Hair, Part 1

In the run-up to my first chemo treatment, I started bracing myself to lose my hair. One of the oncology nurses told me upfront that I would experience “total hair loss” and that it would likely happen after my second chemo treatment.

When she said “total hair loss” I thought, “Well of course, I’ll lose all of the hair from all over my head, not just part of it.” That was true but what she really meant was that I could lose all of the hair from all over my body, not just the hair on my head. Eyelashes and eyebrows were not exempt. I don’t know why this had never occurred to me before. After all, why would the chemo affect only the hair on your head and leave your body hair alone?

In general, chemo targets rapidly-dividing cells. It’s not smart enough, however, to know which rapidly-dividing cells are cancer cells and which aren’t, which is why it generates side effects such as nausea, vomiting, and hair loss. (Nausea and vomiting are the result of chemo hitting the rapidly dividing cells in the stomach and digestive tract.) Not all chemotherapies cause hair loss but it is certainly a hallmark of cancer treatment.

Losing my body hair—and I didn’t lose all of it from everywhere nor all at the same time—was strange but mostly not a big deal, except for when my eyelashes and eyebrows started coming out. Losing the hair on my head, however, was probably the most traumatic and emotionally difficult part of the whole cancer experience. I loved my long, thick, beautiful hair. It was a big part of my physical identity and a huge source of my self-confidence. My hair received many compliments and I reveled in them. This wasn’t just frivolous vanity. My hair was the signature highlight of my physical appearance, the one thing I could always count on to look good no matter how flabby or lumpy or drab the rest of me looked. I might be short and slightly rounded, I might have too many freckles and not flat enough abs, but I sure did have gorgeous hair!

I couldn’t even imagine what I would look like without hair and I certainly didn’t want to find out. I thought of how many years it had taken to grow my hair to that length and thus how many years it would take after chemo to get it to that point again. Logically I knew that the hair loss would be temporary but it nevertheless seemed impossible that my hair would ever look as good again, assuming that it actually did grow back. 

Fall Out

My hair started falling out the day after my second chemo treatment. I didn’t see it on my pillow and it didn’t come out in clumps. Rather, I noticed that when I ran my fingers through my hair, instead of just a few loose strands coming out as was normal, a handful came out. No matter how many times I combed my fingers through my hair, a sheaf of loose hairs still came out with every pass. My hair didn’t look any thinner, but clearly it wasn’t going to stay intact for much longer. I pulled it into a pony tail to avoid leaving a trail of long, blonde hairs behind me.

I knew what came next. I knew the chemo patient ritual that accompanies this stage of treatment: shaving of the head. Get all that hair loss over with in one fell swoop. I stoically made an appointment to see my hair stylist, Kelsey, the next day (Saturday) and invited my friend Michelle to come with me for moral support. Sitting in Kelsey’s salon chair, however, and telling her the reason for my visit and the unusual hair cut I wanted her to give me, my stoicism evaporated and I burst into tears, already grieving my vanishing hair. Kelsey leaned down to hug me and we cried together over how rotten this situation was.

First she lobbed off the bulk of the hair in two ponytails, which we saved to donate. Then she got out the clippers to shear off the rest. It was emotional. It was traumatic. It was a horrible transformation to undergo. I didn’t want to face my reflection in the mirror when she was finished.

Michelle, thoughtful friend that she is, had brought with her to the salon a box full of newly purchased scarves and fashionable hats I could wear post-shave. I can’t tell you how much it meant to me that she had gone to the effort and expense of getting those things for me, knowing what an emotional toll this would take and how it would affect my self-confidence.

When Kelsey was finished, my head was left with a sparse covering of prickly stubble. I was essentially bald and it wasn’t a good look on me. I didn’t look like myself and consequently I didn't feel like myself either. I looked like some freakish alien, some other person who only bore a passing resemblance to me. My facial features looked duller, my skin washed out, my physical form altered. How would I interact with people going forward, when I no longer looked or felt like myself—and not by choice?

Kelsey helped me tie on a scarf I’d brought—the only one I’d purchased, since contemplating what I would want or need when I lost my hair had been too overwhelming before. With the scarf on my head, the look was complete. I now bore a visible sign that I was a cancer patient, a sick person. I was marked as different, as “other,” as a member of the dreaded cancer club. I’d lost my hair to chemo and enacted the cancer patient’s ritual just like thousands before me. With a few passes of the clippers, my very identity had been altered. I hated it.

Later I wondered how my hair would have ended up if I’d just cut it short or not cut it at all. Would it have all fallen out eventually or would I have just had thinner hair but still looked like a normal, non-cancer-patient person? What if I’d shunned the head-buzzing ritual and just let things take their normal course? It was too late for those questions now.

Losing my hair was one more thing about this cancer experience that I couldn’t control—a very traumatic, visible thing. I was falling further down Alice’s rabbit hole into a bizarre world in which I wanted no part.

(Stay tuned for Hair, Part 2, coming soon.)