Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the category “adenocarcinoma”

Storm Clouds, Tornadoes and Carbon

Storm Clouds, Tornadoes and Carbon

Storm Clouds, Tornadoes and Carbon

Storm Clouds, Tornadoes and Carbon

Storm Clouds, Tornadoes and Carbon

A second F-5 tornado strikes Moore, Oklahoma in the past few years and a representative from Moore responds with calls to prayer. The image on the right was shot along I-70 in Western Colorado around the same time this tragedy occurred. I was standing along an access road to a Costco store in the middle of Colorado gypsum country, in fact, the town in which the Costco was located was named Gypsum, in bright sunlight as the clouds gathered to the south producing rain. The storms were perhaps a mile away moving toward us. While in the mountains they didn’t reach the intensity of the Moore event, when we were driving through them on I-70 it was mighty scary. I suppose making images that tell a story is one way to connect to the tragedy suffered by those in Moore, there is little that one can do except to take action to reverse the man made climate change that is now clearly causing more tragic weather events.

The representative from Moore, in asking people for their prayers, did not express anger for the second and now precedented storm, that’s right, not unprecedented but precedented because this is not the first occurrence of such a storm in Moore. No, his response was to fall upon the mercy of his friend in the sky to help the townsfolk whose lives were either lost or disrupted from the after effects of the storm. My response is somewhat different. Over the past 20 or so years, significant weather changes manifest in a more powerful tornado seasons, more powerful hurricanes, drought, melting of polar ice-caps and so on. One thing I have noticed living in the greater Chicago area is that we seem to be having shorter Winters but when snow falls it seems to fall in buckets.

I think that one must recognize the part we all play in global climate change and vow to do something about reversing the problem. While I will not be around to see the effects of either further and more difficult climate change or the absolute reversal of climate change (I turn 70 in two weeks time), my grandchildren will. Yes, tornadoes are dangerous and the devastation they cause tragic but prayers to an imaginary friend in the sky do nothing to address the difficult, expensive solutions that human beings must take if we expect to occupy this planet for much longer. What is needed are not prayers but action. The first action must be to contribute provide aid and assistance to those who suffered this tragic event; that is merely the beginning and is more palliative than affirmative. The affirmative solutions do not come from denial that climate change does not exist; after all denial is not just a river in Africa, rather, affirmative solutions come from recognition that climate change is man made and that we must attack the problem with as much vigor as we prosecute the wars we ostensibly fight for the defense of freedom. Pray if you must, if you think it will help, if it brings you comfort but when you finish praying take up the cause of reversing global climate change as if your life and the lives of your children and children’s children depend upon the actions you personally take…Because they do!

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With Apologies to Emmanuel Levinas…Otherwise than Being

With Apologies to Emmanuel Levinas...Otherwise than Being

With Apologies to Emmanuel Levinas…Otherwise than Being

When faced with one’s own mortality, no matter whether this mortality is imminent or simply a close encounter, it is only natural to examine what life means and what contributions one may or may not have made to the world exterior to the self. My current bout with prostate cancer is a clear case of a close encounter with my own mortality and this encounter prompted me to explore just what it means to be able to draw breath, from where that ability originates and what contributions I made to the world that I inhabit as a sentient being. In fact, I have reached three basic conclusions:

  1. My being is defined by my being-in-the-world as I encounter other human beings and objects of the world around me.
  2. The so-called gift of life comes as a simple mathematical calculation, the probability of a single sperm uniting with a single ova during or shortly after coitus. A different sperm and I do not exist. The odds of my existence are astronomical, but here I am. To attribute my existence to a deity exercising control over everything is a waste of time unless that deity is, in fact, mathematical probability at work; a concept that leads one to understand the existential world I and you inhabit to be purposeless and absurd.
  3. As a teacher and scholar I have contributed a great deal to the world I inhabit. I am the co-author of a book on teaching writing, I published numerous articles, many of which have been cited by others as they extend the knowledge base about teaching and learning, I presented hundreds of scholarly papers at academic conferences and did so internationally, as a consultant I interacted with teachers and their students to expand their knowledge of teaching writing and, finally, I influenced many of my students to strive for excellence and many of those students are in contact with me to this very day.

In short, I am able to say that my life has made a difference in the world to which I am intimately connected by my very being-in-the-world. In ethical terms I stood (stand) ready to be responsible for the welfare of the other, to share my knowledge and skill with others, to stand ready to answer the call of the other without reservation or expectation of reciprocation. This level of responsibility, while not perfect, is a contributor to the most important aspect of my own lived-experience, that of personal integrity.

