Wednesday, October 26, 2005


1. Welcome!

You’ve just been diagnosed with cancer. Your head is spinning and it’s going to take weeks to get your mind around this. Then you pick up a few cancer books. They tell you all of the devastating things that are about to happen to you and they outline what your emotions will be. Now that they’ve depressed you more than you ever have been in your whole life, by the way you’re supposed to have a positive attitude.

Monique Doyle Spencer wrote the book she felt she needed: down-to-earth, practical and very funny. It is for the patient who wants to be herself through treatment, or to find out who that is. If you are looking for a depressing memoir about cancer, skip this. But if life goes on with you or without you, and you want it to be with you, keep this book on your nightstand.

2. What doctors, patients and the media are saying about The Courage Muscle

“Humor is a wonderful way of coping with a frightening disease, and A Chicken’s Guide to Living with Breast Cancer shows you how. When circumstances dictate that you either laugh or cry, wouldn’t you rather laugh?”
Hope Ricciotti M.D.
Assistant Professor Harvard Medical School

"… A down to earth, nuts and bolts guide … a book that will, I believe, reassure patients and their families while providing practical information, with a good dose of laughter thrown in."
Michael Tantillo M.D. Instructor, Harvard Medical School

“The first time I read this book I found myself smiling (at times even laughing out loud), nodding my head in agreement and all the while feeling so excited that someone actually put into words everything I was feeling and experiencing! The second time (but probably not the last) I read it a little slower and savored every lesson, quote and story.”
Mary Anne McDonough, Breast Cancer Survivor

“It’s not often you laugh out loud reading a book about cancer. Everyone involved with breast cancer should read this - especially those of us wearing the white coats. It’s a vivid illustration of what we put people through and how they can endure it.”
Abram Recht M.D., Associate Professor, Harvard Medical School

“… This splendid book will be useful not only to people with cancer but also to those facing other medical or emotional crises. It is engaging, practical and hilarious … Enjoy!
David Savitz M.D.

“… A deeply personal, intelligent and insightful perspective on coping with breast cancer. The Courage Muscle is filled with personal anecdotes and thoughtful recommendations that make sense. I smiled and I wept…so will you.”
Lowell E. Schnipper M.D., Chief, Hematology/Oncology, Beth Israel Deaconess Medical Center

"… A down to earth, nuts and bolts guide … a book that will, I believe, reassure patients and their families while providing practical information, with a good dose of laughter thrown in."
Michael Tantillo M.D. Instructor, Harvard Medical School

“Although The Courage Muscle is not described in my anatomy books, I am convinced it exists as I daily see it flexed. Spencer's witty, irreverent, practical guide to exercising this key muscle is essential reading.”
Susan Troyan M.D., Instructor, Harvard Medical School

Read The Business Week Interview with Monique Doyle Spencer

3. About Beth Israel Deaconess Medical Center
Doyle Spencer was treated at Boston’s BIDMC, which published this book with Chandler House Press. She is donating her royalties to Windows of Hope at BIDMC.

4. A Look Inside The Courage Muscle


A Circle Theory for Coping with Friends and Strangers When You Have Cancer

THERE IS SOMETHING UNIVERSAL about big news in your life. The news can be good or bad, life threatening or joyous. It doesn’t matter. Whatever it is, you can be sure that someone you know is going to say something really awful.
New parents tell stories about this all the time. The co-worker who tells horrifying labor stories is just waiting for the baby to be born, because then she can say “Enjoy this now because wait until you see how awful it gets when they are (pick one or all) toddlers, teething, teenagers.”

When you are diagnosed with cancer, word will spread quickly in your world at work and at home, and the questions, comments, advice and stories will come rolling in. In the first few weeks after my diagnosis I was stunned, and I asked my chemo nurse if other patients have trouble with this. “Let me know when you think of what to say to people,” she said, “because many patients talk about this.”

You know how our generation feels about our mother’s generation -- that they didn’t tell anybody about any thing, didn’t talk about their cancers, miscarriages, life crises. When I told an older woman I had breast cancer, she said, “Do yourself a favor. Don’t tell anybody.”

I was stunned and asked her why. This is a tiny, soft grandma with that white hair, those pink cheeks, that soft twinset and pearls, the album of grandchildren carried in her purse. “Because everybody is a f-ing pain in the ass,” she said. “Everyone will say, poor you, poor you, and if you ever believe that, you’re finished.”

There were times when I wished I made it a secret, when I thought our mothers were right. Sometimes it would be nice to go to work or the grocery store and not have to talk about cancer with yet another person who heard. But at the end of the day, I think it’s better to be surrounded by people who know than not, as long as you can stand the occasional awful moment.
After enduring a few months of those moments, I tried to understand a little of it. First, I noticed that most of the thoughtless people I ran into fell into five basic categories.

This person has known at least five people with your exact diagnosis who look just like you and who died at your exact age.

This person says that “there are so many medical advances these days that I’m sure you don’t have anything to worry about.” End of conversation. Don’t bring it up again. Bye.

This person, strangest of all, needs to investigate. One eyebrow goes up as they glare at you. “When was your last physical/mammogram/colonoscopy?” they ask suspiciously. And then: “Do you smoke?” I have learned the only answer to this person. It’s to ask them, “By the way, what’s a mammogram?”

This person has a lot of advice to give you, from alternative treatments to what doctor you must be seeing or you are throwing your life away. “Attitude is everything,” they will say. “You have to be positive.” This is true, but coming from someone who flips out over a parking ticket it’s a little tough to take.

This person, I don’t know why, is usually an aunt. She cannot stand for anyone else to be sick. You tell her that you have cancer. “I’m sure it will be benign,” she says. For some reason your cancer spoils her enjoyment of her own troubles. Your first reaction to this person is to run when you see her, but try a different approach: wallow in her troubles. Sympathize. Listen for three minutes. The result: you will always feel better, knowing how well you are doing, plus your illness, unlike hers, does not cause you to talk to everyone you meet about your gas.

After defining these categories – and there are probably more – I had a terrible realization: I have said every one of these stupid things to someone at some point in my life. I was stunned, but it was true. How could I have said these things? And why?

I tried to think back -- when and to whom I was so thoughtless? I could remember saying things, but couldn’t remember the people. So then I thought about people I’m close to who have had cancer and realized … I had never said those stupid things to people I’m really close to. Hmmmm. I would say: you’re such a great person and I hate to hear this is happening to you. How are things going? What can I best do to help out? I’ll bring dinner – would tonight or tomorrow night be better? I’m going to pick up your kids and take them out for a few hours. Do you need any rides? Need errands done?

Thinking about this led me to understand why I was not bad with people who are close and terrible with people who are not. It starts with understanding that we are all surrounded by circles of people. … continued in The Courage Muscle.

5. Who is the author?

Monique Doyle Spencer was diagnosed with Stage 3 breast cancer at the age of 46. She writes about the range of cancer treatments she experienced, including surgery, reconstruction, chemotherapy, radiation and post-treatment hormone therapies. Spencer is married with two children and two dogs adopted from the Quincy Animal Shelter.

6. Contact the author

Monique Doyle Spencer offers a funny and motivating speech for many groups. She has spoken to firefighters, elderly women, service clubs and students. To reach her, e-mail her at Spencer’s fee is plenty of water at the podium plus the opportunity to sell and sign books for the audience. All proceeds benefit Windows of Hope at Beth Israel Deaconess Medical Center.