Fun With Cancer

I was diagnosed with testicular cancer June 17th, 2014. Life goes on.

Memory’s Labyrinth.

The loss of Christopher Lee is sad and would be for me even if the only thing I knew him from was that version of Dracula that gave me nightmares when I was a kid. As a teenager I appreciated it much more when I watched it again in my bedroom very late one night. It was almost as much fun as the less well-known Doctor Terror’s House of Horrors, in which Lee plays a critic menaced by…well, I won’t give it away. It’s just brilliant. If Lee’s passing is what finally prompts a proper U.S. DVD or Blu-Ray release of Doctor Terror’s House of Horrors it will be bittersweet.

I didn’t realize it was the same actor at the time but Lee also played a brilliant mad scientist in Gremlins 2, holding his own against the Brain Gremlin. If you’ve seen Gremlins 2 you know that’s no mean feat. If you haven’t seen it you should.

Hail and farewell Christopher Lee.

Less publicized is the loss of Ron Moody. Most people will recognize him as Fagin from Oliver! For me he’ll always be Rothgo, the all-powerful wizard who’s lost his powers in Into The Labyrinth, a British series that ran on Nickelodeon in the early ‘80’s. My friend Andi and I would watch it together. Into The Labyrinth was part of Nick’s “The Third Eye”, a compilation of British and New Zealand supernatural series for children. For some reason Into The Labyrinth was the only one Andi and I watched together. She loved it. From Into The Labyrinth I learned that “souvenir” is French for “memory”.

A few years later Andi would succumb to cancer at the age of twenty-five.

Into The Labyrinth remains one of my favorite souvenirs of Andi, and of Ron Moody too.

Hail and farewell Ron Moody.

A souvenir of Christopher Lee:

And Into The Labyrinth in its entirety, a souvenir of Ron Moody:

I Don’t Want A New Drug.

005My blood pressure spiked at 639 over 225. Or something like that. It’s been high ever since my surgery in December. It seemed natural for it to be high after a procedure that involved slicing me open from my nipples to my navel and pushing everything aside so they could yank out some lymph nodes that, in the end, had a few teratomas which are a benign kind of tumor that can turn into anything like skin, teeth, or eyes. I would have been okay with that, since they could keep watch on what was going on down there, but the doctors didn’t think it was such a good idea. They don’t think my consistently high blood pressure is such a good thing either. I talked to my primary care physician, or PCP, who thought it might be from the surgery. He thought an artery going into one of my kidneys may have been kinked. Because the kidney wouldn’t get enough blood it would think the whole body wasn’t getting enough blood and would produce a hormone to raise the blood pressure. The kidneys also filter your blood and produce urine, and are the site of the adrenal glands which produce the fight-or-flight response when we’re in trouble, all things that seem completely unrelated, and yet no one can explain to me while growing an eye next to my liver would be a bad thing, but that’s another story. My PCP prescribed a drug that would lower my blood pressure. To deal with my hot flashes he’d also previously prescribed a daily testosterone medication. At this point I’m beginning to think I should stop calling him my PCP and just call him my dealer. Maybe I’ll do that the next time I’m sitting in the exam room listening to The Eagles song Journey of the Sorcerer on an endless loop on the office intercom.

“The problem with your artery can probably be fixed non-surgically,” he told me.

“How would they do that?” I imagined some guy punching me in the back until my artery was straightened out.

“They’ll make an incision in your leg and use a probe to place a stent in the artery.”

I’m not a medical professional but any time the phrase “make an incision” is used that’s surgery. I told him this and he agreed, but went on to say it would be very minor surgery.

“They’ll just give you a local. You’ll probably be awake through the whole thing.”

“Maybe not,” I said. “The last time they gave me a local I went out like a light.”

“Oh? You’re a cheap date.”

I’ve got the greatest doctor in the world.

The greatest Doctor not of this world.

