You’ve likely heard it said... delivered with a confident shrug and an air of finality...

"What someone else thinks of you is none of your business."

I understand the intent - boundaries, self-worth, mental peace. It is meant as a shield against unproductive self-doubt or people-pleasing.  But the more I sit with the actual words, the more they feel incomplete.  Or maybe careless.  In fact, I'm willing to go as far as to say that advice feels downright lazy.

If we’re being honest, there are times when what someone else thinks of us should absolutely be our business.  Take, for example, that coworker who is brilliant but everything about his nature rubs people the wrong way.  I've worked with a few people like this, but for demonstration purposes, we'll pick on "Bill".  Bill gets held back from opportunities that involve more interaction with people because, frankly, people don't want to interact with him.  If I am not his direct manager, is my opinion of him really none of his business?  Or, do I have some obligation to the company I represent, to the clients I serve, or even to my coworkers (who are missing out on valuable insight that Bill could contribute) to help him understand how he is perceived?

The problem with the idea that other people's opinions of us are none of our business is that it encourages a mindset that impedes personal growth and strengthened relationships.  I don't see how that makes someone more emotionally evolved, it seems more likely to just make them more complacent.

Dismissal vs Discernment

Let's take a step back, though, and acknowledge that not all opinions are created equal.  Random internet trolls?  Maybe their thoughts aren't your business, but more specifically, their thoughts likely have no influence over your daily life and don't deserve your energy.  But what about your partner who found your communication style dismissive? Or the friend who felt unsupported during a hard time? Telling ourselves their perceptions are “not our business” allows us to ignore valuable insights into how we show up in the world. That’s not empowerment. That’s deflection.

If Perception Doesn’t Matter, What Are We Even Doing?

We’re constantly shaping and being shaped by the people around us.  If I’m misunderstood, and that misunderstanding negatively impacts my credibility, opportunities, or relationships, how is that not my business?  If someone is acting or reacting on a false or partial impression of me, is it not my right to engage with that person to mutually understand each other's point of view?

Yes, we should have a strong sense of self.  But we’re also social beings.  Refusing to care how we’re perceived is not demonstrating emotional groundedness, it’s a missed opportunity to build trust and clarity.

Growth Requires Input

Personal growth isn’t a solo endeavor. We refine ourselves through lived experience—and that includes the mirror others sometimes hold up. Their reflections might not always be pretty. Or fair. But that doesn’t mean we should look away.

True self-awareness lives in the tension between how we see ourselves and how others experience us. Dismissing their view outright in the name of stoicism or “peace” can keep us stuck in self-constructed blind spots.

It’s Not About People-Pleasing

Let me be clear: I’m not advocating that we chase approval or outsource our self-worth. But if someone sees us in a way that contradicts how we want to be seen, we have a choice: double down on our intent, or pause and ask what signals we may have sent that created that impression.

Sometimes, the most courageous act isn’t standing tall in indifference—it’s leaning in with curiosity.

The Alternative

So no, I don’t subscribe to “what someone else thinks of you is none of your business.” I think a healthier mindset is:

“You don’t have to accept every opinion, but you should be willing to understand it.”

That leaves room for reflection, empathy, and yes, boundaries. But it also leaves the door open for better communication, more honest relationships, and maybe even a deeper kind of peace. The kind that comes from being truly seen, not just stubbornly self-assured.

 

Attention Is Cheap: Being Wanted Is Easy. Being Worthy Is Harder.

Every once in a while, Facebook suggests an attractive woman as someone I might know. Lots of cleavage, lots of provocative photos, thousands of "friends," including three or four mutual friends. Before I even click, I usually know exactly who those mutual friends are. I have a small collection of male friends who are remarkably consistent in this regard (you know who you are).

Gentlemen, women notice patterns.

If I look at a man's friends list and it has more cleavage than Tampa during spring break, I don't immediately think, "Oh no. Competition." These days, I'm more likely to think, "Oh. Someone enjoys keeping the fan club well staffed."

But there was a time when I probably did see those women as competition. I was heavier then and not nearly as comfortable with my body as I am today. I also believed what a lot of women seem to believe, which is that if I were sufficiently confident and secure, seeing a man I'm with get attention from other women shouldn't bother me.

So I worked very hard at being the Cool Girl. You know her. She's confident. She's evolved. She's definitely not jealous. She doesn't care who you flirt with because she's far too secure for such nonsense. If something makes her uncomfortable, she carefully examines herself to determine which character defect she needs to correct so she can become even more impressively unbothered.

Yeah, that chick is exhausting. I retired her.

It took me a long time to understand that confidence isn't the ability to tolerate anything without reacting. Sometimes confidence is simply trusting yourself enough to say, "I don't like how this feels, and I don't want this in my life." Feelings aren't the same as facts, of course. They're unreliable little creatures that drag old wounds into new relationships, confuse fear with intuition and occasionally throw a tantrum because someone didn't answer a text quickly enough. And while not every uncomfortable feeling deserves to become a boundary, every uncomfortable feeling also doesn’t need to be conquered.

I learned that distinction the expensive way.

After my marriage fell apart, I met a man who absolutely swept me off my feet. He was handsome, charming, funny and exciting, and after what I had been through, being with him felt wonderfully alive. We traveled together, rode his motorcycle, sang karaoke, watched movies and laughed. God, did we laugh. He made me feel beautiful and intelligent and desired, and I loved him. We dated for several years, eventually lived together, and I genuinely wanted a future with him.

There were things that made me uncomfortable along the way, particularly his appetite for attention from women. I saw them. I just kept trying to decide whether my discomfort said something about his behavior or something about my insecurity. Instead of asking whether the relationship felt safe to me, I kept asking whether a more confident woman would be bothered by the things that bothered me. Then I tried to become her.

I also had another slightly embarrassing romantic theory operating in the background. I believed, at least on some level, that if I loved someone enough, supported him enough, believed in him enough and gave him enough reasons to value what we had, I could inspire him to become the man I believed he was capable of being. Apparently, I listened to too much Josh Groban and John Legend. They owe me an apology.

