Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the tag “Conditions and Diseases”

Weathering the Storm…Nine Months Later but Who is Counting

Weathering the Storm...Nine Months Later but Who is Counting

Weathering the Storm…Nine Months Later but Who is Counting

At six-o’clock in the morning on Sunday I am sitting in my hotel room in Kansas City, Missouri listening to the thunder as the tail end of a violent Spring storm passes by. Looking at the weather radar I can see another small cell approaching from the southwest. Last night the weatherman reported that there was a 60% probability that one would be exposed to a violent storm, possibly a tornado during the afternoon hours when I will be in Denver. Lucky me.

All this got me to thinking that I was and always have been lucky. Most recently, when I was diagnosed with aggressive prostate cancer in September of 2012. What could be lucky about hearing the words, “You have cancer,” you ask? At the time, I didn’t think it so lucky either but then, after all the testing, the poking and prodding, I learned that the tumors were likely (but not positively) encapsulated in my prostate and that surgery would be the most aggressive ‘cure.’ The decision to operate took place in October but, because of the swelling of the prostate due to the needle biopsy, surgery had to wait until late November. That thirty day run-up to surgery was a nervous time, a time in which I thought a lot about my own mortality.

As long time readers know, the surgery was successful, the tumors were, in fact, contained within the prostate; it became clear that life would go on. Of course, I was left with two significant side-effects of prostate surgery. I suffered significant incontinence requiring me to wear diapers for the next five months. As I write this today, I am confident that the incontinence will not be a problem much longer if at all.  This, of course, answered a significant question I had for many years, namely, “Just who would wear Depends for Men anyway?” The surgical procedure was said to be nerve sparing so that sexual functioning would not suffer. Oops, that side-effect remains intact. I think of this as a small price to pay for a long life expectancy; who knows, I’m told this is likely not permanent either.

Since the surgery, however, I have suffered two major setbacks. First, I had a significant urinary tract infection, one that was resistant to many antibiotics, requiring that a permanent line be attached to a vein in my arm for daily injections of some potent antibiotic. While this seemed to do the trick (the infection is gone) I was diagnosed with chronic kidney failure with a kidney function of under 20%. While the reason for this seems to baffle both my internist as well as a kidney specialist I am seeing, the last kidney function test showed a marked improvement in kidney function. The worst seems to be over. Lucky again.

Good, because on Wednesday I will arrive in Las Vegas to play a little poker. While I don’t think of poker as a game of chance, winning always involves a bit of luck as well as a great deal of skill. So, as I go to Las Vegas, I’ll wear the cloak of luck I seem to have been wearing for the past 70 years, one that has allowed me to weather most every storm I have encountered. 

Finally, Good News on the Medical Front

Finally, Good News on the Medical Front

Finally, Good News on the Medical Front

I finally have good news to report. I feel as though I have done nothing for the past four or five weeks but sit in doctors’ waiting rooms but now I have good news. My failing kidneys are no longer failing. The last blood work that measured kidney function showed numbers that were essentially normal. While still a bit below the norm, there is no statistical significance between my numbers and the norm so that makes me quite happy (not that I wasn’t happy before because being happy is really a choice) but happier would be the better term here. The down side of all this is that I can no longer take hard working anti-inflammatory drugs for my arthritic pain because they beat up my kidneys making them undesirable. Tylenol, which will only beat on my liver or narcotics like Norco are the only drug related choices. Since I won’t take the narcotics and Tylenol, while it provides some relief, is not really up to the task, I think I’ll look into alternative therapies and lose some weight to see if that doesn’t help reduce the pain I am experiencing. That being said, all is good. I am going out now to enjoy this beautiful day.

Saying Goodbye to my PICC Line and More

Saying Goodbye to my PICC Line and More

Saying Goodbye to my PICC Line and More

In addition to the reversal of rolls in my household in which I became the caregiver and my wife is the patient, I had my last infusion of the antibiotic erdapentem yesterday. Once the infusion was completed the PICC line (peripherally inserted central catheter) was removed, painlessly I might add. While I hated to say goodbye to this port allowing for fourteen infusions without ever being stuck while inserting an IV line, I was happy when it was gone. The worst part of the whole last two weeks was that I couldn’t get the PICC wet so my left arm could not get washed. This morning I intend to take a nice long shower exposing my left arm to the pounding of hot water until I turn into a prune.