In this sense, I am able to honestly report that I am grateful for my cancer. It provided an opportunity to explore, in practical terms, those things that I hold theoretically dear. In the final analysis, it helped me confirm the practicality of those ideas offered as without practical applications. I am even thinking about a book exploring practical aspects of Levinas’s fundamental ethical obligation.

At the very beginning of this year I think it is appropriate to re-post this gratitude list. It helps keep me focused as I approach the day ahead.

Surviving In This Very Moment...

While waiting around for testing and results, for biopsy results and more, I decided to make a list of all those things I am grateful for rather than dwell on desired results.  I thought I’d share the list here and now…

  1. My wife, a true partner and friend…
  2. My cancer because it allows me to put important things in perspective…
  3. My kids who, like most kids, drive me nuts but so what…
  4. My grandchildren who fill my heart with joy…
  5. Parents, gone but did their very best to mold me into the man I am today…
  6. Family…
  7. Friends…
  8. Books that transport me to places unknown…
  9. Health, pretty good except for that cancer thing…
  10. Questions that drive my thinking and keep me sharp…
  11. Starbucks, I love coffee especially a quad over ice in a venti cup…
  12. Dave, my physical therapist who forces me to perform beyond my own expectations…
  13. Dogs, especially…

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With Apologies to Bob Wills–Time Changes Everything

Oh you can change the name of an old song
Rearrange it and make it swing
I thought nothing could stop me from loving you
But time changes everything

Bob Wills and the Texas Playboys, Time Changes Everything

With Apologies to Bob Wills--Time Changes Everything

With Apologies to Bob Wills–Time Changes Everything

I grew up on music called Western Swing and the king of Western Swing was a band called Bob Wills and the Texas Playboys. I loved the sound of the fiddle and as an adult, learned to play at playing the fiddle. Popular tunes that were trademarks of the Texas Playboys like Faded Love and tunes that only those who loved the idea of a swing band that included fiddles like Rolly Polly and San Antonio Rose filled my record (yes vinyl) collection. Right now I have been playing the tune Time Changes Everything as a reminder that I am but five weeks out of surgery and cannot expect everything to be as it was prior to my radical prostatectomy.

This morning I awoke with an almost dry pad. I don’t think this is anything to write home about yet but it is clear that given enough time, the incontinence I have suffered since the removal of the Foley catheter will resolve itself. Phew, that is a relief.

The severe itching that I experienced from the steri-strips used to close the five small wounds is also beginning to resolve. That is also a great relief.

As things begin to resolve and side effects from the surgery diminish, the title of the song Time Changes Everything has been running through my thoughts. Look, I have what is known in some circles as an addictive personality. This means that I want what I want and I want it right now and I’ll do anything to get what I want. It has taken a number of years (22.5 to be precise) to retrain myself to develop patience (although my wife still thinks I am the most impatient person she knows.) Immediate satisfaction is no longer a requirement in my life. The phrase “This Too Shall Pass” taught me that even the greatest emotional or physical pain is not a forever pain, it will pass because Time Changes Everything.

I also learned that living in the moment, in the immeasurably brief moment of time that is always already past, is a powerful way to release negativity and embrace the positive contained within the moment of life. Measuring one’s breath during meditation is a way to engage in the simulacrum of that instant of time, the existential moment of the lived-experience.

I believe it was Edgar Allen Poe that said that life is a dream wrapped up in a dream, or something like that. What remains of the existential moment is a trace, a memory engram that seems to lose much of the negativity of the moment as it fades into distant remembrance. It is impossible to remember what physical pain feels like, rather, we recall that pain was present but not what it felt like. Time Changes Everything. The trace is not the event, is not the moment, is not existential reality. It is merely a recall of time past re-presented in its most positive light. Our remembrance of time past is much like a dream wrapped up in a dream…it is what allows us to survive to face just one more existential moment.

Yes, Time Changes Everything. In the Bob Wills song there is a verse that begins, “The time has passed and I have forgotten you, Mother Nature does wonderful things…” The simple words of the song, one speaking about a lost love, captures the very idea of existential time in terms of both hope and how the trace fades into acceptance the further removed from the moment of lived-experience it gets.

