Ennui in Long-Term Cancer: Existential Consequences Experienced by an Academic

Abstract

Individuals with long-term, incurable cancer may experience ennui. Ennui, a state of boredom, dissatisfaction and weariness may arise from not being able to engage regularly in meaningful activities. Not being able to take part in purposeful work or activities may result in existential issues that individuals with incurable cancer struggle to address. Within this article, the experiences of an academic experiencing ennui because of incurable cancer will be presented.

Introduction

Living with incurable cancer—cancer that will never go away—is a challenge. ¹ I have lived with Stage 4 breast cancer (incurable) for close to 6 years. To still be alive is such a blessing to me and to my family. But it also entails challenges that may go unrecognized by others but are felt keenly by me. Within this brief description, I address the challenge of responding to the reactions of others about my situation and mostly, expose the troubling ennui I experience living with long-term, incurable cancer. Ennui, a condition characterized by “dissatisfaction” and “weariness” and “boredom,” ² may lead to existential angst. I link ennui to existential questions I wrestle with, as finding purpose through activities is important to my well-being. Lastly, I offer suggestions for professionals working with individuals encountering similar situations.

Perspectives Practical

How Individuals React to My Situation

One challenge I experience is how individuals respond to my situation. Sometimes, sincere people offer lengthy accounts of their physical problems that are comparably minor ³ to mine. They are trying, I presume, to show how I am not alone in my suffering. I have encountered well-meaning individuals offering gracious comments about how fortunate I am to still be alive, how medications have come so far in their effectiveness, and other similar affirmations. I also have often fielded the comments of those who don’t understand that my cancer will never be cured (as is a possibility in Stages 0-3). While I try to explain that there is no cure for Stage 4 cancer, ⁴ some individuals doggedly hold on to the notion of a cure. While the above sentiments come from people wanting to thoughtfully respond to my situation, they often are not helpful. They do not reflect the other side of living with incurable cancer: At times, life is more of a burden than a blessing. I am living with painful ennui. And that ennui impacts how I feel about my usefulness as a person and an academic.

How Ennui Affects Me

As previously noted, ennui involves “weariness,” “dissatisfaction,” and “boredom.” ² Though ennui sounds benign, I have experienced it as being significantly destructive to my life and my identity. Since beginning treatment for Stage 4 breast cancer in 2019, weariness, dissatisfaction, and boredom have been continuous. They stalk me throughout the day and evening; relief is found at night in falling asleep. Finding meaningful activities in my day is difficult. Often meaningful activities involve commitment (weekly for 6 months to a year), structure (one day or half day per week), and sufficient energy to engage in them. Because of the energy consumed by my body fighting cancer, ⁴ and fatigue related to medications, I cannot necessarily make a long-term commitment because I cannot guarantee that I will be able to fulfill my responsibilities. The opportunities to regularly engage in meaningful activities that would help my existential angst are limited.

Ennui also impacts my professional life. I have loved the life of an academic. Being able to teach, write and research has been a tremendous privilege and a welcomed responsibility. When I entered academia about 25 years ago, I knew I had found my calling. I envisioned working full-time until perhaps 67 or 68 years of age, and then would reduce my hours, but continue researching and writing. When I was diagnosed with Stage 4 breast cancer in early 2019, I gamely tried to keep up with full-time work. I struggled though. In 2023, with the discovery of a tumor in my liver, I needed to reduce my workload to one third. Not only did I experience fear of the future—how long would I live and in what shape would I be?—I also encountered unwelcome side effects of the medications. The reduction allowed me to continue to work and not feel snowed under by its quantity. The fallout, however, has been significant ennui.

Within a full-time position, my work involved greater responsibilities. This connected me to colleagues. Collegial banter involved connecting with others about their lives and discussing concepts germane to our shared work. The energy gained from relating to others quelled weariness and boredom; it helped bolster motivation to tackle projects. Understandably, my work purview is much narrower now; reduced contact with others and their ideas have resulted in boredom and dissatisfaction.

Cognitive Challenges With Medications and Chemotherapy

The quality of my academic life has been greatly impacted by the side effects of medications. I have noticed several changes to my cognition. These include dullness of mind, difficulties concentrating, and word-finding challenges. All of these are related to ongoing chemotherapy^5-7 and other medications to manage symptoms. This is a tremendous issue for me. It impacts my academic work, as well as my sense of identity tied to the work.

Dullness of mind involves slowness of thought. When conversing with my academic colleagues, my responsiveness feels diminished. Sometimes, I simply cannot react quickly. Also, word-finding can be a challenge.^7,8 Although my colleagues are gracious and deny noticing these issues, I notice it, resulting in me feeling shame and sadness. I am ashamed of who I have become, with the illness and medications stripping away my effectiveness as an academic. And sadness reminds me of what I could have done if not afflicted with Stage 4 cancer.

Difficulty concentrating also largely impacts my creativity. Prior to the treatment for cancer, I could easily envision how I could structure a book or a book chapter. This enhanced my productivity—particularly my ability to publish—a necessary component of being an academic. Now, if I am stringing an outline or paragraph together, I must act immediately to document my successive thoughts lest I forget some. Not only can I not assume that I will remember a point in a couple of days, but I may also not recall the point in a couple of minutes ⁸ or even seconds (although the thought usually returns later). This is frustrating as my writing style is to “sit” with my ideas for several hours as I work and rework how I will piece together sentences and larger thoughts.

Overall, the changes to my work have created existential problems. Who am I now? that I can function only on the periphery of the academic world? How do I rebuild an identity with the changes to my thought processes, fatigue and resultant ennui? Do I bow out graciously from academia or keep fighting to produce? How do I know I am still “pulling my weight” on the faculty team and not simply a charity case? I have not yet found answers to these questions and fear that the obvious solution would be to retire sooner than later. But then, who would I be? Ennui has become an existential issue for me as who I am—an academic—is not reflected strongly in what I do.

Recommendations and Conclusion

It is important that professionals working with individuals experiencing ennui within long-term cancer treat this issue seriously. For some individuals, particularly those who strongly embrace an identity that comes with their work, ennui can feel frightening. It can impact how they see themselves and their future. Ennui—a condition not understood by so many who view ongoing living of those with incurable cancer as a “win”—is a “dis-ease” within the disease that those with cancer cope with. A few tips may be helpful. First, professionals should acknowledge the presence of ennui when present in their clients’ lives and work with their clients to find ways to combat it such as exercise ⁹ and facilitating hope,^10-12 Second, family and friends need to be cognizant to “read” the moods and physical capacity of their loved ones and question how they are feeling. Third, if they are able to help individuals to engage in meaningful activities, whether this means errands or activities, short visits with individuals or discussions about issues in society, these may engender hope. Fourth, a willingness to team up with another person or persons in new projects may provide depth of interest and safety for a person with ennui caused by long-term cancer treatment. A pastoral counselor I know has taken me onto her teaching team; with her I can teach without bearing full responsibility for the course. Finally, there is no one solution, but even the acknowledgement, with perhaps efforts to increase meaning in the lives of those dealing with it, can go a significant way to easing the ennui of those coping with the disease and the ongoing effects of living with it.