Blooming in the rain

On a rainy day

the sky stained grey

the storm roars

the wind blows

the thunder is louder

the fear is greater.

I tremble.

It’s cold

it’s dark.

I dread

I’m weary

I’m lost.

I cry

I scream

I collapse.

My heart is weak

my anguish at a peak,

but as love flows into my veins

I can overcome the chains.

Your hearts won’t beat in vain.

Like a flower, I’m blooming in the rain.

With this poem, M. – a 20-year-old who recently completed his maintenance therapy for a lymphoblastic lymphoma – wanted to tell us about the trauma of a cancer diagnosis and treatment, but also about the chances of finding the inner resources needed to face this challenge.

In the last two years, M. has been involved in the activities organized by the Youth Project, a scheme dedicated to adolescent and young adult patients with cancer that aims to optimize medical aspects of their care, but also pays attention to their quality of life (www.ilprogettogiovani.org). In particular, the Youth Project organizes creative and artistic activities that give patients special ways to express themselves more freely, to talk about their hopes and fears.^1-7

M.’s poem well describes the destabilizing effect that cancer can have on a young person’s life, a disruptive trauma at a time when they are beginning to find their place in the world. M. explains his words at a Youth Project meeting with his companions on the ward:

I understood what my family and friends meant when they told me, “The storm will pass, the rain will stop”. But the reality was much worse than they could imagine. The image of a storm comes nowhere near close to what we cancer patients experience. The physical and psychological torture that we suffer is unfathomable for most people.

M. was able to process this trauma and develop a sense of acceptance and resilience.

I didn’t see my illness just as a storm, but also as a chance to bloom. Time spent in isolation and suffering offers a chance for introspection, a chance to gaze into our soul, and become more intimate with our essence. The pain presents the path of resilience, both physical and mental, which builds strength of character that is useful for the future. The lack of freedom brings out the possibility of sparking an inextinguishable desire to live life to the full. The proximity to death produces a rejoicing and gratitude for being alive, enabling us to live every day as a precious gift. Hence the image of a blooming flower in the rain. Even in its fierceness, the storm allows for a beautiful blooming of the individual. I was able to bear the rain and the wind with the help of my stem and roots, they being my friends and family with their love: a bond stronger than the pain and the anguish. Even when the sky cleared and the rain stopped. I feel weak and fragile, but love has also made me strong: truly a flower blooming in the rain.

M. tells us about the fundamental role of friends and family on his cancer journey: ‘The fight against cancer cannot be won by a one-man army. In the Youth Project, I found support and lifesaving friendship’. His poem is really evocative and gives us food for thought. Our patients can often adapt to a diagnosis of cancer, but resilience is only one side of the coin. M. talks about weakness and fragility, and the need for support.^8-11 This support may come from family and friends, but we believe that professional support is essential too. A global, multidisciplinary care is needed, considering not only patients’ clinical issues, but also the meaning of their lives. Professional projects devised for young people with cancer should provide age-specific clinical facilities, dedicated spaces, and opportunities for socializing, recreation, and friendships on the ward.^12,13 They should make room for lightheartedness, beauty and hope, but also offer ‘stability’ and a form of protection during the storm of their disease

We have learned from M. and other patients like him involved in the Youth Project how important it is to give our young patients the opportunity to freely voice their feelings, as a key step in helping them to process what is happening to them. We have learned that, alongside the conventional methods of providing psychosocial support, it can be important to offer our patients novel and creative ways to express themselves. This is a core premise of the Youth Project, that could be seen as a valid patient-centered model for developing a more holistic approach to young people’s specific issues and concerns.