January 1, 2013…Happy New Year

January 1, 2013...Happy New Year

January 1, 2013…Happy New Year

It is midday on the first day of the new year. I celebrated with my wife and some friends with our annual December 31st dinner (I cooked). Beginning with a small bite of ratatouille on a sour-bread crostini and a hearty bowl of lentil soup we moved on to a nice salad of mozzarella, basil, heirloom tomatoes, complemented by two black olives, a slice of avocado and Mission olive oil. On to the main courses. Scallops seared on a watermelon radish, a rich apple, raisin, brown sugar, butter and coconut milk compte, an onion pickled in a balsamic brine and a sprinkle of corn. This dish was followed by a palate cleanser of raspberry sorbet. Next came a chicken roulade stuffed with carrots, pistachios, green kale and corn accompanied with an oven roasted mushroom potato (a potato carved to resemble a mushroom). All this was complimented by a homemade fruit tart topped with whipped cream. What a dinner.

The truth is that not only were we heralding in the new year, an ever so arbitrary designation on an ever so arbitrary calendar, my wife and I were also celebrating the knowledge than my post-op PSA came back at a 0.06 level, nearly undetectable. The announcement arrived in the mail on the last day of the year. This low of a level was, frankly, unexpected. I was told to expect a level closer to a 1.6 due to the half-life of the antigen being measured so the shocking news of a 0.06 was something to be quite happy about.

Along with that good news, I can report progress with the incontinence I am experiencing. Over the past several days the leaking has slowed significantly and the stress incontinence, while still there, is more easily controlled. I can control the flow when I sneeze, cough and laugh. I can also control the excess leaking when I stand and walk about half the time. Progress is a wonderful thing.

Along with this good news along with my reflections on this past year, a year bottom loaded with medical issues that seemed to take over my life, I decided that I would make only a single resolution for the new year, it is a simple resolution, one that is clearly one that comes deeply from my core beliefs: I resolve to be available for the welfare of the other, to do so without reservation or expectation of reciprocation, to answer the call of the other whenever I am able to do so and to make no excuses when I fail in this ethical endeavor. There, I put it down in writing, not merely a theoretical ethical construction but a fully formed ethical obligation, one that cannot be recalled or redefined as fancy might suggest. I have accepted a rule for ethical behavior that, once accepted, is cast as a permanent obligation.

It is a beginning of thinking in Jewish, that an obligation, a Mitzvah so to speak, it seems is an obligation from which there is no appeal, no way of undermining or overturning. It is cast by acceptance of the obligation as a fundamental truth that one must connect to or suffer the consequences of willful failure. The very idea that the “law” is unchanging is contrary to rational thought. Laws are written by men who, at their very best, are flawed for any number of reasons. To think that there is no appeal from the law, there is not a possibility for reconsideration or for alteration as circumstances warrant seems to me to be harsh.

I learned this tidbit of thinking in Jewish from my friend, Rabbi Mendel, last Tuesday (Jews don’t celebrate Christmas). In a discussion of the law, Rabbi Mendel pointed out that the last bastion of appeal expired when the Temple was destroyed in 78 CE. It was at this point that the Sanhedrin  the court of appeal on the law was disbanded. After the demise of the Sanhedrin, there was no longer a court of authority that could change or alter the law. Now, Rabbi Mendel spoke of the possibility that there may be changes in the law that might be warranted but the decision on that would have to wait until the Messiah comes, the Temple is rebuilt, and the Sanhedrin reinstated. At that point, and only at that point, will the truth of the law be explained and, most likely, narrowed making many obligations no longer valid.

At this point I have many questions for Rabbi Mendel, many I will ask this evening when we speak of the next segment of the Torah we are reading. The very idea that something can be unchanging for so long troubles me. But it is, at the same time, intriguing. There is something to be said for stability and permanence penetrating to the core of one’s existence. How is this thinking relevant in the modern world in which we live? I have trouble reconciling the two. More to come.

Thinking About the Other (Person)

On November 14, 2006, I wrote in my journal:

The trace is othered when the trace places the solitude of the self in contact with the knowledge of the other. The other does violence to the solitude of the self in the sense that the other creates a break, a tear in the condition of solitude, the only experience of the trace. The tear disrupts the hegemony of the self by offering up a knowledge that there is something external to the trace which is otherwise a self-contained existent.

Thinking About the Other (Person)

Thinking About the Other (Person)

The notion that the trace is a remembrance isolated, belonging only to the self, that is capable of being torn from the self by the appearance of the other is an important way of thinking of the difference between the encapsulation of the self in isolation and the efference of the self experiencing the other as other.