After I met with my PCP I was referred to a very smart cardiologist who told me she didn’t think it was a problem with the artery, which was a huge relief. If I can skip the surgery, no matter how minor it is, that’s a good thing. When she told me it might be a part of my kidney dying that didn’t sound so good, but she said, “It’s not quite dead,” in a Pythonesque voice, and that reassured me that I was dealing with a professional with priorities. If it didn’t bother her that a small part of my kidney was on its way to join the bloody choir invisible I wasn’t going to let it bother me, especially since the goal is to get my blood pressure down.

To that end, though, she prescribed another drug. And then she had some tests run and noticed that my thyroid was low, so 005she prescribed a drug for that too.

For three months last summer I had a killer cocktail pumped through my body, and on top of that I had regular doses of pills. I was IBEATCANCERprescribed anti-anxiety meds, pain pills, pills for nausea, pills to make me piss like a racehorse, an array of blitzers, tinglers, zippers, and baby aspirin. Most of these I didn’t take more than a couple of times because I didn’t need them, and the ones I did need I weaned myself off of as soon as I could. Drugs just aren’t my thing. It’s not that I’m afraid of addiction—I’m not. I can’t even remember to take a multivitamin regularly. I’m too lazy to be an addict. Think about it: addicts are the hardest working people in the world. They have to be because nothing will stand between them and their next fix. Eventually for most it’s not even pursuit of the high that drives them; it’s the need to feel normal. And deep down I think that’s what worries me. I don’t want to be tethered to something, especially a drug. It feels so limiting. What if I get stranded on a desert island? Yes I’ll have bigger things to worry about, and maybe eating coconuts and fish all day will naturally level out my blood pressure and thyroid. And if I look at it one way it depresses me to think I’ll probably be taking some of these drugs for the rest of my life, but looked at another way the phrase “the rest of my life” has taken on a whole new meaning over the past year. A life of popping pills is better than no life at all.

And then I realized I already am an addict, and have been for a long time. I start every morning with a cold coffee with milk. I didn’t realize how important that was until my wife and I were staying in a hotel and I started a couple of mornings with a Coke instead. I was getting the caffeine, but it just wasn’t quite right. The third morning I went to the hotel coffee shop and ordered a gargantua triple cappuccino over ice.

“Is that for here or to go?” the woman asked as she frothed the milk.

“Just pour it in an IV bag and stick a needle in my arm.”

Try getting that on a desert island.

palmtree

The Flash.

IBEATCANCERThe hot flashes started around January. I didn’t think much about them. I was still having lingering issues related to chemotherapy. My hair was still coming back and so were my nails. It was less noticeable, but my blood was recovering too. For a long time after chemotherapy I couldn’t walk long distances without being short of breath. The low blood counts started during chemo. One morning my white cell count was so low that a nurse came out to yell at me from across the waiting room that they weren’t sure I would be getting chemo that day. I thought about yelling back, “Thank you for letting everyone in the hospital know that right now a bad cold could kill me.”

Before chemo, before anything else, in fact, there was the orchiectomy, or having the offending testicle, which was on its way to becoming a goose egg, removed. I didn’t have much time to prepare for it emotionally because it happened two days after I got the news that I had cancer, but I took it in stride. I thought about when a friend of mine had his three male cats neutered. One of them was named Curly. Curly was a character, always doing something bizarre like climbing the kitchen cabinets or flipping over the litter box.

Curly was last in line to get neutered, and before the vet made the final cut my friend said, “Maybe you’d better leave him one testicle just in case we want another like him.”

After my own half-neutering there was chemotherapy. When I finished chemotherapy I thought, well, this is it! Back to life as it was before.

Then I had the follow-up work and found I had to have surgery.

When I finished surgery I thought, well, this is it! Back to life as it was before.

And then I had some other follow-up scans. These, I assumed, would be the first of my biannual, eventually to become annual, checkups. The tech who did my ultrasound had trouble finding my testicle, which had apparently retreated out of fear after it saw what happened to the other one. So she called in another tech. And they called in a third tech, and finally the radiologist had to come in and say, “No, no, no, don’t you know anything? It’s between his legs.”