It does seem as though the infection that caused this whole thing is gone. I feel much better than I did two weeks ago but, because no test was done to confirm the bacteria is gone, I have a small lingering concern that maybe some of the bacteria wasn’t killed. Only time will tell if that is the case but for now I can only believe that a cure was accomplished. The infectious disease doc assures me that so long as I am symptom free no testing is warranted, that the treatment worked and there is no longer a need for concern. So I will trust in that assessment even though I have a lingering doubt that wants to hang around just to play with me.

On another note, now that holidays are over I want to rant a bit. As readers know, I am Jewishish, an atheist Jew. Culturally Jewish, a reader of Jewish thought and religious texts (I hesitate to call it scholarship) and a citizen of the United States, I have yet to find a proper response to someone uttering words, as sincere as they might be, like Happy Easter or Merry Christmas. I don’t know how to answer them. I could say, “Look, buddy, I don’t know what to say to you. It isn’t my holiday.” But that would be rude. On the other hand, I find it offensive when someone assumes I am a member of their particular mythological cult without knowledge of whatever mythological cult I call my own so why not be rude. The fact is that rudeness never solves a thing. It merely heightens underlying tensions that we know exist between competing groups.

I could, on the other hand, be quite passive and say, “Same to you.” But that response would be hypocritical. Because I don’t understand the hoopla behind either Christmas or Easter (sure I know the mythological foundations for them I simply don’t understand why people believe them) my response would be one of acquiescence to the fundamental ideas of these particular myths. This hypocrisy would also be rude, albeit, not an overt charge of rudeness rather a rather covert mocking of the sincerity of the original utterance.

Another response would be to simply nod my head in the direction of the well-wisher. This silent mocking is less offensive than the mocking response of, “Same to you,” but the intent is similar. While acknowledging the well-wisher’s utterance it silently evades a direct confrontation with the well wisher but doesn’t acknowledge the well-wisher’s words.

The problem lies in the hegemony of the well-wisher’s understanding of the world without considering the alterity of the other. The fact is that each human being is unique. Sure we belong to social, cultural, political, religious and linguistic groups (tribes) but even within each group and across groups our uniqueness, our alterity, is a principal part of who we are. To mash alterity into something one may consider as normal or normative and apply that norm to all is a reduction of the self (as unique) into the same (as defined only by the normative experience). The well-wisher reduces everything into a mush of normalcy thereby reducing everything to the same without regard for the uniqueness of the other. Hegemonic thinking, the reduction of everything into the same, amounts to a cauldron of roiling hate and distrust of the other, the non-compliant.

I would never wish anyone a Happy Passover unless I knew that the other was Jewish. Why would a Christian assume I am the same as she is without knowledge of my core beliefs or disbeliefs? It is offensive to me when someone chooses to lump me into their sameness without even a little bit of knowledge about who I am.

The solution to all this is simple. If you are certain you are talking to someone who shares your mythological stories, go ahead and include them in your wish list for happiness. If you aren’t just wish them a Happy Holiday; surely this will not offend anyone. Remember that all cultures celebrate rites of spring and the depths of winter in some form or another, even when those forms have taken on a life of their own divorced from their origins. So I wish most people a Happy Holiday and save the specifics for those with whom I share mythological foundations whether I believe them to be true or not.

Infusions, Doctors and Life Generally

Infusions, Doctors and Life Generally

Infusions, Doctors and Life Generally

As I was sitting in the very comfortable reclining chair getting hooked up for my sixth infusion of antibiotics to deal with the  resistant echoli strain that has seen fit to invade my body, I was struck by the idea that since my cancer diagnosis, surgery, and recovery period, I have slowed down. Now slowing down is a good thing. It began when I took off my watch forcing me to be less concerned with time in general. While the act of refusal to recognize time as a constraint was difficult at first, it has become a blessing. To not feel the urgency of time makes the time I have more precious; something akin to a gift from myself to myself. At the same time, I have not lost my appetite for punctuality. This may seem a contradiction but I think it is not. When everything is run by the clock then punctuality is an obsession but when I take the time to just take in what is there, punctuality becomes an ethical act; an act of respect for the other whether the other is driven by the clock or not.