So I invested. Not just emotionally. I helped solve problems. I encouraged ideas. I gave advice. I provided support. I lent money and paid for things when he couldn't. At one point I added it up and realized I had spent or loaned somewhere around $30,000 over the course of the relationship. I don't say that because love should come with an invoice or because relationships need to be financially equal. They don't. I say it because it illustrates how thoroughly I had learned to measure love by what I was willing to contribute.

Eventually, despite all that love and support and impressive Cool Girl confidence, I learned that some of the things making me uncomfortable weren't products of my imagination after all. He was unfaithful. Repeatedly. The relationship ended, and I was devastated.

Years passed. A lot of life happened. I changed.

Then, many years later, we found our way back into each other's lives.

This time the dynamic was different. He told me he had changed. He told me he loved me. He talked about marriage and building a future together. He moved across the country, at considerable expense, to the city where he knew I planned to build my next chapter. He was the one pushing toward a future, and I was the one standing there wondering whether trusting him again was an act of forgiveness, an act of stupidity, or perhaps some uncomfortable combination of the two.

I wanted to believe him because I genuinely believe people can change. It would be rather hypocritical of me not to. I am not the same woman I was ten years ago, and I don't want to live in a world where we're all sentenced for life to the worst version of ourselves. Forgiveness, growth, and grace are all important to me.

But true change has an inconvenient little requirement. You actually DO have to change.

So when the familiar patterns began appearing again, I noticed. Photos posted in singles groups. Messages to women. Conversations that appeared to be moving toward meeting them. Alongside that was the steady stream of selfies and videos and posts displaying the car, the motorcycle, the apartment, the income, the lifestyle. None of those things is inherently wrong, of course. If you've worked hard for something and you're proud of it, show it off. If you happen to look particularly good one Tuesday afternoon, by all means let Facebook know. The rest of us have survived worse.

But patterns are different from isolated behaviors, and I had seen this particular pattern before.

The explanation I received for some of the more troubling activity was that his account had been hacked. Now, I'm an IT person, so perhaps I have an unfair disadvantage here. Could someone hack a Facebook account? Of course. Could someone theoretically hack an account and use it to message women? Sure. Could a mysterious hacker gain access to a man's account, ignore every available opportunity for financial fraud or identity theft, and instead devote his criminal talents exclusively to recreating the exact romantic behaviors that had damaged this man's relationship years earlier, apparently for the sole purpose of sabotaging a relationship most people didn't even know existed?

I suppose. Anything is possible.

I also suppose Katsu could be running an offshore gambling operation while I'm asleep. He's very clever, and he does have quite a bit of unsupervised time.

Kiba, meanwhile, may be responsible for figuring out how NASA fabricated radio transmissions convincing enough that independent observatories around the world believed they were coming from the Moon in 1969. I haven't found any evidence connecting him to the operation, but apparently the evidentiary threshold for doubting a moon landing is considerably lower than the one I'm expected to use when doubting a Facebook hacker. I should probably check Kiba's browser history.

At some point, probability deserves a seat at the table. But the more important realization for me isn't whether I can prove his explanation wrong. It's that, for perhaps the first time in my life, I don't feel any need to try.

Years ago, I would have investigated. I would have looked for messages, checked timelines, compared stories, watched who commented on posts and searched for the piece of evidence that would finally give me permission to trust what I was already feeling. In fact, that is exactly what happened before. Once trust was damaged, tiny things that probably meant nothing became suspicious. I couldn't concentrate at work. I lost sleep. I felt physically sick when I found evidence that confirmed my fears. Eventually I was hiding what I was going through from friends and family because I didn't want them to think I was crazy for staying.

I won't become that woman again.

I won't be a detective in my own relationship, and more importantly, I don't want a relationship that requires one. I don't need to prove infidelity beyond a reasonable doubt before I decide that a relationship doesn’t feel emotionally safe to me. I can acknowledge that my feelings aren't evidence of someone else's guilt while also recognizing that they ARE very relevant when considering whether this is a relationship I want to participate in.

That's a distinction I wish I had understood years ago, because what I need from a relationship now isn't certainty that nothing bad will ever happen. I need emotional safety and security. That doesn't mean I require a man who never notices another attractive woman or never receives attention from one. Good grief. I have eyes too. Attractive people continue to exist after we fall in love. I don't need a man nobody else wants, and I'm certainly not interested in spending the rest of my life guarding one like a Labrador with a sandwich.

But what I DO need is to be able to trust the judgment of the person standing beside me. I don't want to prevent someone from having options. I want to be with someone who understands that having options and continually exercising them are two very different things.

Maybe that's why, after all these years, my message to the man who seemed to believe attention from women meant he was winning has become remarkably simple:

Put the phone down.

You don't need another woman flirting with you to prove you're attractive. You don't need another suggestive conversation, another DM, another woman waiting in the wings or another little hit of validation from someone you don't actually want a life with.

At some point, you may meet a woman who changes your definition of what it means to be wanted, and the habits that helped you collect attention from women you don’t really care about may be exactly the habits that prevent you from building a life with the one you do.

She is intelligent and accomplished, confident and independent. She has built a life she loves entirely on her own. She doesn't need you to rescue her, finance her, complete her or convince her of her value. She has survived enough life to know she is perfectly capable of standing alone.  And she was ready to choose you anyway.

Don't underestimate what that means.

Attention is not respect. Being desired by a lot of women doesn't make you more valuable to the woman whose opinion actually matters, and keeping doors cracked open with other women doesn't demonstrate your desirability. It simply communicates that being loved by one person, no matter how good that person is for you, still isn't enough to quiet whatever part of you needs to know you could have another.

I don't know what drives that need. Maybe it's ego. Maybe it's insecurity. Maybe it's habit. Maybe attention just provides a dopamine hit. Maybe some people spend so many years proving they CAN attract someone that they never stop to ask WHY they need to prove it. And I don't actually need to know, because another lesson I've learned with age is that understanding why someone behaves a certain way doesn't change my willingness to live with that behavior.

There is nothing wrong with enjoying attention. There is nothing wrong with knowing you're attractive. There is nothing wrong with being charming, flirtatious or sexual. But there is a difference between knowing you could get attention and needing to keep collecting it.