The first time I had a CT scan I just felt an incredibly warm sensation in my groin, like it was being microwaved. The second time I threw up in the middle of it. The third time I just felt like I was being microwaved again. Back to life as it was before.

I met with my oncologist who told me everything was fine. Back to life as it was…okay, I need to stop saying that, because I also had to have a follow-up with my urologist. This required a blood draw first thing in the morning. Then my wife called me to say they’d made a mistake on the first blood draw, and I was thinking, did they accidentally draw phlegm or something? I went back that afternoon and had another blood draw.

Then my urologist called to say the blood draw needed to be done first thing in the morning because he was checking my waitingtestosterone and that’s when it’s highest.

So I got my blood drawn again the next morning.

My urologist told me my testosterone was between ten and thirteen.

“That doesn’t sound too bad. What’s normal?”

“Forty-five.”

Actually that’s the low end of normal. Decreased testosterone is a fact of life. It’s part of growing older. If I may speak to my fellow Y chromosomes for a moment: you may have seen advertisements for drugs intended to treat low testosterone. These advertisements may have asked if you’re feeling tired, if you have mood changes, or if you no longer get the sort of erections that embarrassed you when you were in middle school and had to go up in front of the class to answer a math problem. If you’ve experienced these symptoms chances are you’ve just got a condition known as Getting Older. The only treatment is a healthy dose of Deal With It. This is available without a prescription.

Low testosterone, the sort that needs to be treated with hormone therapy, only comes from chronic conditions like cancer or being kicked really hard in the nuts. Low testosterone needs to be treated because it can cause things like muscle loss, aches, and migraines. Migraines are typically described as headaches even though they should be called everythingaches. When you have a migraine your hair hurts.

Low testosterone can also cause hot flashes. It wasn’t my blood after all.

There are three important lessons here. The first is, there is no such thing as life as it was before. The second is, every little thing can be significant. If you’re having hot flashes and you can’t find any reason why you might be having hot flashes tell your doctor. And third, spay and neuter your pets, but if you have a favorite cat leave one testicle just in case. Once it’s gone it’s gone.

balloon

Think Pink.

006These earbuds were a free giveaway. I picked them up partly because I can’t resist anything free, but also because I’d left my regular earbuds at home, and sometimes I like to sit back and listen to things while I ride the bus. It’s one of the advantages of riding the bus. I can devote my full attention to whatever I’m listening to, at least until I get close to my stop.

The earbuds sparked a mini-dialogue in my head.

Should I wear these?

Why not?

Well, they’re pink.

So are your ears.

Good point.

It also sparked a memory of when I was four and told my mother pink was my favorite color.

“Oh no,” she said. “Pink is a girls’ color.”

At the time that colors having a specific gender was the stupidest thing I’d ever heard. I also didn’t put it in those terms. “That’s dumb!” was what I thought but didn’t say. And I became hostile to any mention of favorite colors. There was a show on the local PBS station called Jellybean Junction. The host Fran Powell sang about how you could be any color jellybean you wanted. Any color, I thought angrily, except pink.

I don’t blame my mother. It was the conventional thinking at the time. It’s thinking that’s persisted. I had a college roommate who happened to be gay. Our room’s previous occupants had, for some reason, painted half the room blue and the other half pink. It was a coincidence that we were put in that room, and we laughed about how oddly appropriate it was. We could joke about it because it seemed like things were changing, but according to an Atlantic article from December 2014 toys are becoming more divided by gender. Color is an easy divider: “Rigid boundaries segregate brawny blue action figures from pretty pink princesses.”

Pink has also become the color of breast cancer awareness and support for both IBEATCANCERthose lost to it and the survivors. I’m opposed to breast cancer, and, for that matter, any other form of cancer, but I resent the fact that pink as a way of showing support for those dealing with breast cancer seems to have made it okay for guys to wear pink. I’m against all forms of cancer because it’s a terrible disease that’s killed some of the people closest to me. If I’m wearing something pink it’s because I just happen to like pink. Or because it was free.