So sitting in that chair, talking to Cynthia, the nurse administering the antibiotic, I noticed all of the surroundings, the pictures on the wall, the clock with the broken second hand, the smell and taste of the antibiotic as it drips into my veins. In the moment of that half hour of dripping solutions I was at one with the universe.

Since taking off the watch six or so months ago the world seems to spin at a slower pace. Of course it isn’t the case but the fact that I take the time to notice things I didn’t have the time to notice before is a bonus that was totally unexpected. I hear the voices of doctors as they try to figure out what is going on with me and find the urgency of one doc countered by the patience of another as they look at the results of the data. One doc looks at a number and nearly panics while the other looking at the same numbers takes the approach of waiting to see how the whole picture develops before striking out with a treatment plan. I think that one should never treat a number, rather one should look at the whole picture and treat the cause of the abnormal data that emerges over time. Jumping in without all the facts is as dangerous as denial of the emerging data. While one cannot be absolutely certain when incomplete data is present, one cannot allow oneself to be driven by the presence of a single abnormal number either. That too is an insight I learned after taking off my watch and allowed myself the luxury of observation.

As an aside, I found it interesting that even with the PICC line inserted I had to be stuck to draw blood in my internist’s office. What a waste of a good PICC line. When in the infusion center blood was also drawn and the same blood numbers will be analyzed. Why twice? Could it be profits are involved?

 

Good to Be Back

Good to be Back

Good to be Back

I feel like a suspended NHL player, having missed a week or more of posting to the blog. Let me explain. A week ago today, my wife began complaining of severe pain in her neck, upper back and knees, especially the left knee. Nothing, not medication, physical therapy or sleep seemed to do much to relieve the pain. She went to her internist who scratched his head and said, “Hmmmm?” and sent her to the emergency room where the ER attending physician scratched his head and said, “Strange?” and wrapped her knee with an ace bandage for lack of anything better to do and suggested a follow-up with both the internist and her orthopedic physician. The orthopod drained a bit under 200 cc of fluid from her left knee and said, “Hmmmmm, the fluid is cloudy suggesting gout…Let’s run some tests.” When the tests came back all within normal range, he scratched his head and said, “Hmmmmm?” in agreement with everyone else. It is no small wonder that my grandfather always said, “Doctors don’t know nuttin!”

Over the past week I have tended to her needs, her demands and her complaining. The one thing the three doctors did agree on was that she contracted some strange virus but none were willing (or able) to identify the virus or suggest a cure. Hmmmmm!

Since we have a wedding to attend in Grand Forks, ND (in February for goodness sake) we left home yesterday after going to the orthopod for a cortisone injection in her right knee. It seems the stress of the pain in the left knee placed an additional strain on her right knee and, well, you can guess the rest. Now in Grand Forks, the weather was good to us, we are getting ready to join family for dinner. I am tired from all the driving but not so tired that I didn’t want to avoid another day of not checking in.

On another front, I have been reading a lot that I want to comment on but that will wait until the very next post.

Treating Disease and Not Risk Factors: A Holistic Approach

Treating Disease and Not Risk Factors: A Holistic Approach

Treating Disease and Not Risk Factors: A Holistic Approach

I spent the day yesterday with my wife as she went for a baseline heart assessment. She worries because her father and mother as well as her brother all had significant heart disease diagnosed in their late fifties. She is in her early sixties with some risk factors for heart disease so her goal was to establish a baseline as a way to measure changes in her risk for heart disease. That is all well and good. I am a firm believer in understanding risks and probabilities, I play poker after all. What I am most worried about is the desire of physicians, especially cardiologists in my experience, to treat risk factors in the absence of actual disease. When I was in graduate school we were encouraged to ask two questions as we began to investivate research reports. First, who funded the research; is there a funding agent that has a significant dog in the fight because if there is the results of the research are significantly less valuable than if the research was conducted objectively. Secondly, we were encouraged to ask just who actually benefits from the results of the research; understanding the relationship between beneficiaries of research and those upon whom the research is actually intended to benefit along with the divergency in ultimate beneficiaries is important in evaluating the results of the research itself.

