Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the month “November, 2012”

Here is not an Indifferent Place

Here, for example, is not an indifferent place.
Jacques Derrida

Reflection

Reflection (Photo credit: martinak15)

Happy Thanksgiving to anyone reading this piece. Yes, it is Thanksgiving Day in the United States. For some it is a day without work unless, of course, you count the interaction with relatives work. For others, Thanksgiving is a day for reflection set aside to contemplate all of the things for which one is grateful; it matters little whether one is grateful to a deity, a gaggle of deities, or that one eschews religious or theistic connections to find a place for gratitude. It is not necessary to be grateful to something rather one is grateful for something. As a modifier, grateful stands on its own two feet without the necessity for an object to which one is grateful. I am grateful for something is as clever a use of the modifier as being grateful to something or another is. The distinction between “for” and “to” is one worth exploring; it is not indifferent nor is it neutral, rather it is a distinction that marks the boundary between ethical responsibility and social compliance.

Let me announce two things for which I am grateful: First, I am grateful for my wife (tomorrow we celebrate 26 years of marriage) without whom I would not be the man I have become. Secondly, I am grateful for my diagnosis of cancer without which I would not have had to explore theoretical ethical obligations with the object of discovering practical applications for otherwise theoretical platitudes. I suspect these two items on my list of gratitude are deeply connected. Without Susan, I might have continued to live a life of wandering from pillar to post “with no direction home, a complete unknown” and no focus. I became a teacher because she opened the door to teaching as a real possibility and that, in turn, opened the door to an examined life in which thinking about things and discovering ideas, both old and new, was engaging and, even more importantly, fun. But all that exploration was just that, exploration, until I heard the words “You have cancer.”

There is little else that focuses one on one’s own mortality than facing a life-threatening disease. In my case, that focus turned to that which I know, that which I learned from Emmanuel Levinas, that which Hillary Putnam calls the fundamental ethical obligation in order to find a practical application, one that would allow for the deeper practice of an ethical life. The fundamental ethical obligation is the obligation to be available for the other without reservation or expectation of reciprocation. Substantially different from Martin Buber’s I-Thou relationship primarily because the I-Thou requires reciprocation, Levinas’s ethical obligation proposes that one announce one’s presence to the other, thereby creating a proximity, a nearness without the barrier of space or time, while, simultaneously, waiting for a response that may never come. This is a responsibility for and is, therefore, quite unlike Buber’s responsibility to, the other.

On this Thanksgiving Day, it occurred to me that writing this blog is not an indifferent act, rather it is one of announcement, of “Here I Am!” made without reservation and without any expectation of reciprocation. I invite others to join in this conversation through comments but I cannot expect people to accept that invitation. It is quite enough to make the announcement, create a proximate place, and then wait, to sit quietly and listen to the absolute silence of the almost infinite universe.

So Happy Thanksgiving…Take some time to reflect on what you are grateful for! You may find unexpected surprises buried underneath the rubble of the lived-experience. I certainly did!

To the Pain

Thanksgiving oven

Thanksgiving oven (Photo credit: Wikipedia)

The day before Thanksgiving and seven days before surgery. This is the day I am instructed to eliminate blood thinners and all NSAIDs from my daily regimen. Substituting Tylenol for Naproxin is like replacing wine with water; it just isn’t the same no matter how you slice it. I ache all over and I am not through the first day.

I don’t think that I would feel as badly if it weren’t for the fact that I am preparing food for 22 people. Sure they will all bring a dish or two but I prepare the soup, traditionally a squash/apple or squash/pear soup, this year it is squash/apple with honey and it tastes divine. But the backbreaking work of preparing soup for 22 is not made any easier with a pain reliever that is simply not up to the task.

I also cooked two turkeys (one is still in the oven), a pumpkin pie, a braised brussel sprout and cheese dish and chopped liver. I am simply exhausted.

What interests me, however, is not that I am in pain or that I worked hard today. What interest me is the fact that while cooking I felt connected, in the zone, focused on the performance of the task at hand. This is living in this very moment, a practice I am continuing to perfect.