The Hair Apparent.

Losing my hair was fun. I’m not kidding. I’ve always wondered what I’d look like bald, and it was the one bright spot in chemotherapy. Now, though, it’s growing back, and I’m starting to get a little frustrated. On the one hand it’s nice to have hair again. One thing I never realized about going bald is that my head would get cold. I guess guys who’ve gone bald naturally just get used to it. I don’t have to wear anything on my head anymore except when it gets cold–and since we’re moving into spring that’s going to happen less and less.

With my hair coming back so are memories of when I was a teenager and determined to grow my hair long. My parents wouldn’t let me as long as I lived under their roof, but when I  I went off to college and just stopped getting it cut. If there was a barber shop anywhere near the campus I didn’t know about it–or care.twoyearsIt still seemed to take an annoyingly long time for my hair to grow out. It was frustrating. I wanted to be like one of those Crissy Dolls that push hair out like toothpaste out of a tube. Sometimes I thought if I could hold my breath hard enough my hair would spool out. Eventually, though, it got long enough. People would come up behind me and address me as “ma’am”. Or guys would see me in a public restroom and do a double-take, checking the door to make sure they were in the right place. Hey guys–how many women do you see standing at a urinal?

Then I cut it short in 2009, just because I was ready for a change. Then cancer came and it was a big change. And it’s been frustrating in its own way. People told me my hair might come back gray and curly. “Cool!” I said. Maybe they thought this would upset me. I was thinking I’d look like Peter Capaldi, only shorter.

It hasn’t quite worked that way, though. My hair is coming back the way it was, more or less. It’s a little unruly, and I have no idea what it will be like when it gets back to normal length. I hope it gets there soon, but I won’t hold my breath.

portraits

 

Avoid The Broken Sofa.

There’s a story about Salvador Dali that he once asked to sit on a sofa with a broken spring. The discomfort, he said, would remind him what an extraordinary act sitting is.

I think this is a pretty ridiculous philosophy. Sitting is only extraordinary if you can’t do it. The same is true for standing, walking, scratching, blinking, or a countless number of things we do so regularly we don’t even think about them. Awareness of your body is a good thing, as I’ve learned, but making yourself miserable is unnecessary. Be aware of your body when there’s something wrong with it. Otherwise if it ain’t broke don’t fix it.

dalimuseumAs I said a mundane act is only extraordinary if you can’t do it, and then it does become extraordinary if you’re suddenly able to do it, or if you could once do it and have recovered the ability. So the other night opening a can of Dr. Pepper with just my fingers was extraordinary. It was extraordinary because it was something I hadn’t been able to do in months, and was something I thought I’d never be able to do again. Part of my chemotherapy cocktail was a drug called Cisplatin that made my fingers tingly and numb and caused a couple of my fingernails to fall out. (Thanks  my friend Jamie Zoe Givens for recommending B6, which helped.)

Life after cancer isn’t something I’ve heard much about. Maybe this is because for lifeaftercancer1too many people there is no life after cancer. And for the survivors talking about the experience may be unpleasant. It’s also something a lot of people simply don’t want to hear about, and that’s okay. Before I was diagnosed what happens to someone who’s successfully been treated for cancer wouldn’t have been something I could relate to either. This is a reminder to myself of what I lost, what I thought I had lost permanently, and what I’ve regained.

More importantly this is for people who are facing chemo or other treatments and who have no idea what to expect on the other side. I hope your experience will be like mine. I hope your chemo will also be boring.

Some other things I thought I’d never be able to do again:

Walk more than one-hundred feet without stopping to rest.

Go outside without a hat or other head covering.

Live without fear.

I’m still working on that last one, because it’s a delicate balancing act. On the one hand I have to be aware of potential dangers. My body has been through some major changes. It’s been like puberty, but not as much fun. There are downsides. I hadn’t had a migraine since I was thirteen. Now I’ve had two in the last three months. And I have to be aware that every minor ache or pain could be a warning sign.

