The difference between joy and relief with Allison Sweet Grant

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1:21Look for Nature Raised Farms chicken next time you're shopping and make your choice a little easier. When the brain fog is at its worst, it feels to me like being a painter and not being able to direct your paintbrush in the exact way that you want it to. And so everything is sort of like drippy or melty or just, you know, more abstract. I was just working with a much more limited palette, and I couldn't find the colors, even though I was looking for them. Hey, everyone. It's Adam Grant. Welcome back to Rethinking, my podcast with Ted on the science of what makes us tick. I'm an organizational psychologist, and I'm taking you inside the minds of fascinating people to explore new thoughts and new ways of thinking.

2:16Backed by popular demand is one of my all-time favorite authors, Alison Sweetgrande, who has a psychiatry background and also happens to be my wife. She came on for the first time a year and a half ago, and I'm still getting emails, calls, and texts about our driving debate. If we're taking two cars somewhere, if you're following me, I think it's the person following who's responsible for keeping up. No, if you're ahead of me, it's your job to slow down so that I don't lose you. Just asking if you could drive a little faster if you're following me. I think you're in the wrong and I think everyone is going to agree with me.

2:54We finally found a solution to this debate. We're going to talk about that and some burning questions that often come up for us like whether Seinfeld is better than friends, why you don't want to run into your dentist at the beach and what habit she wants me to rethink. But we're starting with Alison's first memoir, Lump, which debuts this month. It's poetry and prose about her experience with breast cancer. And she writes beautifully about the fear and guilt many cancer patients feel, the joy versus relief of healing, why it's complicated to be called a survivor, and how we can provide better care and support to our loved ones.

3:30Alison, welcome back to Rethinking. Thank you. Thank you for helping me. Helping me. What? Was that a word? I don't know. Tell me something that you've rethought lately. I mean, I guess the easiest answer is to say coming on your podcast, because I don't want to be seen as like a podcast nepo baby. You just coined a new term. Yeah. There's no such thing in this context. Well, I'm here. I'm doing it. I'm so glad you came. So I did rethink it. Yeah. You are officially here to talk about your new book, Lump, a memoir in ineloquent reflections. Indeed. Which I loved and I didn't just love it because I love you.

4:12You say that a lot. Well, it's true though. I think, I mean, I think this is a writer's dream that the best version of you shows up on the page. I would agree. And all the rough drafts that you discard and don't publish, people who know you see in real life. So your day-to-day personality is a rough draft in a way? Yes, exactly. Which is why so many people are disappointed when they meet their heroes. Oh, interesting. Because they saw the peak snapshot and not the daily struggles. Yeah. But Lump. I'm not the only one who loved it. Lots of people I admire and respect have said it stopped them in their tracks.

4:54Well, thank you. It's certainly nice to hear. There's so many things from it that I want to talk about. But maybe the place to start is the genesis of the book was you having to rethink what a lump was, or at least how you felt about lumps? Well, I think the genesis of the book was being put in the position to have to rethink that and maybe not wanting to rethink it, fighting against that to begin with. I mean, I think what stands out to me is that I didn't think lumps, right? I mean, when I used to hear the word lump, I thought of mashed potatoes or kids hiding under a blanket or maybe the moguls on a ski hill or something like that.

5:43It did not have anything dark or scary or traumatic associated with it. And then in a matter of moments, that changed. So spring 2020, we were two months into COVID roughly. You found a lump and you were diagnosed with breast cancer. And I didn't know you were writing about it. Great. When did you start writing and why? Well, I think once I started chemo is when I started writing because I was on the couch a lot. Our kids were in online school. And so I was just kind of had set myself up in a little station, you know, next to our son. And I was writing about what I was currently going through with cancer and chemotherapy and not really expecting it to go anywhere, but just using it as a way to process my own thoughts and experiences and get them out of me and into something else.

6:45And that's where it started. Oh, so it was a journal. At the beginning? No, I don't think I would say it was a journal. It was very piecemeal. Probably wouldn't have made sense to anybody else who read it. Sentences here, you know, metaphors there. But for me, it was a productive way of managing what felt like a very unproductive thing I was going through. Yeah. Okay. So initially it felt like early days of COVID, it was the worst time to get a diagnosis like that. You had to go to every appointment alone. And on the other hand, we realized over time that in some ways it was the best moment if you're going to get a cancer diagnosis to get it because you weren't out in public.

7:34It was an interesting time to get sick because you're right. In some ways, it was beneficial. I didn't have to worry about the way I presented myself to the world because nobody was presenting themselves to the world. We were all hiding, right? But like you said, it was also terrifying because you couldn't accompany me to anything. Anytime I did go into an office or a hospital, it was like nothing I'd ever seen before. The halls were empty. There were no support groups. There were no people chatting in waiting rooms. There were no communal treatment rooms, you know, or things like that. Everything was incredibly isolated.

8:19And that made it really hard. One of the things that you wrote about in Lump very powerfully is the pressure you felt in the hospital to actually please healthcare providers. Talk to me about that experience of feeling like you had to audition for the approval of healthcare providers. Yeah. I mean, well, I have a piece in the book, The Perfect Patient, which is sort of a parody of a interaction between a patient and a physician where the patient sort of sacrifices their own needs and wants in order to come across as pleasant and accommodating and compliant and friendly and all of those things.

