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An image of a man, half of him smiling and the other half is in pain and frowning

The Pain of Faking It

I’m smiling as I talk to the young lady across the counter from me. We have exchanged pleasantries about the day, the rare pleasure of a rainy and overcast morning in Southern California, and she just asked genuinely how I am doing. She knows that I have lung cancer, though I cannot recall whether I had mentioned my new medication. And there I am, still smiling at her, pausing for a moment while a fresh rush of pain crawls over my scalp as though a hot blade is peeling away the skin while salt is spread in its wake.

Trying not to show my pain

The sensation passes quickly and I try not to wince — I am getting better at not reacting every time a chill makes me shiver, causing my scalp to tighten up momentarily where my rash is most sensitive. I am not sure whether she senses my silence as anything other than taking a breath, but for me, it seems overly long.

“I’m doing okay.” I shrug, changing my smile to something more wry, and continue: “Relatively speaking.” I decide to leave it at that. She’s busy and there is nothing that I can do about the pain right now other than try to tolerate it.

I never quite know how much to share about how I am really feeling. There are some people, of course, who need to know. My oncologist, for starters, and those tightly associated with my care. My family has to have some indication of what I am going through — the more we communicate about what we are going through, the easier it is to be empathetic or offer help to one another, or even get the space we might sorely need. But there is also a point where I feel it becomes an over-share, where the other party just feels helpless. That’s when I might bite down and say, “it’s going to be all right.” Because I believe it will be, generally speaking; all of these things eventually pass. And I don’t want to keep talking about it.

From annoyance to anguish

This rash has spread quickly, beginning as an annoyance and turning into a menace in less than 72 hours. I have tried every lotion, ointment, and spray that I could get my hands on, first to treat it as acne, then to treat it as a sun or wind burn. On the plus side, it has taken my mind off the aches in my joints and the strained muscles in my back and arm. For the first time, I find myself thinking about how great it would have been if my hair had just fallen out and I could actually get something therapeutic slathered all over my head. Instead, I am left dreading the next time I need to shampoo.

It has not been my everyday experience with cancer treatment. Most of the past three and a half years have been more physically tolerable, even when bogged down with fatigue or nausea. But there are times when basic functioning is difficult and faking it is near impossible, and that in itself takes a toll.

Smiling through the pain

It all ties into the stigma of lung cancer, the stigma of drug use, the stigma of being chronically ill or disabled. It is not that I am ashamed of my pain, but it becomes a burden to carry. And I have endured the looks in the pharmacy, the delays from my insurance company, and even medical professionals who second-guessed what I needed to simply feel close to normal or even safe. Keeping some of that pain for myself, then, has become both second nature and part of my natural defense system. Still, I try to smile, though it hurts no less.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Chestercat
    1 year ago

    Thanks for sharing this . I appreciate you taking the time to write out your experience . Definitely I can relate to smiling thru the pain and often tears.

    All the best to you on your journey,


  • Jeffrey Poehlmann moderator author
    1 year ago

    I am so glad that you connected with this post. Best wishes to you. – Jeffrey, team member

  • Moira Cistola moderator
    1 year ago

    Hi Jeffrey,
    I have been thinking over the past several days about your share. First and foremeost, sending soothing thoughts your way…I hate hearing that this new tx plan has so many painful side effects for you. Verbalizing it IS important…not just for you but for others as well. Those of us in our community who have pretty clear idea of what you are feeling sympathize, and those that don’t yet can stock this info in the back of their mind so that if the day comes for them when they are experiencing something similar, they are perhaps more likely to speak out about it than suffer in silence. You bring up a great point when you write about receiving “the looks” from pharmacy staff, insurence companies, and even the medical professionals taking care of you who at times probably really are second guessing you…you SHOULDN’T EVER have to feel that you are being second guessed when you are simply trying to receive what you need to to live as optimally functioning a life as you can. I am just so sorry that it is this way, and most of us know it really is unfortunately sometimes that way. I want to thank you for always being so real when you write…I have learned alot from your shared experiences since I came into our community, so others certainly must also, so I hope you never stop keeping it so real.
    Thanks Jeffrey.

  • Jeffrey Poehlmann moderator author
    1 year ago

    Thank you for the kind and supportive words. I am a firm believer that if we are going to advance understanding of this collection of diseases we call lung cancer, then it requires speaking openly and honestly about it as much as possible. And, of course, we are all in this together with our varied experiences and viewpoints. Thank you for being a part of that.
    All the best,

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