Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the tag “health”

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.

A Near Purchase

I almost bought Christopher Hitchens, Mortality, today but decided to take a pass.  I am a huge fan of Hitchens, his wit, his thoughtful analysis of events even when I didn’t much care for his conclusions, his rational stand on religion and his approach to atheism in general.  In Mortality he talks about facing his own imminent death from esophageal cancer, a battle that recently took his life.

As I fingered this short book, read a bit of the introduction finding it as intriguing as anything I ever read from his active mind, I decided to put the book down and walk away mainly because I didn’t think it was time for me to be reading about this grim subject.  After all, my cancer is still diagnosed as a Stage P1C with a very bright prognosis.  There is plenty of time to think about my own mortality if and when I am facing it.  Besides, the book is out in hardcover and I thought I could wait for the paperback version (or perhaps the Nook version) before I plunk down some hard to part with money.

Speaking of printed material, my wife ran into a representative from the American Cancer Society while I was having my scans.  A package arrived yesterday from the American Cancer Society that has any number of pamphlets, most written so that a third grader might be able to glean some information from them.  They are written in terse language and overgeneralize.  A glossary was included in one that had terms like cancer, tumor and chemotherapy among others.  I was reminded of a paper one of my 8th grade students once wrote, an autobiography in fact.  This student had several surgeries to remove benign tumors from the brain stem.  At the back of the paper was a medical glossary containing terms like surgery, tumor and brain among others just in case I wasn’t aware.  While my student’s glossary was simply perfect, the assumption of the American Cancer Society brochure was that most people are simply too stupid to make heads or tails of their illness.  The language panders to the least common denominator and, quite frankly, I found it insulting.

In another of the many brochures in that package was a piece that spoke about just how much should be revealed to the patient, how much should you tell your loved one.  Screw that.  I spent too many years in school, earned a doctorate in language and literacy, did significant educational research, was published in scholarly journals and even co-authored a book; I’ll be damned if I’ll be pandered to.  No, I want to know.  I understand the statistics, laws of probability and the like.  While medicine is not my field, I can read the relevant research and come to meaningful conclusions myself.  I expect to be kept fully informed regarding the progress (or lack thereof) of my cancer.  All I have to fall back on is knowledge.  Like Hitch, I have no religious faith to fall back on, I am an atheist because there is no evidence that there is a god out there and so I depend on knowledge in this very moment, in the present because only knowledge provides me with the tools to fight this disease.

So, I didn’t buy the book, I did get rather angry reading the American Cancer Society pamphlets and so I decided to rant just a bit.

Making Right Sized Decisions Ain’t Always Easy

Sitting down with my urologist after hearing the diagnosis of adenocarcinoma of the prostate to discuss the options for additional screening and possible courses of treatment, one of the things he advised was to change my eating habits; “Eat healthy,” he observed.  That was about two weeks ago, maybe three, and I have yet to change my diet.  While I know that it is best to eat more veggies, less red meat and so on, I am having trouble making the commitment to doing so.

So what is up with that?  Here I am, making arguments for the ethical relationship with the other and I am avoiding the ethical relationship with myself.  So here is what I have decided to do…and it won’t be easy.  I decided to limit my consumption of red meat and eggs to once a week.  I figured I would start with a basic commitment rather than make an entire plunge into something I am pretty sure I won’t be able to maintain.  It would make my wife quite happy if I added fish to my diet, but I can’t stand the stench in the house after most fish is cooked so that is hardly a legitimate option unless I add fish while eating out.  In place of the protein from the red meat and eggs, I can easily substitute dairy protein in the form of cheese, yogurt and milk.  In addition, the vegetarian staple of beans and rice along with the addition of tofu in stir fried veggies seems to be a reasonable option as well.

The plan is to follow this plan of eating for the next month while committing to blog about how I am holding out.  About four weeks from today I will have my surgery which may screw up my plans a bit but who is to say.  In the long run, I am certain that this change in lifestyle will be good for me and for my family as well, if I can maintain it.

All that being said, as I write this I am cooking a mushroom barley soup with lima beans and lentils.  Now there is a marrow bone with a bit of red meat attached and two short ribs for flavor, but the meat per serving will be less than one ounce.  The soup along with a small salad should prove to be a hearty fall meal, one that fits within the bounds of this new approach to eating a bit more healthy.