9:00I just, I think that people who find themselves in a position where they are not just going in for like an annual physical, a root canal, right? Something pretty minor and ordinary, but people who find themselves in long-term care, that there's a lot of pressure to be the perfect patient and not to ask any questions, not to cause any inconveniences. And I think it's a shame, you know, because it's hard enough being a patient and having to deal with everything that's going on health-wise, but having this added layer of feeling like you have to come across as easy to please your provider, it's just an unnecessary layer of stress.

9:52It's so backward too. Their job is to take care of you. You shouldn't have to worry about their feelings. That's something that you tell me all the time is they're working for you. Make sure everything that you want is what happens in that appointment. But I think so often like the tables get flipped and the patient feels like they're the one who has to put on a show for their provider. Why? I mean, I think a lot of it just comes from the assumption that a physician is an authority figure and feeling like there's a power imbalance and feeling like it's your job to meet that provider where they are, as opposed to what I think is completely the opposite, where it's the physician's job to meet the patient where they are.

10:41I mean, I've wondered if there's a gender difference here. We know that women face undue and extra pressure to appear warm and communal and polite. And men just don't face that same expectation. And so are probably more comfortable just asserting what their problem or their issue is. Do you think this is partially gendered? I do, but I mean, I can only speak for myself, but I do. I think women in healthcare are used to being dismissed or, you know, I don't know if I'd go so far as to say belittled, but gaslit to use a very popular term right now. And yet in order to avoid that happening, I think a lot of women will walk into an appointment and not be as honest or forthcoming as possible because they're afraid of the consequences.

11:32And you have a New York Times piece about this. The evidence is clear that women are less likely to be believed when they report pain, right? That a man who says, ow. Do you mean, ouch? Yes. I mean, can I say, ow? Is it ouch? I think it's ouch. I didn't. Have I, have I been Miss Onomatopoeiaing all my life? Maybe. Okay, fine. But yeah, I do think this tracks with gender stereotypes, right? People assume that men are strong and tough. And so if a guy says, ouch, people take that really seriously. whereas when a woman does it she's seen as hysterical or emotional or as weak in some way which is grossly unfair it's an experience that i had frequently not only with my cancer care but just in general and so if you feel dismissed as a woman just at your routine physical imagine feeling that way when you're receiving treatment for cancer and wanting to do everything within in your power to make sure that you get the right care.

12:33And if you have to sacrifice a little bit of yourself in order to do that, a lot of women will do that. And I think that's sad and unfortunate, but understandable. And I think that's why it happens. Yeah, in your article, one of the things you highlight is that the stakes are much higher than I realized too. That when patients feel pressure to minimize their symptoms or when they try not to be labeled as difficult, they actually end up getting worse care. You actually told me when you preface it with, I'm not trying to be difficult, but that already like plants the seed that there's something difficult coming.

13:10And so you're kind of setting yourself up for a worse experience. Yeah. That kind of disclaimer can backfire. And so it feels like a double bind in a way. Like there's this unfair dilemma of, on the one hand, if you get labeled as difficult, then you're just going to get less care. You might not get care at all. Right. And if you're afraid of being labeled as difficult, if you're afraid of the stigma of being seen as a problem patient, then you don't actually get your needs addressed and you don't get good care either. I think it's, you know, it's tempting to say, well, what can a patient do? But I think the onus is really on the provider.

13:46What do you think healthcare professionals can do to make this easier on patients? I mean, it seems kind of silly and maybe counterintuitive, but I think a provider saying something like, what is it that you want to tell me that you're afraid to tell me? Or what is it that you want to tell me that you think will make you look crazy? Or something along those lines might sort of break that wall and help patients feel more comfortable. I think that is such a good idea. I think it's actually a really simple but powerful way to create psychological safety. right to say hey I know there might be something that to you feels like it might be hard to talk about and everything is discussable here I'm here to take care of you and I can only do that if I know what's really on your mind right or even going so far to say something like what would you say to me if there was no judgment you know or if I wasn't writing it down or something like along those lines.

14:44I think that's such a great idea. It's actually very similar to something that NASA started doing after a deadly accident. It's not that easy to say to a rocket scientist, I think you might be wrong. And so they created a norm that at the end of important decision meetings, they would ask, does anyone have any information that might be relevant, but hasn't been shared yet to try to open that door? Yeah. I think you're onto something here. Okay. All right. Let's talk about some other topics. There's so many parts of Lump that I love. There's so many poems and essays that I just, I can't stop thinking about that it's hard to pick.

15:22But one of the themes that really jumped out at me is you are, I think, appropriately critical of the way that we tend to glorify the fight against cancer. I'm going to read you your words. Are you ready? Yeah. Okay. You wrote, don't call me a survivor. I didn't do anything to earn the title that the people who didn't, didn't. I did write that. Tell me about it. I mean, it's very easy, I think, for people to call having cancer, like a journey and you hear it all the time. But it's used, in my opinion, as a way for people who don't have cancer to feel better about people who do have cancer and what they're going through.

16:15But for the person who's going through it, for me anyway, it felt kind of patronizing. This isn't a journey. This sucks. And I'm just doing the best that I can. And I don't know which way it's going to go. Nobody knows which way it's going to go. You know, with a journey, you hope for a destination. And although you hope for one with cancer too, it's not as black and white. Yeah. And so that word in particular, like, I don't know very many cancer patients who do like it. Yeah. Yeah. I mean, you really made me rethink that because I think coming in, thankfully not had a lot of exposure to cancer.

