One month after I completed chemotherapy for Stage 3 breast cancer, and two weeks after I underwent a double mastectomy, I sat in bed, my surgical wounds itchy, my morale at an all-time low.
“I would pay $1,000 if I could have any real amount of hair right now,” I told my husband. He nodded, politely understanding, but his eyes widened. We owed a colossal sum on our taxes. I was on medical leave from my job. We were not exactly flush. But I was lying: I would have paid vastly more than $1,000 to have a real amount of hair on my head. I still would. I have played with different theoretical sums: $5,000? Maybe $10,000?
Without hair I feel diminished, undone. My grief over my hair exceeds, I think, my grief for my disappeared breasts, or my health more generally. There are moments when I worry it will swallow me whole, moments when it inches dangerously close to despair.
Next to the threat of death—the firm, cold gun against your temple that is cancer—it seems petty. Shouldn’t I be grateful to have a treatable cancer, to have completed the most onerous portions of treatment? Shouldn’t I be carpe-ing the diem?
I am not. I am just really sad about being bald.
“Your body is an instrument, not an ornament,” I have insisted to the middle schoolers to whom I teach sex ed in my role as a school social worker. I have tried to prepare them for a world that hopes you’ll always want to look a bit better than you already do, and to challenge the notion that looking good has moral weight.
But I am not an idiot, nor am I naive: I know the pull of beauty. I have spent decades of my life trying to look good. I think I have often been successful. Still, as a woman—even a relatively confident one—I am always dancing on the edge of acceptability. Not enough or too much makeup, clothes ill-fitting or ill-suited to the occasion, hair poorly cut or styled could send me plummeting off the cliff toward ugliness. In college I never went to class in pajamas. If I had a pimple, I covered it with makeup.
Then, a few weeks after turning 40, I was diagnosed with breast cancer. I began chemotherapy, and, like so many cancer patients before me, I faced the prospect of losing my hair. I would like to tell you that the lesson that I’d tried to impart to my students rang in my brain, and that I focused on my health. That, too, would be a lie.
At first I tried clinging to the hair. At many hospitals now, chemotherapy patients can opt into an expensive, somewhat questionable world of hair preservation: You freeze your head before, during, and after your chemo infusion. “Cold capping,” as scalp hypothermia is colloquially known, costs patients thousands of dollars (and is generally not covered by health insurance). It also made me (and I am not alone) profoundly nauseous, so I had to be pumped full of anti-nausea medication while undergoing chemo. This meant that I was, essentially, sedated for hours at a time. While having a very cold head.
My hair fell out anyway. It fell out in large clumps. It covered every surface of my bedroom and bathroom. I felt as if I had suddenly acquired a loveless Irish setter whom I was constantly cleaning up after but never cuddling. I was afraid to shower, because my hair filled the drain almost immediately, and the sight filled me with a rising sense of panic. So my husband, at my request, shaved it all off.
I was not prepared for what I saw in the mirror once my remaining hair was strewn over the bathroom floor. I looked grotesque.
“I’m a goblin,” I say to my friends. “Like Gollum.” Somebody corrects me: Gollum, from The Lord of the Rings, is a hobbit, not a goblin. But I can’t get his bald, sickly, bug-eyed face out of my mind when I look in my bathroom mirror.
Friends laugh it off, or try to talk me down.
“You look beautiful,” they tell me.
“You look amazing. Very punk rock. You really pull it off.”
I do not look amazing. I look hollowed out and alien, and objectively worse than my prior self. But no one will say this. No one will console me, because to console is to admit that there is a problem.
When my mother died, everyone told me how terrible it was to lose such a wonderful parent. I felt seen, and supported. No one said, “Oh, don’t worry, she’s not actually dead.” If they had, I would have cried harder.
I recognize that I have been part of this charade, with my false cheer about instruments and ornaments, my lesson plans. I feel desperate for someone to agree that looking worse feels very bad, but I am also desperate for this nonsense—the belief that we are all equally beautiful, or that being ornamental is unimportant—to be true. More difficult than living in an appearance-obsessed culture is living in an appearance-obsessed culture that pretends that appearance does not matter, or pretends that everyone is equally visually acceptable.
