Chemo Brain Goes to Work

What, you missed it? Last Monday was National Bring Your Chemo Brain to Work Day, when you leave your functioning brain at home while wading through a veil of mental fog in the workplace.

I know what you’re thinking. When you have chemo brain, every day is a holiday. It disgusts you the way they’ve commercialized everything, but I assure you this is not one of those holidays they have cards for. Come to think of it, though, it would make a great  coffee mug.


Fog over San Francisco

All jokes aside, your cognitive abilities can be humming along just fine and then, BAM! A blackout. A system crash. The information is still there, but you temporarily can’t access it.  The fog creates a veil of confusion that renders you blind and dumb. Unlike real fog, no one else around you is affected by it and they can’t understand your lack of clarity.

One cancer website suggests writing everything down so you don’t forget. Brilliant! Why didn’t I think of that? I probably did but can’t remember. I do remember shortly after completing treatment being in the middle of . . . whatever . . . when I got one of those glistening gems that writers often get . . . well, I thought it was good and the dog seemed to like it. Wait, the dog … where’s the dog?! Oh, right, I don’t have one. Now where was I? Oh, yeah. So as not to lose that nugget of genius, I’d simply memorialize it on paper. Easy enough. This consisted of two preliminary acts, that of grabbing a pen, followed by a piece of paper. In the two seconds it took to pick up a pen and grab a scrap, I completely lost my profundity. What’s worse, I looked at my hand and wondered why on earth a pen dangled between my fingers.

Now this may seem funny and benign, even if the reason for chemo brain isn’t funny, or benign for that matter. Yet, as frustrating as it can be, we learn to laugh at ourselves. We compensate as best we can. We learn compassion toward ourselves.

The problem is that others are not always so understanding or compassionate of the change in weather that occurs in our brains, much less willing to adjust their thermostats for us. They may not even understand why otherwise intelligent people have unexpected, uncharacteristic blackouts that leave them doe-eyed, forgetful or screwing up the simplest of tasks. Beyond the Baby Boomer “senior moments,” this forgetfulness can leave you grasping for things you learned in grade school.

When that happens in your place of employment, it has the potential for serious, irrevocable consequences. Shortly after being diagnosed, I’d read about an attorney whose chemo brain left him with spotty cognitive abilities that got in the way of practicing law. His employer let him go.

I’d thought it wasn’t much of a problem anymore for me, and mostly it’s not, but since returning to a fulltime work schedule, my fatigue level increases as the work week goes on while mental clarity decreases.

I had a layer of fog roll in this last week at work. It’s not the first time this has happened since chemo, but it’s probably the first time my error was glaring to my superior, where I couldn’t quickly correct it and make everything okay. He’d had the utmost respect for my abilities, so grateful to finally find someone competent. And then it happened. He seemed absolutely boggled. His eyes bore through me as if trying to penetrate the facade of my flesh to discern who swapped Eileen’s body for this zombie woman.

I should point out that memory has always been one of my strong points. Even after chemo, when I’d do the tests to strengthen cognitive ability on, I’d tested four times as strong in memory as I had in the other areas. That, however, was because I wasn’t having a wave of foggy weather when I took the tests. Those tests are done in the quiet of the home without any multitasking.

On this day at work, however, without exaggeration, I screwed up numbers, miscounting days of the week — simple math that a second grader could do. I miscalculated a due date. It wasn’t horrible in the end. It wasn’t one of those mistakes that cost the firm money. It didn’t even embarrass them, but it did make the attorney scratch his head and question my ability to do a simple equation. Whenever the fog rolls in and affects my work performance, it usually has to do with numbers, especially dates. I’m not kidding when I say it’s second-grade stuff. Yet, when it’s happening, the synapses aren’t connecting and a thick cloud of confusion sends random data into hiding. The worst is when I think I know what I’m doing and I’m not even aware I’ve screwed up.

Chemo brain is like that. You don’t always know when you mess up or forget things. It’s dark in there! The damage is done before you even realize you’re brain dead.

In an office, there are other people, multiple voices and activities happening that make it difficult to focus when you’re already having focus problems. So when I screwed up on the date and I was called on it, I started to mutter something about chemo brain. He said, “What?” I caught myself and thought better of it. After all, to admit to chemo brain could be taken as an admission that I might not be the stellar employee he’d thought, that I might have a cognitive problem, that he’d better not relax and trust me because who knows when this bout will strike again. What if she doesn’t know that 2 plus 2 equals 4 forgodsake!? So I swallowed my excuses, looked at him and acknowledged he was correct in his calculation, and that I had screwed up.

For the rest of the day, I felt like crying. I was exposed. Chemo had ruined me and I wasn’t functioning at the level I once had. At my last office, I could hide it better. It also wasn’t so much a problem because my prior boss gave almost every instruction in an email, so essentially HE had written it down. I didn’t have to worry about not getting it, and the office was quieter. I could focus and work with little distraction.