I still have some apprehension about the surgical procedure that I am facing a week from today but I think that is perfectly normal. I don’t think of it often but I would be outright lying if I said it didn’t pop up every once in a while. What I am focusing on: reading, learning something new, a new way of thinking about something is a powerful block. Of course, as the day of surgery comes closer there are any number of things that serve as a constant reminder that the robot is just around the corner. More about that later but for now just think of it as the anticipation of emptying the vessel.

When all is said and done, I remain quite positive at this time. I don’t expect that to change any time soon.

Play is the Dress Rehearsal for Eternity

Baseball rules

Baseball (Photo credit: Hugo!)

Zygmunt Bauman wrote that play is the dress rehearsal for eternity. His point centered on two important points. First, play is governed by agreed upon rules that, if broken, breaks the very essence of play and is, thereupon, subject to penalty or even the end of the game itself. Secondly, time is important only to the game and within the confines of the game.  When the game is over, the meaning of time ceases to be of any importance. Every moment within the game is a new beginning, every new game, a new allotment of time.

To play, in this sense, is to understand the very foundations of the existential life; the very life lived withing the boundaries of existential time; each life with a clear starting point and a clear ending point. Every moment lived is a new beginning within the confines of the existential life. Every moment is a moment of genesis, of renewal.

Given this analogy, can a life well lived be considered one resembling a game? Until I read Bauman’s analysis I didn’t think so but now there is some room for consideration. Play is absolutely natural for children. They can play in isolation or together, make-up rules and break them only to make-up a whole new set of rules again. They act with energy and creativity as they laugh with and at each other. They are unambiguously engaged in a welcoming practice, one in which only they are privy to the governing rules.

As we grow older, games played are more formal. Baseball, for example, has a long history of rules, umpires to enforce those rules and teams and leagues to organize the game. From little league to the major leagues, the game changes very little. What changes is not the game; the game is embedded in the rules. Each game played is a new beginning, a brand new opportunity to get it right. On the other hand, each game is also primed with the very roots of failure and, as such, each new game provides fertile ground for revenge, improvement or both. But each game is a new beginning, a fresh start as it were compressed withing a set number of innings, outs, balls, strikes and hits. No game is the same as the one before it. No game is ever played in exactly the same way. What changes, albeit in small increments, would be the skill of the players engaged in the game. Otherwise the game is the game, self-contained, self-limiting and final.

When Bauman references play as a rehearsal for eternity he is talking about a full life, one lived without fear of the other, the alien among us, the stranger next door. He is envisioning a life lived free of the bureaucratic nigglings brought about by a xenophobic fear of the other. He is thinking about a world in which mis-apprehension is set aside, where mis-meetings in which the gaze is diverted are avoided. In the societal world of play, the joy of life is apprehended in lieu of the profound sadness and isolation prevalent in the modern world.

Play allows for each human being to live in this very moment. It allows for the joy of discovery, creativity and accomplishment without requiring a forced isolation from the other due to the apprehension of difference. Play erases difference, allowing for the embrace of that very quality rather than a pushing away. In this very moment I shall continue to play and thereby live a full and contented life.

Approaching Thanksgiving

Updated scene of Anakin Skywalker, Yoda and Ob...

May the Force Be With You (Photo credit: Wikipedia)

My father’s diagnosis of squamish cell carcinoma of the lung in 1977 coincided with the release of Episode IV of the Star Wars movies, the original Lucas film. On the night before his scheduled lung surgery my mother and father went out for BBQ ribs and a movie. They went to see Star Wars. Both my mother and father found the whole idea of “the force” compelling. The film was released in late May of 1977. When the surgeon came to talk to the family after the operation he was not too very encouraging. “Go home and put your affairs in order,” he cautioned.

We did not expect my father to be alive for the Thanksgiving of 1977 yet when the fourth Thursday in November rolled around, there he was, quite alive and not ready to give up. Apparently the Force was with him! I learned a powerful lesson 35 Thanksgivings ago; never give up and be thankful for this very moment of life.

As the first Thanksgiving after my own diagnosis of adenocarcinoma of the prostate, I have been reflecting on those many years ago when, as a son, I experienced my first real experience with cancer. Much earlier, around my 14th or 15th year my grandmother died of colon cancer, but, while we knew grandma was ill the whole thing was hush-hush. Not until my father developed lung cancer was there anything like a recognition of the effects of this disease.

