to bury her head in dealing with the pain and struggles in her life.
As we approached our parting, we walked into the subway together, and indifferent faces slipped past us.
"Sometimes it feels like my life is like a pool of stagnant water. Chen Chen's voice was low.
She immediately laughed at herself, "Why didn't you think about this kind of problem in the first two years, I just thought about how to live." It's still too idle, and life is too good. ”
In silence, two subway trains arrived almost simultaneously. We went in opposite directions, and she waved goodbye to me.
Chen Chen is in Qinhuangdao
(Originally titled "When Young People Go to Work with Cancer")