I’ve also recovered so much, and I have to be aware to be grateful for those things. Just because it ain’t broke doesn’t mean it should be taken for granted.

IBEATCANCER

It’s Really Nothing.

It’s probably nothing.medicine

A year ago I could say that. A year ago if I’d discovered a small lump in my armpit I would have thought it’s probably nothing and forgotten about it. I’ve had lumps before. They went away. I’m pretty sure they were nothing. The body is a quirky machine. Sometimes little things go wrong, get discombobulated, then fix themselves. Besides I never get sick. Or at least that’s what I used to be able to say. Now I find a small lump in my armpit and it doesn’t matter how small it is. My mind immediately starts flashing red neon signs that say LUMP! ARMPIT! LYMPH NODES! CANCER!!! My wife was there to reassure me it was a skin tag, a little bit of flesh that got lost on its way to replace an old layer of epidermis. Or maybe it’s just a small collection of cells that said, “Let’s get wacky!” This is benign. It’s like the cells having a little too much to drink at aparty and ending up on the roof screaming “I can see the Islets of Langerhans from here!” Cancer, on the other hand, is when cells have a psychotic break and decide they’re going to climb into the aorta with enough weaponry to arm the entire pancreatic military and take out everyone they can, but that’s another story. The skin tag is annoying even though it’s small, so small, in fact, that I only notice it in the shower when I’m washing my armpits. It’s so small you wouldn’t notice it if I waved to you while wearing a tank top, and not just because I’ll never wear a tank top. microscope On the one hand I’m relieved. On the other hand I’m annoyed that something this minor would choose now to pop up. I would be a lot less happy if it were something major, but really I just want to call a truce with my physiology. I want a break. It hasn’t yet been a full year since I was first diagnosed with cancer. It hasn’t even been a year since the leg pain that was the first sign started. And it hasn’t even been three months since my last major surgery, which I sincerely hope really will be my last major surgery. It’s just too soon. I know cells have to burn off some steam once in a while, but, as their supervisor, I’m not inclined to grant even a short vacation right now. If some of them want to get drunk and go crazy right now they need to go find another body to live in. I’ll never be aslaid back as I once was, but in a year or so I’ll be a little more relaxed. Things are just still a little tender at the moment, and my body, of all things, should understand that. You’ve got a pot of spaghetti boiling over on the stove so it looks like an octopus trying to escape. The sauce is smoking, and you’re pretty sure it’s burned to the bottom of the pan, and it’s thrown little red flecks all over your white shirt so you now look like you’ve stabbed someone in the jugular, and you’re kicking yourself for not putting on an apron because tomato sauce is magnetically attracted to white fabric. The mail you casually threw on the hall table just slid off and catalogs skidded everywhere, the refrigerator is running, and the dog, who’s been barking nonstop for the past hour, is now peeing on your shoes. And he’s giving you that look that says, “I TOLD you I needed to go out!” It's like this, but worse. In a sudden frenzy you get the spaghetti and the sauce off the heat, put the dog outside, wipe up the floor, catch the runaway refrigerator, and pick up the mail. Your heart is racing, you’re breathing heavily, and your pulse is pounding in your ears. Then the phone rings. Still frazzled you answer with “WHAT DO YOU  WANT? WHO IS THIS? ANSWER ME BEFORE I RIP YOUR KIDNEYS OUT THROUGH YOUR NOSTRILS!” And your mother-in-law who called just to ask how you were doing is barely able to break through her catatonic shock and say, “Nothing!” It was a similar feeling that had me yelling at my armpits in the shower. I can’t see into the future, but I know that, in spite of my generally positive prognosis, there’s a chance my cancer will come back. The doctors may have used the word “cured”, but it’s never something that really goes away. My body could turn on me at any time. I just hope that if it does it’ll be in five years or ten. With enough breathing room I hope I’ll be able to respond calmly and rationally instead of having a total, even if temporary, meltdown that left me lying naked on the bathroom floor wondering if it’s time to cash in my retirement account and start the farewell tour. It was just a little too much too soon. Yes, there is a part of me that wishes that instead of a skin tag it was really cancer, not cured but steaming right ahead, and that I just yelled it into submission. A feeling of lost control is part of the life-threatening illness package. I want to feel like I’m back in charge and that this time around I didn’t need no stinkin’ chemo. This time, I want to believe, I showed that cancer who’s really boss around here, but realistically I know it was really nothing. surgery