At the Thanksgiving table in 1977, my mother, in tears, expressed the simple idea that until this very moment, Thanksgiving was just a time to eat turkey and be stuffed. At that very moment, her deeply felt thanks was clear and unequivocal.

Flash forward 34 years to last Thanksgiving. My wife and I have hosted the family for the past 20 years. At the table, before we began to eat, my oldest grand-niece, my sisters grand-daughter, Ellie, all of 5-1/2 years old, decided it would be a good idea that everyone at the table tell everyone else exactly what they were thankful for. We all did. I thought at the time that this would be a grand tradition to continue for many years to come.

This Thanksgiving, we have expanded from a small family group of around 10 people to a host of folks (24 at last count). I will ask Ellie to ask people to talk a little about what they are thankful for and then go around the several tables, each in turn. When my turn comes…well I don’t think I’ll tell here because then people at the table won’t need to listen to me. Suffice it to say that as this Thanksgiving approaches I am thankful for early detection, for the diligence of my internist, and for the thoughts of so many people offering their support as I face the coming ordeal. This year Thanksgiving takes on an entirely different meaning.

Making the Ethical Choice: It’s a Matter of Human Dignity

It does not matter how many people choose moral duty over the rationality of self-preservation — what does matter is that some did.
Zygmunt Bauman, Modernity and the Holocaust

Bauman is writing of Jews and Gentiles alike who made the choice to resist the German genocide some refer to as the Holocaust, I prefer the Shoah. But Bauman’s ethics here goes beyond hiding a few Jews from the Nazis or taking up arms to resist. His message is far more ecumenical than that. It is a message that resounds with the courage to resist any and all attempts to substitute morals or ethics with the unrelenting rationality of the modern bureaucratic desire to make any idea one in which efficiency and cost are considered prior to human interaction. Trading proximity for distance is a model for the objectification of the other leading to total separation from that which is social.  It defines the other as outside and thereby creates what Georgio Agamben calls the “state of exception.”

When faced with a difficult decision, one must always choose; decisions are not always easily made. When faced with one’s own mortality, as I am, clearly the choices available are not always clear. Treatment options are presented, research is done, decisions are made. For me, the decisions are made after considering both the ethical and practical aspects of treatment. The first ethical question I ask is will the treatment option help preserve life. Closely thereafter, assuming a positive response from the first question, come questions about the quality of life one can expect from any treatment option available. These are, of course, questions concerning the preservation of life where that life has a quality that is worth sustaining.

There are, of course, other ethical questions to consider. For example, decisions made have an impact on others around me. If I am making the ethical choice I must always consider how that choice will impact those around me. Will I be a burden on those with whom I share a common gene pool or a connection built on love, trust and friendship? Making certain that others are both consulted and kept informed is, for me, a critical consideration as I face my cancer head on.

As of this very moment, I made the choice to undergo the surgical removal of my prostate. During this surgical procedure other organs such as surrounding lymph nodes will also be removed and biopsied to assure that no metastasis has taken place. I rejected options such as proton beam therapy because the overall potential for a cure simply wasn’t there. The surgical option provides me with the best change of long-term survival and so I made it.

Assuming the outcome of surgery is the best possible outcome, I will be available for presenting myself to others with what Hillary Putnam calls Levinas’ Fundamental Ethical Obligation, presenting oneself to the other in order to be of service for the other. Whether the other is family or friend, or simply another human being I do not know, a stranger, my obligation is to present myself without reservation to perhaps be of some help. This ethical obligation comes with some degree of patience. The other has absolutely no obligation to receive help from me and I cannot force the other to accept that help; reciprocation is up to the other. Here I Am…That is my obligation; where are you?

Traces of This Very Moment

Shadow Rays (b&w)

Shadow Rays (b&w) (Photo credit: spodzone)

About a week has past since I took off my watch (I’ve lost track of time) in order to remind myself to spend more time focusing on this very moment of living; for showing up for life. For the first two days I found myself taking a peek at my bare left wrist; habits, it seems, are hard to break. Over the following few days, however, the frequency of sneaking a peek at my wrist diminished until yesterday when I noticed at the end of the day that I wasn’t looking at all. The simple idea that removing one ubiquitous reminder of linear time could remove the desire to actually know what time it is could actually happen quickly astonishes me.

