Friday, November 30, 2012

The Importance of Tone

Before I begin, I'd like to direct your attention to today's XKCD cartoon.  I think the reason why will be apparent. 

So the other day I was in the cafeteria at work, making myself a cup of coffee (as is my wont), and a co-worker came in.  She'd been with the company and known me since before my surgery, though she works part-time so she perhaps didn't know me as well as some others, even though we work about ten feet from one another.  She started making the usual morning small talk, how are you, how was your weekend, et cetera.  I responded that not a whole lot was going on, went for an MRI, just the usual.  I know that for most people an MRI is kind of a huge deal but I figured everyone at work knows what's up with me, they know I get routine MRIs as part of my treatment.  It seems strange, coming from a man who writes under an alias, but I am rather open about my cancer with my friends and co-workers.  Not open enough, it would seem.

My co-worker looked to me with concern and asked, "oh?  What's wrong?  Are you OK?"  

Now, I don't expect that everyone's memorized each and every step of my treatment.  When I went off chemo, many people were surprised to hear I was still on it.  Certainly it doesn't affect their lives in any way, that I get routine MRIs.  I assumed she must have simply not known.  As casually as telling her which hand I favor, I said, "I have brain cancer.  I get regular MRIs to keep an eye on it and make sure it doesn't pull anything sneaky."

"I had no idea!," she replied, just as casually.  We chatted a bit about that, how I had no idea she had no idea, or that anyone had no idea, wondering who else was in the dark, and then we went our separate ways.  It was as though brain cancer is only serious if one speaks of it in a fittingly serious tone. 

I can't say I'm disappointed.  Those, "I have cancer" talks are really hard and unpleasant.  Definitely not the way to start a morning.  It was just so surreal to see it go over so smoothly.  It's made me think about the importance of tone, and how we communicate.  I wonder if she would have been more concerned had I mumbled, "we're out of creamer" in as miserable, hopeless a voice as I could muster.

Or maybe she thought I was making a really tasteless joke but didn't want to call me on it. 

Either way, I am left wondering who else doesn't know.  There isn't much I can do to raise awareness, if I even wished to do so.  I can't send a company-wide e-mail saying, "hey guys, just a reminder, man with cancer over here!"  I can't go around inserting it into casual conversation, hoping that everyone will react as well as that one co-worker.  I don't really want people thinking about it.  I am not my cancer.  It does not define me and it does not limit me.

I guess I just don't want to have that hard conversation with anyone.  I don't want to put them through it, and I don't want to put myself through it.  But above all else, I don't want to surprise anyone with it.  I don't want to get someone invested in me, only to feel I've presented myself falsely.  My cancer is not who I am, but it is part of who I am. 

Anyway, yes, I did have an MRI this month and it came back with no progression.  No one has said the word "remission" to me, but from what I understand I meet all the criteria.  I suppose I'm afraid to ask, should I be confronted with some technicality that means I'm not really in remission.  I did get a call from my oncologist in Manhattan concurring with my local doctor's opinion that we should stop the chemo, so that, my friends, is a done deal. 

Thanksgiving has come and gone - for those who may be unfamiliar with the custom, it's an annual feast where we Americans give thanks for all we have by stuffing ourselves stupid with rich, heavy foods - and my mom's been pretty enthusiastic about all the things we (by which she means I) have to be thankful for.  I'm not sure how to feel about it, really.  Things could be much, much worse, to be sure.  I'm not going to be as dark as to say I'm still trying to fight my way back to zero after a setback as huge as cancer, as I believe my disease has helped me to grow as a person.  Right now I'm as close to cancer-free as I can expect to ever be, given the level of technology I have available to me, but that's all I am: close.  I'm not cured.  So long as that's the case, so long as I'd trade anything for a cure, it's hard for me to feel all that thankful.  It's hard for me to give thanks that a bad situation didn't get worse, no matter how glad I am that that's the case. 