Ironically, I'm more physically confident now than I was a few years ago, yet somehow appearance matters less to me than it ever has. I still want to look good. I take care of myself and intend to present the best version of me that I reasonably can, but I no longer confuse looking good with having value.

The funny thing is that letting go of one way of measuring my value forced me to recognize another. I may have stopped needing to be the prettiest woman in the room, but I am still awfully invested in being the most valuable one.

And I am valuable in a relationship for reasons that have very little to do with my face or my body. I'm intelligent, accomplished, creative, generous, loyal, loving and supportive. I know how to turn ideas into reality. I know how to solve problems. I know how to help someone I love succeed, and I genuinely enjoy doing it. I can take an idea someone mentions over dinner and figure out how to build the technology to make it happen. I can encourage better habits, challenge questionable thinking and, apparently, create artificial intelligence tools that make you look considerably more competent at work than you have any right to look.

I'm useful as hell.

And for a long time, being useful felt a lot like being loved. So when a man told me, "You make me better," I heard it as a profound compliment, and part of me still does. What could be more loving than knowing your presence encourages someone you care about to become a better version of himself?

But when I hear that sentence now, a question immediately follows:

Who do I become when I love you?

Because I spent a lot of years evaluating myself according to what I brought to another person's life without applying nearly enough scrutiny to what his presence brought to mine. I knew how I helped him. I could see the problems I solved, the opportunities I created, the encouragement I provided, the money I contributed, the ideas I helped launch and the ways his life became more functional when he wasn't alone. I could point to tangible evidence that I made his life better.

But did he make mine better? The answer, inconveniently, isn't no.

He brought fun into my life. He brought adventure and laughter and affection. We took trips, rode motorcycles, sang karaoke, watched movies and genuinely enjoyed being together. He complimented me often. He made me feel attractive and intelligent. There are parts of myself that came alive around him that I genuinely loved, and I won't rewrite history simply because the story became painful.

But while those things were very real, so was the other woman I became.

The woman who couldn't focus at work because something felt wrong. The woman who lost sleep. The woman who felt physically sick when she discovered another lie. The woman who watched Facebook comments and wondered what they meant, questioned harmless details because she had learned that sometimes the harmless-looking details weren't harmless, and concealed what was happening from people who loved her because she already knew what they would tell her.

That woman’s story is just as important.

So perhaps "Does he make my life better?" isn't quite the right question. Relationships aren't spreadsheets, and people aren't collections of debits and credits. Fun doesn't cancel betrayal, and betrayal doesn't erase every beautiful memory that came before it.

The better question may be - who do I become when I love him? And more importantly, do I WANT to be her?

That question has changed what partnership means to me.

I don't need someone to make me better by launching my ideas or teaching me how to function. I've spent enough years learning how to carry myself. What I want now is almost embarrassingly ordinary. I want stability. I want to sit down and eat dinner with someone at the end of the day. I'll cook if you do the dishes. I want weekends camping, shared responsibility for whatever breaks around the house or camper, and someone who makes the coffee in the morning because he knows I am functionally constrained before caffeine.

I want someone who accepts that sometimes I'm brilliant and productive and funny, and sometimes I'm moody and short and tired and perfectly content to accomplish absolutely nothing. I want someone who can manage my investment accounts because I'm fully willing to concede that another human being may possess skills I do not. I want someone whose judgment I trust enough that I don't have to be the competent one all the time.

But mostly… I want peace.

There was a time when "boring and predictable" sounded like an insult to a relationship. Now it sounds almost luxurious. I've had enough excitement. I know what chaos feels like. I know what it feels like to wonder and investigate and hope and explain and forgive and wait for the other shoe to drop.

Now? Give me boring.

Give me coffee in the morning and dinner at night. Give me someone who says he's going to Home Depot and, believe it or not, actually goes to Home Depot. Give me ordinary weekends and inside jokes and shared chores and a relationship so predictable that a random woman commenting on Facebook doesn't even register as information worth storing.

That's the kind of better I want now.

So when someone tells me, "You make me better," I still want to receive the love in that statement. I want my presence to make the life of someone I love richer. I want to encourage him, challenge him, support his dreams and help him become whatever version of himself he chooses to build.

But I no longer want "you make me better" without a comparable "and I make your life better too" somewhere in the relationship.

Not in identical ways. Love isn't a barter system. I don't need someone to create GPTs for me because I created GPTs for him. I don't need someone to earn what I earn, solve the problems I solve or contribute precisely what I contribute. Reciprocity isn't sameness. It's mutuality.

My presence should create something good in your life, and yours should create something good in mine.  And if being with me helps you become more motivated, successful, organized, ambitious or hopeful while being with you turns me into someone anxious, distracted, suspicious and physically ill, then "you make me better" is just a nice way of saying “I benefit considerably from what this relationship costs you.”

I have spent enough of my life becoming capable of carrying myself. I don't want my primary function in a relationship to be carrying someone else. I want a partner.

Which brings me back to where this whole train of thought started: women, attention and that Facebook friends list full of cleavage.

The woman I am today isn't threatened because other women find her partner attractive. Frankly, I expect them to. I'm not looking for a man nobody else wants. I'm looking for a man who doesn't require constant confirmation that they do. I'm paying attention to what he does with attention when it arrives. Does he enjoy the compliment and move along, or does he cultivate it? Does he collect women around him because each new admirer provides another tiny reminder that he's still got it? Does he protect the relationship he's asking me to invest in, or does he continually introduce ambiguity into it and then expect me to prove my confidence by tolerating that ambiguity?

The question for me has never been whether a man is attractive to other women. It has always been whether he has the judgment, confidence and emotional discipline to build something meaningful with this ONE woman.

I don't need to make someone a terrible person because he can't give me what I need. I don't even have to know why he can't. Maybe he really does want the future he describes. Maybe part of him genuinely wants marriage, partnership, stability and a person beside him who makes him better. Maybe another part still needs the little rush of being noticed by strangers. Both things can be true.

But wanting a life and being capable of protecting what that life requires are not the same thing.