I cannot share the trace I have constructed from this very moment with any other human being. My trace belongs exclusively to me. To share trace as a record of a lived-experience is quite impossible for two important reasons. First, because trace is something akin to embedded memory and because memory is an unreliable source for recalling a past event in a lived-experience, whatever I share can only be something of a partial exposure of that lived experience. Memory tends to disgorge that which is unpleasant, uncomfortable, or is damaging to one’s projected image. Time softens memory so that we forget that which was forgettable and enhance that which can be recalled safely. Secondly, even if one could share a trace as a true recording, the time it would take to retell would be equal to the time it took to record the trace in the first instance. Reliving a lifetime would take a lifetime to retell.

Once the other tears the hegemony of the self by making itself present to the self, once the self becomes aware of the other as a fully formed existent, the potential for shared experience is open and on the table. This does not, however, include the idea that a shared trace is possible. No, even when two or more people experience the very same event, when they witness something, their individual perspective will not accommodate a shared trace. The event will be viewed from different perceptual points, even when the witnesses are standing right next to one another. Next to is not the same as the position of the self. In addition, cultural and linguistic differences will cause each self watching an event to see the event through a lens of cultural and linguistic taken-for-granteds that, while appearing to the individual as perfectly normal, will appear to the other as unusual, different, out of touch.

The truth of being-in-the-world is that we are all self and we are all other! The distinction is that each self is uniquely different from every other and each other is uniquely different from each isolated self. This, then, leaves open two distinct possibilities: first, that the self reduce the other to the same, that the self create categories or cubby-holes to effectively isolate the other as a stereotype, of belonging to a particular class (e.g., teachers, union members, thieves, blacks, Jews, Mexicans, and so on) in which a conversation about, say, teachers begins with “all” as in all teachers are (fill in the blank). Secondly, one may choose to look at the other as unique and embrace the differences that each and every other encountered brings to the social encounter. Rather than lumping into a hegemonic category, this approach embraces the diversity each of us brings to the encounter allowing one to take away something positive rather than encapsulate one’s taken-for-granteds about any single group as an excuse for hate, rage and violence.

So what, if anything, does this have to do with the fact that this blog is about my surviving prostate cancer in this very moment? Simply this, I have cancer but I am not governed by the fact that I contracted this disease. Oh at times I am absolutely required to respond to something or other because of the disease but I am not ruled by nor do I identify myself as only a cancer patient. Quite the contrary. I am more than my disease. In fact, I am made of many facets, each of which are part of my lived-experience. Only one small part of that lived-experience has anything to do with my personal struggle with disease. So, yes, sometimes I ramble on about things that interest me because it provides an opportunity for me to present myself to the other in such a way as to embrace the Levinasian fundamental ethical obligation without reservation. As a self I announce my responsibility through any number of means and then I wait to hear the demand of the other.

Simple Reflections Before the New Year

Simple Reflections Before the New Year

Simple Reflections Before the New Year

It is always important to reflect on the events of the past year, the traces of memory that make a life remembered. This past year has been a doozy with ups and downs that shake one to the core. Some of these events were anticipated while others were not. Some caused great pain while others inspired great joy. To say the least the peaks and valleys of 2012 felt a bit like being on a never ending roller coaster. I want to share the highlights.

  • The birth of my second grandson on March 22nd, Eddie is an absolute joy to behold.
  • The nomadic wanderings of my son who moved in with Susan and me in June for five months, a terrific re-connection.
  • The news from my orthopedic surgeon that I required a total left knee replacement which was then performed in late June–OUCH!
  • The diagnosis of prostate cancer, a very aggressive strain, in October, a diagnosis that put my existence on hold, forced me to face my own mortality and reflect on my own value as a human being in this world.

I want to expand one by one.

The Birth of My Grandson Eddie

Eddie

Eddie (Photo Credit: Roger Passman)

In March I called my sister to inform her that while she was always a great aunt, she was once again a Great Aunt. Eddie was born on March 22 in Madison, Wisconsin sometime before dawn. Mark, my son-in-law couldn’t wait till the sun came up to call and tell us that we were once again grandparents. Both Susan and I jumped from bed to the showers, dressed, grabbed a bite to eat and brewed some coffee to take along for the 1.5 hour drive to Madison.

Anticipation is an emotion I somehow learned to suppress simply because it makes for doing stupid things. I set the cruise control at precisely 5 mph over the posted speed limit and drove from our house to Madison, following Veronica’s (my gps) instructions to the hospital. We were the first of the grandparents to arrive.