16:53Yeah. I I thought about the journey metaphor as a way to signal the diagnosis is not an endpoint. That, you know, people get fixated on this horrible news that could be a death sentence. And to say it's a journey, it gives you permission, I thought, to stretch it out into the future, to realize that you might be in a valley, but you may climb out of it, right? There's a road ahead of you, I think, is what journey signaled to me. I never thought about it the way that you describe it of no journey is going somewhere really great. And I don't know where this trip is going to take me, but I didn't sign up for it.

17:29Right. Yeah. No, I completely agree. Yes, there is a road. Right. And there are hills and valleys for sure, but it's not a road that anybody would choose to be on. No, it's more like an odyssey, I guess, in that way. Right. I don't know. Like an odyssey, like all of life is a journey. right? Or an odyssey. There's a start point and an end point. And just, I think in cancer in particular, it's used to make it look prettier, to make cancer look prettier. Yeah. It becomes a saga instead of a struggle. Oh, that's great. Yeah. Yeah, you're right. It's almost like it's airbrushed. And, you know, I think the other point that's so salient from the way that you wrote about calling someone a survivor.

18:16I'd also never considered that before that the person who quote unquote wins the battle against cancer probably did not do anything different from the person who quote unquote lost the battle against cancer. You know, presumably they had similar treatment options. They followed their doctor's recommendations and one was lucky and the other wasn't. Yeah. Yeah. I mean, I personally, like, I find it very difficult to hear those words for that exact reason. And it's also a lot of pressure to put on a cancer patient to call them a survivor, because really, they're just trying to live their life like everybody else.

18:56I think though that there are a lot of cancer patients out there who use that term like a goal, right? To be a survivor. And they like wearing that armor around them and it's helpful to them and that's wonderful. But I think there are a lot of people out there also who it's just, it's like an added layer of guilt on top of things. An added layer of pressure and maybe a mask that they might not feel truly fits them. Wow. And why guilt? I've never heard you talk about that before. I think that there's a lot of pressure for cancer patients when you're done, if you survive, right, and come out the other side, to be a cancer spokesperson, to be a survivor, to wear a ribbon, to do all of those things.

19:43Not everybody wants to do that. A lot of people want to just get back to their normal life and they don't want to be faced with that. You know, well, why aren't you wearing the ribbon? From Seinfeld? Yeah. Who does not want to wear the ribbon? Right. I often don't want to wear the ribbon because I don't want to be reminded of what I went through or for a million other reasons. And that survivor label makes it hard to make those choices. Yeah. So you're coming up on six years cancer free. Is that right? Yeah. God. I'm the date remember in this relationship, right? Yeah. One of the things you've taught me about that is that at least for you and others who don't love the survivor identity, the noun is the identity.

20:30That's the part that you're not comfortable with. But you said, don't call me a survivor. I'm surviving. Yeah. I mean, you are surviving. Yes, but we're all surviving. I mean, I think the best day for a cancer patient is when you don't have to think about whether or not you're a cancer patient. And if your entire identity is built around being a survivor, I don't know how you stop thinking about that. Yeah. At least for me. All of this preference for everything that I say regarding cancer is all very personal and somebody might feel the exact opposite. Yeah. Which is okay. Okay. I think the reminders point is one that I also did not fully appreciate.

21:17before. I think about two markers that are just unavoidable, one of which is Hamilton and the other of which is our anniversary. For us. Yeah, for us. And I thought you wrote about both of those markers so poignantly in love. Well, I mean, it started with our anniversary, so we might as well kind of start there. So the day that I got diagnosed was our wedding anniversary. So that was, it was actually fine because since it was COVID, we weren't doing anything special. I think we were throwing socks into a hamper for the kids to play soccer inside or something like that. Remember when the PE class was like, here are all these activities you can do to stay active at home.

21:58But yeah, it was an interesting coincidence and it's definitely now easy to keep track of both of those. You never forgot our anniversary after that. Yeah. And then with Hamilton, that was sort of a mistake that we both made, which was after we talked about the diagnosis with our children and sat them down and listened to their questions and answered their questions and went through the whole plan. Then we decided to sit down and watch Hamilton, which we thought would be a great distraction. But because Hamilton turned out to be the huge success that it was, and everybody was talking about it all the time, it was just a reminder for the kids of that first conversation.

22:45I think where it's landed is, I think two of our kids love Hamilton and one still, when a Hamilton song gets played, it's a little bit distressing. Yeah. Or even at school, they ended up watching parts of Hamilton in history class or whatever. And she had articulated that it was difficult. Yeah. Yeah. So I think that's a lesson. Don't take something that's culturally ubiquitous that people have positive associations with and link it to a bad memory. Yeah. Noted. Did not get that advice in advance. Okay. Something else we have to talk about from Lump is Sheila. Okay. I try to see the good in most people having a hard time with Sheila.

23:30Yeah. It's interesting that you're like latching onto this because Sheila's only mentioned once in lump. I know, but she's, I feel like she's my nemesis. Yeah. Sheila sort of represents all of the nameless bureaucratic like inconveniences that come with being in the hospital, being a cancer patient, having to like jump through all these ridiculous hoops, paperwork, you know, all of that stuff. Yes, Sheila, I can fill out your stupid form that I've already completed nine times. Yeah, you're right. Sheila was sort of the face of all of the preventable nuisances. Yeah. I don't know. It feels like something controllable in the midst of something that wasn't.