I think that's one of the hardest lessons I've learned about love. Someone can love you and still be unable or unwilling to love you in a way that is healthy for you. Someone can genuinely want a future with you while continuing to make choices that make that future impossible. Someone can recognize your value and still lack the discipline required to protect it.

Love doesn't automatically cure whatever came before it.  And apparently neither does a really good custom GPT.

At this stage of my life, I don't have time to wait for a catastrophe before I decide to leave something that costs me my peace. I don't need photographic evidence. I don't need a confession. I don't need to find someone else’s earrings on his nightstand. I don't need to win an argument about what technically constitutes cheating. If I reach the point where I feel compelled to monitor, investigate and worry, I already have enough information about whether this relationship is healthy for me.

That's my boundary. Other women are entitled to have different ones, and the men I date are entitled to decide mine is unreasonable. That's the wonderful thing about boundaries. Nobody has to agree with them. They simply determine who gets access to your life.

Perhaps that's the message I would really send back, not only to the man who thinks attention means he is winning, but to the younger version of me who thought being secure meant learning not to care.

Put the phone down.

And I will put the detective badge down, too.

Neither of us needs to prove anything.

Attention is remarkably easy to find. Facebook will deliver it directly to your suggested friends list, cleavage included. But being known deeply, respected completely, trusted safely and deliberately chosen by someone whose respect you genuinely value is rare.

If you're fortunate enough to find that, recognize the difference.

You don't lose your freedom when you stop auditioning for attention. Instead, you stop trading something valuable for something cheap.

Where Does Responsibility For Happiness Lie?

“Nobody is responsible for your happiness but you.”  Such a simple and often quoted phrase, yet it has the potential to be one of the most damaging pieces of advice one can give.  My belief is that the underlying intent of these words is to encourage self-awareness and discipline to understand what creates happiness within us and make conscious choices to be involved with people and activities to achieve that end.  From this perspective, “I am responsible for my own happiness” can serve as a useful mantra to help guide our daily decisions.  Indeed, if we expect someone else to fundamentally change the nature of who they are for our benefit, we are not making a choice that is likely to result in happiness.

What I see more often, however, is this phrase used as a trite response to someone else who is in pain when we can’t be bothered to hold space for them through their suffering.  Can you imagine approaching a hungry child living in poverty, a parent whose star athlete teen was paralyzed by a drunk driver, or a groom whose bride was killed in a robbery attempt the night before their wedding and saying, “You are responsible for your own happiness?”

 

We wouldn’t consider giving that advice in those cases, yet many people don’t think twice about saying those words to someone who feels trapped in an abusive relationship, or at a job they don’t enjoy, or whose 20-year marriage has ended.  This guidance isn’t particularly helpful, and in some cases, can propagate the feelings of inadequacy that are already plaguing that person in those circumstances.

 

Allow me to back up a bit, though, and explain my issues with this phrase.  In the 1970’s, psychologist Paul Eckman defined six core emotions experienced by all people:  Happiness, Sadness, Fear, Disgust, Anger, and Surprise.  Additional core emotions have been identified since that time, the below wheel also includes Bad.  There is an important distinction between an emotion and one’s feelings, affect, or mood.  An emotion is a physical response to external stimuli controlled by areas of the brain like the amygdala and prefrontal cortex.  If you have heard of the “fight or flight” response, you are already aware of the physiological changes triggered by the sympathetic nervous system in response to one core emotion, fear.  In contrast, a feeling is a mental state and is based on how you experience and interpret an emotion.  This graphic shows common feelings we express in response to the core emotions.   

The sequence of events is:  External Trigger -> Physical State (Emotion) -> Mental State (Feeling).

For example, my spouse is diagnosed with a terminal illness (trigger), I experience sadness (increased heart rate and skin conductance followed by tears), and I feel grief and despair. 

 

My first issue with the topic phrase is that it sets an expectation of being able to control a physiological response to an external trigger.  The ability to choose an emotion is no different than any other physical sensation.  Imagine being stuck with a needle and being told you are responsible for feeling pain, and that you could instead choose for it to feel like being licked by kittens.  Try putting a hot pepper on your tongue and convincing yourself it really tastes like cotton candy.

 

People with some level of emotional intelligence can choose how they react to a feeling, and with a lot of self-work, can also learn to moderate what feeling they have in response to an emotion.  Studies have shown that people who are healthy and practice a mindset of gratitude are more likely to experience happiness.  However, the ability to control the body’s physiological response to an external stimulus is not commonplace.  One could argue that you can choose what external triggers you expose yourself to, but it is unreasonable to expect that you can shelter yourself from all negative stimuli in the world.  I remember the day I went to the mall and bought myself a beautiful pair of diamond earrings to match a diamond necklace I received as a gift.  That same day, I returned to my car to find that someone had backed into it and didn’t leave a note.  A few months later, I went for a walk and returned home to discover one of those earrings had fallen out.  I could have avoided the negative feelings associated with my car being damaged and losing an earring had I not gone to the mall that day, but giving up happiness to avoid potential sadness or anger is no way to live.

 

This leads into my second issue with that phrase.  Happiness shouldn’t be the goal in every situation.  We are supposed to feel a wide range of emotions.  It is not only healthy to experience an emotion and work through it, but it is necessary for growth.  I have known a few people who try to live out only positive feelings.  They will express when they are angry, but won’t work through it.  Likewise, if you try to talk about a difficult feeling you are having, they will shut down the conversation until the uncomfortableness leaves.  The resolution to any disagreement is pretend it never happened.  While their outward positivity is quite charming when you meet them, they are exceptionally emotionally immature and lack the ability to create any real depth in their relationships.

 

I also have a problem with any advice that marginalizes legitimate mental health struggles.  When I was in college, I attended a church where I was encouraged to pray more when I started to feel a little depressed, because happiness comes from God, not antidepressants.  This is the most dangerous use of the phrase “You are responsible for your own happiness” that I can think of.  Saying that to someone who is clinically depressed is like telling someone it is their fault they have cancer.  As a cancer survivor, that wouldn’t go over well with me.