There he was in all of his 4 to 5 hour glory all swaddled with a wool cap covering his head, eyes shut even while awake and cooing. He was smaller than I remembered babies to be but they say that memory is the first thing to go. His fingers and toes were intact, he squirmed and fidgeted, cried a little but mostly he slept. As the other two, yes two, sets of grandparents arrived (my ex and her husband and Mark’s parents) the hospital room got smaller and smaller. After about three hours with Becki (she sometimes goes by Leah but that is a very long story) Mark, Eddie and the rest of the family we decided to leave with a few pictures and a whole lot of joy. Pointing the car back to Gilberts, IL we made the return trip and were home for supper.

Watching Eddie grow and develop for the past nine months has been the joy of all joys. He responds, is getting his top two teeth (he already has his bottom two) and is generally in good health. Who could ask for more?

Re-Connecting with Ben

In December 2011, my firstborn decided to pick up stakes and move from Phoenix to Austin, TX. He is in the throes of a midlife crisis that is quite interesting to watch. The move to Austin was motivated by the fact that his girlfriend wanted to go there, his son Drew (my first grandson and a joy to watch grow into a young man; he is now 14 years old) moved to Albuquerque because his mother landed a terriffic new job and he felt that since he really had no ties to Phoenix, why not.

In late April or Early May his girlfriend moved out leaving him stranded in Austin without any close connections or ties to the city. Within a few weeks the girlfriend decided she wanted back in but by this time Ben decided that he would be best served if he moved back to Chicago, his home town. After some discussion, he and his girlfriend got back together and she agreed to accompany him to Chicago. This is the stuff of soap opera scripting, yes, and it only gets better.

Ben called and asked if they could stay with us. We have a spare room and so it was decided that this would be okay. Now the girlfriend had two kids and Ben had Drew for the summer so, literally five new human beings moved into our house just days prior to my knee replacement. Ouch. It was a madhouse for nearly two months when things calmed down a bit as the two girlfriend kids were shipped back to Phoenix. Then it was Ben, the girlfriend and Drew for a few more weeks. Drew went back to Albuquerque and the house settled down to Ben, his girlfriend, Susan and me. Phew!

In October Ben and his girlfriend moved into a small apartment in the city; Susan and I were finally back to some semblance of normal.

Then the hammer blow, the girlfriend decided she missed her kids too much to stay in Chicago with Ben and she up and moved back to Phoenix leaving much of her stuff in storage in my basement. Ben spent some time agonizing about his move to Austin and then to Chicago, over his relationship with the girlfriend which he finally decided was going nowhere, and the fact that his ex’s contract in Albuquerque was ending and she was moving back to Phoenix to her old job plus a plumb promotion so Drew would be back in Phoenix. Finally, he decided to move back to Phoenix (a place I think he never should have left in the first place) so he could be close to his son.

During all this time we had a chance to talk, share ideas, ask for and provide advice and generally have a powerfully good time. I will miss his leaving at the end of January but I am also quite pleased that he may have stopped his nomadic ways. I can’t wait to see what develops in the coming year.

Knee Replacement

Then there were the low points. In late April or early May I slipped and suddenly was unable to place any weight on my left knee. Susan was meeting me for lunch that very day; rather than lunch we went to the emergency room where they put me in a brace and told me to make an appointment with an orthopedic surgeon.

I met the orthopedist a couple of days later and he told me I had three choices: First, I could do nothing and suffer, second, I could try injecting the knee with a substitute cartilage that, if it works, will provide relief for six to nine months and could be repeated until it no longer worked, or third, I could opt for a total knee replacement.” I opted for the second choice. Unfortunately it didn’t work.

I believe suffering is reserved for martyrs or saviors so I opted to undergo a total knee replacement. Being no stranger to orthopedic surgery (I have had two total hip replacements and a laminectomy) I thought that I was aware of the recovery period and what I could expect during recovery. The doc told me that knees are more difficult than hips or back surgery so in my mind I compensated for that as I prepared for surgery.

Oh man was I disappointed. Waking from surgery I was in the worst pain I could have ever imagined. Thoughts ran through my head that were as mild as “Why did I ever agree to this?” to “I want to die right now!” In the past I never needed heavy duty pain relief. I recognized the pain as bone trauma and that it would get better over the course of six to eight weeks. But with this knee surgery I was pushing the button on the morphine (or whatever drug was in there) machine as often as I could. The pain was unbearable most of the time.

