Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the tag “medicine”

Simple Solutions to Complex Problems? I Think Not

Simple Solutions to Complex Problems? I Think Not

Simple Solutions to Complex Problems? I Think Not

I should be riddled with guilt because I haven’t posted a thing in the past nine days but I am not. My schedule has been absolutely crazy going in and out of doctors’ offices, geting poked, prodded and ultrasounded to see if there is a root cause for the high calcium levels I am experiencing. Coupled with a recent diagnosis of osteoporosis, my internest thinks I have some kind of parathyroid condition but both a nuclear medicine scan of the thyroid and recent blood tests seem to point elsewhere. The ENT specialist decided that I should have an ultrasound of the neck looking specifically at abnormal parathyroid activity. While in the ultrasound chamber the machine simply died and could not be brought back to life. This meant that I had to come back for a second round. It turns out that the main board burnt out and had to be replaced. The second time around everything went according to plan. I won’t know the results until next week but I am not going to worry about it but I sometimes wish there were simple solutions to the medical issues I face. The point is that everything is good considering I am a prostate cancer survivor!

I am going to a chiropractor this afternoon to see if he can rid me of the lower back pain and the pain in my neck and shoulders that medicine has not been able to treat. The chiropractor is well versed, I am told, in Chinese Medicine and acupuncture, techniques that brought significant relief after I was involved in a serious automobile accident about 20 years ago. I thought I would give this approach a try since Western medicine is not bringing me any relief at all! Seems like I have nothing to lose.

On a final note in this rather bland post, I am quite tired as I write this. I stayed up until the wee hours of the morning watching a great hockey game. The Chicago Blackhawks and the Boston Bruins faced off for game one of the Stanley Cup finals. Two evenly matched teams had at for nearly two full hockey games when the Blackhawks finally scored the winning goal at 12:08 of the third sudden death overtime period. If this is any indication of the type of series we have to look forward to then I will be most happy especially if the Blackhawks are victorious in the end. That being said, I am retiring for a nap because I only had 5 hours of sleep last night and I am wiped out.

Turning Tables: Waiting in Proximate Space

Turning Tables: Waiting in Proximate Space

Turning Tables: Waiting in Proximate Space

I am writing this while sitting in the waiting room of the Valley Ambulatory Surgery Center while my wife undergoes a surgical procedure on her right knee. What is unusual about this is that I am on the other end of the surgery, the person who waits. My own medical history contains many surgical procedures, almost all related to arthritis, where I was the patient and she was relegated to waiting for the results. This particular moment, therefore, is quite different for me and I can only imagine how it is for her.

Waiting, in this sense, is the core of the ethical in the sense that I am now making myself available as I await the call of the other, in this case, the call of my wife as she awakens from her drug induced slumber. Here I am, in proximate space, having made myself available, assuming the response-ability to be of service in her time of need.

As I wait for the call I am reduced to an observer, a singular point from which I wait. This reduction, however, does not make me into the same, into that which becomes normative. Waiting in proximate space is a unique, albeit, selfish space in which I have clear choices. On the one hand, I could dwell on what is taking so long, why isn’t this thing done, or, on the other hand, I can sit in this very moment letting the flow of time wash over me like a flowing river. I choose the latter. I choose to write rather than dwell on the negative aspects of time. Negativity helps no one, to the contrary, it freezes one in a cube of stress.

The very act of writing propels me to interiority, a space that is private yet made public by the very fact that I post this writing for the public to read. The interiority of writing is where I begin to see what I think, to build on an idea and to test its limits. It is the place where knowledge is constructed. It is the place of proximity, a productive waiting for the call of the other to pierce the fabric of the ethical, to tear apart the difference between the self and the other while preparing to bind the self to the other in service to the cry of the other. Writing prepares one for the existential experience of an ethical life.

So here I sit, waiting for the call, waiting for the surgeon to tell me what a grand job he did, waiting for the nurse to allow me to ease into the twilight of Susan’s recovery.

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?


