Is there a cancer bell for anger?

Have you seen videos of patients ringing the cancer bell? It’s the bell in many hospitals and clinics that patients ring to mark the end of treatment and the beginning of a new phase in their lives. Sometimes other patients and staff watch, often with cheers, laughter, and tears. The videos show happy, relieved people in celebration. For patients in the audience, hearing or seeing the cancer bell at the beginning of treatment offers hope – something to whisper to yourself: “that will be me one day!”

But there’s another side of the cancer bell. Many patients don’t ring the bell. For some, ringing the cancer bell in front of people is daunting – they opt out of bell ringing because they do not like so many eyes on them. Some patients have been alone during their treatment and choose not to ring the bell because celebrating without friends or family could make them feel even lonelier. And then there are patients for whom ringing the bell isn’t an option. For patients with terminal conditions or whose treatment will never end, hearing the bell can be a reminder of what they will never do – that while others will go on to a life after cancer treatment, they will not.

For these patients, the cancer bell is a cruel reminder of their condition. And they have ignited a debate: Should we do away with the bell?

It’s an emotional debate, pitting some patients’ need to mark this milestone with joy against others whose treatment journey contains only loneliness, anger, grief, and sadness. One suggestion has been to make the bell ceremony a bit more private, moving it out of infusion centers and waiting rooms. Some patients who are terminally ill say they would appreciate this. And it might offer introverts the chance to celebrate in a way that is not so public.

Here is another thought: Are there other rituals to give space for the “other” emotions that are part of the cancer experience: fear, desperation, grief? The bell is a ritual meant to express joy; why are there no rituals to express heartbreak or anger? I’ve been asking myself this same question about our schools, our offices, our public areas – where can we express the emotions that society deems “negative?” Where can we say that we are lonely or desperate, while being seen, without being judged?

Would rituals that express sadness help to create a sense of inclusion and community for all those cancer patients who will never ring the bell? How could we design rituals to support all lives – whatever course they may take?