 

Finally, I have an issue with that phrase because when interpreted literally, it encourages a self-centered and entitled attitude in favor of compassion and empathy.  Taking responsibility for your own happiness shouldn’t come at the expense of your integrity or obligations to others.  We lose our humanity when we take actions for our own personal gratification without at least being mindful of the happiness or well-being of those impacted by our actions.  The people in your community and in your personal relationships should be able to reasonably expect certain standards of behavior.  The most extreme example of this is the pedophile who finds happiness preying on children, should he act on this desire under his responsibility to own his happiness?  No, people who pursue happiness at the expense of violating others’ rights are held accountable for their actions.  A more common example is neighborhood communities.  I was the President of my Homeowner’ Association for several years.  During that time, I dealt with countless complaints about neighbors who agreed to a set of association rules when they moved in, but didn’t abide by them because they wanted to do something that wasn’t allowed.  This involved everything from owning more pets than were allowed, to parking campers and boats in driveways, to building sheds and play systems without approval.  These may seem like benign offenses, but they weren’t to the people who moved into that specific neighborhood because they wanted to live in a community that had these types of standards, and they had a rightful expectation of others who signed the same agreement.

 

This time of year, social media arguments over fireworks are rampant.  Those who want to celebrate our nation’s independence with nightly fireworks for a week prioritize their fun over veterans who suffer from PTSD and pet owners who have to deal with dogs who are terrified of the noise.  These groups can’t coexist with a “you’re responsible for your own happiness” mentality.  Inevitably, one group tells the other, “If you don’t like it, move to the country.”  Thoughtfulness for neighbors and a sense of community is thrown out the window.

 

On an individual level, think about the Black Friday shopper who rips a sale item out of the hands of customer who got there earlier.  The spouse who decides to purchase a car they can’t afford, or to quit their job without another one lined up while their partner tries to figure out how to make ends meet.  The single person who inserts him/herself into your relationship because their ego craves the challenge of getting a person in a committed relationship to stray.  Any one of those people could justify their actions with “This is what I want.  Your happiness is your responsibility, not mine,” rather than hold themselves to a standard of respect for their fellow man and prior commitments.

 

Of course, there are times when we need to make a decision that will be difficult on another person.  Consider the person in an unhappy relationship.  Their choices are to continue being unhappy or to end the relationship and eventually find someone they can be happy with.  The person only concerned with their own happiness lies to their partner while looking for someone else to be with, then ends things when they have a new relationship lined up.  The person who is mindful of both their rights and the rights of those around them realizes that their partner deserves the same opportunity to seek happiness elsewhere and ends the relationship so that both people can move on.  Both scenarios depict someone taking responsibility for their happiness, but the latter describes a person who pursues that happiness within the boundaries of socially acceptable treatment of another human being.

 

I am responsible for my own happiness.  I am responsible for how I react to negative external stimuli.  I am responsible for protecting my boundaries.  I am accountable for my commitments and obligations.  I am accountable for not leaving a path of emotional destruction in my wake as I pursue my happiness.  And if your pursuit of happiness violates my rights, I will hold you accountable.  But if you approach me because you are going through a difficult time and are struggling to find happiness, I will sit with you, walk with you, or talk with you as you work through it – because if I can help you find your happiness, I don’t see anything wrong with that.

The "C" Word

I’ve probably spent too much time contemplating if and how to share my cancer story.  Should I write an inspirational story feigning strength and bravery?  Should I simply present the clinical facts?  The truth is, I survived because my cancer was caught early… many people aren’t as fortunate and I’m not comfortable celebrating my good fortune when I know so many who have had less positive outcomes.  So instead, I’m going to share the day-to-day reality of a cancer patient because my story would be nothing more than a few pages of useless words if it didn’t offer some insight that might be helpful to someone else facing a cancer diagnosis of their own, or of a friend or loved one.

Photo by Junion Photography - 2019

I remember once asking my doctor what an abnormal breast lump felt like.  She commented that benign breast fibroids, cysts, and calcifications are common, but that I had unusually smooth breast tissue – which was good because it would be especially easy for me to notice any changes.  She was right.  In late 2020, I felt a lump in my breast.  However, I assumed it was just changes related to age and with the hassles of appointments during the pandemic, I waited a month or two before calling to schedule that mammogram I was overdue for.  I didn’t really want to tell anyone that I felt a lump, I just wanted to know if it showed up on a mammogram.  Unfortunately, there was about a 3 month wait for screening mammograms, so on December 15, I saw my primary care provider who scheduled me for a diagnostic mammogram 3 days later.

On December 16, I closed on the purchase of a new home.

 

More on that later…

The mammogram was followed by an ultrasound – as is always the case for me.  Apparently even “smooth” breast tissue can be too dense for a decent quality mammogram image.  They found six or seven abnormal spots, so they scheduled me to have them biopsied on Christmas Eve.

This was my first mistake… we have our benefits open enrollment in November, and at that time, I realized that I didn’t use any of my health savings account in 2020.  I had more than my annual out of pocket maximum saved, so I reduced the amount I would contribute in 2021.  But in the last two weeks of December, I met my full deductible for the year.  Had I believed that the biopsies might actually result in a cancer diagnosis, I would have waited 8 days and had them done in the new plan year.  That little mistake cost several thousand dollars, as the tests and surgeries scheduled in January quickly added up to my deductible for 2021.

Although my clinic didn’t allow guests to accompany patients to appointments during the pandemic, they made an exception and Jim was allowed to sit beside me during the biopsies on Christmas Eve.  They took over 20 tissue samples from 6 different sites.  Only one of the sites was the lump I could feel.  There was one more spot that they wanted to sample, but I was nearing the limit for how much lidocaine they could inject in me in a day, so we decided to wait until we got the results before taking any more.  I remember not wanting to worry my family on Christmas Eve, so I stuffed ice packs in my bra on the drive to dinner at my sister’s house, then hung them from the passenger side window of my SUV while we ate so they would re-freeze for the ride home.  My brother-in-law doesn’t miss a thing, so of course he asked what was hanging from my car door – I don’t recall the answer I gave, I think I just tried to quickly change the subject.

