There is a version of me that exists now only in my head. This person routinely says yes to social invitations, has the energy to style her hair more than twice a year, and can still imagine — and plan for — a future that doesn’t revolve around health limitations. She is a fiction, but I can’t seem to let her go. 

Sometimes I shop for this fantasy self: I load up an online cart with the clothes that she would wear to important meetings or the heels she might dance in during a night out. I ultimately empty the cart but save the items to my list of favorites — a feature that most digital retail apps have nowadays. I revisit the lists and daydream. Then I delete the lists and mourn. 

Occasionally, I buy something for her: a new shade of nail polish or a new tin of blush — practical enough that the real me might use it and small enough that it can languish in a drawer without creating too much guilt or shame.

I’m not so sure this fantasy self is healthy — research shows people get a dopamine bump from adding items to our digital shopping carts, potentially making it addictive — but it’s hard to set realistic goals when you feel depleted every day. Plus, big picture, I don’t know how long my runway is. So, I retreat to this strange mental space, like an adult version of playing house or dress-up. Inside my little mental castle I can run errands, go on hikes, and enjoy hobbies without the body aches or crushing fatigue that often accompany the most minor exertion. I can do big things, too, like launch a community newspaper, start my own business, or run for local office. I can foster dogs, return to teaching, or even be an adoptive parent to a child — or two! — in need.  

When I was growing up, I had a fantasy self, too, which is likely the case for most kids. But back then, I also had reason to believe that I could turn my fantasies into my future. Now this fictitious self is out of reach, leaving me wondering: If I keep indulging far-fetched dreams, am I setting myself on a path toward depression and other mental health problems? Or am I merely keeping hope for better health alive? And is that possibility really so unreasonable or unrealistic? I go back and forth between accepting my limitations and searching for new health interventions that could help me to improve my quality of life. Some days, I strive. Others, I allow myself to just be.

Don't get me wrong: I still experience joy and gratitude. And I still have reasons to celebrate. For example, after a recent recurrence scare, scans of my spine and brain — the areas giving me problems — came back clear. Despite some troubling symptoms, the MRIs showed no detectable signs of metastasis.

My relief was, and still is, enormous. However, the results revealed other problems, including a couple of bulging discs, benign masses, and significant spinal stenosis, which happens when the spinal canal becomes too narrow to comfortably house the spinal cord. The pain can be tremendous, frequently keeping me up until 3 or 4 a.m. 

Instead of tossing and turning all night, I typically get up and have some toast or hot tea. I also read and reflect. In these quiet moments, my fantasy self beckons. 

Do other survivors have these thoughts? Do they create alternative realities like mine? 

The answer, which I gathered last weekend after attending a summit for young survivors of breast cancer, is yes. For three days in Las Vegas, I was surrounded by hundreds of other cancer survivors and thrivers (people living with metastatic disease) who are all navigating life inside a body that is forever changed. Every woman I spoke with shared similar stories about grieving for options that are no longer available to her. Many participants, including me, could not keep up with the packed summit schedule and had to take naps in between sessions. One presenter I befriended burst into tears after the first day because she still had another session to lead, but she was already physically spent. 

As I saw and heard about my fellow survivors’ challenges, my heart ached in solidarity. I also felt validated. During presentations, some speakers stumbled over their words or lost their train of thought because of (very relatable) post-chemo cognitive issues; attendees asked questions during Q&As that easily could have been my own; survivors let down their guards and admitted having trouble not only accepting their new reality but learning to like themselves again. I listened as mothers wept about feeling they had failed their children; women discussed how critical and even downright abusive their inner voices could be; and caregivers (sometimes called co-survivors) shared the pain of watching their loved ones suffer. 

Although many of us began by commiserating over our physical issues, our mental health struggles were just as pronounced. Anticipating this, the summit speakers and organizers addressed mental health during many of the educational sessions, and on-site counselors were available to anyone who needed to talk.

Additionally, the closing speaker focused almost exclusively on mental health and self-care. His talk helped me broaden my understanding of wellness. He explained that a person does not need a clinical diagnosis of anxiety or depression to deserve support. When survivors minimize our difficulties (after all, someone always has it worse), we’re not being fair to ourselves, he said. Rather, we need to confront our problems to create opportunities to heal. To help us down this path, he discussed some sneaky ways mental illness can present itself that we may not always recognize. The first category (see attached slide) left me stunned. 

“Constantly chasing a ‘normal’ life,” it says. 

Bingo. 

Now that I’m back home, I plan to discuss with my psychologist my tendency to chase the myth of normalcy. Eventually, with her help, I hope I also can find a better balance between extremes: I want to cultivate healthy levels of hope without indulging in foolish fantasies; I want to accept my situation without resigning myself to a life devoid of dreams. 

Wrapping my head around these nuances will take time, so I’m trying to be patient with myself. And although I want to tone her down a bit, I’m not ready to sever ties with my second self just yet. She’s the version of me I channeled to claw my way out of poverty. She’s the idealist and the rabble-rouser. The visionary and the high-achiever. Fantasy Heather scoffs at challenges — the harder the better! — and has no use for the word “can’t.” How can I annihilate the version of me whose steadfastness and sky-high self-belief arguably got me through chemo? What if instead of burying her, I think of these competing selves as volume dials that I can turn up or down, depending on the situation and what it calls for? 

Phew. I think that's all the contemplation my mind can handle for tonight. As I start letting my brain relax and my thoughts drift, a familiar voice creeps into my head. She's reminding me that there is a spring sale happening at Portland Leather, a company that sells gorgeous jackets, bags, and shoes. Did I mention that Fantasy Me has excellent taste in fashion? It's true. Maybe she'll order some new slingbacks to prove it.