Maybe that appreciation that things haven't totally gone to hell is close enough.  I mean, dad's turkey was pretty good this year.  That's something.  Right?

Tuesday, October 30, 2012

Time for a New Chapter

I meant to write something about this on Wednesday, but wanted to give myself a little more time to process things.  Then I tried again on Sunday for reasons that will become apparent, but Hurricane Sandy had other ideas.  So now that I'm finally in front of a computer with working internet access, let me give this another shot.

On Wednesday, October 24th I had my routine pre-chemo check-in with Dr. C.  As I mentioned last time, this marks one full year taking cycles of chemotherapy, a significant milestone as "one year" was the minimum recommended dosage.  I hadn't brought it up lately out of fear that Dr. C. would have changed his mind, or forgotten about it entirely, or otherwise responded with anything but a, "sure, go ahead."  When I saw him on the 24th, I figured there was no point in dancing around the matter and asked him directly if I could stop.  He flipped through my file - now quite sizable - and casually said, "sure."

There was a little more to the discussion than that, granted, but that's how it started and proceeded along those lines, with Dr. C. giving me reasons why it would be a good idea, or at the very least, not a bad one.

So that night, I took the first dose in my last round of chemo.  At least, my last round for now.  There's no way to know what the future holds and I'm sure this is not the last I've seen of my cancer, but for the time being I am no longer a cancer patient, but a cancer survivor.  Dr. C. wants to see me in 3 months and I'll still have my regular, bi-monthly MRIs, but no more chemo for the foreseeable future.  I'm free.  That was the thought going through my head on Sunday, as I prepared to take my final dose and listened to the winds of Hurricane Sandy howling outside, drawing forth all sorts of new and interesting sounds from my poor little home.  I briefly entertained the thought of a tree falling through the roof, killing me on the spot.  It would figure, you know?

I actually got off pretty well from the storm.  I lost internet access, but my electricity and water supply held.  Or at least I think it did; on the radio this morning I heard some warnings about sewer treatment plants backing up and contaminating the water supply, but the report helpfully excluded any mention on which towns were affected.  I did wake up feeling a little nauseous this morning but that's hardly unusual.

We lost power at work but they'd purchased a shiny new generator after the last storm and were quite eager to try it out.  My normal workstation is without power, so here I sit on a laptop.  Perhaps not doing exactly what my employers intended, but something I need to do nonetheless.

On Wednesday night, near to midnight, I sat on my couch and held a letter in my hand.  Three pages long and hand-written, from a dear friend from my childhood.  One whom had helped to shape who I am today, but with whom I'd lost touch over a decade ago.  This letter had sat, unopened and sealed, on my coffee table for over a year at that point.  Every night I had looked at it, and refrained from opening it.  I don't know why.  Maybe the time and distance had made us strangers, or maybe I feared what emotions the letter might evoke.  Maybe I felt it was something I lacked the strength to deal with, or was unwilling to face even the possibility of drawing upon emotions long buried.  But as one chapter in my life drew to a close, I felt the letter an appropriate way to open the next.  I wrote back to my old friend, and haven't heard from him yet.  Seeing as his letter went unanswered for a year, I feel he's entitled to a little more time before I conclude he's written me off. 

I'd wanted to post something about Tig Notaro, but have enough respect for the sanctity of a work computer not to go digging for a link.  Suffice it to say you can find a clip of the set I am about to reference at Louis C.K.'s website, or just by Googling for her name.  Short version, she's a comedian who was diagnosed with cancer, and the very next day did a routine about it.  A brutally honest, open routine, in which you can hear her uncertainty, and also her desire to come to terms with her new reality.  It's a beautiful set and I encourage everyone to go check it out.  I'll do another post about it in a day or two, with a link.

Thank you, everyone, for taking this journey with me.  I'll continue to post, maybe even more frequently as the chemo flushes from my system and my head clears.  My story isn't over yet. 