Most of my life, especially since I entered kindergarten, was neatly tied to the clock. I had to get up and out of bed at a time certain in order to do all the things one does in order to arrive at school on time. The school day ran on a schedule with weird bell times; in high school class periods ran for 43 minutes, add 5 minutes for passing time and do that nine times each and every day…well you get my point. Because I was in school for a total of 27 or 28 years (from kindergarten through graduate school and a terminal degree (Ed.D.)) and because I spent the vast majority of my working life as a teacher and then as a professor, everything was driven by a calendar and a clock; sometimes it felt like a train schedule. One of my academic interests turned on the ethical meaning of time; how time itself is elusive, a simulacrum of the real yet without substance or space to give it form. Inspired by postmodern thinkers like Levinas, Derrida, Foucault and Heidegger, the theoretical question of time was something I pondered.

In retirement I learned a great deal about time and life; I could not help but put theory into practice. One of the things I retired to was, or more precisely, is making photographic images. The very act of making a photograph is the closest approximation to this very moment as one can ever come. A photographic image is most often captured in fractions of seconds freezing a particular moment in linear time that can never be captured again. A photographic image is, in effect, a simulacrum of the infinitely brief moment of the here and now. As I made images I began to think about how the photograph is, in fact, an historical artifact of the very moment the image was made.

Capturing a frozen moment in time is, at some level, a reduction of time and space into a single tangible trace of that which once was but is no more. The photographic image has the ability to squeeze four dimensions into two by stopping the moment and then flattening the image into a two dimensional plane, one which is not permitted to ever expand to its original magesty; a singular reminder of an unrepeatable moment. The image is a preserved, two-dimensional approximation of the very moment of capture; one that can not only be experienced by another but can act as a bridge to memory, to traces of experience remembered by a viewer of an image. The image itself is an artifact, a trace of that moment that always already happened.

So what does this have to do with me and my cancer? Only this…As I think about releasing myself from the trappings of linear time, time governed by calendars and clocks, I begin to immerse myself in the stream of moments strung together as if pearls snatched from the insides of an oyster are strung to decorate a neck. There is a string of moments that decorate my life, a life that I barely remember except as a string of traces, of memories, some vivid, others hidden away only to sneak up from time to time to remind me of imperfections. The traces of my memories are but whisps of the always already past moment, the moment of my personal exposure to the universe in which I reside.

Through a conscious act of releasing myself from the physical trappings of time, a discarding of the watch on my wrist, I am brought closer to the proximity of this very moment, the always already past moment of existence. Additionally, without the necessity of worrying about some possible future, my concentration on the now leaves me open to encounter the other, to be of service through proximity with the other. With proximity comes a terrible responsibility (not terrible in a negative sense, rather in a respectful yet difficult undertaking), the responsibility for the other. Ethical obligations force me to turn outward, to approach the other without reservations and without expectations for reciprocity, to be of service. Proximity is external to the self leaving little room for self-pity or focusing toward the interiority of the self.

Living in the proximate moment relieves one of the necessity to obsess about the future. It is enough to proceed forward in time while leaving traces of oneself behind. It is that ethical life I choose to live; looking outward rather than isolating inwardly. Being of service for others is the absolute key to living an ethical life. I learned this long ago from a dear friend, Lenny Stark; it is a fresh today as it was when I first learned this gem. It is that ethical obligation that carries me through these difficult times.

With Apologies to Bertrand Russell: Why I Am Not a Believer!

Studying the Talmud

Studying the Talmud (Photo credit: Wikipedia)

A few posts ago I mentioned that I am an atheist. I was raised as a Modern Classical Reform Jew in the suburbs of  the North Shore of Chicago however I never much found the need to devote much effort to a piecemeal Jewish education. As an undergraduate student I took an elective in comparative religions. During that semester I came across the works of Joseph Campbell and his inquiry into comparative mythology. I became more convinced that man created his gods and not the other way round.

