Just not a just world

There are two kinds of people. Those that believe life is fair (everything happens for a reason) and those who don’t (shit happens).

These differing viewpoints may seem like no big deal until you start thinking about the moral implications of belief in a just world. I suppose if everything is working out for you it’s a pretty convenient philosophy. However, if life has thrown you some major curves (such as a diagnosis of terminal cancer) than you probably don’t believe we all get what we deserve.

My own diagnosis of lung cancer left me completely gobsmacked. How on earth did a young, seemingly healthy woman who had never ever touched a cigarette (me) get lung cancer. And yes, I was struck by the unjustness of it all. I mean, why me?

Well, first of all, lung cancer in non and never smokers is nowhere near as uncommon as most people believe. Approximately 60-65% of newly diagnosed cases occur in former or never smokers.

Secondly, life is not fair.

However, most of us grew up believing in a just world, a well ordered place where sensible and good behavior was rewarded and risky or bad behavior duly punished. This viewpoint not only shaped our moral code, it lent us an invisible cloak of safety.

This philosopy is the very reason that those of us with lung cancer are consistently asked as to whether or not we smoked. The asker wants to be reassured that our lung cancer is the direct result of cause and effect. Of course they haven’t stopped to think about how this question will impact us. If the answer is yes, the implication is that we are the agent of our own misfortune. And if it is no, we are reminded once again of our extraordinarily bad luck.

Belief in a just world is the thinking behind the stigma associated with a diagnosis of lung cancer. Stigma is defined as ‘a mark of disgrace associated with a particular circumstance, quality, or person’. In the case of lung cancer, our diagnosis is inextricably linked to shame and a blame the victim mentality.

Which makes us all incredibly sensitive to any suggestion that cancer, and our disease in particular, is almost entirely preventable. ‘Helpless to Prevent Cancer? Actually, Quite a Bit is in Your Control‘ reads the catchy title of a recent article from the New York Times. The author, a professor of pediatrics (and therefore, I think, not an expert on adult cancers) makes statements such as this: ‘… you’d have to be living under a rock not to know that smoking causes lung cancer…’ Or this ‘About 82 percent of women and 78 percent of men who got lung cancer might have prevented it through healthy behaviors.’ The author makes a stab at empathy with this observation: ‘You don’t want to get into situations where you feel as if people don’t deserve help because they didn’t try hard enough to stay healthy’. However, the word deserve and that bit about not trying hard enough harkens right back to shame, shame, shame.

The way in which disease is characterized matters. Talking about lifestyle changes that can optimize health is always a good thing, but it is important to remain sensitive to the language that is used.

Calamity of all sorts and cancer in particular is often beyond our control. Nobody deserves lung cancer, whether they smoked or not. But sometimes, shit just happens.


13 responses to “Just not a just world

  1. Right on, Linnea. Beautifully written and right to the point. I found out two weeks ago
    that my original bilateral lung cancer has returned in both lungs. After lower left lobectomy, targeted radiation, and oral chemo( Tarceva) in 2011, I have been cancer free although with multiple GGOs. Anyway progression is minimal and hopefully slow growing. The docs at MDA in Houston have assured me that when the time comes for further treatment, there are several out there.
    I tell people upfront,when they ask about my cancer, that I never smoked, and most of them are shocked and immediately want to know how I got it. I probably was in that group before lung cancer came calling. I surely was shocked at the diagnosis.
    Keep up the good work. You are my role model.

    • Mary, I am sorry to hear you are experiencing recurrence but happy to hear that it is minimal, slow and with treatment options—all good things.

      xo Linnea

  2. Theresa Smith

    Thank you thank you thank you. I am constantly reminding people who ask me this question : ‘did you smoke?’ that I did not deliberately give myself cancer!!!!! I am reposting your blog to my FaceBook time line to remind people again. I hope you don’t mind.

    • Of course not (the don’t mind part). Sadly, people need to be reminded again and again and the medical establishment doesn’t help when they perpetuate this sort of thinking. There should be no blame—it just isn’t helpful.