Yes, A Week for Medical Concerns: Dealing with the Aftermath of Cancer and More

Yes, A Week for Medical Concerns: Dealing with the Aftermath of Cancer and More

Yes, A Week for Medical Concerns: Dealing with the Aftermath of Cancer and More

In the next ten days, starting today when I visit my internist and oncologist back to back, I begin a ten-day period of rather intense medical review. While I expect to find things right on schedule, one never knows. My internist drew blood last week in preparation for this morning’s visit. Leaving his office, right around the corner from Starbucks, I went to read and enjoy a cup of coffee. While sitting in Starbucks, I began to notice some significant back pain along with gripping groin pain. It took a few moments, but it soon became clear that I was passing a kidney stone. As if I didn’t have enough urological problems, I then noticed that I was running a fever of around 101 degrees. Yikes, now I am getting sick as well. Just what I needed. Since the symptoms weren’t getting any better, last Friday I went to my internist complaining of cloudy urine and this on again off again fever. He prescribed an antibiotic, one I had never taken before and said I should keep the Monday appointment as a follow-up as well as one in which we would address any number of issues. By Saturday, I couldn’t stay away from the bathroom and I had developed a bright red, blotchy rash all over my body. I stopped taking the antibiotic on Sunday. It is now Monday morning and I still have bowel trouble but at least it is not constant and urgent.

Soon after I post this I will be on my way to Starbucks once again in preparation for my trip to the internist’s office. As soon as I finish with him I must go to the oncologist for an infusion of iron as my system simply refuses to ingest iron from any source whatsoever. This means a bag of the dirtiest looking rust water (I know it is not but that is exactly what it looks like) will be introduced into my veins and allowed to course through my system adding iron to my blood stream.

Finally, I get to see the urologist who replaces the urologist who treated me for the past fifteen years. He took a new position and so I am left to see if I like his understudy or not. I am actually feeling a bit uncomfortable about this change but my old urologist swears that this new doc is even more affable than he is and that he would send his own brother to him which, I suppose, is a strong recommendation. Time will tell whether I like this new guy and whether he will become my urologist of choice or will I have to shop for someone else? Tick tock tick tock!

Other than that, not much is new on my medical front. The kidney stone pain has subsided which may only mean that the stone is not moving about or it could be that the stone has passed. My fever is gone but there again, on only two days of antibiotic it may return. I think I’ll suggest to my internest that he stick with antibiotics that we know I have absolutely no allergic response to and take it from there. I nervously await the PSA results of my blood test, he also tested for testosterone levels but I don’t know why. I think I’ll ask. May post later with some news about the test results. If not, I’ll surely post tomorrow.

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.

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 (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!

With Apologies to Martin Luther King, Jr. — Free at Last!

Free At Last

Free At Last (photo credit: Roger Passman)

The first words I heard on the news this morning as I was getting ready to take a shower was that the area was seeing a bit of light rain and that it would last at least through rush hour and maybe beyond. “Oh no,” I thought, “this will make our drive into the city miserable!” There I go, projecting again. When will I ever learn? What really might make the drive miserable is traffic for whatever reason that traffic builds, be it time, weather or early holiday shoppers and I never even thought about other reasons.

This morning I had an appointment to remove the catheter that has been my constant companion since surgery last Wednesday. While mostly going unnoticed, there were times when the catheter was a royal pain, mostly when it came to doing the necessary upkeep to make the whole thing run smoothly. Then I had a day bag and a night bag, each one requiring a different skill set to manage. But this would all end this morning when the catheter would be ripped from my insides to bother me no longer.

Driving into the city was nothing like I imagined. There was no rain, only a bit of holiday traffic but it was still early. We left the house at 5:50 AM to make an 8:45 AM appointment. While I didn’t think it would take that long to drive into the city, I knew if we left much later our 1 hour drive could easily turn into 2 hours and then who knows. My mother taught me that if you aren’t at least ten minutes early for an appointment, you are definitely late. We arrived, dry, at 7:10 AM and sat down to a healthy hospital food breakfast. Yummy?