Here’s the thing, I am looking to focus on eating healthier in order to positively effect the outcome of my prostate cancer.  At the same time, I know I have absolutely no control over the outcome in any real way and that if I thought I did I would be ready to become obsessive over the outcome itself rather than to focus on the moment that surrounds the actions I take in this very moment.  For me this is less about results than it is about acting appropriately, of becoming present for myself in order to be more present for others; it is an ethical responsibility that I cannot pass off to any other person; there are no substitutes.  So here I go, ready to jump off the cliff and see just what might happen if I stay focused on this moment, the one that will never be repeated, never be reenacted.  It is in this very moment that I make a decision to act or not act, to do what is next before me or to shirk.  It is a choice, an ethical choice that I am placing at my own doorstep.  Only time will tell how successful this will be.

At This Very Moment…

At this very moment I am bombarded with any number of factors I could obsess on, make projections about or worry over.  Of course, I have the upcoming surgery and along the way to that procedure I have any number of things I must do to prepare for that moment.  I have pre-op testing to do, pelvic exercises to perform and more the details of which I need not bother to address.  Each of these present unique reasons to become obsessive over what the future holds.  I am, however, quite calm, feeling little or no stress.  I take each requirement, each obligation, as a thing to do in the moment, a thing over which I have a modicum of control.  What I don’t have, however, is any control over the outcome so I let the outcome go.

I am reminded of a Zen tale in which a novice monk is seeking enlightenment.  It is, of course, elusive so he goes to his master complaining that enlightenment is never going to be his and so he is quitting.  “Before you quit,” the master responds, “please travel to see my friend and you may find what you are looking for.”  So the novice agrees.  He travels over tall mountains, through the dry desert, across endless marshland and swamps, finally arriving at the monastery of his master’s friend.  He climbs off his horse saying to the monk, “I searched for enlightenment and could not find it; I was told to come to see you as my last effort to find that which I seek.”  The master replied, “Where can you find your clothing?”  The novice was immediately enlightened.

The simple truth is that enlightenment is something that one finds, not by looking or seeking, but by experiencing the world around us.  To experience the world is to stand on the inside and focus on the outside, to embrace exteriority, to be compassionate and responsible.  Becoming responsible, in Levinasian terms, means to become responsible for the other person; to present the self to the other with no reservations or expectations and then to wait patiently for the other to perhaps, though not necessarily, respond.  Extended beyond the other, to situations of anticipation, being responsible means, perhaps, to learn patience, to be able to be in a state of proximity, waiting for events, rather than the other, to reveal themselves in their fullness.  Until the moment arrives where the event is upon the self, there is no reason to anticipate or project.

The fact is that I have prostate cancer.  I could spend all my time being slave to that fact or I could simply extend myself by continuing to live life in this very moment.  For me the choice is quite simple, living life in the moment is a superior ethical response than the problematic of living life tied to something outside of my control.  It is useless to anticipate, to project, to try to control the future.  If I take all the measures I am asked to take, perform all the obligations presented by my doctors, and otherwise live responsibly I have done all I can do and I am quite happy with the moment I am in.

Four Weeks to Go

On Saturday a package arrived from my Urologist that contained so much information that I simply wanted to curl up into a ball and go to sleep.  Forms to fill out, orders for pre-operative testing, a medical history (which they already have) and page after page of what to expect before, during and after this procedure.  Since we were on our way to the symphony, I just put the package away and didn’t think about it until this very morning, Monday!

Now I am no stranger to operating theaters.  Arthritis tends to wear out joints, impact the spine and central nervous system and I have experienced both.  Two hips replaced, one knee replaced a short four months ago, a cervical fusion and a lumbar fusion among other things have brought me under the surgeon’s knife.  So the information I received was, to say the least, redundant.  But, this one seems a bit different.  My very existence, my life, is at stake here, not merely relief from pain and suffering.  While this is perhaps a bit of an overstatement, it clearly reflects the gravity of this surgery…and it is being performed by a robot.  Once I am put under I won’t even know if the surgeon will be in the room or out in the lounge with his console performing radical surgery like it is a video game.