To name my agony, I must admit that I once felt pretty, which sounds vain or prideful. The socially acceptable way to talk about yourself is a tightrope. It would also be uncouth to describe myself as feeling perpetually ugly. I would be fishing for compliments, or demonstrating depressingly low self-esteem. But to tell you that for years I admired my reflection? If I’m going to confess this, surely I had better wrap these words in a comeuppance, or a lesson about how beauty does not matter. I scramble around for a moral, hoping to find one but coming up empty. Losing my hair and feeling ugly in this landscape has not improved my character, or provided me with a new perspective on life. It has just made me depressed.
“It will grow back,” people remind me, as if I didn’t know that.
“It’s temporary!”
They are right. So how, then, do I make sense of the feelings of horror and shame that have shrouded me since my husband shaved my head, my children huddled outside the door: unwilling to watch but riveted by this frightening transformation?
I pester other women who have undergone chemo about how they felt about losing their hair. They are uniform, both in their unhappiness and in their eagerness to tell me about their misery. They practically leap toward me in their excitement to answer my question. I hated it, they report. I felt like a monster, one said. It was a trauma. I deleted every picture on my phone from that time. If I’m wearing a hat that covers my hair and I catch sight of my reflection, I begin to panic. A 2019 study found that nearly 60 percent of the 179 cancer patients surveyed experienced hair loss as the worst side effect of chemotherapy. These people are facing death. Chemo makes you feel very sick. But what is even worse than nausea, or crippling fatigue, or explosive diarrhea? Looking like a goblin. Or feeling as though you do.
“All bodies are good bodies,” I would write on the whiteboard for the 12-year olds. “Let’s talk about this,” I said brightly. I explained about ableism, and fatphobia, and the racism of beauty standards. Some of them nodded along, earnest and ready to buy what I was selling. Some of them smelled bullshit, wrinkling their noses. What did they make of me, with my long hair and thin frame, my blue eyes and jeans that fit well, and my subtly lipsticked mouth? I don’t know. But I wonder: When my tsunami of doctor appointments and treatments has receded and I return to work, will I say this to them again? This was once a theoretical position, and it was easy for me to believe in it. But now my body has tried to murder me, and what’s more, I hate the way it looks.
I wrestle with this as I go about my day-to-day life. I have no real evidence that anyone treats me differently from before, although a child at my children’s school misgenders me, much to my daughter’s horror. (I am embarrassed, but unsurprised.) But everywhere I go, the absence of my hair haunts me. I feel like explaining to the barista at the coffee shop: I used to have hair, and eyelashes and eyebrows. I used to look better.
I feel certain—more certain than I have ever felt of anything—that when my hair does return, covering my pink-white scalp and the forehead that I have always thought was too large, I can be happy again.
It’s the cancer, you may be thinking. Not the hair. It’s the illness, the constant drain of thinking about your own mortality. It’s the fear, the anxiety, the depression that accompanies a Very Serious Disease. And of course it probably is, to some extent. But I invite you to consider the possibility that a lot of it is the hair.
When I was diagnosed at 40, I was on my way down the staircase of middle age, already descending into invisibility. But this business of being bald, this is like slipping when you’re halfway down the stairs, falling with painful and terrifying speed. And now I cannot wait to return to that gradual state of decline.
Will that be the gift of cancer: to force me into gratitude for my graying hair, my marionette lines? I cannot tell you yet. But I imagine returning to work, speaking loudly from the front of the room. “Looking good sometimes feels really good,” I will tell the middle schoolers. “We all like to pretend that it doesn’t matter. But feeling like you look bad stinks.”
In the middle of my summer of chemotherapy, on a rare night when I was feeling energetic, my husband and my children and I met my sister’s family at the beach for dinner. The sun was setting, so I was not wearing a hat as we corraled ourselves and our sandy belongings into the car afterward. A woman stopped me in the parking lot. “Chemo?” she asked. I nodded. She told me that she had been cancer-free for a few years. “Look at my hair!” she implored me. It was nothing special—long, messy and beachy, graying—and yet it was, because it was there. I found myself crying. She asked if she could give me a hug, and I accepted, and allowed her to fold her arms around me, and felt her hair against my bathing suit.
She had spotted me: I stuck out like a sore thumb, and she didn’t pretend otherwise. She acknowledged, out loud, that I looked and felt strange. I thought of her every few days for the remainder of my treatment, and how comforted I’d felt by this stranger seeing me, calling out, and holding me in her arms.