Being conscious of the time, we arrived at the urology clinic at 8:30 AM for my 8:45 AM appointment. Good, I was on time. Once checked in, I received a pager and a set of instructions for where to go when the pager went off. I expected rapid treatment because I booked the first appointment of the morning. So I sat patiently, waiting, waiting, waiting…until 9:30 AM when I went to the receptionist’s desk to ask if the pager was working or not. After many questions, the nice young lady behind the counter paged the nurse practitioner with whom I had the appointment. In a few moments a nurse appeared and led me to the procedure room. She was quite apologetic, perhaps because she was not the nurse practitioner with whom I scheduled the appointment, but she was efficient and pleasant; before long I was sans catheter. Oh happy days…

I came to the procedure armed with two pair of Depends for men. I expect to leak a bit as my body becomes used to working without help. There are exercises I am supposed to do and because they are so easily accomplished I do them frequently. I expect to not need these male diapers for too long but I am prepared for several days worth of leaking. I can always buy more if I miscalculated.

The whole point of this post is that progress is being made. Not only am I cancer free as of this very moment, I am also catheter free. We’ll see about erections and incontinence as time goes by.

One of Those Days

Happy Place

Happy Place (photo credit: Roger Passman)

Yesterday was one of those days that make life interesting. As I recover from surgery, I must be aware of some warning signs, things like a fever of 101 f or above, unusual pain or swelling at the incision sites and so on. Well yesterday, I was keeping my eye on my temperature. I was lethargic, running a temp hovering around 100 for much of the day. I didn’t want to get up from my chair to walk around as I should. I dozed off much of the day. At one point, I remarked to my wife that this is the worst day I can recall since my recovery from knee replacement (a mere 5 months ago).

Like all things, however, I realized that this was a temporary condition, that it will pass given enough time. So it did. I awoke this morning with a clear head and a normal temperature. My incision sites still provide a minor irritant, mostly itching as they heal, and a bit of pain when I change positions, nothing I wouldn’t consider part of the normal healing process.

I still have a sore throat, the result of intubation. Apparently the anesthesiologist had a difficult time getting the breathing tubes down my throat which resulted in sore vocal cords. Even that is getting better.

Because of the fever, however, each of these seemed to multiply yesterday into a day I wanted to feel sorry for myself. As I kept repeating the mantra, “This too shall pass,” I was able to let go of the aches and pains as I moved through the day. I am happy to report that I am back feeling as well as I could expect to feel on the sixth day post surgery and for that I am grateful.

Let It Ride

Hope (credit: Roger Passman)

Hope (credit: Roger Passman)

Here it is Sunday morning and I continue to be euphoric about the results of surgery. When my urologist spoke the words, “You have prostate cancer,” I was in a state of shock. These are words no one wants to hear especially with my family history of cancer. My mother died from ovarian cancer and my father died from the lasting effects of radiation when he was fighting off lung cancer. I suspect that somewhere in my psyche I expected to hear those dreadful words.

So why am I so euphoric. Well, as many of you already know, my urologist caught up with me in the recovery room speaking these words, “Surgery went quite well. I believe we got it all but we won’t know for certain until we get back the biopsy of the lymph nodes. Right now, I see no reason not to be optimistic.” Okay, so nothing is for certain here, but clearly there is something to be quite thankful for and I am quite thankful that the time for me to transition from life to the infinite is not likely to occur anytime soon. Of course, waiting is part of the game. I expect that I will get the call on Wednesday with the final results of the surgery and biopsy so I won’t celebrate until then but I am already picking out places where I want to kick my heals back and just let this feeling ride.

Now, in this very moment, I am being quite selfish. I recognize that so I will allow myself to cross that line and focus inwardly for a while. But I have to remember a line from a Guy Clark tune that speaks to this very situation. It goes like this:

Nothing lasts forever say the old men in the shipyards
Turning trees into shrimp-boats, hell I guess they ought to know!

Right now I am celebrating my life. But soon I will become tired of that because, at the core, selfish behavior has no moral or ethical compass; it will become a bore. It is then when I must return and announce, “Here I Am!” thereby creating the space of proximity for the other and simply wait for some kind of response. Because the announcement is spoken without reservation, a response may never come. Even when it does come, it may be difficult to understand because it fails to incorporate the fundamental ethical obligation. But on some occasions a received response will touch a nerve, sparking a conversation that may change the interlocutors’ view of the world. It is those moments that the ethical compass is working at its very best.