24:15It seems like the least a hospital could do is try to minimize the bureaucratic indignities and the little slights that make you feel dehumanized during a process that's robbing you of your humanity. Yeah. But I think we were lucky, actually, you and I, in that I think we got to sidestep some of that, one, because of COVID, you know, but also I kind of refused to do a lot of it too. Like I would be given an iPad at an appointment and Sheila, right, would say, your doctor wants you to fill this out, you know, and I would just casually forget to fill it out and nobody would say anything. So like, why am I doing it anyway?

24:57And so if I can forget to do something that isn't necessary to begin with, I'm going to do that every time. Yeah. Yeah. Or the text message questionnaires that you're supposed to fill out. Yeah. Yeah. I remember thinking at some point, okay, you were going through chemo and I'm watching this thinking, like you're poisoning my wife in order to try to heal her. And you're also, you're just robbing her of her dignity in the kinds of questions that are asked on these forums. I thought you got great revenge with the medical form that you wrote about in love. Well, thank you. I don't know. I'm just trying to make the best out of an uncomfortable situation.

25:43So I'm pretty sure it was a questionnaire about anxiety, which is great that providers are asking about that because obviously cancer is a very anxiety producing event. But some of the questions were just kind of outlandish and become so rote, like after you're asked them five, 10, 15 times. And so I just like to play on that a little bit. I mean, I remember being asked by medical assistants who were like doing your vitals, Have you been experiencing any depression? Well, no. I mean, of course not. I've only been diagnosed with cancer. I'm only sitting here in a chemo suite. Like, no, that would be so odd.

26:29Why would I be depressed or anxious at all? Like, there's got to be a better way to monitor because, of course, patients need mental health support when they're going through cancer. But to say, like, are you feeling down? Like, that's just such a dumb thing to ask. Yes. Yes. Yes, obviously. It would almost be a mental health concern if you weren't. Right. If you were excited to be there. Yeah, actually, I'm feeling better than usual. I think that that speaks to something that we've talked about a lot, which is in some ways your anxiety, your everyday anxiety was lower while you were going through cancer treatment than I think before and after also.

27:13Yeah, because it's focused. Like you have one thing to worry about and everything else is not cancer. And so, yeah, your anxiety or my anxiety anyway, it changes and it shifts and it focuses. And of course now, right, that I'm doing better, it's much easier to be anxious about all of the little things now that cancer is not like staring you right in the face anymore. How many times a week do I say some version of, let's remember, this is not cancer? Absolutely. And it works. Too many? Or is it helpful? No, it's helpful for sure. Really? Because you lose sight. Yeah. I mean, if you have the luxury of losing sight that cancer is your biggest problem, then you're a pretty lucky person with cancer, you know?

27:56So it is helpful for me. Okay, good. Then I'm going to keep doing it until you tell me to stop. On the chemo subject, one of the other things that you wrote about in Lump that I thought was profound was the experience of having the intelligence to notice that you were losing some of your intelligence. Yeah. I mean, brain fog is a pretty typical side effect of chemotherapy. And it's something that I experienced pretty quickly, I would say, and something that I feel has stayed with me. It's incredibly frustrating to be able to sense when your senses aren't working properly. Yeah. And when your mind isn't working properly.

28:47and it's for me been one of the hardest side effects of this entire experience is knowing what I want to say but not being able to say it, not being able to articulate my thoughts and feelings, feeling like there's a disconnect between my brain and my mouth. It's a horrible way to live, yeah. Yeah, I mean, I think my instinct was always to tell you it's not as bad as you think it is. You might feel like you're 7 % off, but I see the 93%. And most of the time in most of the situations, I can't even tell. And if I can't tell, there's no way anybody else is noticing. But I think that felt to you like I was minimizing the symptoms.

29:32It did feel that way because I might have looked to you like I was 7 % off. But to me, maybe I was 50 % off. And I couldn't even convey that to you because you kept saying, no, you're making a big deal out. It's nothing. I can't see it. And I'm trying to explain to you that even though you don't see it, I see it. I feel it. If you gave me a math problem to do in my head, right, and I got the right answer, you don't care how I got there. But if I'm sitting there struggling, knowing that I should be able to do it this way, but I have to do it this way instead, that takes me two or three times as long, right?

30:09That's a very frustrating internal experience as somebody who used to be able to do it like this. Yeah. Well, I'm sorry that I didn't understand that sooner. You don't have to apologize. No. I mean, I feel bad about that. It's part of my pattern of wanting to help and sometimes being too quick to rush into a solution as opposed to really making sure I understand the problem. Right. I would react to that when you were worried that other people were judging you as stupid, when they didn't even know that you were being treated for cancer or that you had brain frog, brain frog or that you had brain fog, which is different, right?

30:47So I think what I was really struggling with was empathizing with or showing compassion for your internal struggle while also reassuring you that you didn't sound like an idiot and that other people couldn't see most of what was going on internally. And so if you were going to worry about something, it's the internal experience, not the external judgment and shame and embarrassment that was the concern. Does that make sense? It does. It does make sense, but it's not as reassuring as you would like it to be because I'm still experiencing the struggle. And so even if I get the right answer, even if somebody else doesn't notice, I'm still using twice as much energy for the same output.