After undergraduate school I chose to go to St. Louis University for graduate studies in Latin American history under the mentorship of John Francis Bannon, SJ. Being one of only a handful of Jewish students (it’s like the mafia, once you’re in you’re in and there is but one way out) at a Catholic university, I experienced a sort of strange, albeit, unexpected acceptance. This was the time of John XXIII and Vatican II when the Jews were absolved of any further guilt for their perceived sins. I actually felt no relief, rather the raw emotion was one of indigence; who gave you the right to absolve me of sins I could never have committed and where is the apology for nearly 2000 years of persecution and lies? It helps to remember that this was a mere twenty years after the Shoah (you might know it as the Holocaust). As a brief note, Shoah is a Hebrew word meaning destruction while Holocaust derives from a Greek word meaning burnt offering. Most Jews today prefer the term Shoah to Holocaust because of the sacrificial (religious) undertones of the latter.

In my middle years I looked at the synagogue as a place to go for weddings, funerals and bar (bat) mitzvahs. The general liturgy made little sense to me. I went about my life, not seeking a god but not avoiding one either. As an atheist it was and is clear to me that if there were convincing (not self-serving) evidence for the existence of a god, any god, then I would be convinced and would no longer be an atheist. I make a rational choice to reject the theistic choice based on evidence rather than take the coward’s way out and claim to be an agnostic.

Much to my surprise, about ten years ago I became quite interested in the notion of the ethics of responsibility, a postmodern idea arising from the work of Emmanuel Levinas. The more I read Levinas the more I became attracted to Jewish texts, many of which had a profound influence on Levinas’s work. I began reading Torah and Talmud, studying first with a Lubavitcher rabbi and later, for a very brief time, with a Conservative rabbi. When I moved to the Northwestern suburbs of Chicago I no longer had ready access to a Chabad house and so I stopped studying. About three months ago a Chabad house not 10 miles from my house opened and I am pleased to announce that I will be reading Talmud and Torah with the new Lubavitcher rabbi at this Chabad house.

Why would an atheist Jew want to read sacred texts? Frankly, the answer is quite simple. I find great ethical wisdom in the methodology attached to reading Jewish text. The readings are alive, subject to interpretation in the postmodern world we live in, have significant influence on social justice and, if one can read beyond the verse as expected, the ethical implications are significant. Furthermore, reading these texts, the texts that are so closely attached to my cultural history, is another way of knowing. The pages of the Talmud are filled with an existential argument deconstructing the very texts they are commenting upon. As an alternative to the Greek approach of logical argumentation, that which I am steeped in, the arguments of the Talmud appear to skirt around the point until the point can be made and even then there is potential disagreement among the sages.

Learning to think in Jewish (Talmudic discourse) as opposed to thinking in Greek (philosophical discourse) allows for the potential to synthesize the two, to join the two in a proximity that affords a deeper understanding of my own ethical obligation to others even before I have an obligation to myself. This does not mean that this course of study will “allow” me to “find” god or gods; that, I think, is not my motivation. The evidence for the existence of such a deity is overwhelmingly absent. What it will do, however, is allow me to pursue a course of study that is open to a different way of thinking.

I was, to tell the truth, inspired to write this because so many people who have visited my blog have offered to pray for me. While I have no objection to those finding comfort in prayer (I meditate after all), I have no expectation that those prayers will be heard by anyone or any thing other than anyone within earshot. I certainly have no expectation that such prayers will make any difference at all in my course of treatment.

Please, don’t get the wrong idea. I am not disrespecting your beliefs or your religious practices. I am merely explaining briefly why I am not a believer; I do not expect miracles, expect to be singled out, either positively or negatively, by some inaccessible deity hovering around in some supra-natural context. I do not believe that my cancer is a punishment for past sins or that any potential recovery will be a miracle. I put my trust in the existential moment of existence, try to show up the best I can at any given moment and deal with the messy stuff that is the hallmark of the existential life.

Given my encounter with my own mortality, I take great comfort in those atheists who have faced their demise with dignity and hope; Christopher Hitchens comes immediately to mind. Like Bertrand Russell once said when he was asked what he would tell god if, after his death god asked him why he did not believe, “Not enough evidence!” replied Russell. I might alter Russell’s quip to be, “Far too much evidence against!”