Too often, in this existential world, actors fail to assume responsibility for their actions toward the self and toward others. We see it in the income gap between CEOs and their factory floor workers. There is only so much money one needs to say, “I’m rich.” Any more and you are just a pig (although I shouldn’t be so unkind to these most interesting animals). Up until this very moment, I have not really had a cause to fight for, to volunteer for or to donate money to. That has all changed. The Prostate Cancer Foundation is my new project. Perhaps I can get some of those rich folks to part with a lot of their money in order to help find both a prevention and a cure for this dreaded disease.

Going Home…I Think?


Hospitals are absolutely no place to get a good night’s sleep. Even with the door to my room closed, the noise in the hallway at 4:00 AM was deafening. It seems that the patient in the room next to mine had a crisis to which the entire hospital seemed to respond. I was awakened by the shrill scream of one of the nurses, “Help me, I need help. I can’t do this alone.” She repeated this cry with some minor variations for about three minutes. It was enough to wake the dead.

I am scheduled to go home this morning. I am now waiting for the urology docs to arrive to release me. Up until today, my urine was clear but this morning it was a bloody red color. This morning, however, the catheter bag is filled with a bright red colored urine. I don’t quite know what this means, other than the simple fact that I am bleeding and the blood is finding its way into my bladder. I hope this doesn’t mean that I cannot go home until they figure out what is going on. On the bright side, the pains caused by the infusion of CO2 is much better. After the vampire came to draw some blood, I took a walk around the hallway and had absolutely no pain. These are the facts, the raw data. Now it is up to the chief resident and my urologist to determine if the bleeding is significant or not. I will project no further.

Here I Am, waiting in proximate space for the urology team to arrive. I decided to do something productive with this waiting period so I write my first coherent blog post in two days. I think that I want to comment on the bureaucracy that is in the hospital and how crazy some of the rules are. I start with the dispensing of medications. Yesterday, the day nurse came into my room at 7:00 AM with one pill I take on a daily basis. The problem is that I have a regimen of seven pills I take every morning and four that I take in the evening. I asked her why she didn’t have my full morning regimen. She told me that she would be back at 8:00 and again at 9:00 to complete the entire cycle. I asked her why this is scheduled so as to provide extra work for her and anxiety (not really but I thought it was important to mention it) for me. She just shrugged her shoulders and smiled. I would like to meet the genius who decided on this practice.

I could provide more examples but I’d rather concentrate on the effect of the modern bureaucratic design and just how that bureaucracy effects the patient/staff relationships. Bureaucratic organization reduces each task in the hospital to a specialty to be performed only by people with the proper credentials. It is the job and not the person performing the job that is important. As an example, I have now had blood drawn early in the morning by three different phlebotomists and one nurse. Is there any chance that, as a patient, I can develop any kind of relationship with the person drawing my blood? Down the line, after the blood is drawn, it is sent to a lab where a lab tech runs the blood through a machine which, in turn, spits out a set of numbers. These numbers are then sent to the medical team who, I believe, are not acquainted with either the phlebotomist drawing the blood or the lab techs running the tests on that blood.

This one example goes to the core of the bureaucratic organization that is designed to create a distance between patient and hospital staff. This scientific detachment is, I believe, creates a space in which errors are bound to occur. Doctors write general orders even when patients have specific medical issues that my be contrary to these orders. Nurses, while working with these standard orders on a daily basis, cannot be fully aware of the special needs of individual patients because they are trained to be scientifically objective rather than be an empathetic care provider. The very organization of the hospital is designed to reduce the individual patient into the same so that the interchangeable providers of care don’t have to think a lot about individuals. Hospitals, in this sense, are clearly bastions of modernity designed for efficiency and economy.

This is, of course, the very reason I anticipate going home, where my recovery from surgery will be provided on a human level.

FLASH: The urology team just left my room. I am going home. I expect to leave the hospital around 9:30 AM and be home around 11:00. YEA!

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