Refractory Period

I had never heard of the Refractory Period for cancer patients until last week. Now I believe it is important to anticipate it.  



Last week, I participated in a patient and survivor panel for MOVEMBER representatives from around the world. I had the pleasure of meeting Jonny Imerman, founder of Imerman Angels. He’s a terrific cancer survivor filled with enough energy, love and encouragement for any number of cancer patients.

During the panel, Jonny spoke of the refraction period. As Jonny puts it, cancer’s prism bends and forever changes us. We are the same beam, of light yet forever changed. It is a strong emotional experience that leaves many, once they are on the other side of their journey, in a prolonged refractory period. As in sex, where the refractory period is the time in which a man is physiologically incapable of having an erection and orgasm again, a prolonged emotional refractory period can render some patients incapable of finding calm, moving forward and living life without cancer.

Paul Elkman, PhD, an acclaimed psychologist who retired as a professor from UCSF in 2004, has written many books on emotions, including one based on conversations with the Dalai Lama. It is entitled Emotional Awareness. Elkman refers to the refractory period as how long it takes for a person to come back to a quiet baseline condition of calm after being provoked by an emotion. Often, this is a short period such as one might go through following a fit of rage. But, for those who have experienced a prolonged period of being provoked by emotions–say several years of battling cancer–the period can understandably last a while. InEmotional Awareness, Elkman writes: “Once the emotional behavior is set off, a refractory period begins in which we are not only not monitoring, we cannot reconsider. We cannot perceive anything in the external world that is inconsistent with what we are feeling. We cannot access the knowledge we have that would disconfirm the emotion…” To me, it sounds like all the necessary ingredients for a downward emotional spiral just when one would think we should be in a state of euphoria.

Jonny and I spoke of the refractory period following the conclusion of the panel and I asked him to contribute a personal piece on it. Forewarned is forearmed. I think you will find it interesting.

The Refraction Period of the cancer journey– “What the hell is that!!?” you ask… The Refraction Period is one of the most under talked-about parts of the cancer journey.

My name is Jonny Imerman and I was diagnosed with testicular cancer at 26 years old, beat it at 27, and then the docs found four tumors behind my kidneys by the time I was 28 years old. By 29, I beat cancer again–the whole journey was about two and a half years. Along the way there was a lot of chemo, surgeries, probably infertility, wacky side effects, and other unusual stuff that I sure wasn’t expecting in my 20s.

Of course, it’s challenging to get though all the treatments, but the survivors out there know just as well as I do–you have no other option!  You do it, smile as much as you can, laugh as much as you can (testicular cancer guys like me get plenty of “one ball” nicknames – people are creative!!!), stay as positive as you can, and do whatever it takes to get to that 26.2 mile finish line!

Now, for the Refraction Period… It’s that period of time AFTER you cross the finish line. After you beat cancer. Trying to build back up.  Emotionally.  Physically.  Getting back in the gym. Trying to feel strong.  Trying to feel confident.  Wondering if anyone would actually want to date you after all that.  Trying to figure out who the hell you are after all that chaos and all those shenanigans. Trying to figure out your values, your morals, where you want to spend your time-and with whom.  The way you look at life.  What you want to do with your life.  How you feel about helping others, and making the world a better place.  In short–having completed the journey and being affected by it, figuring out what you really are about.

It feels like everything has shifted.

The Refraction Period is trying to figure all this stuff out after cancer.

It’s friggin HARD.  REALLY HARD.  And most people never expect it.  They go into it completely blind, making it even harder. It can cause depression.

Why is it called the Refraction Period?  Picture a beam of light going in a straight line. That light is you and your life. You think your life is moving straight forward.  Then, shit – you get cancer! All of the shenanigans of the cancer experience knock you off your rocker!  Then, this beam of light is “refracted” let’s say, 25 degrees to the left and on a different trajectory. Cancer refracts us and we’re no longer going in the same straight line.  It’s our job to figure out what all this means.  It’s not easy. It is a life-changing experience.

But, I believe STRONGLY that after we get through this refraction period – sometimes lasting a few months and sometimes 2 or 3 years – that life’s beam of light is on a BETTER trajectory.  I believe that we become better people after cancer. We have stronger, if not new values. We have learned a BIG lesson about the fragility of life, and through our hard mental and emotional work during the refraction period we become better people. We are more committed to being kinder and working together to make this world a better place.

The #1 way to get through the refraction period is to CONNECT with others who understand–survivors who are going through it also, or better yet, those like you who have been there but have come out the other side and landed on top.  And there is a “top.” I believe I became a better person through my cancer experience and consequent struggle through the refraction period.  My reflection and challenges through this period have helped me see the world and what I want out of it in a much clearer way.

The key again is: connect with others who understand and empathize. TOGETHER we are stronger.  I wish each of my fellow brothers and sisters going through cancer and refraction ALL of my very best- and the ability to find the positive in this very challenging, and often myopic journey.

Love and light- Jonny Imerman

Having read Jonny’s piece I was reminded of what it was like when my wife and I returned after living in the Netherlands for almost three years. The experience changed us forever. It did indeed feel as if everything had shifted. There was a sense of alienation as even good friends had trouble relating to us and our changed frame of reference, new values and new preferences. I can only imagine that returning from the journey with cancer can be exponentially more difficult.

As I said… forewarned is forearmed. Jonny’s insight is an important trip advisory for those of us who have not yet come out the other side. For those readers who have, I wonder what your experience with the refractory period was like?