There was a lot of waiting due to the holidays.  Sometime around January 8, 2021, I learned that the biopsies revealed a 2.3 cm ductal carcinoma in situ (DCIS, stage 0) that was positive for both estrogen and progesterone receptors, as well as a rare but benign tubular adenoma, and several fibrous spots that weren’t concerning.  Interestingly, many doctors don’t believe that DCIS is palpable, but I confirmed that the DCIS was found in the lump I could feel.  Treatment for DCIS is typically partial mastectomy (lumpectomy) followed by radiation treatment.  However, my oncologist recommended more testing before making a final decision on the treatment approach.

A quick note on DCIS.  It is not invasive and is considered Stage 0.  Some people consider it “pre-cancerous”, but it can become an invasive cancer if left untreated.  I know someone who had this diagnosis and was told she didn’t have “real” cancer because she didn’t need chemotherapy and didn’t lose her hair.  As far as breast cancer diagnoses go, it is the best one to get in terms of outcome, but it is still a cancer diagnosis!  Please don’t ever downplay what someone is going through during cancer treatment just because the staging is low, or their prognosis is excellent.  Cancer treatment sucks, even when the cancer itself isn’t one of the “bad ones”.

A breast MRI and genetics study were added to the list of tests to undergo before deciding on a treatment plan.  While waiting for the genetic test results (which came back negative for any gene mutations that made recurrence more likely), Jim and I began moving our belongings from both of our apartments into the new house.  I was on a lifting restriction for part of this, so things went much slower than I had planned.  We got everything into the garage and set up the bare necessities in time for my lumpectomy on February 18^th.  The surgery went smoothly, although I was a bit unsettled when one of the meds given to me immediately before the surgery caused a loud ringing in my ears.  I woke from surgery more easily than I usually do with no noticeable side effects from the anesthesia, so I went home and logged into work.

 

Prior to my surgery, I hadn’t told anyone about the diagnosis except for immediate family and two close friends.  I posted about my experience on social media the evening of my surgery, which likely caused several other close friends to wonder why I hadn’t told them.  The truth is, I didn’t want to worry people before I had answers.  At that point, I thought I was done with everything except a few rounds of radiation.

My son’s lease was up at the end of February and so we started adding yet a third household of furnishings to the new house.  My phone rang as I was driving a U-Haul truck down Grand Ave in Wausau.  It was my oncologist’s nurse wanting to follow-up now that they had the histological results from my lumpectomy.  Expecting to be told that everything looked good, I asked if she could call me back in five minutes when I arrived at my son’s apartment.  She called again with my oncologist standing by as I stood in my son’s doorway greeting the movers.  My phone was acting up, so I answered the call on my watch.  Between the background noise of the movers, the low volume of the speaker on my watch, and my oncologist’s heavy accent, I made out only some of what he was telling me before I heard him suggest that I just come to his office.

Upon settling into my oncologist’s office, he explained that they didn’t get clear margins on the lump that was removed, and within that lump were 8 separate cribriform carcinoma tumors that hadn’t been picked up by any of the prior tests.  Had there been one tumor the size of the sum of the 8 tumors, it would have been considered a Stage 2 diagnosis.  However, technically, I had 8 stage 1 tumors.  My oncologist had never seen a case like this, and if the 8 tumors didn’t show up on the tests, it begged the question of whether there were more.  Because of this, he recommended we treat it as Stage 2 cancer with chemotherapy and radiation.  But first, I had a full body PET scan to look for signs of any other masses, a second surgery to remove more of the area where the first (DCIS) tumor was as well as to remove a couple lymph nodes and insert the port that my chemotherapy would be administered through, followed by a poorly timed echocardiogram less than 24 hours after surgery to make sure my heart could handle chemotherapy.

I remember going into the second surgery on March 4^th ready for the loud ringing in my ears again, which didn’t happen, and expecting to wake up feeling as good as I did the last time, which also didn’t happen.  I found it curious how the exact same surgery, surgeon, anesthesiologist, and surgical team resulted in two very different experiences.  I realized later that day that it was exactly 8 years to the day after I had my right adrenal gland removed due to a tumor that was producing too much aldosterone.  Although that tumor wasn’t cancer, I was treated in Froedtert’s Cancer Center.  I remember thinking how much nicer Froedtert’s facilities were.

On March 9^th, we picked up a new member of my care team…. Sookie, an 8 week old English Springer Spaniel.

 

I had been given an overwhelming amount of information about my diagnosis, even a book from the hospital where the nurse had marked pages and highlighted parts that were relevant for me.  Being who I am, of course I read everything I could get my hands on from reliable sources about the chemotherapy drugs I was told I would receive.  On March 10^th, I arrived for my first round of chemo and learned they changed which drugs I would receive.  I went from planning to have 6 rounds of cyclophosphamide and doxorubicin over a 12 week period to 4 rounds of cyclophosphamide and Taxotere over the same period.  Because of the change, I wasn’t familiar with Taxotere but I learned a week later that it is associated with permanent hair loss in some patients.

The actual administration of chemotherapy itself isn’t all that bad.  I went in early every third Wednesday, from March 10 through May 12.  They checked my blood first to make sure I was healthy enough to get the treatment.  Then, I relaxed in a chair and was given drugs to prevent nausea as well as a steroid and Benadryl to prevent any reactions to the chemo drugs.  I found myself fighting to stay awake long enough for them to start the first chemo drug.  All of this, from the blood draw to the drug administration, was done through a needle that was inserted through my skin into the port in my chest.  Before sending me home with more pills for nausea, they taped a small device onto the back of my arm which inserted a small tube through my skin.  24 hours later, a dose of Neulasta was injected through that tube, and roughly 20 hours later is when I started to feel like crap.  Neulasta is a $6500 shot in the arm that kicks your immune system into high gear, causing your body to rapidly produce white blood cells to prevent infection.  In the process of doing this, it causes inflammation in your bone marrow – literally causing every bone in your body to hurt.  Badly.  I feel nauseous just remembering it.

