We would rather be ruined than changed;
We would rather die in our dread
Than climb the cross of the moment
And let our illusions die.

W. H. Auden

Through their words and actions, the women and men who have animated the pages of Advanced Breast Cancer have laid bare the anatomy of courage. Courage implies, in Webster's definition, "The attitude of facing and dealing with anything recognized as dangerous, difficult or painful, instead of withdrawing from it."

These people have been able to summon the strength to turn toward what is most frightening, rather than to turn away, as our culture of denial encourages us to do. They have chosen to embrace the "full catastrophe," as Zorba the Greek termed it.

In doing so, they have sought out new sources of meaning and joy, as their lives unfolded moment by precious moment. They celebrated and they mourned. They let go of illusions and revised their expectations. They held tight to those they loved, forging real intimacy through honest expression, and they reached out to help others. They weathered the physical and emotional distress of treatments and disease progression with compassion for themselves, expressing emotion yet not drowning in suffering. They informed themselves and sought out the best of care, at times raging at the unfairness of the system and fighting for their right to treatment. They made conscious choices and plans. They sought transcendence and beauty in creativity--through poetry, music, art--and often through the writing they did for this book. They sought a communion with the natural world, sensing their own place in the flow of the seasons and in all of life. They passionately pursued a connection with God or whatever spiritual force they understood for themselves. From all these sources, and many more, they kept on keeping on--reinventing the strength day by day to live fully for the time that remains to them.

They are ordinary women and men just like yourself, possessed of no special heroic capacity before illness came into their lives. Put simply: they rose to the occasion. They did not accomplish this alone, without help. They learned, often from other patients, to assert and inform themselves. They depended upon the love and support of their families and friends. They relied on the skill and compassion of their doctors and other care providers. With the help of their spiritual communities, they sought comfort and meaning. By telling their stories, and sharing their insights, it is their hope and my own that your own journey will have been made less lonely and frightening.

It is they who should have the final words. First, Caren Buffum, responding to a letter from a woman newly diagnosed with metastatic breast cancer, who questioned how she would ever be able to cope with this disease.

I want to encourage you to focus on each day you live rather than trying to "know". I can't tell you how long it takes--I think it is more of a gradual process--each day gets a little easier. I guess you will have to trust those of us who have come through it--that's what we're here for, to tell you we are on the same journey as you are and have just made it down the road a bit further. We are like scouts, trotting our horses back to tell you what's on the other side of the mountain. Of course, everyone's experience is different, but I do believe we share similar stages or cycles in our process.

If you can't rest in your own lack of knowledge, at least know that we know that it can happen, and no doubt will happen for you in time. Meanwhile, do your best to learn what is most important in life for you right now. How do you want to spend your time? What haven't you done yet that you have dreamed of doing? Whom do you want to get to know better but haven't taken the time? What places bring you the most peace? What time of day are you most relaxed? What memories do you enjoy recollecting? Since you can't know your future and a lot of other things about the disease, take the time to know yourself better and find what gives you greatest meaning and deepest joy. Then focus on those things. You might try keeping a journal of what you learn and feel, if you don't already. Don't try to do it all at once--a little every day.

At the closing of the year, Sandra Yandell offered these reflections:

This morning I was thinking about the Solstice--the shortest day and longest night--and I realized that's what my life feels like. Then I started thinking about my seventeenth winter, when temperatures at Christmas time were in the 50's and 60's, and I was in love with the younger version of the man I love now. And I can't stop crying, because I feel distilled into a moment in time--a bright, warm, too-short winter's day. I remember walking around the lake in the park with him, young love passionate and unsure of myself. One of those intense days that you don't want to end. That day went on into evening, but this "winter's day" ends with the light. Unseasonably warm and too brief, too few hours left of light. My first love becomes my last love in another winter.

There is another light waiting in that darkness, an unending season of joy. It would be so easy, sometimes, to slip away, to let go into that place where there will be no pain, and I will no longer need this body that has become my prison. I remember that seventeen-year-old body almost seventeen years ago, so self-consciously aware of myself in the presence of a young man I adored. Some days I am again self-conscious, this time of the ravages of this disease on a once beautiful body.

Today was a bright, warm December day. My love's kiss tastes the same as it did then, and though I live in my winter, it too is bright and warm. And I am not ready to watch the sun set on this winter's day.

One of the definitions of survival is "that which endures." I think I fit in this category. I've been battling this enemy for five years, through numerous surgeries, lots of radiation and now my second regimen of chemo. Sometimes I feel like a soldier who keeps getting shot, then patched up and sent back on the front lines. I know it's hard to hear stories like mine--it could have been, might have been, one day may be you. I pray that it will never be so, for anyone, but the fact remains that, although I am not disease-free, I am alive, and I will do whatever I can to keep going. In spite of the fact that I have serious bone mets, and my prognosis is not very pretty, still I can say I am a survivor, I have endured, I will continue as long as there is breath.