The Way Ahead

January 30, 2015

“I was cured all right.”
-A Clockwork Orange

 

So where do I go from here? Everyone’s experience is unique, but in my case beating cancer was the easy part. A few brief bouts of nausea, a temporary allergy to sunlight, anemia, and fatigue were as bad as the side effects got. Surgery wasn’t fun, but it went smoothly. When all this started in June 2014 I thought things would change significantly. I wasn’t sure how they would change, but I thought it would be dramatic and obvious. Instead everything went so easily it’s tempting to feel like nothing’s changed, least of all my outlook. I’ve always been an optimistic guy. The doctors helped me maintain that by telling me I could look forward to being cured. People with some other forms of cancer, if they’re lucky, go into remission, which merely maintains the status quo. The cancer could come back at any time. When I heard the word “cured” I thought it would mean I’d go back to being like I’d always been. Before the cancer I could say “I never get sick.” It was a time when I wouldn’t know my general doctor if you put him in a lineup of people who looked nothing like him. When I decided to see him about the pain in my leg that had been keeping me up at nights for a couple of months I hadn’t had a checkup in three years. I’d volunteer for medical experiments and the people doing the tests loved me because I was a medical blank slate: no allergies, no major medical issues, and not even any minor ones. I still have my tonsils, my appendix, and I’ve never had a broken bone. If I’d known then what I know now when the doctors told me I’d be “cured” I would have asked, “Like a ham?” And maybe they’d say yes, because it is sort of like that. Everything has changed. I’m still an optimistic guy, but I’m changed. There’s a cloud that I’m aware of every minute of every day. I will wear a medical bracelet listing my allergies and other issues for the rest of my life. I will have regular screenings for the rest of my life. I can’t take it for granted that the headache, the stomachache, or the persistent leg pain will just go away anymore. It’s a lesson I’m still processing. I’ve read about people in near fatal car crashes, or who just barely escaped disasters or other life-threatening events. They walked away feeling like the bravest person in the world, but a few days, or a few weeks later they’d have a complete meltdown. We don’t always respond immediately to trauma. In my case I was, metaphorically, in a car wreck that went on for six months. I was able to walk away from it because I had help, especially from my wife, who, metaphorically, was out there directing traffic, but as the only one in the car I need to, metaphorically, drive more carefully from now on. Hindsight is 20/20, but it’s only useful if we apply whatever it was an experience taught us, and I need to be more conscious because the phrase “the rest of my life” has taken on greater significance.

 