31:34Yeah. Yeah. Yeah. That makes sense. And I think that was one of the places where writing proved to be extremely helpful. Absolutely. Because there's no clock ticking there. Yeah. There's nobody observing. You had unlimited time to express it the way you wanted to articulate it. Absolutely. It's one of the reasons I'm so anxious about promoting this book to begin with is because I know cognitively I don't feel the same that I used to. And I am worried about sounding stupid or not being able to come up with the exact right word. Like recall is really hard for me. When I'm writing, I can take as much time as I want.

32:13I can revise as much as I want until I can communicate exactly what it is I want to communicate. And that's why it's a different... When you say, let's talk about the book. Well, I wrote the book. I don't want to talk about the book. You got it right. It's for itself. Exactly. Yeah, you got it right on paper. You don't want to now flub it in conversation. I felt like when the brain fog is at its worst, it feels to me like being a painter and losing my color palette. So you have this huge range of beautiful colors and your paintbrush goes exactly where you tell it to. And it looks exactly how you want it to.

32:56I'm not an artist, but that's what I imagine, right? Being able to convey the picture that's inside your head into something on canvas and then imagine all the color fading away and just having sort of the basics to work with. That's what it felt like to me. Wow. You've never described it that way before. That's powerful. It's almost like cancer is the rainbow bright villain. What was the villain's name? Do you remember? He looks like the Hamburglar, right? No, he's got a mustache and a, like a helmet. I don't remember his name. It's not the purple pie man. Something gloomy. Murky dismal. Oh, murky dismal.

33:38Thank you, Jessica. Murky dismal. Yeah. Murky dismal. Everything goes from beautiful color to more of a gray sort of monotone. And that's, that's what it felt like to me. So I actually, I think this speaks to something else you wrote up about in the book, which is you have synesthesia. Yeah. It's the pairing of different senses. So some people like taste shapes or hear. They hear color. Hear color or hear, or there's tactile types of synesthesia as well, where they like feel words or sound or things like that. Exactly. Mine is the simplest and most common form, which is color number synesthesia, where when I hear or see a number in my mind's eye, it is associated with a particular color.

34:28I wonder if, because you have synesthesia, if writing was a way to bring some of the color back. That is a very beautiful thought. I'm not sure. It felt more for me like writing was just really a pressure release, you know? It's sort of like the top of the teapot, like coming off and letting all those steam out. That's what it physically feels like for me when I'm writing. But yes, being that like you write in letters and numbers and I'm typing on a keyboard, it is a way to sort of incorporate more color, so to speak, into the experience. So that's a really interesting observation.

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37:56okay Allison you've mentioned a few times being a private person yeah and Nancy Rothbard studies this we've talked to her about it you are a segmenter not an integrator you like to have your personal life walled off separate from your professional life. Yes. Which is one of the reasons you don't like to come on podcasts. Right. I'm a segmenter too, but you had such a funny observation about being a segmenter when I think we ran into someone work-related when we were on vacation at the beach. Oh, the dentist. Yeah. We ran into our dentist on the beach in the Caribbean. The Caribbean. And I just couldn't handle it.

38:42Because once you see your dentist in a bathing suit, you don't want them to be your dentist anymore. Why not? Not that anything was wrong. You're judging our dentist by his knees. No, no, no. I'm not judging him in any way. I don't like his toes. He can't clean my teeth anymore. No, it's not about judgment. It's not about their physical appearance in any way. But once you know what your dentist's toes look like, you don't want him in your mouth. Like, that didn't come out well. Once you know what your dentist's toes look like, you don't want him as your dentist anymore. I don't. Why? So I think this is a prototypical reaction of an extreme segmenter because he's crossed a boundary.

39:31It's like in Seinfeld. It's like you're killing independent George. A George divided against itself cannot stand. When George wants to keep Susan, his fiance, separate from his group of friends. Yes. I think that this is a boundary violation for you. That when you see the dentist at the beach, you say, oh no, he has exited the professional world. And now he's in my family life. And therefore I can't see him as a professional anymore. Right. And it's not about him. Our dentist is wonderful. We love him. But I have a very visceral reaction. It's a disgust reaction. Not at the toast. No, no. It's a disgust at the person who belongs in one sphere being in a different one.

40:10It bothers you. I truly just think it's a visual disturbance. You can't unsee it. Yeah. You can't unsee it. Actually, the brain fog sort of plays into that too, because I'm afraid of running into somebody I should recognize in a different environment and Not being able to recognize, at least not right away, and then being offended that I don't know who they are. Oh, wow. That's not fair. But that's a fear. You mentioned fear, and I thought this is another thing that you captured so beautifully in Lump. I'm going to quote you on this. You wrote, I'm still afraid, and this is how I know I'm alive.

40:54It seemed Cartesian to me. I fear, therefore I am. Yeah. That seems like, in some ways, an adaptive take on anxiety, right? To have everyday things to worry about is a reminder that you have a life now that's not dominated by disease. To worry about cancer coming back is to be privileged enough for it to be gone to begin with. And so it is a constant worry. but I also know I am lucky to be in the position to have that worry. Okay. A few other things I want to talk about. You wrote in Lump about waiting to unruin your life. I thought that was a striking way of capturing what you were trying to accomplish.

