Unwelcome guest.

How are you feeling?" My friend and I are sitting on overstuffed sofas sipping hot tea. Her usual attire of big, dangling earrings and flamboyant, colorful fabrics has been replaced by sensible sweat pants and a sweatshirt. No effort has been made to hide the flatness of her chest on one side.

"Terrified. I am terrified. What do you do with the fear?" This is a woman with a PhD, a job as a university administrator, a husband, and two children. She has faced down angry departments, hired and fired, designed programs, but this is something new. She discovered a lump in her breast, and within one week her life has taken a sharp turn. She underwent a mastectomy and is now facing four months of intensive chemotherapy during which she is guaranteed to lose her hair and be sicker than she can imagine. She declines an offer for breast-cancer literature, certain that it would only increase her fear.

A couple of weeks earlier I had visited a Mennonite mother of eight in the hospital. It was my month as a "Reach to Recovery" volunteer, so I got a call every time the surgical floor had a new breast-cancer patient. Every volunteer has had breast cancer herself. I had it twice. The first time, at age forty-one, I had a lumpectomy and radiation. The next time, with a new cancer on the other side, I had a lumpectomy, radiation, and chemotherapy. The first go 'round I was embarrassed to admit to anyone that I had breast cancer. I never took a single day off work. After the second occurrence, exhausted by seven and a half months of treatments, I just wanted to forget and put the ordeal behind me. I definitely did not want to become a professional cancer survivor. Later, though, with some distance, I realized that I could do a service for other recently diagnosed women.

The Mennonite woman I was visiting had had a mastectomy the afternoon before and was going home. I hurried to the hospital by 8 a.m. so I wouldn't miss her. She was already sitting up in bed, her hair neatly combed back into a white mesh head-covering, the drain in her chest hidden under a hospital gown. We chatted about her farm and her children, aged four to sixteen. "Do you have some help when you go home?" I asked.

"The children do a lot." She smiled, and I pictured her stationed at a big stove, steam rising from a canning pot filled with jars of applesauce, her children strategically deployed to chores around the house.

"Here are some booklets you can look at when you get a chance." Lumpectomy, Radiation, Cancer Dictionary: with their shiny covers, they seemed as sterile as a doctor's examining room. "And here is my phone number. Please call if you want someone to talk to."

I was walking out when she spoke so softly that I almost missed her question: "Does the fear ever go away?"

I returned to her bedside, "No." I shook my head "It is always there." It is like the unwelcome guest you make room for in a crowded car.

Breast cancer changes you. How often I had heard this, and after two bouts, I had to agree. But for the longest time, I could not put my finger on how. Then I read about monks in the early church who kept human skulls in their cells. "Memento mori" they called them, "remember death." How morbid, we think. Even ghoulish. We should focus on life and love and beauty. Then something like cancer strikes. That car that's been rolling along so smoothly comes to a bone-jolting halt.

According to Dr. Armand M. Nicolli Jr., the average life lasts less than thirty thousand days. Since we sleep a third of that time, we experience less than twenty thousand. We think about mortality when we have to, when someone close to us dies, it is a terrible shock. But we know we are mortal when illness strikes us. That unwelcome visitor is at my door. I am suddenly vulnerable.

But why would those monks want to be reminded of it day after day? They believed that being reminded of death would help them live a different and better life. "From dust you came and to dust you shall return," the priest intones each Ash Wednesday Would you do anything differently if you knew you had a limited time to live?

So, no, the fear does not go away. But it can become something positive, a memento mori, standing always at our shoulder, reminding us, as the psalmist said, "to number our days aright that we may gain wisdom of heart." After all, why waste a day in anger or self-pity if we have a limited number? Acknowledging death, we live life. The unwelcome guest becomes the traveling companion.

Sarah H. O'Connor is a professor at James Madison University in Harrisonburg, Virginia.