The weekend after chemo was usually the worst, and that sometimes carried over into Monday, but by Monday evening I was through the worst of it.  The thing to remember about chemo, though, is that the effects are cumulative.  On March 18^th, my best friend flew in from Arizona to spend a few days with me and help me cut the hair that I was about to lose into a short style.

 It wasn’t long after that I got tired of shedding and just shaved it all off.  I stuck with turbans throughout the chemotherapy and waited until I was feeling better before buying a wig.

As I mentioned, the effects of chemotherapy are cumulative.  Although my last treatment was in May, my blood tests in June still showed my red blood cell count, hemoglobin, hematocrit, and lymphocyte counts all below the target range.  At some point in there, I felt so weak that I was nervous just taking the one step down into my sunken living room.  I can remember carrying a basket of laundry from my bedroom to the laundry room and just sitting on the floor in tears because of how hard it was.  I felt as if all my muscles had shrunk.  I couldn’t bend down to pick something up or roll over in bed without feeling like I was pulling something.

I was spending more time in bed, eating comfort foods to combat the nausea, retaining water, and unable to get comfortable.  I felt like a short, bald, fat circus freak.  My house was a disaster from the incomplete move, my garage too full of boxes to park in, but I turned down offers of help because I just didn’t want to be seen.  At some point during that time, I remember thinking, “If it comes back, I won’t put myself through this again.”  Weeks after my last chemo, I was still developing new side effects – my skin started flaking, my nails became discolored and started to lift off, and the edema in my legs became worse.  I developed an allergic reaction which presented as a rash across my entire back.  That also had to be biopsied to confirm the cause.

I started radiation a week after chemotherapy ended.  I was given the option to heal a bit more first, but I had hopes of being done by the 4^th of July and maybe being able to enjoy the summer.  Every weekday for 4 ½ weeks, the left side of my chest was irradiated.  Like the chemo, radiation side effects are cumulative.  They also are delayed by about 10 days after the treatment.  Although I finished my radiation treatments in mid-June, my skin was still falling off in chunks two weeks later.  But at the same time, I also figured out how to wear a wig.

There is more... the estrogen blocking medication that gave me daily migraines, not being able to wear regular antiperspirant or a bra during radiation treatments, trying to find shoes to fit my swollen feet before a business trip, new kidney stone attacks, neuropathy in my feet, continued numbness in my chest and underarm, and so on.  But I think the important stuff has been sufficiently covered. 

All this might seem like TMI, but I’m sharing the details because inevitably someone would say something like, “Now that you’re done with cancer treatments….”  And it is important to realize, being “done” with the treatment is not even close to the same thing as being “done” with the side effects.  I’m writing this in mid-Sept, still fighting a rash, as well as some fatigue and weakness.  But, I’m still here to share my story, so I guess that makes it all worth it.  As for those earlier thoughts that plagued me… In hindsight, yes, I would go through it again if I had to.  But I’ve learned a lot… I would do things differently, which means I have to change things now if I want to be prepared for the possibility of a recurrence.  There may never be a “next time”, but if there is:

• I need to be healthier going into it

• My life needs to simpler, my surroundings less overwhelming and chaotic

• I must have a fallback plan if I suddenly can’t work, because my health and life insurance are provided by my employer

• I need to let go of the things that no longer bring me joy – because hard times will come, but living a life of joy is what allows you to face them without regrets

So that is my story.  People comment on how strong I must be to fight cancer, but honestly, there is little bravery in doing what you’re told you must do to stay alive.  The one thing I can do by choice for no other reason than because it feels like the right thing to do is to implore you to do the following:

• Stay on top of your regular screening exams.

• Don’t tell someone who has a health change or concern that it is probably nothing.

• Keep more money than you think you need in your HSA, especially if you can carry it over from one year to the next.

• Have good health insurance, even if just for major medical conditions - so far, my medical bills have totaled over $300,000.
  

• Don’t minimize a cancer diagnosis because it is early stage or doesn’t require chemotherapy.

• Be aware that a cancer patient may feel as obligated to comfort his or her loved ones about the diagnosis as you feel obligated to comfort him or her.

• Know that the effects of cancer treatments last much longer than the actual treatment schedule.

• If you care for someone facing a cancer diagnosis, understand that the kind of support they need may be completely different than what you think.

• If you know someone facing a cancer diagnosis, ask them how they are.  Please don’t ask them what their prognosis is, and please don’t be completely absent.  Reach out – even if you aren’t sure what to say, trust me, they will notice your silence far more than any awkwardness in your call, email, or text.

• Hug your people and tell them you love them because life is short.

• Enjoy your life today, tomorrow isn’t guaranteed.

The Great Vaccine Debate

Ernst & Friederike Lindeman were my great, great grandparents.  As of 1877, they had seven children.  On Saturday, August 4^th of that year, they lost their 10-year-old daughter, Helene, to diphtheria.  The next day, their 9-year-old son, Arthur, passed from the same cause.  On Monday, they said goodbye to their 12-year-old daughter, Bertha.  On Tuesday, they lost their daughter, Maria, who was almost 7 years old.  Thursday claimed their almost 5-year-old son, Ernst.  And on Friday, they lost their last two children – 3-year-old Georg and 13-month-old Emilie.  In less than one week’s time, Ernst and Friederike went from having a full house to starting over with just the two of them because of diphtheria.  The peak of the diphtheria epidemic was between 1921 and 1925, with 206,000 cases resulting in 15,520 deaths.  The diphtheria vaccine was developed in the 1920s, and people are still vaccinated against diphtheria along with pertussis and tetanus today with a shot commonly known as DTaP.  As for Ernst and Friederike, they went on to have seven more children, one being my feisty great grandmother, Anna.

With the current controversy surrounding COVID vaccination, I decided to research how early vaccines were developed and tested before being widely used.  My searching took me back to 1721, when people who didn’t really know much about immunity attempted to prevent smallpox infections by scratching a small amount of the pus from a smallpox lesion into a healthy person’s skin.  Unfortunately, some people contracted full blown smallpox from this experiment, and those who developed only a mild case were still carriers of the disease, spreading the full illness to those they came in contact with.