41:47Waiting to unruin your life, it feels different emotionally than waiting to heal. It made me think about the psychology of prevention and promotion focus, where promotion focus is seeking a positive outcome and prevention focus is avoiding a negative outcome. And I think you have always been more prevention than promotion focused. And I think we saw this when you got the news that you were cancer free or NED, right? No evidence of disease, which I guess that's the term of art now. Yeah. Not remission. Right. or not cured for sure. So I remember when we got the no evidence of disease information, I think if you'd been promotion focused, let's celebrate.

42:31That would have been joy because it would have been the experience of the outcome that you were hoping for and wishing for. And I think you felt much more relief, which is what the research shows about prevention focus, that for you, that was not the presence of something good. It was now the absence of something bad? Well, I actually think that that ties to something that cancer patients experience a lot, which is that a lot of people think when you get that all clear, the hard part's over, right? But it is not over. There are side effects that patients experience every day that they don't talk about.

43:10There's fear of remission that sits on their shoulders every day. There are things that they've lost in that time period that they don't talk about because it's really hard to express those things that you're still struggling with when people just want you to be like, you're all better and you are better and you're grateful to be better, but that doesn't mean everything's over. It doesn't mean that struggle is over. It may never be over for some people and it's still tough. It's still tough every day, but you can't talk about how it's tough every day. You did write about how gratitude and grief are not adversaries.

43:49Yeah, right. Yes. I can absolutely be 100 % grateful that I'm better. 100 % grateful for my treatments, for everything that I went through. And also acknowledge that it sucks and it's hard. And I'm still dealing, still grappling with some of the leftover side effects of those treatments. You know, I'm not the same person, even though I don't have cancer right now, that I was before I ever had cancer. It's just not possible. And that's a hard thing to explain to an outsider. Yeah. I think it's hard to explain to somebody who has seen it up close even, too. Yeah. It's hard. Yeah. It's hard for me to relate to sometimes because I see you look and sound like you're healed.

44:43Right. And like this never happened. Right. But I don't feel the symptoms that you feel. Unless I tell you, I got to sit down. Yeah. And then I have to ask the question of, is this a lingering side effect of cancer or did you just not sleep enough last night? Right. Yeah. I don't know. Probably both. Yeah, maybe. Was it my snoring or was it cancer? Right. I think the thing that surprised me most in the whole book, there were a lot of things in it that I didn't know. The thing that kind of blew my mind was the letters. I had no idea. Did you know I didn't know? I don't think I thought about it.

45:22Yeah. So when I was first diagnosed and first told that I had to have chemotherapy, I felt very afraid of the chemo. I had sort of an irrational fear that I would not return home, that it was going to be the chemo that would kill me. And so I wrote letters to numerous people, particularly you and the kids and one or two others. And I left them in a room of the house that is not frequented so that you wouldn't find them on that day. Yeah. And then when I came home, I moved them. I took them back. I did eventually give them to the kids. Did I not give you yours? Are you sure? Yeah. It was just something that I felt I needed to do because the diagnosis came so quickly.

46:14And then starting treatment, it all happens like in a whirlwind. It was so fast. And I was so overwhelmed. overwhelmed I didn't know how to say all the things I wanted to say and I wanted to leave something permanent-ish behind and so that's what I did. It broke my heart to know that like you had to sit there and write goodbye letters and that you were that afraid. Why didn't you tell me? I don't know because I didn't want anyone to know. I mean that's why they were letters that I sealed in an envelope and put away. So I wonder, it makes me think that at some level, you write the letter just in case, but if it's just written and it's never said, then you can still tell yourself, this is just a what if.

47:04This is just a worst case scenario. Yeah. It's not real. Maybe. It just felt like something I had control over in a situation where there was none. Yeah, yeah. I think that's right. Well, I think the book is such a gift. I think it's a gift to anyone who's facing a cancer diagnosis or any life-threatening disease. I think it's a gift to anybody who's caring for or close to someone who's going through something difficult. I also think it's a gift to people who really love poetry and who love prose and who appreciate the art of the written word and are sort of literary. But it's also, I think it's been a gift to our family.

47:51And I think it's helped me understand you better and what you went through. It's helped me try to be a more supportive husband and partner. And I think it's one of the reasons why I think when you say I'll never write another book again, I say, no, you have to write. Because it's something that you share with the world is also something that you share with us. Well, thank you.

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50:17So on a lighter note, when we were talking about fear, there is something so paradoxical to me about you and fear on our tv on our tv yes what do you mean you won't watch horror movies because they freak you out no you're wrong hold on wait let me finish before before before you correct me let me at least observe the paradox and then you can course correct it so you don't watch horror movies see you're starting wrong all right we'll come back to that. Okay. You were once watching, is it called American Horror Story? Yeah. You once told me to delete it from the DVR. Yeah. To purge it because it was giving you nightmares and you couldn't handle it.

51:03Okay. You are very, very distressed by horror fiction. Okay. By imaginary fears, but probably two nights a week, I come upstairs and you're watching Forensic Files, which is a terrifying show about actual serial killers and husband-wife murderers and... Husband-wife murderer? Husbands who kill their wives. It's a show about the very worst of real humanity. It makes my blood curdle. And the thought that that's actually out there is frightening to me. I can't watch that show. I can watch any horror movie and feel nothing because it's not real. And I think this is totally backward. for you. Okay.