The morning of the second day, the physical therapist walked into the room and said, “Time for your morning walk, ready?” I was in a fog, but I knew that if I did what I was told that I would get better faster. So with much help I got out of bed to begin my first walk post surgery. Offered a walker or crutches I chose the crutches but I couldn’t find balance that first time so a walker it was. I made it about twenty steps out of my room before I needed to stop. Finally, turning around I slowly walked back to the room where I was ready for bed. No such luck. It was time to learn how to sit in a chair, go to the bathroom and get back into bed with some help.

The afternoon walk was actually a bit easier and I pushed myself to walk to the nurses station. This time the crutches worked, I found balance and they made the walking easier. The next day I was walking up and down stairs, learning how to get in and out of a car and walking longer distances with the aid of crutches. But the constant pain was still there. We tried many drug combinations to help relieve the pain and finally decided that, in spite of my history, Norco in combination with Tramadol would be a reasonable choice. I went home with that cocktail the morning of the third day post-surgery.

I started out patient physical therapy two weeks post surgery (for the first two weeks a home-bound physical therapist visited me 3 times a week); for the next three months I dutifully went to PT and while I could see results in flexibility the pain would simply not go away. I couldn’t sleep well because the pain was agonizing. Drugs helped but couldn’t provide enough relief to make me happy I did this surgery.

One morning in mid-September, I woke up and noticed that my knee, while stiff and a bit swollen, didn’t hurt. It was as if some switch was turned off. I stopped taking the Norco which led to withdrawal symptoms for ten days but that was a small price to pay.

I continued with PT until mid-October and today, six months post surgery, all seems okay with the knee. While I think I have some fluid on my knee, it doesn’t bother me too much, other than making standing for long periods of time difficult. I see my orthopedic surgeon on January 4th so I’ll know more then.

Prostate Cancer

Then there was the kick in the head. In September I saw my internist for what amounted to an annual physical. He was quite concerned that I had a PSA of 23. Wow, so was I. He told me to see my urologist as soon as possible to track down the cause of this spike in PSA. Getting in to see the urologist has always been a difficult thing. Waiting two to three months was not unusual. When I called for an appointment I mentioned that my PSA spiked to 23 and the appointment person said, “Oh, then I can squeeze you in next week, would that be soon enough?” I responded in the affirmative and the appointment was made.

During the week prior to the appointment, I began to puzzle with my own mortality. What would be my contribution to this world? I didn’t much worry about what the transition to death might be like other than it is a deeply personal transition that only I could make, there are no substitutions possible.

When I saw my urologist he drew blood for another PSA (the result was 26) but when he did a prostate exam he felt nothing out of the ordinary. Several years ago I had a spike in PSA which required three needle biopsy procedures of my prostate, all of which were negative. BPH was the diagnosis which led to a procedure called a Trans Urethral Resection of the Prostate (TURP) and the biopsy of the tissue removed was negative for cancer. I vowed that I would never do another needle biopsy again, however, now I had to rescind that vow because of the unusual set of circumstances.

The biopsy was scheduled for the following week (in the past I had to wait two to three months to be inserted into the schedule). When the results came back he called me to tell me, “You have cancer of the prostate.” We set up an appointment for the following week to meet and discuss options. This diagnosis was like being kicked in the head by a mule.

We met and the facts were laid out in front of me. I had a cancer of the prostate with a Gleason score of 8 (4+4) with a PSA of 23 (my internist did a second PSA which came back with a score of 21) so the average of 23 appeared to be the best working number. This meant that I had a very aggressive cancer and that metastasis had to be ruled out or identified. This meant a bone scan and a CAT scan. Both of these turned out negative, but the CAT scan was inconclusive due to interference from my hip replacements and back surgery so the lymph nodes in the groin could not be clearly ruled out.

Surgery appeared to be the best course of treatment. A biopsy of the lymph nodes along with the prostate post surgery would find the lymph nodes clean and the prostate 35% involved with the tumor almost at the margins of the prostate but it does seem that the disease was entirely contained within the prostate.

So what does all this mean. For now, I am a prostate cancer survivor but even this is tentative. Some cells may have escaped prior to surgery or even during surgery and are just waiting to settle in to wreak havoc. For the next year I will have my PSA checked every three months and once a year thereafter for the remainder of my life. It is as if I have cancer rather than I am a cancer survivor and that cancer is just waiting around like a monkey on my back.

So there you have it. Some highs, a bit of drama, pain and suffering, and finally hope. What a year this has been!