So pray for me if you must. I won’t object. But, please, don’t come back to me with reasons I should become a believer, work on my eternal soul, or take a positive stance rather than one that you feel endangers my eternal soul. Look, there is nothing positive about cancer; there is, however, something quite positive in living in this very moment and continuing to do what must be done. There is, it seems to me, clarity in being a post-Shoah Jew with a lust for life yet being aware of living within the bookends of the infinity of nothingness. I refuse to hang on to the Bronze Age mythology that just happens to have a history of longevity, other than to understand it as a discourse worthy of engagement on an intellectual rather than on a spiritual level.

Challenges

Meditation

Meditation (Photo credit: Moyan Brenn BE BACK on 10th OCT)

These days I find myself facing unexpected challenges. The apprehension accompanying a diagnosis of cancer is, to say the very least, something I am unaccustomed to. The biggest challenge I face with regard to the waiting for surgery is one of waiting, of sitting quietly and simply listening to the silence. I find that my mind wanders away from the clarity of focus, from the silence of the universe that I am more or less accustomed to.

In addition, there are challenges that accompany my almost daily dealing with my medical team and the sense that one hand doesn’t actually know what the other is doing. Contradictory directions, pharmacy rules and the overall apprehension that accompanies the run-up to surgery interferes with my otherwise calm, rational demeanor.

I’ve written this before but I think it stands repetition; I am no stranger to surgery! I have two titanium hips, a titanium back and now a titanium left knee. In each of these cases, however, I was in desperate pain prior to surgery creating a condition in which surgery was actually anticipated. I expected a “cure” from the pain that was a constant reminder that I had no cartilage in my hips and knee and a spinal column that was shrinking due to calcium deposits causing a severe stenosis. After the first hip surgery, I could anticipate a recovery that would leave me pain free.

Not so with this surgical procedure. I have absolutely no pain, no symptoms at all. I will enter the hospital feeling just fine and will wake up with some degree of discomfort, how much pain I have no way of anticipating. There are also two potential side effects of this procedure that I must admit scare me. While robotic surgery is less invasive than other potential procedures, it still comes with risks of erectile dysfunction and incontinence. But with a Gleason score of 4+4, a PSA of 23 and no metastasis I have little choice but to get holes poked in my belly and get the cancer removed.  But I’ll go into the hospital feeling fine and wake up in pain.

My solution to these and other challenges is to do what I know how to do. I meditate for longer periods of time, just sitting quietly and listening to the silence of the universe. I have taken to measuring my blood pressure before and after meditation and I record a ten point dip in pressures post meditation. I am not surprised. Sitting quietly helps clear my mind of the hamsters running through my head that want me to expect the worst possible outcome. After 45 minutes to an hour my mind is clear and I am better able to face the real challenges of the day. Just doing the next right thing, that which is right before me at this very moment, that which must be done right now. I am also better prepared to understand and, thereby, separate that which is urgent and that which is not.

At this very moment I am headed to the gym in my basement to strengthen my knee, ride the stationary bike and see if I can’t drop around 12 to 20 pounds.

How Stress Affects Prostate Health | Prostate Net

How Stress Affects Prostate Health | Prostate Net.

An interesting article that I can share. I don’t support the ads on this page so don’t get mad at them.  I just found the article to be pretty much spot on.

Well worth reading from a blog I now follow.

THINGS TO PONDER by Mary Beth LaBar

Does Certainty really exist?  We wake each morning – the sun rises.  That’s certainly real!  Night falls and another day follows.  I go to the bathroom and the shower is waiting for me.  My toothbrush is right where I left it.  I am certain of that.  I head to the frig and I am certain that I will be out of Half & Half.  I am right.  I think the proof is stacking up in favor of certainty.  What a relief!

But, suddenly everything changes when I awake to find that my muscles no longer remember how to lift me out of bed?  I know with certainty that my toothbrush and shower are waiting for me exactly where I left them last night.  But, I can’t get to the bathroom.  Muscles have memory.  I know that.  So, I wait for them to remember.  With a little coaxing, they begrudgingly accommodate me.  But…

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