Take Lipitor, as an example. According to Wikipedia, “Atorvastatin [Lipitor] was first synthesized in 1985 by Bruce Roth of Parke-Davis Warner-Lambert Company (now Pfizer). The best selling drug in pharmaceutical history, sales of Lipitor since it was approved in 1996 exceed US$125 billion, and the drug has topped the list of best-selling branded pharmaceuticals in the world for nearly a decade.When Pfizer’s patent on Lipitor expired on November 30, 2011,generic atorvastatin became available in the United States.” (emphasis added) While I am not looking at specific studies, I can imagine a reasonable scenario in which the vast majority of research done on Lipitor was funded by Pfizer or their predecessor company, studies that showed the benefits of Lipitor in preventing fatal heart disease. I immediately am skeptical of research that is funded by the company that benefits in terms of manufacture and sales when the drug goes on the market. In the case of Lipitor, the drug was the best selling pharmaceutical for over ten years; a patented drug the profits from which flowed into the coffers of Pfizer’s treasury. Clearly, Pfizer was a major beneficiary of the drug Lipitor.

The question of patient benefits are a bit more sketchy. Side effects from Lipitor (and other statin drugs) are many and some are even deadly. Again according to Wikipedia:

As stated earlier, myopathy with elevation of creatinine kinase (CK)] and rhabdomyolysis are the most serious side effects, although rare at <1%. Headache is the most common side effect, occurring in more than 10% of patients. Side effects that occur in 1–10% of patients taking atorvastatin include:

  • Weakness
  • Insomnia and dizziness
  • Chest pain and peripheral edema
  • Rash
  • Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, nausea
  • Urinary tract infection
  • Arthralgia, myalgia, back pain, arthritis
  • Sinusitis, pharyngitis, bronchitis, rhinitis
  • Infection, flu-like syndrome, allergic reaction

Atorvastatin and other statins are associated with anecdotal reports of memory loss by consumers, which have been seen in clinical practice in a tiny percentage of users, particularly women. Evidence is conflicting with anecdotal reports contrasting with a well-established association of high cholesterol with dementia. However, it is known that cholesterol synthesis is necessary for normal neuron functioning. According to Pfizer, the manufacturer of Lipitor, clinical trials “do not establish a causal link between Lipitor and memory loss.”

Elevation of alaninetransaminase (ALT) and aspartate transaminase (AST) has been described in a few cases.

High-dose atorvastatin had also been associated with worsening glycemic control in the Pravastatin or Atorvastatin Evaluation and Infection Therapy – Thrombolysis In Myocardial Infarction 22 (PROVE-IT TIMI 22) substudy.

Side effects occur in up to 10 percent of all patients taking Lipitor, or now generic Atorvastatin; one in nine people will experience some side effect from this drug. What is even more interesting is the list of side effects does not include potential damage to one’s liver, neuropathy, or other conditions that may occur when using Lipitor. What is even more unsettling is that the drug is designed to treat “Secondary prevention in people with coronary heart disease and multiple risk factors for myocardial infarction, stroke, unstable angina, and revascularization.” The first part of this sentence shows a use for treating disease while the second half of the sentence specifically treats risk factors for, or the probability of being affected by, something that has not yet occurred. I wonder just how much profit Pfizer made from treating risk and not treating actual disease? My guess it that it amounted to over 75% of all profits earned from the sale of this drug.

Risk factors are just that, factors that may or may not contribute to an individual’s chances for developing a particular disease. With regular doctor’s visits, a solid program of reasonable weight control, exercise and a baseline from which to assess risk, clearly one need not spend untold thousands of dollars popping pills. A personal example, from the time that Prostate Specific Antigin (PSA) testing was available I had mine checked at least once a year. I had significant risks for prostate disease, especially prostate cancer so establishing a baseline that was particular to me, not to some generality of statistical risk, became a guide post for my own awareness of the changing risk factors. When my PSA suddenly spiked to 23 the time had come to actively pursue treatment options. Until that time, however, taking prevention pills was not a personal option. Treating risks is something like carrying an umbrella on a sunny day thinking that there is a potential for rain albeit an unlikely chance that rain will occur at all. When there are potentially deadly side effects in taking a drug aimed at prevention, when the drug is known to destroy one’s liver, the risks of taking the drug are perhaps greater than the risk of disease itself.