Belonging: Life Before Retirement and Cancer

Belonging: Life Before Retirement and Cancer

Belonging: Life Before Retirement and Cancer

I never knew what I wanted to be when I grew up. As a result I bounced from job to job, always being lured back, like Homer’s call of the Sirens, to a family business that I absolutely hated. That all changed the day I walked into my father’s office and quit for the last time. “What are you going to do,” he asked?

“Teach,” I replied and I left.

What I learned was teaching is not a job, or if it is it is unlike any other job I ever held, it is a mission, a calling. Severely underpaid compared to private sector work and overworked when one considers all of the time spent grading student work, planning daily lessons and the time spent in professional development, whether school provided or personally funded earning advanced degrees; teachers work long hours and are generally not paid for their efforts very well.

While I had some inkling that this was the case, my wife was a primary grade teacher and I could observe just how hard she worked at her job, I was unprepared for the pressure and rigor required to be a teacher when I first entered the classroom. Finding my way to comfort was a matter of learning how to belong.

Yes, teaching is something like a club, one in which the classroom teacher faces many audiences. First, one faces an audience of students, each one different and each group different as well. I was a middle school teacher with a home room and three other classes of language arts (the politically correct term for English). I saw around 120 students each and every day and found that I had to plan for each group differently because each class was a different audience. I arrived at school early every morning, generally an hour before the day began, not because it was expected (as a requirement of belonging) but because it was absolutely necessary to ground me for the day. While I left school when the last bell rang, I generally went to a local library where I spent hours grading papers before I headed off to graduate school where I earned my MEd and EdD degrees. Finally arriving home at ten, I was exhausted. And that was the preparation needed to address the most important audience, my students.

Then there were those other audiences in order of importance: school administrators, parents, political leaders, and the community leadership embedded in the social and business strata in the community in which I taught. Parallel to those interests was the Union, a body to which I was also a delegate representing the teachers in my school. The Union provided an umbrella of protection from the whims of the governing school community.

Once I earned my doctorate, I left the classroom and moved to higher education. I began teaching at the university level in Lubbock, Texas at Texas Tech University. That first job was as an assistant professor in the department of reading, the area in which I earned my doctorate. Not unlike the pressures of the k-12 classroom, the university added additional requirements, specifically the requirement to do research and publish those findings as well as to do service for the university community by serving on committees for the benefit of the governance of the university community.

Given that background, brief though it may be, the issue of belonging, of becoming an insider rather than an outsider, was one of learning the rules of conduct. What was and was not acceptable. Which rituals must be followed and which could safely be ignored. What constituted being a faithful representative for the teachers I represented and what set of circumstances might allow me to follow my conscience even when I was found to be in conflict with the faculty I represented in the house of delegates (this didn’t happen too often as we tended to be a rather radical group working for a tyrant of a principal).

As a new teacher, it was enough to just learn the patterns of the school year, a process that took me a couple of years. That, by the way, was partly relearned when I went from middle school to higher education, not so much the teaching role, rather the administrative interaction had to be relearned. As a veteran teacher the goal was no longer to accommodate to the rules but to often act in spite of them by doing the ethical rather than the demanded.

As my career advanced I learned how to be more independent as a scholar, to become more empathetic as a teacher and to be a friend to my colleagues. This required me to balance many roles at once. I served as a spark for my students to think clearly, to consider alternatives and to become better preservers of knowledge than they were before they encountered me as a teacher or professor. I don’t say this in an arrogant, self-serving way, rather I see evidence of this among a small group of middle school students that have ‘friended’ me on Facebook. I see the way they think, the way they consider problems and ideas and how they interact with the world in which they live. I’d like to think that I had something to do with that.

As a retired teacher and professor, I continue to read, to write, to think about those things I thought about before I retired. The primary difference, especially since my prostate cancer diagnosis, is that I can do it all on my own terms. I am beholding to no one; I answer to only myself without having to be on any committees, please any parents, pretend that I am doing the will of the principal (in higher education there is, or at least in my experience, was far more independence given the importance of academic freedom) and I don’t have to bow down to the will of the political or business community. It seems that cancer is liberating in a way I could not have expected.