  3. Great job Linnea. Imagine walking up to the overweight heart-attack victim and questioning them about their red meat consumption. Our society needs to learn more about compassion. Sherpa

  4. Karen Arscott

    So well said – thank you my friend!

  5. Many Smilez Shellz

    Love Love Love the post today Linnea. I am still one of those that believe everything happens for a reason with the twist of sometimes the reason BITES! The stigma with Lung Cancer is particularly harsh but I have even experienced it when telling others that the cancer is now in my kidneys. I don’t think there will ever be an easy way to answer the ” How did you get it? ” question.

  6. As a former smoker I can tell you that my intent was not to kill myself. But God seems to have a sense of humor as she allows me to remain a smoker in my dreams! That said, I’ve a few things I’ve learned in my almost 11 years since diagnosis. What I know to be true is:
    * Not all smokers get lung cancer. In fact, the majority of smokers don’t get lung cancer.
    * If you’re a smoker, or a former smoker, AND you’ve exposure to asbestos your chances of getting lung cancer increase by 5,000%. That’s 50 times more likely than a just smoker.
    * If you live in the midwest there’s a pretty good chance that you have radon exposure, and that you’ve had that exposure your entire life.
    * If you’re a veteran your chances of getting lung cancer are greater than if you never served.
    * If you served in Vietnam your chances are even greater than those who served elsewhere – but I’m betting that as our vets from the current wars continue to age we’ll find increased incidences in that population too, and that it will be tied to oil fires, depleted uranium and a host of environmental exposures.
    * If you own birds (parrots and macaws) you’re at increased risk of lung cancer.

    My personal diagnosis – according to the VA – is asbestosis with complications of lung cancer and COPD. Isn’t that special?

    Bottom line – to me – is that if you’re breathing you’re at risk of lung cancer. And I dare anyone to tell me that they’re immune.

    Love you dear. Keep up the good work, and STAY LOUD!

  7. Great post as usua Linneal. Have been confronted with this just this week. A colleague has been diagnosed with lung cancer. I told my wife and she asked did he smoke?. I discussed it with another colleague who said he was shocked because the other guy had never smoked. So what?? Even if he had smoked did he deserve to have lung cancer. Of course not. The stigma is stifling. I smoked for years, stopped and 10 years later was diagnosed with metastatic lung cancer. Do I deserve this? Is it my own fault.? I think not. Shit happens. Always believed that. Am still insulted by implication from others, (close others) that I brought this on myself. Thanks for the post. A lot of food for thought. Can think of a lot of people who could benefit from reading it and will forward to them. SHIT does indeed happen!!!!

  8. HI Linnea….I SO APPRECIATE your post. I have forwarded it to my entire contact list…and I’d like to include it in my blog (you as “guest poster?”) – “Dancing through Cancer” – o.k?
    It seems that no matter how often we tell others that we have lung cancer, we are asked if we ever smoked. (and if they don’t ask, you know they’re thinking it)… WHY IS IT that we can’t seem to change that perception? With this post you certainly help change it. THANK YOU for continuing to advocate for those of us with “non-smokers lung cancer.” If the perception is changed then there will be more money for research and treatment! (we hope)
    And it is also important to point out that smokers don’t deserve the stigma anyway! Everyone in my generation smoked and didn’t know the link with cancer. Why aren’t we blaming the media and the tobacco industry for their addiction?
    No one needs to be blamed personally for getting any kind of cancer!
    Let’s start blaming the media, the food industry, our legislators, etc. for obfuscating cancer prevention strategies, and then force them to take action for policy and marketing changes!

  9. Pingback: Just stop saying it | DEAR MAIZIE

  10. I commented on this post, but my comment was long, so I’ve published it on my blog.

  11. Ginny O'Brien

    Linnea, My friend Laurie Geary forwarded your recent post to me and I just want to say THANK YOU for making your voice heard and reminding everyone that shit happens. Ginny O’Brien

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