The narrator of The Stranger by Albert Camus says, “Either way you’re going to get it.” He’s talking about two possible paths through a town, each of which has its problems, but also metaphorically about life and death. Whatever path you take the destination is the same. When I was young I thought that very profound. I’d never really confronted death, so I thought it was all that needed to be said about death, and life. Because death was distant and abstract it could be romantic. Dylan Thomas, Edgar Allan Poe, and Emily Dickinson were all special, I used to think, because they died young. I even thought of them as almost lucky. It was an attitude I eventually outgrew, long before I’d outlived all of them. I realized that even if their reputations had fallen if they had lived longer that didn’t make death a better alternative. There’s no shame in old age. This was a conclusion I came to even while death was still an abstraction, something I’d experience through the loss of some friends and family, but that I didn’t think I’d have to face, or even think about, one-on-one until I was closer to the end of my allotted three score and ten. There’s physical death, which, with some exceptions, we experience only once, but there’s another kind of death, the kind that comes when an experience transforms us. It’s a kind of death we all experience as we age. I’m not the same person I was ten years ago, although I can’t put my finger on what exactly changed. Sometimes, though, it’s less subtle. I’m not the same person I was a year ago, and I know exactly why. I’m a long-time Doctor Who fan, and one of the things that’s always appealed to me is the Time Lord’s ability to regenerate. On the point of death he survives by becoming a completely different person. I always liked that, but never realized the significance. We come through traumatic events, especially those that make us aware of our own mortality, a different person. Like the Doctor I have all my memories and everything I had before my own regeneration, and like the Doctor I’m going through a settling-in period, a period of asking, “Who am I?” It’s necessary to get to know this new me, but it’s also an opportunity to make changes, which is even more important. A metaphor that non-Whovians might be better able to relate to is the caterpillar that becomes a butterfly. It’s a cliché, but only because it’s so damned accurate. The butterfly is still the caterpillar, but completely transformed. The butterfly can do things it never could before, but it’s also got new, and bigger, responsibilities. It has wings, which are fragile, and in flight it will be more exposed than it ever was as a caterpillar, but it will also see a bigger world. I have to accept new responsibilities, but I’ve also gained a whole new perspective. If I look behind me I may even have wings.

Under the Knife

December 5, 2014

“Oh my goodness, this one’s pregnant!”

Ms. Swisher was leaning over my shoulder looking at the starfish I’d carefully dissected. In hindsight she was one of the better science teachers I had, although I didn’t appreciate her at the time. She was a passionate teacher and enthusiastic about science, and biology in particular, which was remarkable for someone who’d been facing rooms full of surly teenagers for decades. We were given a choice of animals to dissect in ninth grade biology, and I’d chosen the starfish because starfish are cool. Also in my career as an amateur scientist I’d dissected frogs, crickets, crawfish, clams. One thing remained consistent across the phyla: their insides didn’t look anything like the textbook illustrations. Even the ones that hadn’t been embalmed had wads of gray or yellow indistinguishable stuff where certain organ systems should be. It’s why I never became a doctor. Well, it’s one of the reasons. Another reason is that I never wanted to be a doctor, and that’s one of those professions that you should only go into if you’re really passionate about it. I’d hate to be in the middle of an operation thinking, “Man, I’d rather be selling urinal cakes to coffee shops right now,” and oblivious to my patient flatlining, but that’s another story. So it didn’t surprise me that while the textbook illustration of the starfish had everything clearly marked and different organs in different shades of blue, red, and green its real insides looked like three different brands of Dijon mustard. The distinctions were clear enough that I could at least make a good guess at what was what, but it was Ms. Swisher’s years of experience that allowed her to know at a glance that the starfish’s gonads, which, like its digestive, nervous, and other systems, were spread throughout its entire body, were swollen.

There was a model of the human body at the front of her classroom, one of those with lopped off arms and legs, as though someone had tried to turn a corpse into a broken Greek statue, and the skin of the trunk cut away to reveal everything from the lungs to the liver. All my years of experience with dissection had taught me was that if I were cut open my viscera wouldn’t be that neatly color-coded, separable, easily removable, and made of plastic. We couldn’t have played football with a real liver. Well, now that I think about it, I guess we could, but there’d be a lot more fumbling.

When I started my journey with cancer I was told there was a fifty-fifty chance the chemotherapy would take care of everything, that there would be no need for further treatment. The coin was tossed and came up tails. Now there’s one more bridge to cross. I hope it’s the last one. The surgery is called a retroperitoneal lymph node dissection. In layman’s terms the surgeon’s going to cut me open right down the middle, shove most of my organs out of the way, and yank out my lymph nodes from my nut to my navel. When I was young I had nightmares about the thing that lived in the attic threatening to stab me in the stomach. Now it feels like that nightmare is coming true, although I’ll be asleep for the three to five hours the surgery takes. And I’ve met my surgeon, and I’m about as reassured as I can be. He’s a good guy, very smart, and passionate about what he does. He’s also done this operation several times, so he’s got plenty of experience. It’s good to know I’ll be in the hands of someone who knows that when he opens me up it won’t look anything like the textbook illustration.

