Elaine was a fiery red head who loved her family, open water sailing, and Schlotszky’s sand­wiches. She was mother to my best friend and grand­mother to our god­children. She was care­giver to her hus­band, whose can­cer took him sev­er­al years ago, and she was my friend.

She was also a patient.

In one of life’s ironic tragedies, Elaine tran­si­tioned from can­cer care­giver to can­cer warrior when she was diag­nosed with ad­vanced stage mantle cell lym­phoma in 2012. Elaine became a patient at the can­cer center where we live soon after my hus­band Daniel, and since then we shared many con­ver­sa­tions, treat­ment up­dates, and hos­pi­tal visits over the last eight years. Her advice was invaluable, and her insights brought with them a unique under­stand­ing of my role as care­giver and Daniel’s role as patient.

She had many treat­ments over the last eight years. Like Daniel, she ex­peri­enced clin­i­cal trials, tough pro­ce­dures, successes and failures. As her op­tions began to run out, she underwent CAR T-cell ther­apy. Sadly, it was un­suc­cess­ful, and her doctors said that nothing else could be done for her. Elaine passed away last month.

I have strug­gled to write this column because Daniel and I shared a con­nec­tion with Elaine that went beyond friendship. It was a blood can­cer con­nec­tion. And with her passing, I feel acutely the finality of the blood can­cer cycle. It is some­thing that only people who read this column are likely to under­stand. Seeing another person fight the same complicated, all-consuming strug­gle as Daniel and I fight – as many of you fight every day – is enough to instantly bind people to­geth­er and be­come a heart-wrenching loss when they leave us.

Legacies are a tricky thing. Death is so final, and we want our lives to have meant some­thing. I know that Elaine’s family could describe in detail how she was a loving wife, mother, grandmother, and friend. But for me, her legacy is not just based upon the rela­tion­ship that we shared. Elaine’s legacy was what she paid for­ward.

Elaine was the recipient of others’ kindness when her hus­band David was fight­ing can­cer. She told me stories about patients and nurses she would run into at the hos­pi­tal. There were nice strangers who shared inspirational stories or who provided her with en­cour­agement when she needed it. Then, again, when she re­turned to the can­cer center, this time as the patient and not the care­giver, again these kind nurses, strangers, and physicians appeared. It never seemed to fail that when she was the most discouraged, one of these can­cer con­nec­tions gave her what she needed the most. Their gift to her became her gift to us. Just as those people paid it for­ward to Elaine, Elaine paid it for­ward to us.

Having mul­ti­ple myeloma is not like hav­ing other can­cers. It can be very isolating. Explaining to most people how your loved one’s chromosomal ab­nor­mal­i­ties im­pact their risk level, or why you’re worried about an in­creas­ing M-spike, will often get you confused looks and blank stares. People don’t under­stand why lasting remission is dif­fi­cult, if not impossible, to achieve with myeloma. People don’t under­stand why Daniel is still getting treat­ments two years after he started them. It’s been going on for so long now that I think most people forget that his myeloma is not in remission. We rarely talk about it with other people because they can’t imagine what it is like to live with the side effects – the diarrhea, the swelling, the sleeplessness and fatigue – all while still work­ing a full-time job.

Elaine under­stood. She was an anchor for us. She gave sup­port to us in ways that we needed and could not even articulate. She listened, gave advice, checked on us during clin­i­cal trials, and made time to visit with us when we were at the hos­pi­tal. It was a comfort know­ing that Elaine’s wisdom was only a phone call or a text away. These past eight years would have been much lonelier without her.

Recently I began a friendship with someone whose hus­band was just diag­nosed with smol­der­ing myeloma. Having “watchfully waited” for six years with Daniel’s smol­der­ing myeloma be­fore he progressed to active myeloma in 2018, I instantly empathized with her as she is trying to navigate these new and dif­fi­cult days. I hope that I can pay it for­ward and be for her the ex­peri­enced voice of reason that Elaine was for Daniel and me. I remember so vividly how much I needed a voice of sup­port in those dark days, and how thankful I was to connect with Elaine on how to be a good care­giver to Dan.

In the end, per­haps paying it for­ward is the one legacy worth striving for. All we need to do is to help. Be there. Listen. Knowing that when we do, we honor those who first helped us. I think Elaine would have agreed with that. I think Elaine would have reminded us that no one wants to leave this life early, but what we do with our time here is as im­por­tant as what we leave behind.

Giving to others, paying it for­ward, and being a com­munity is the best way to not only use your time well, but also create a legacy to pass on through others. I don’t want to remember Elaine’s lym­phoma or how she left us too soon, but every time that I share a word of en­cour­agement with another care­giver, or I assure a new patient that they’re in good hands, I will honor Elaine’s memory.

Legacies can be so much more than names on stadiums, uni­ver­sity build­ings, or large estates. The best legacies we can leave behind are the peoples’ lives we’ve touched. I’m thankful to have been a part of that, and I hope to con­tinue to be so, re­gard­less of how long we have in our own blood can­cer cycle.