Beating The ‘Cold Cap’ – A Story Of Pain Transformation


A couple of days ago I did one of the most intense and sensitive jobs I ever did. I was asked to help a young woman endure the pain of a ‘cold cap’ treatment. She was recently diagnosed with breast cancer for the second time in two years, which completely suck because it means the cancer has come back or that they missed a cell during the previous treatment. Once again she has to undergo chemotherapy. Only this time she had decided that she refused to lose her hair. That was what the treatment was for: to freeze the scalp before the chemo enters the bloodstream and keep it frozen for a while so the chemo can’t reach the hair follicles. In 88% of the cases a patient can preserve his hair this way. Apparently and unsurprisingly this is a very painful treatment. She described the pain as a 9.5 on a scale from 1 to 10. I assume that if it were easy very few cancer patients would pass on the option to keep their hair, especially women. I assume that only men who already have little hair (like myself) don’t give a shit.

It was her employer who called me last Thursday and asked me if I had any experience with pain management and if my mindfulness techniques would work. I didn’t know. Meditation can definitely provide a different perspective on pain but never before I had worked with somebody who is enduring constant and severe pain during the whole session. That idea frightened me. If I failed I had to face a suffering soul and my powerlessness for the whole duration of the treatment which was an intimidating 2,5 hours. But I had already decided that I could better be with her than not be with her if she had no better options than me. Also her chance of pain relief was more important than my chance of painful and traumatizing failure.

A request like this is a very difficult call to make. It immediately brings up questions like ‘am I good enough?’ This is not something I want to screw up. But I am also not willing to let somebody suffer because I am just too big of a coward. The ultimate question is ‘can I remain present with somebody who is suffering right in front of me?’ I know that if I can keep my heart open while bearing witness to her pain healing must happen. This is how the universe works. So do I absolutely trust these universal laws even when the situation is extreme? My answer is yes.

These type of answers come from a very deep place of trust. And I know that if I say yes to such an assignment that ‘yes’ comes from a deep place and that it will resonate. But my ego becomes very nervous and starts worrying. My ego doubts these so-called ‘deep answers’ and is concerned about my reputation (what if I fail?) and about the fact that I now have to cancel appointments that are about easier and more profitable assignments.

But my ego knows it will lose this battle. As a reaction it will keep my mind busy during the whole of Saturday, even though I have to give the Warriors an important workshop on Sunday and would like to focus. My ego wants me to spend time looking for information on how to approach this task. But I am not really finding anything; I am only creating some false relief with the suggestion that I am working on the task ahead. Worrying makes my ego feel better.

After the workshop on Sunday I was beat but happy with the results. I went to sleep quite early so I could rise early and prepare. In the morning I made a protein shake and prepared food for the day. I didn’t want to risk feeling weak at any point in the day.

The interesting thing happened in the train: a sense of silence and strength came over me. I can’t describe it differently than that I am ready to die. I still feel fear but also an unconditional readiness.

An hour later I meet the young woman. It is an awkward moment. We both know that we have a difficult afternoon ahead of us but we have never met before so our meeting is kinda formal. We chat in the car. When we arrive at her place we have a couple of hours to get acquainted and practice a couple of meditations. Then her boyfriend drives us to the hospital.

Entering the hospital was the most difficult part. Never before I walked with somebody to the chemo ward. The reality of the whole situation kicks in. My client is welcomed with a mixture of warmth and pity: ‘hello love, are you back again?’ I feel moved. At the same time I inspect the room: where will she sit? Where will I sit? How much distance between us? How much noise? How much privacy?

Fortunately the nurses have a room for us with some privacy for the first hour. They place the ‘cold cap’ on her head. The temperature will drop to minus 6 very soon and this is the most difficult time. The nurses are pulling, tugging and pushing to make the cap fit super tight; it is not a subtle process. At the same time I want to make a transition to a more tranquil mind state as soon as possible because the pain will come fast.

Then we go to work. I ask her to close her eyes and focus on the breath. I close my eyes too. I have nothing else to navigate on than my trust and my intuition. I can only hope that what I say works because I can’t feel what she feels. I want us both to lose our sense of time because 2.5 hours is fucking long, way to long to look at a clock regularly. If I fuck up she will suffer so my concentration becomes immense. I will not drop the ball.

In a way it is very beautiful. I trust my intuition completely. She trusts me completely. We both depend on each other and we both have complete focus. We both sink into a deep state and I take her on a journey through her body and the universe.

After 2.5 hours the nurses come in to remove the cold cap. As she opens her eyes I ask her with a gesture: ‘thumbs up or down?’. Aaand IT WORKED! She says: ‘it seems strange to say this but I almost felt sorry it was over’ I feel an enormous relief and my eyes tear up. We made it. We were able to transform an extremely painful treatment into something almost pleasant. How about that?

I hardly ever feel proud of myself but the last 2 days I did. I really feel like we battled and conquered a mighty opponent and that feels good. But I also realize we are just at the beginning and that she needs 10 more treatments, probably increasingly difficult because the chemo will weaken her. And it is nice to be able to endure the cold cap but it is a 1000 times more important that the tumor will shrink.

So far, so good. This mission was a big fat success and we will keep repeating as long as it works. I am prepared to go all the way and will not abandon her. Back straight, heart open, fingers crossed and let’s fucking do this.


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