51:51Is there a question? Yes. Explain this to me. Tell me what I'm not getting because I don't understand being terrified by fiction and being not only comfortable with, but oddly fascinated by real horrible events. Okay. Well, I have plenty of thoughts on this, but first of all, fiction is much scarier than reality. Disagree. All right. Well, Well, let me start by saying you're wrong that it's not that I don't watch scary things. I do enjoy thrillers or horror movies or I do enjoy them as long as they're not about particular subjects. So anything with children and children being kidnapped, I have a blanket no policy.

52:37Agreed. It's only when the focus is on certain things that I have to say no. Okay. Then regarding forensic files, forensic files is not scary. Forensic files is interesting. There's so much science involved in the show. It's not like visually disturbing. True. It's really about the science and the law enforcement and the mystery and the strategic investigation. I grant you that. Yeah. I agree with that. It's not horror. There's nothing like scary on the screen. And if anything, that's like a low, low level creepy, like there's nothing scary. Point taken. It's not viscerally disturbing in that way.

53:23The images. But I think it's still much more terrifying to know what some of these people have done. No, because then I watch it and I'm like, oh, I could have figured that out. It's actually. But not prevented it. It's actually reassuring. No. I see the tire tracks or oh, like. No, no. No, forensics by definition are only after the crime has been committed. Yes, but it makes me feel better to know that somebody always leaves something behind as opposed to in Texas Chainsaw Massacre where they're all just horrible people getting away with horrible things. Oh, there's a sense of justice. But that does nothing for me unless it's minority report and the forensics are all precogs and they can anticipate the crime happening in advance based on some of the early signals and then prevent it, which we're not there.

54:14I don't know if we're ever going to get there. But if you watched true crime, you would know that doesn't work. Well, it doesn't work yet because social science is still in the dark ages. We're in the infancy of understanding human motivation and behavior. And one day we might get good enough that you could pick up some possible signals that someone is not good marriage material because they might have violent, aggressive tendencies. And that doesn't mean you prosecute them, right? We're not going to go the minority report direction. But we might get better at recognizing red flags. That would be a forensic files I would watch.

54:48I don't think that would be called forensic files. No, it wouldn't. But do you see why I think it's terrifying that these people succeeded in doing horrible things and they weren't preventable? But that's the point. Oh, that they succeeded. Yeah. Yes, but that's... I just don't want to know about that. Oh, I like knowing about it. It feels sort of like, you know, you tell your daughter to cover her drink at the bar because, you know, there are bad people out there who might try to spike her drink. Like, I feel like I know that there are bad people out there who might do whatever this episode is about.

55:22I'm kind of glad I know that. I feel like I know how to keep myself safer. Wow. When I know what people are capable of. So interesting. When we think of behavior that's both illegal and widely accepted as morally wrong, almost all of that behavior is disproportionately done by a few bad apples. I think that's what the data tell us. And I don't want to see those bad apples and start to think, there are more of those out there than I thought. Because there aren't. Whereas you, you look at that and think, all right, I can recognize the rotten apple. Yeah, maybe. Interesting. Okay. That's interesting.

56:04Something else I wanted to talk about speaking about TV. We have to talk about Seinfeld, which in its time was the greatest show on TV and maybe the greatest show ever. But Friends has ascended. Our kids think Friends is better than Seinfeld. Why? Why? They're more likable. The characters. Yeah. I think Seinfeld was a better show, but you really like Joey and Phoebe and Rachel and Ross and Chandler and Monica. And it's more fun, I think. Yes. And more - It feels like you're friends. Exactly. You want to hang out with those people. Right. Whereas you're not even sure if you like Jerry, Elaine, Kramer, George, Noonan.

56:47What you're laughing at with Seinfeld is you're laughing at the writing, I think. Yes. And where more with friends, like they feel like people. Yeah, that's interesting. Feels like you're part of the story maybe. Yeah. Whereas with Seinfeld, you take a step back, I think. That's so interesting. Yeah, I think that's right. You don't feel immersed in the same way. You're an observer as opposed to a participant. There you go. Which makes friends much more parasocial in that way. You know what I think is amazing about both shows? Both shows are what, like 25 years old now? and people are still watching them and relating to them as if they just aired yesterday, particularly Friends, I think, which is amazing because I feel like when I was like a teenager, I would not have related to or watched anything 25 years old.

57:32I don't think I did. It felt so old. It felt like it was from a different world. Exactly. And so that just speaks to, you know, what great timeless shows they are. Okay. It is time for a lightning round. I am so good at lightning rounds. Said no Alison Sweet Grant ever. I was quoting friends. That's a friends quote? Yes. Who says that? Wait, hold on. Who would say that? In my favorite episode. Wait, in the apartment swap? Yeah. Well, in the game. I feel like Monica's the most competitive, so she would say it. Good job. Yes. Okay. What is Chandler Bing's job? Is that the question? Yes. Is that the real, like, that's my question?

58:11That's the first lightning round question. It's a transponster. That's not even a word. Do you know his real job? Statistical analysis and something like that. I thought he was an IT consultant or something like that. I don't know. I don't know either. We'd have to, we'd lose our apartment. Okay. Well, it's a cow's opinion. It's a moo. Okay. Next lightning round question. What's something you want me to rethink? Like as a podcast host? No, no. Just anything. Okay. This is your chance to publicly critique me and get other people to hold me accountable for the change you want to see in me. Okay.

