Online Extra: The Laughter Cure

Monique Spencer couldn't find what she wanted in books about breast cancer. So she wrote her own -- and made it funny

When Monique Doyle Spencer learned she had metastatic breast cancer four years ago, at age 46, her first thought was that she couldn't possibly have the Big C, because "I'm a chicken, and I've noticed that there are no chickens with cancer." Instead, there were people like Lance Armstrong or English jockey Bob Champion, who conquered not only cancer but their respective sports.

And then there are all those aunts one hears of who acted like a saint throughout their ordeal and never complained. "That wasn't me," she says. She looked up books that might help her on (AMZN ) and found 1,275 of them, but they all seemed to be about "people who fought incredible odds with valiant courage and found faith along the way."


  What she wanted, she decided, was to laugh, so she set out to write her own, funny guide to getting through cancer, for all the chickens like her. The result is The Courage Muscle: A Chicken's Guide to Living with Breast Cancer.

Spencer starts the book by noting that, though many who receive a diagnosis of cancer find prayer and grace to be helpful, she found that anger and swearing are just as effective. "Someday, scientists will discover why this helps, but until then, I just believe."

Her guide has chapter headings like, "But God, I'm a chicken," "Doctors are from Pluto, Patients are From Goofy," and "In Which I Discover Topless Ironing." Spencer talked to BusinessWeek Senior Writer Catherine Arnst from her home in Brookline, Mass., about her book, her treatment, and the value of keeping it funny.

How did you first react when you learned, at age 46, that you had Stage 3 breast cancer?

Well, I thought I had just been given the best excuse to go to bed for a year and pull the covers over my head. I thought I could get out of doing a lot of stuff. You know, "I can't make the beds, I have cancer. I can't do this assignment, I have cancer." I just wanted to whine for a year.

But I had children, a family. That approach wasn't practical. Besides, my doctor told me that women with a positive attitude do better in treatment, and then I read this Mayo Clinic study that said optimists live longer than pessimists. So I figured I'd better cheer up.

What prompted you to start writing during your illness?

I'm certainly not a writer -- I was a communications director for a company. I started writing while I was in treatment because I picked up a lot of cancer books and I didn't find what I was looking for. I wanted to know how you get yourself a positive attitude if you're naturally a cynic.  I started thinking about how you develop the courage to face something so difficult when it doesn't come naturally.

How do you?

Well, I started by joking. I come from an Irish family, I'm the seventh of eight children, and I was not the funny one. But my brothers and sisters are, and I insisted that they keep telling jokes. I just wrote them down.

I wanted to laugh as much as possible through this ordeal, so I picked the funniest friends I had to be my chemo buddies, the people who stayed with me during treatment. It couldn't be my husband, he looked worried all the time.

Your children were 14 and 8 at the time of your diagnosis. How did you handle your disease and treatment around them?

A) With my children, I was very different. I didn't joke about it, I was just very low key. There was no fake enthusiasm, they would have seen through it. My daughter, who is 13 now, says she only recently realized that cancer can kill you.

In your book, you dismiss a lot of conventional wisdom about how a cancer patient should act, and complain about how others treat you -- the whole kid glove approach. What was particularly irritating about other people?

I can't believe all the idiotic things people say to you. You know: "My mother died of cancer at your age," or "They can cure anything these days, don't worry about it." Then there are the people who tell you: "Don't go to a traditional hospital, use alternative medicine." That is really not helpful.

I asked my chemo nurse how you should handle these kinds of remarks when you have cancer, and she said: "When you figure it out, tell me, because that's what everyone wants to know."

How did you handle it?

I finally realized that I had said all those things myself to people. I realized that people didn't mean me ill, they just didn't know what to say. So I started saying, "Enough about me. How about you?"

A lot of books will advise you to tell people not to ask personal questions or whatever, but I don't think you should have to start assertiveness training while you're in chemo.

How are you doing now?

I'm four years out, and I'm cancer-free, so so far so good. I think that every year your chances get better.

The Courage Muscle: A Chicken's Guide to Living With Breast Cancer is published by Beth Israel Deaconess Medical Center in Boston, where Spencer was treated, and all proceeds from its sale benefit the hospital's Windows of Hope, which supports women going through chemotherapy.

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