In 1796, Edward Jenner tried something different – he scratched pus from a cowpox lesion onto a child’s skin then exposed the child to smallpox.  The child remained healthy.  Cowpox was similar to smallpox, but much less severe.  Jenner spread the word of his results to other physicians, seeking nothing in return.  Soon, physicians around the world used this approach.  To deliver the vaccine to other countries, orphans were infected and put on ships, carrying the vaccine in their lesions.

Obviously, many improvements have been made to the inoculation approach in the years that followed.  Smallpox claimed over 300 million lives during just the 20^th century, but in 1980, the World Health Organization declared smallpox eradicated.  It is the only infectious disease to receive that status, and it was achieved through a vaccination approach that began with no scientific controls and frankly, a complete lack of ethics.  Thank goodness we’ve advanced since then.

Someone recently asked me my opinion on the current COVID-19 vaccination situation. The rest of what I’m about to say reflects my understanding and opinion, I am not an expert on these topics and I encourage you to talk to your physician if you have questions. 

 

First, I wish people had taken the recommended precautions related to sheltering in place, wearing masks, washing hands and maintaining 6 feet of distance from others so that COVID-19 vaccines weren’t needed. But here we are, so here are my thoughts:

• Very few viruses can be cured with medication.  The way of dealing with almost every virus is to treat the symptoms, reduce their severity through the use of antivirals, allow your body to build it’s own immunity by creating antibodies in response to being infected, or avoid serious infection through vaccination.  We don’t have 100% effective medications to treat the symptoms of COVID-19 or reduce the severity of the disease after symptoms start.  I support vaccination because it reduces severity of the disease.

• Some viruses are prone to mutating more than others.  DNA based viruses, like smallpox, are more stable.  That is why we were able to eradicate it after it had been spreading for centuries.  RNA based viruses, like the flu, the common cold, and COVID-19, are prone to making mistakes when they replicate, which causes mutations.  The longer a virus goes unchecked, the more likely variants will form.  As variants turn into new strains, it becomes harder to prevent infection through vaccination.  Chickenpox doesn’t mutate, so you will only get it once.  Influenza does mutate, which is why there is a new flu vaccine every year.  This is the primary reason I support emergency use vaccines -  I don't want us to be in a situation where we have to develop new vaccines annually for COVID-19 variants (we don't catch all annual variants with the flu vaccine, the same would be true for COVID-19).  Time is of the essence if we want to slow the rate of transmission to prevent variants and new strains.

• To reduce the risk of new variants, we also must reduce the number of infected individuals.  Herd immunity is essential.  The “right to choose” frequently comes up in conversation.  I understand this is a sensitive topic.  I support the right to choose, but with prejudice.  I have seen too many people digging in their heels because of misinformation or based on principle rather than on scientific evidence.  If your decision to not get vaccinated is purely to take a stand on your right to choose, I would ask you to reconsider your priorities.  I support the right to choose when there are legitimate medical reasons to not be vaccinated.  However, I also think people should be challenged when their choice provides no benefit to themselves but does reduce the likelihood of us or our children’s generation living in a world where COVID-19 infections are rare, like measles or polio.  At some point, we must acknowledge that being part of a civilized society involves being inconvenienced for the greater good - and for the good of those with medical conditions that prevent them from safely being vaccinated.

• While the FDA hadn't fully approved the vaccinations before their use, they did authorize them for emergency use, which is far more FDA involvement than any number of over-the-counter supplements, herbal preparations, essential oils, and other unregulated home remedies that people regularly use to improve their health.  Not to mention the things people willingly inject in or through their skin without FDA approval, such as piercings, tattoos, and recreational drugs.

• Speaking of government oversight, I don’t recommend government mandated vaccinations, but I'm not opposed to organizations requiring evidence of vaccination status.  Daycare providers require it before enrolling your children or sending them to summer camp and that is accepted.  Exceptions are allowed, but they have to be documented.  I know some people think the vaccine is being used to somehow control us.  I don’t personally believe there are enough corrupt people in positions of power or influence to poison the nation or world’s population.  I can remember thinking things had gone too far when seatbelt laws were enacted, but those laws did save lives.

• IoT and smart devices are a hobby of mine.  I don’t believe any type of tracking device is being injected with the vaccine.  Devices that transmit data must be powered.  Devices that contain static information that can be read by a scanner must contain a unique identifier which is associated with your information in a database if they will be used to track you or information about you in a meaningful way.  When I received my vaccine, it was drawn from a multi-use vial.  At no time did anyone scan anything to associate my identity with a microscopic chip.  In addition, you have to hold a scanner very close to a microchip to read any data from it, so it would be fairly obvious if someone was trying to track you.

• I willingly subjected myself to chemotherapy and radiation, both cancer fighting treatments that are known to have long term effects, because those side effects were less risky than allowing cancer to go untreated.  For me, the decision to get vaccinated to prevent or reduce the severity of COVID-19 was minor in comparison.

• I trust the scientists.  I trust science when sound research methods are employed and the results are published in peer reviewed journals.  I have not studied the research on the current COVID-19 vaccines, so I can’t say I trust the science, but I do trust the scientists at the organizations that have authorized and recommended their use, and I fully accept that they are human and may make mistakes.  There isn't enough time in the day to fully research every possible threat to my health that I may come across in a day.  I used Zantac.  I used Round-Up.  I got cancer.  I have no idea what caused it, but I'm going to go on living my life rather than spending it personally validating the research behind everything I come in contact with daily if I can reasonably believe it won't harm me.

• I know people who have personally experienced long terms effects of COVID-19, and people who have lost loved ones to it.  I don't personally know anybody who has experienced a serious side effect of the vaccine.  In general, I have not heard of any vaccine side effects that are is as serious as the risks of COVID-19.  Yes, there are people who have had serious allergic reactions to the vaccine – an allergic reaction is not the same thing as a side effect.  Nonetheless, the rate of serious side effects and reactions is still far less than the rate of those in people who contract COVID-19.

So those are my reasons for being vaccinated and hoping my friends will follow suit. I’m not one to get into heated debates or end relationships over it, but if I can get one person to think about and further research their decision, then writing this was time well spent.