Sunday, September 30, 2012

Still here

It's been a while, longer than I like to go without a post, and for that I apologize and have decided to throw something up here, for better or worse.  The short version is that I just haven't really had the energy lately.  I don't think it's any real sort of change and have no reason to suspect otherwise.  Maybe it's because it's a busy time of year at work and I need to put my energy into that.  Maybe I'm just tired of the grind.  Either way, my blog is not the only thing I've been neglecting.  My work, my own personal pursuits...  they've all fallen to the wayside in the face of the all-encompassing blah.  I hold on to hope that once I stop taking chemo, I'll have less trouble keeping up.  Sure, I started falling behind even before my surgery, but I had a growing brain tumor at the time.

It appears that right now, I do not.  I had an appointment with Dr. C. to start round 11 and it took him a few minutes to get over my blood results.  In his own words, they're essentially perfect.  Not for a cancer patient, but for anyone.  He had me stand up and walk around the exam room a bit, checking for coordination, and he told me that I'm doing remarkably well.  More than that, he said he sees no reason to suspect that'll change.  I still hold on to my suspicions - the minor headache that I feel right now makes sure of that - but it's still good to hear.  About as good as it gets without going into "miracle" territory.  Even so, I didn't bring up the idea of stopping chemo.  I feel like if I do, he might respond to it negatively, or say that he doesn't recall discussing that with me so long ago.  I am just one of many patients, after all.  He isn't my main oncologist anyway, so I'm not sure it's his call to make.  On the other hand, it's not either of my oncologists' calls.  It's my call.  It's always been my call.  What I'm really after is their blessing more than their permission.  We'll discuss it next time.  In the meantime, I've been shopping around for anniversary presents for Dr. C.  Maybe one for the lab tech, too.  And a box of donuts for everyone, so no one feels left out.

It's finally autumn, my favorite season, and I've been paying close attention to all the changes it brings.  Around here, it creates a lot of mist and fog, for quite a dramatic effect as I look out across the valley I can see from my home.  When the weather's just right, the fog settles in the bottom and I can still see the peaks of the hills beyond.  But it's the small changes that mean the most to me.  On my way to work I can see the ghosts of dewy spider webs spun between power lines, sometimes dozens between a single set of poles.  The spiders have no concept that those wires are more than oddly smooth branches.  They cannot possibly fathom that they have built their homes between two cords carrying enough current to burn them to a crisp a million times over.  It's like building a tree-house on the warhead of a nuclear missile.  There might be a more meaningful, significant metaphor to be made here, but I really don't feel like making it.  I don't want to attach any further significance to something I enjoy purely for its delicate beauty. 

I guess it's back to work tomorrow.  I'm going to try to get caught up.  I always do.  Somehow it just doesn't work out.  "Just make it through the day" is much better advice when you don't have a schedule to keep.  Maybe I'll feel better in the morning, and I'll manage to make some solid progress.  That happens from time to time, usually unrelated to anything I do beforehand.  I suppose drinking my bodyweight in coffee probably couldn't hurt.

Friday, August 31, 2012

The Relief of Mundane Problems

I had an awful day on Wednesday.

Stressful, long, exhausting, nigh-disastrous, its fires still burning (figuratively... I think), and infectious, it was my worst day in recent memory.  Let's start at the beginning.

It rained heavily on the way to work.  The defogger in my car hasn't worked since I last had it repaired, something I've meant to address but between work and my various treatments I've lacked the time and energy to do so.  At least, that's what I tell myself.  During my commute the ventilation blowers kicked on full blast and refused to shut off, even when I took the key out of the ignition.  Maybe the car was trying to dehumidify the interior - impossible to do, given the aforementioned problem with the air conditioner - and drained itself in the vain attempt, but by the end of the day the battery was completely dead.  Jack was kind enough to jump it for me and tried to help me find the problem, or at least get it to stop wasting power, but nothing short of unplugging the battery did the trick.  As soon as we reconnected the battery, the blowers started right back up.  Yeah, this is pretty boring.  It was better at the time, because then it was less boring and more of a tremendous hassle.