58:45I know what it is. Yeah. Like not using a towel to dry your hands and like dripping all over the floor. Who cares? I do because then you leave little water marks all over the floor. Every water droplet I leave is a little forensic file for you to then trace my footsteps. It's evidence to figure out where I went, what I was doing without any of the harm or fear that happens in those creepy crimes. All right. But why does it bother you? Because it's just unnecessary. Like why? There's a towel right there. I don't understand why you don't use it. I think this is a diver thing. It's like not using a tissue and just like...

59:27No, because water is not gross. It's clean by definition. It's clean. But then if I'm wearing socks, then my socks are wet, you know? You know, I'm like an absent-minded professor. I know, it's a diver thing. I don't even think about it. I get it. But it is a diver thing. you're wet all the time in that sport. And I bet swimmers and water skiers. No, no. But what I'm saying is if I don't dry my hands, there's nothing visible. That's not true. I often say, why is this thing wet? And it's because. But I don't notice. That's what I'm saying. I'm not observant. Have you noticed this? Yeah. Are you conceding this one or are you still asking me to rethink it?

1:00:00I don't know. I don't think about it. Okay. That's fair. I'm going to to notice if my hands are wet. Check. What's the worst writing advice that you hear? Oh, I think it's probably to set a certain number of words to write per day. For me, that would be the worst writing. You don't like that. Why? No, because I don't think it's helpful just to write, to get to a certain word count. I think sitting down every day to write is a good idea. And I think writing different types, not to just stick to one specific format or genre, but like really just expanding your writing abilities as a whole is a great piece of advice.

1:00:38But people who say, oh, I want to write a thousand or 1500 words per day. If it's not coming naturally, it's going to be wasted time in my opinion. Got it. So you think when you have a word count goal, a quantity, you end up producing drivel. Yeah. Whereas if you set out a block of time and said, I'm going to write for an hour, than you give yourself permission to wait until something worth writing comes. Right. I'd much rather have 150 words of something brilliant than 1 ,500 words of nothing. I think that works for a skilled, confident writer. If you're a novice, I think the quantity goal can be helpful just to show yourself you can write and start building the habit and the rhythm and not worry about judging the quality of it.

1:01:21I think once you have skill and taste, that's when the quantity goal probably becomes counterproductive. What do you think? Maybe. Yeah. For somebody like me, it would be much easier to say, here's an hour's tough. Here are three hours, right? Sit down and write something. And it doesn't matter what the quantity is that you produce in those three hours, as long as it's good, right? Versus I want to say 1500 words. Okay. So if you love to write, if you're intrinsically motivated, pick a window of time. If you're trying to push yourself to write more and it's not yet something that you enjoy the process of, that's when the quantity goal can be a motivator.

1:02:01Maybe. I like it. So last time you were on, I got more comments about our discussion of driving than I think I've ever gotten on any podcast topic. That it is the lead driver's responsibility to go slow enough so that the person following them doesn't get lost. Did you change your mind or do any rethinking about it? no I mean because I was right and I think didn't everybody almost like 90 % of people agreed with my take maybe 10 % are you serious no I think people are actually split oh um I haven't rethought that I'm sorry I'm gonna fire you from the rethinking podcast I'm gonna stick with my original position I still want you to rethink that all right because as the lead driver I have to look in my rear view mirror or behind me to see you.

1:02:53Whereas I'm in your field of vision. So it's much easier for you to keep up with me than it is for me to make sure that you're behind me. Maybe I should be the lead driver that might solve this problem. I actually think that's the solution to it. Right. So you have rethought it. Well, I just rethought it. I was talking with somebody else who was on your side and they, just like us, they had the faster driver leading and the slower driver was following it. I said, why don't you flip it? If the slower driver leads, then this is not a problem. Sounds good. Okay, good. All right. Rethinking complete.

1:03:25I'm glad you came today. Yeah, it's over. Wow. That was easy. Well, Alison, thank you for returning to Rethinking. My pleasure. Thank you for having me. I love you and I love Lump. I don't love Lumps, but I love your book Lump. Thank you.

1:03:45Rethinking is hosted by me, Adam Grant. The show is produced by TED with Cosmic Standard. Our producer is Jessica Glazer. Our editor is Alejandra Salazar. Our engineer is Asia Pilar Simpson. Our technical director is Jacob Winnick. And our fact checker is Paul Durbin. Our team includes Eliza Smith, Roxanne Hilash, Banban Chang, Julia Dickerson, Tansika Sung Manivong, and Whitney Pennington Rogers. Original music by Hans Dale Su and Alison Leighton Brown.

1:04:15I think you should talk about what the book is about. I love when you tell me how to do my job. It's great. Thank you. This episode is sponsored by Kohler Smart Toilets. The objects we interact with most are often the ones we notice least. Kohler's Smart Toilet challenges that assumption. What if the most overlooked space in your home could become the most considered? Their Veil Smart Toilet is a sculptural silhouette that isn't just intentional, It's a philosophy that design changes everything. The Kohler Veil Smart Toilet is sleek, with a rounded shape that's more like architecture than just plumbing.

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