Look Forward

November 7, 2014

One Monday morning on my way to work I started chatting with a woman in the elevator. “I wish it were Friday,” I said. “You’’re wishing your life away!” she snarkily replied. That set me back a bit. Was I missing out on something, wasting my life, by looking forward to the future? The key to happiness, I’’ve often heard, is living in the moment, enjoying life as it comes. It’’s a philosophy that appeals to me because I like spontaneity. I’’ve been known to take wrong turns just to see where they go, and to wander into places still under construction just out of curiosity, —and these are decisions I’’ve made with no advance planning. Most days at work I take a walk during my lunch break, and most of the time I don’’t decide which way I’’m going until I’’ve left the building. Sometimes when I come to a fork in the road I flip a coin. And I love surprises. My wife knows that one way to make me happy is to say we’’re going to a movie and not tell me which one. It’’s even better when it’’s one I know nothing about even when we get to the theater. So I’’m very much a fan of living in the moment, but that doesn’’t mean I never plan. It’’s also nice to have things to look forward to. The present and future aren’’t mutually exclusive; after all the future so quickly becomes the present. The more I thought about it the more I realized that woman was wrong. Looking forward to the future doesn’’t preclude, or even diminish, whatever happiness we can find in the present. Multiple studies of work habits say that multi-tasking lowers productivity, that it’s a bad thing, but multi-tasking happiness—–enjoying the present and looking forward to the future–—isn’’t just good. It’’s essential. If it were possible to live exclusively in the moment we’’d never have the satisfaction of achieving long-term goals, and if we’’re always looking to the future we don’’t stop and enjoy happiness when it comes along.

I thought about all this when I was first diagnosed with cancer. As I said I’’m generally a spontaneous kind of guy,  but part of my strategy for dealing with what was suddenly a strange and uncertain future was to promise myself things that I could look forward to. Some were small things, like a special (and expensive) microbrewed beer that’s been sitting in the pantry since my first week of chemo. “When I get the all-clear from the doctor,” I said, “drinking this will be part of my victory lap.” And some are big things, like a trip to a part of east Tennessee, to Ozone Falls–—a place that’s special to me. I was very lucky in that I had very few side effects from chemo—–fatigue, hair loss, and three five minute bouts of nausea were as bad as it got. There was no way to know it would be like that going in, though, and having things to look forward to helped me remain optimistic, even happy while toxins were being pumped into my veins on a daily basis.

My one mistake was being a little too optimistic. —I was unrealistic. Six weeks after finishing chemotherapy I was supposed to have a few tests done and then meet with my oncologist. And I expected her to look at the results and say, ““You’’re completely healthy. Get out of her and never darken my door again!”” Admittedly I knew there’’d be regular checkups, which is fine because my oncologist has been fantastic, and going back once in a while wouldn’’t be a bad thing. The problem—–and if I hadn’’t been so blindly optimistic I would have been more aware of the facts–—is that there’s been a slight bump in the road to recovery. I was hoping the orchiectomy and the chemo would be the end, but I have one enlarged lymph node. It could be dead tissue, it could be a teratoma, or it could be the embryo of the Loch Ness monster. We won’t know until I have surgery to take it out, and to be on the safe side the doctors are taking out the neighboring lymph nodes as well. Such is the joy of having a cancer that’s metastatic, a term which comes from the Greek words “meta”, meaning “after” and “static”, meaning “shock your friend after rubbing your feet on the carpet”. So I’’ve got one more step to go, and hopefully I can get it done soon. I don’t want to be split open and have my guts pulled apart, but it’s not a step I want to skip either, because it could mean complications in the future. And it’’s a reminder that even a surprise that I didn’’t want and plans for something that scares me can still make me happy. Surgery isn’’t fun, but I can look forward to the future that comes after.

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