So I took my car to the local Sears, which was the only service shop I knew of that was open at the time, only to find that they don't actually do repairs.  About 30 miles wasted, since traffic forced me to take the long way back toward my home, and my usual repair shop.  Their mechanics had all gone home so I'd have to leave the car overnight and pick it up the next day.  The owner drove me home, and it was about 2 minutes from my front door when I realized I'd left my house key on my car keychain, and my spare was locked inside my house, which in retrospect is a really stupid place to ever keep a spare key.  To be fair, this had been the first time I've locked myself out of my room since my freshman year of college.

My parents had my spare spare, but were a good 40 minutes away.  As the sun set, I sat on my tiny deck and watched a spider weave its web in a tree across the way.  The heat of the day relented under a cool breeze.  None of my neighbors spotted me, which spared me the humiliation of explaining why I was suddenly such a fan of fresh air and mosquitoes.  When I asked my father to bring my key, I'd apologized so many times I lost count.  Yet as I sat there, swatting at the insects of the growing dusk, I felt as though I'd won a strange sort of victory.

I'd had a truly rotten day, but not one of my problems had a thing to do with my cancer.  Each problem was mundane and common.  That I could still drive enough to have car troubles, was a victory.  That I could still pay my mortgage such that I had a place to call home, was a victory.

When Dad showed up I apologized again.  We hugged, I unlocked my door, and the both of us went home.  It was 8PM.

I have my car back now, and it's mostly fixed with the few remaining parts on order.  It's good enough to drive for now, and the blowers are working properly again, $230 later.  Good enough to take me to the MRI I had today, then to my parents' place for dinner, and back home again.  Next week I'll bring it back in to finish off those remaining repairs.

In the meantime, I should probably figure out a better place to stash my spare key. 

Thursday, August 16, 2012

Nocturnal Admissions

The time is currently 4:46AM.

I woke up just a few moments ago, surprised to find myself an unwilling participant in my own dreams.  Not so much dreaming unpleasantly as instead quite abruptly finding myself, in my dream, refusing to keep playing along.  No longer in the mood, as it were.  Possibly by presence of mind (but more likely due to whatever discomfort had spoiled my affinity for the surreal and for sleep), I awakened and tossed about for a few minutes before realizing my uncooperative attitude had followed me.  Each position was less comfortable than the last.  I got up out of bed, and was hit by the most intense nausea I've felt in years.  As I stood in the doorway to my bathroom, insisting to myself that of all the things I was not eager to do this night, vomiting was right at the top, I wondered what in the world could be causing this. 

Tonight is the first night of my 10th round of chemo.  I know my way around a bottle of Temodar.  I'd taken my anti-nausea Ondansetron (aka Zofran) as prescribed.  I could do this in my sleep.  Once my nausea had come under control I got myself a drink of water and popped another Ondansetron.  It tasted of mint.

Ondansetron does not taste of mint.

Rather, a new allergy pill I'd purchased tastes of mint.  I'd taken them all out of their bubble sheet and put them in an old empty pill bottle, an Ondansetron bottle, but I'd taken care to cross out the name of the drug to write, "Allergy" in pen.  I'd also picked up my last refill of Ondansetron at a new pharmacy, one which used ordinary pill bottles instead of the usual, squat, over-the-counter-style bottles.  I would like to take a moment to stress how important it is to know what your pills look like, and not swallow any old thing just because the bottle is the right shape and you're pretty sure you've seen that pill before somewhere.

The time is currently 4:58AM, and I'm typing this as I wait for my first Ondansetron of the night (and morning) to kick in.  I should probably have a trash can or a bucket next to me but I don't.  That cardboard box there will have to do.  I'm already feeling better but I have no idea how this little adventure will impact work tomorrow.  I was hoping to be productive.  On the plus side, my sinuses are clear.