I was relieved when a project came up the day after Bring Your Chemo Brain to Work Day. I redeemed myself, showed off when I had the chance and compensated for the day before. I was back in the good graces, but it’s scary because I can’t seem to control when the blackouts happen. I know they happen less when I’ve had a good night’s sleep.

I’ve decided next year, I will not celebrate Bring Your Chemo Brain to Work Day. I will boycott it. You can expect a petition that I will circulate with regard to banning chemo brain not only from the workplace, but from all aspects of life. It will be just another day. A better day, I hope. And I’m already working on a boycott slogan that would make a great coffee mug…


  1. Oh, Eileen! I didn’t have chemo, so I don’t have the full blown effects of chemo brain to contend with, but Tamoxifen and the stress of a mastectomy have definitely added to some issues that I already had prior to my diagnosis. My husband, before I was diagnosed with BC, would question if I had the beginnings of dementia when I would tell him to turn right, but be pointing left. If I was thinking of a zillion things, who cares if I was sending us off into oncoming traffic? He should know which direction I meant! I’ve always told my students that if I saw them a few years after I taught them to not be offended if I forgot their names–in almost 15 years of teaching, I’ve had over 1500 students and for good or bad, I haven’t kept each student fresh in my memory bank. It has always been a concentration issue with me and my memory and now post-diagnosis I find it means I have a much harder time concentrating. I got the ‘uh oh, Alzheimer’s is setting in look from my husband last week because I couldn’t remember that the name of the plant that was blooming so beautifully was an orchid. My students thought I was losing it when we were watching the movie ‘Sarafina’ and I referred to Whoopie Goldberg as Oprah. Not surprisingly, the school year is wrapping up and there is a lot on my plate so I’m all over the place–but these memory slips give me pause.
    Great post!

  2. Great piece Eileen. Your sense of humor is intact. You’re a great writer.

  3. Hi Eileen, sorry to read the residuals of chemo is screwing with you. Well written post, as you know I luv to read your stuff. Are you sure living in the San Francisco Bay area isn’t causing all this fog? Didn’t know they have a site for cognitive testing. I’m part of a study at Stanford where they test me for all sorts of sh!t before chemo and after and then again a year out. Oh and they MRI my head in all three occasions (funny struggled with spelling three just now, fog).

    How is your new place treating you, hopefully better than work?

    Doing the big countdown, 7 days and counting and it all changes, yuk, and God Damn it!! ~Dd

  4. Messing up can be scary at home and even more so when you’re on the job. Don’t be too hard on yourself. I’m sure that over all you’re doing a great job. Thanks for writing about this important issue. I’ve got some memory issues myself…

  5. Well done, Eileen, and I felt your pain. Been in that situation on more than one occasion–even without the Chemo Brain. Have to simply chalk it up to Mark Miller Brain.

  6. Oh, Eileen…
    I don’t think I need to say anything aside from: I get it. ONE FREAKIN HUNDRED percent, Get It.

    Second grade math, blown deadlines, trying to figure out how to organize myself so I don’t lose my home over forgetting to pay an $8.00 water bill.

    You nailed it when you talk about Lumosity being done in the quiet of your own home (and at a self chosen time – for me, when my brain FEELS sharp). There’s also a school of thought about those programs… we “get better at the tests” but that may not translate to real world situations.

    There were a couple of recent publications that validate my mess (I’m six years post chemo) and I don’t know whether to celebrate or fall into a heap and start to cry…

    Just thought I say, I Get It…..



  7. JoAnn, Mar, Nancy and AnneMarie, thanks for commenting. If nothing else, it feels good to know we’re in this together.

    Diane, very happy with the new place. Lots of sun, trees, flowers, and good neighbors. So healing! You know we’re all behind you whatever you decide with what you’re facing. Hugs!

    And Mark, no need to apologize for Mark Miller brain. It’s a very funny place to be. 🙂

  8. Linda Rochelle Malis says

    Eileen, you write so good. You took me right into the law office and that awkward moment. No one is 100% accurate all the time. I am certain the lawyer you work for is positive you are the BEST and it would take a lifetime to find someone to fill your shoes. Keep shining on. You are a winner. xoxox

  9. Go ahead, girl, and girlcott that day. Chemobrain is a bear.

  10. Thanks, Linda, for the kind words. I’m glad you’re confident in me.

    Jan, I love the term “girlcott.” Girlcott it is!

  11. My chemo brain lasted a full two years. Now, I just suffer from intermittent chemo brain. That would be good on a mug: WARNING: Intermittent Chemo Brain

    While going through my chemo treatments, I was crocheting, what I called, “My Chemo Blanket”. I still have 8 skeins of yarn to add to it (three years later) and am stuck because I can’t remember how to do the pattern. I thought of just changing it, mid-blanket, so that I could see what was created while on chemo and what was created while off. Still considering that, but for now, it’s left to be an unfinished heap.

    • Rosie, it sounds like your unfinished heap got your through chemo. Whether you finish the blanket or not, it served a useful purpose. Re the chemo brain, mine is also only intermittent at this point and not a concern as it had been before. There’s definitely something to be said for the passage of time.

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