I am ranting here because my wife was prescribed Lipitor by a new cardiologist, had to undergo a stress-echo test in which her skin was sandpapered raw, and she was told that she could only eat chicken, fish, veggies, and fruit and she had to eat all this food without seasoning the food. Seriously? If it were me, I’d simply run the other way. I avoid doctors that prescribe medication on a first visit and surgeons who do not offer non-surgical treatment before they recommend surgery. I am disturbed by the practice of medicine that throws the patient under the bus in order to benefit pharmaceutical purveyors and themselves first and the patient second. I am not sure what she intends to do but I will do all within my power to encourage a second opinion, one from a cardiologist who doesn’t reach for the prescription pad first and alternatives second. For me it is a matter of medical ethics and holistic treatment of a patient and not a risk factor.

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.

PET Scans to Image Prostate Cancer Advance Toward Mainstream Clinical Use – Prostate Cancer Foundation PCF

An interesting development in diagnosing prostate cancer. Click to read the article from the Prostate Cancer Foundation

PET Scans to Image Prostate Cancer Advance Toward Mainstream Clinical Use – Prostate Cancer Foundation PCF.

Probability and the Meaning of the Universe

Probability and the Meaning of the Universe

Probability and the Meaning of the Universe

An age old question that human beings have asked since the beginning of our species (not the beginning of time because we weren’t around at the big bang) is what is the purpose of the universe, of life, of anything at all. The underlying assumption is that there must, of necessity, be an entity that decides on said purpose and it is up to us to figure out just what that entity has in mind. The question itself is absurd on many levels but, perhaps, most profoundly on the level that presupposes that one is able to understand the ineffable, the mind of whatever god or gods you attend to. The supposition that there is a purpose to the universe also presupposes that there is a purpose to war, pestilence, famine, hurricanes and tornadoes, earthquakes, disease, love, compassion, empathy, fear, hatred and so on an on we go.

I am an atheist which is to say that there is not enough evidence (other than the pronouncements of sacred textual material such as the Bible, Koran, Upanishads or other texts written by people for people) to justify the existence of an all knowing, all powerful, all loving god. While I am open to changing my mind if the evidence were to prove me wrong in my rational conclusion, in the absence of such evidence I must accept the fact that the universe itself is an absurd construction of human beings. Others on distant planets that have evolved to the point of intelligence may also think they are so important that they must too find meaning in that which we don’t understand.

I find it quite absurd that people think that success is a gift from god while failure is a punishment for sins, real or imagined. That health is a gift from god while disease is a punishment for sins, real or imagined. I rely, not on god or gods rather on the notion of probability. Probability is not luck, good or bad, it just is. If something can happen it will happen. If one in six men will be diagnosed with prostate cancer in the course of their lifetime then the odds of my getting prostate cancer are 5 to 1 against. The fact that I have prostate cancer is not a punishment, it is a simple roll of the dice and my number happened to come up. The same thing is true about the fact that I have osteoarthritis, while I don’t know the precise odds, I do know that the probability of my having arthritis was enhanced by the fact that my family has any number of members that have this disease.

Probability is not purpose, it is a simple mathematical calculation that, for the most part, can be done on the back of an envelope, on a napkin in a restaurant; no computer needed. While understanding statistical concepts like central tendency, variance and standard deviation, for example, is a more complex calculation, it is not rocket science (which is also based on mathematical formulas), it is still something that flows from and is dependent on math and math is neutral when it comes to the very notion of purpose.

I am content to know that I experience the world in infinitely brief moments of now, embedding traces of memory that allow me to find meaning in and through the existential moment of existence. I find meaning in my family, my wife, kids, grandchildren, multiple nieces and nephews, and cousins. I find meaning in the worldly relationships I have with my friends, colleagues, and others that roam in and out of my life. As to purpose, well no, I don’t pretend to find an answer to purpose because I don’t think there is such an answer. What I will do is find meaning in my life, try to always do good, and refuse to hate because it is arrogant to think I am so important as to decide that the life of another human being is less worthy than my own.

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.

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