I'd like to end by sending support to Joan.  Some of my regular readers may have seen her commenting on some of my posts.  Her husband Duke had been battling cancer for nearly one year, and Joan had always been very willing to give support and care to his fellow patients, including myself.  Sadly, Duke recently passed away.  They had been married longer than I've been alive, and I feel that the breadth of their experience renders any words of comfort I can find as trite.  So instead, I'll say that I'm here for you, Joan.  Just as you've always been there for me.

Tuesday, July 31, 2012

Comfort for a friend

Let me tell you about a friend of mine.  Let's call him Bob.

I'll give you the short version.  I'm not sure I have the right to give all the details.  Bob has about as kind a heart as you could ask of anyone.  Active in his church, always willing to help a friend, car constantly loaded with food to donate, he was the first person to offer me a ride should I need one during my radiation. 

Recently, Bob found himself in the hospital.  His blood work was worrying.  Like, "they need to run some more tests but I think it's leukemia" worrying.  He was supposed to get his results yesterday, but he didn't come in to work.  I took that as a bad sign, and spent a few hours last night thinking of what I would say to him. 

People always use the same metaphor, when trying to comfort the dying.  "Anyone could step off the sidewalk and get run over by a truck."  It's supposed to emphasize how ephemeral life is, and how no one is guaranteed as much time as they deserve.  But if you step off the curb and get flattened, it's because you didn't see the truck.  I see my truck coming.  It's a long way off, and there isn't much I can do to get out of the way.  So no, having cancer is not like getting hit by a truck, though the point does remain that people with cancer still can get hit by trucks.  Just kind of assumed that wasn't really the main point since, well, no shit. 

So I think having cancer is more like getting tied to the railroad tracks, like you'd see in those old Westerns.  You're stuck.  Death is inevitable.  You can hear it coming.  See it.  Feel it.  It's hard to judge how far away it is, but it's clear that it is on its way, and the closer it gets the more its thunderous heart shakes your body to the core.  The more its call drowns out all other sound.  The more real it becomes.

But you don't have to focus on the train.  You can still see the clouds, and the sky, and the mountains.  You can feel the breeze and the sun on your skin.  You can smell blooming wildflowers and fresh grass.  You can listen to rustle of the trees, and the bird songs. 

And you can fight.  You can struggle against your bonds.  Maybe you'll break free, and even if you don't, there is something to be gained in the effort, if only the pride that comes with fighting to your last, and the inspiration that brings others.

Turns out Bob doesn't have leukemia.  He's still sick, but what he has is manageable.  My train metaphor no longer really applies, so I figured I'd leave it here.  I kind of like it.

Tuesday, July 24, 2012

Woody Roseland gets it

 "When staring cancer in the face, you learn who you are."  - Woody Roseland
I almost feel arrogant, offering this man my approval as if I were some sort of arbiter when it comes to thoughts on cancer.  He's been through it five times and it cost him a leg.  Still, so much of what he says resonates with me so deeply, by its truth or by coincidence: like me, he went through his first bout with another patient who had the same diagnosis, and was also experiencing it for the first time, at the same time.  Except his friend has lost his battle.  Should I outlive my friend, I wonder if I'll respond to it in the same way.  I wonder if I'll have that guilt and rage that, by the luck of the draw, someone with whom I shared a unique bond is dead while I am not.  I wonder how Will will feel if he outlives me.  The biggest difference is that Woody's friend was only 8 years old.  I consider myself lucky that Will is more my age.  We can communicate on a higher level, as adults.  That, and I can distance myself from the fact that for as young as I may be, there are always younger patients dealt worse hands.  I at least got the chance to grow up.

Woody also produced this video, aptly titled, "S#!% Cancer Patients Say."  Good stuff.