Back Home After The Doctors Visit

Back Home After The Doctors Visit

Back Home After The Doctors Visit

Making an appointment with one’s urologist on his last day in this office was more interesting than I had ever imagined. For the first time in my memory I was buzzed back to the examining room on time. The efficiency of the staff was at its best. I first was visited by a resident who laid the groundwork for the ultimate visit from my urologist. Blood was drawn, fluid samples left and then some genuine time spent talking about how normal my recovery was up to this very moment. Absolutely nothing unexpected, unheard of, abnormal, or even slightly out of the ordinary. Good news once again. I’ll wait for the PSA results which are expected to be significantly lower than they were before this whole cancer thing began, maybe even undetectable but who knows. More than likely, given the time frame of four-weeks since surgery, a number slightly under 2 can be expected. Four weeks from now, however, a PSA of around 0.1 would be more like expectations. We’ll see. For the moment, however, everything looks quite positive.

As Guy Clark (a Texas singer-songwriter) once wrote,

Nothing lasts forever
Say the old men in the shipyards
Turning trees into shrimp-boats
Hell, I guess they ought to know.

Clark’s words have often been of great comfort to me. Change is a constant; randomness in this world is the grease that lubricates the entire machine. Accept that and the very idea of turning trees into shrimp-boats is something one must not only expect but accept as a rule of living in this world.

In my mind the universe is a very large random number generator, run by probabilities, predictable to a fault but not to the detail of any single individual actor in the play. If something can happen, if something is possible, no matter how small the probability, it will happen. You can absolutely count on that. It may not happen to you but if it is within the realm of possibility it will happen to someone or something. One cannot live in fear of the possible. That is a waste of one’s time and effort and gets you absolutely nowhere other than, just perhaps, causing significant stress, a factor which could actually trigger the unwanted. No, the only rational place to be emotionally is to be in this very moment, a time in which we deposit traces of an existential life and think about our own potential future by creating goals, hopes, and dreams.

Wasting time on the what could be, the what might be, the otherwise than what is wanted, the worst possible outcome without accepting what could be, what might be, the otherwise that what we want, or the worst possible outcome opens the door to negative energy and outcomes to occur. By accepting the worst, the otherwise, the could be, the door is open for us to work positively toward a more positive outcome.

Let me give you an example. After a radical resection of the prostate, even with nerve saving techniques and the steadiest of surgical hands, it is quite likely that one will suffer from some form of urinary incontinence. I know this for an absolute fact. The truth is that it is possible for this condition to be permanent, the worst possible outcome I can think of; the otherwise of desired outcomes. That being said, if this were true in my case, that the worst outcome possible were to occur I would not allow that to interfere with my zest for living. I have accepted that possibility. It would be something I would simply have to get used to. But I am doing everything humanly possible to assure that this outcome doesn’t occur. I do pelvic floor exercises on a regular basis. I left the urology clinic with a new, quite difficult, pelvic floor exercise that I do twice a day, morning and evening. This combination is expected to produce results sometime in the next 11 months, yes 11 months; I have already experienced some positive signs from just doing the pelvic exercises regularly.

So there you have it, accept the worst, work toward the best; it is a combination guaranteed to provide one with a serenity beyond one’s wildest dreams.

Off to the Doctor

Off to the Doctor

Off to the Doctor

Today I have my post-surgical check and I say goodbye to my urologist (he is moving on and will hook me up with one of his partners) but the day is bittersweet. I have so many questions about this recovery and the two side effects that leave me helpless and I will have to break in a new urologist along the way. While my urologist will answer my questions he will not be the one to treat the issues; he will be gone, replaced by a doctor I don’t know who potentially will treat the issues and side effects that present themselves.

Trust is the issue here. Over the years I have built up a trust with my doctor that is hard to set aside. His advice has always been sound and it has always been provided with a smile and care. Unlike most surgeons, his first course of action is to treat medically leaving the knife as a last resort. He always took the time to explain the options, the pros and cons of each, make suggestions but he left the final decision to me. His demeanor always took on the posture of a caring physician first and a surgeon second. Not only that, I genuinely like him. So where does that leave me?

A new urologist, no matter how well trained or capable he might be, will present himself to me without the advantage of trust. He will have to build that trust a visit at a time. That is no easy task, especially after so good a relationship as I have with the present one.

My task in all this is to remain open. In this case I am the other calling to the new urologist to take charge, to be available, to care for my welfare without reservation (I cannot say without reciprocation because he is paid a handsome fee to care for me). It is funny how roles switch from self to other depending on circumstances. While my call is a call for care, a call that says I trust you, it is also a call of caution because, while I want to trust, I cannot until it is earned.

This day I confront the disquiet of change. What I do know is that life will go on because the crux of this very moment is change.

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