I am not at all certain that I am comfortable with a remote control device poking and cutting inside my body.  It somehow feels like the Matrix or Tron or something that is somehow the property of film special effects departments, not the surgical suite.  Of course, I have little choice in the matter for this is now how a prostate is removed from one’s body these days.

Sure I use computers and I even play games on the computer, but I know that eventually I lose the game.  The game is stacked against winning.  Perhaps that has something to do with my apprehension about having a remotely controlled surgery.  At least the surgeon is not trying to rack up as many points as possible before the game finally ends.

All that being said, I am still approaching this surgery with a bit of awe.  I would like to have a video made (I assume that since the operation is guided by a camera that is shoved inside of me that a record of the surgery is made for later evaluation if needed) so it would be easily transferred to a DVD for later watching.  I think that might be interesting.  I have watched a YouTube video of a DiVinci resection of a prostate but watching my own resection would be interesting to say the least.

Solitude: The Irreplaceable “I”

Emmanuel Levinas’s ethics creates an impossible condition, that of being present for the other; of being responsible for the other person without reservation or expectation.  Fundamentally, the self is irreplaceable in the sense that absolutely no other person can substitute for the self to act upon this sole responsibility.  In a social world, this responsibility can only be performed by the self, the irreplaceable “I.”  Along with this astonishing responsibility comes the solitude of responsibility.  There are no rules to follow, no guidelines, no legalities, just the terrifying knowledge that the “I” is irreplaceable.  Contained in this idea of responsibility is the very notion that one truly is one’s brothers keeper.

But, there are moments in one’s life where the outward looking self is required to turn inward, to look for strength within because one faces adversity that is overwhelming.  Protecting interiority is, during these moments, more important than the exteriority of the other.  Moments like the death of a loved one, the loss of a child, the breakup of a long-term relationship all cause one to turn inward in order to deal with the emotional pain involved with the experience.  These moments are generally short-lived but purposeful in their ability to cleanse the self and to return to a normal (whatever that is) life.

Having a diagnosis of prostate cancer is, it seems, one of those moments.  Unlike the death of another, facing one’s own mortality requires one to dig down deeply into one’s own interiority to find the strength to fight.  It is an interesting place to be, focused on myself and my determination to fight this disease.  On the surface, everything appears to be unchanged.  I am still spending time with friends, reading the books I love, thinking about the ethical applied to education and making future plans.  But that is the face I present to the world.  The face I present to myself is quite different.  It is dogged by the constant knowledge that I have cancer, that my mother died from ovarian cancer, that my father survived lung cancer only to die from what the doctors thought was an after effect of the radiation he received fighting his cancer, that my paternal grandmother died from an unnamed abdominal cancer when I was fourteen (my first encounter of the death of a loved one).  As I sit and wait for a more detailed diagnosis so that treatment can begin, I realize that only I can participate in fighting my very own cancer.  No other person can replace me as I hunker down to focus my strength on the battle to come.

Sure, I will have a team of doctors focused on state of the art treatments, nurses that focus their partial attention on me, a wife whom I love but who likes to hover, children and grandchildren who will not learn of my struggles unless they come upon this blog, and friends who will show concern.  But in the end, none of them can substitute for me.  I fight this disease alone, in solitude, while surrounded by friends and family.  The solitude comes from this irreplaceability; it is nothing, however, if not a place to find and develop the strength to face the absolute unknown with dignity and deference.

Here I Am: Ethical Engagement with the Infinite

Last June I had a total knee replacement.  It is now the end of October, nearly four months since that surgery and I am about to finish my physical therapy today.  Now it is not that the knee is fully recovered, but I no longer think about it the first thing in the morning, all day long and the last thing before I go to sleep.   It must be getting better.  So rather than completing that recovery before having to face another major medical problem, I get whacked over the head with prostate cancer.  Who ever thought life was fair.

I have been convinced for quite some time that the universe is a very large random number generator, that probabilities rule, that there is little purpose in the universe save for the personal responsibility asymmetrically undertaken to live an ethical life.  To command the other to command me is the essence of the ethical project of Emmanuel Levinas.  I take that responsibility quite seriously and now that my own mortality is called into sharp focus, the impossibility suggested by that asymmetrical ethical stance is being put to the test.  I cannot ask for a stand-in, for a substitute, as I come face-to-face with the otherness of the infinity of death.  Oh, I don’t think it is an imminent possibility, but the truth is that I have a disease that is likely to end my life; a daunting reality to say the least but the simple truth is that I must face this possibility alone while surrounded by friends and family.

Not only is there no stand-in for my death, there is no stand-in for me as I fight to remain alive, to battle this disease with every ounce of my resolve and strength.  While surrounded with support, I am the one that must live at this very moment; only by living in the moment will I find the resolve to play my part.  If I spend too much time regretting the past or projecting into the future I will be unable to live at this very moment; I will be unable to present myself by crying out “Here I Am” as a presentation without reservation to the work that I must do.

At this very moment, my work is to wait patiently.  I cannot push Monday to this moment so I will sit and wait.  My plans call for me to complete physical therapy today, pick up veggies at the Farmers Market on Saturday, help a friend design a website for his mayoral campaign in the afternoon, visit my 7 month old grandson on Sunday, cheer for the Bears on Sunday.  On Monday I’ll go to the hospital to have the bone and ct-scans and then I’ll go back into waiting mode.  It seems so simple.

For years I told my students a simple Zen story, one I feel compelled to repeat here:

There was a young monk seeking enlightenment but it wouldn’t come.  One day he went to his master asking, “Why can I not find enlightenment?”  His master replied, “Have you had your supper?”  The monk responded with a terse, “Yes.”  The master said, “Go and do your dishes.”  The monk was immediately enlightened.

If I keep doing that which is directly in front of me, that which needs doing, then I am taking responsibility for the very responsibility of the other, those other people I meet as I shout silently, “Here I Am!”

Holy Cow, What Do I Do Now?

Just four days ago I was told by my urologist that I had prostate cancer.  The results from my biopsy were in showing an aggressive adenocarcinoma in around 5% of three biopsy samples.  This was a diagnosis I was expecting but, nevertheless, I was stunned by the news.  I was taken back to my parents, both of whom were diagnosed with various cancers, my father lung cancer and later prostate cancer as well while my mother died from ovarian cancer after an eighteen month battle.  Even more ironic is that my diagnosis comes at precisely the age my mother was when she learned of her ovarian cancer.  I am a mere 69 years old as I write this.

I met with my urologist yesterday and in a brief meeting he outlined potential courses of treatment, each one dependent on whether or not the disease has metastasized into the bone or lymph nodes.  This determination is made after a bone scan and ct scan are completed and read by a radiologist.  The scans are scheduled for Monday meaning I will remain in suspense until at the very earliest Wednesday for the complete results to be revealed.

I think the worst of this at this very moment is the waiting; the limbo that comes with partial information and the inability to make any meaningful decisions about treatment or the future.  So I wait…

Of course, it is not only treatment that depends on the localization or metastasis of the tumor that is called into question.  So is the ten-year survival statistics which, depending on the scans range from 45% to 85%, from a coin toss that I’ll live an additional ten years to a pretty good bet that I’ll survive this whole ordeal.  What I must remember, however, is that since those numbers represent the mean or the average, that from 15% to 55% of those with prostate cancer will die before ten years.  It is a good thing I am in individual and not an average.  The average smooths out the data reducing the data set to a universal number.  That is good for a benchmark but is not applicable to the individual patient.  So I plan to treat this disease in the most aggressive manner possible; for that I take full responsibility.  What I have no control over is the effectiveness of any aggressive treatment so I am resigned to let the chips fall where they may.

One last thought for today.  Men, it seems, are 35% more likely to be diagnosed with prostate cancer during their lifetime than women are likely to be diagnosed with breast cancer yet breast cancer awareness is ubiquitous.  NFL players, coaches and referees trot around wearing hot pink to call attention to breast cancer awareness throughout October.  Isn’t it time that prostate cancer get the same kind of recognition?  I don’t wish to diminish breast cancer awareness, that would be foolish and counter-productive.  The fact is that this is not an either/or proposition, rather, it is a YES / AND proposal.  I believe that working with existing cancer groups, a national prostate cancer awareness month can and should be a priority helping men become aware of screening and treatment options.  Won’t you join me in this effort?

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