Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the tag “Prostate”

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. 

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It is Raining Outside Chicago In January

It is Raining Outside Chicago In January

It is Raining Outside Chicago In January

It is raining, well not quite rain, rather a mixture of rain and sleet, freezing rain I suppose. This means that the electrical grid will be stressed to its limits this evening as temperatures drop into the mid-twenties. Tomorrow, however, the forecast calls for temperatures in the mid to high forties and it is still January. Something is awfully wrong with the weather. Of course, I live in the United States, the land of denial (that’s right the Untied States not Egypt). Global climate change is only a mythological story told by liberals in order that they might spend more money and grow the size of our government or so goes the tale told by the denial group. But temperatures in the high forties and low fifties in January in Northern Illinois are simply not normal. Perhaps it is time to wake up and smell the roses (that may bloom in February if this keeps up) before the world my grandchildren inherit from us is destroyed.

That being said, after all it is good to rant once in a while, I spent an interesting weekend at the Chabad of Elgin, where the Rabbi and his wife hosted a Friday night dinner. The evening included both a Shabbat service, a dinner and Shabbat games played by a raucous group of folks attending this event. The food served featured the seven native fruits of Israel including: dates, figs, pomegranates, sesame seeds, olives, apples and oranges (if memory serves me correctly). The food was simply outstanding, rich in tradition with a modern presentation that left everyone there satisfied. The hit of the evening for me was a potato kuggel, a baked potato pudding, that swept me back nearly 60 years to my grandmother’s table and her outstanding potato kuggel. I even asked for the recipe it was that good.

Part of the evening was spent talking to one of the regular attendes at our weekly torah study group. We see each other on a week to week basis but never really get a chance to talk much. Spending time building this relationship was both interesting and enjoyable. It turns out that he is a “Jew by Choice” having converted to the religion I was born to. Because we come to the table with such different perspectives our conversation explored nuanced belief; how, for example, I could be so interested in religious texts while I simply do not believe in a God (or gods for that matter) and while no conclusion was reached, I found myself thinking more clearly than ever about the differences between belief and non-belief, between faith and rationality. I suppose that is a good thing but I cannot yet draw any conclusions about the conversation we engaged in.

At one point in the evening Rabbi Mendel told us an interesting tidbit of information. We were celebrating the holiday of Tu Bish’Vat, the festival of trees, a holiday in which Jews traditionally eat fruit. The holiday that celebrates the harvest and, by implication, fruit, Sukkot, doesn’t have a tradition of eating fruit at all. Curious. But, needless to say, he found a lesson in all that. Eating of fruit on Tu Bish’Vat symbolizes the potential in the fruit tree, the very reason for the existence of the trees in the first place. Celebrating by eating fruit on this holiday reminds us of all of the work to nurture the trees, to pull the weeds, water the orchard and so on. It reminds us of the purpose of nature harnessed. The harvest, on the other hand, the picking of the fruit, represents a period of dormancy that doesn’t require a special food to remind us that the seasons turn in order. Now these are stories I can understand. They are simple, almost folksy, reminders of an ethical life lived encapsulated by infinity. The stories lend purpose to an otherwise absurd life, a life in which purpose often eludes us.

One last thing, I am actually feeling quite giddy today. I spent the last two nights sleeping through the night, the first time since my prostatectomy. Not only that, but in the morning the only thing in my Depends for Men was the baby powder I put in before I went to bed. I take this as a sign that things are actually improving. I am pleased to report this progress as it gives me something to look forward to. Yea!!!

Simple Reflections Before the New Year

Simple Reflections Before the New Year

Simple Reflections Before the New Year

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

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

I want to expand one by one.

The Birth of My Grandson Eddie

Eddie

Eddie (Photo Credit: Roger Passman)

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

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

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

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

Re-Connecting with Ben

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

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

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

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

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

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

Knee Replacement

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

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

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

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

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

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

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

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

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

Prostate Cancer

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

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

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

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

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

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

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

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

Bittersweet News For Sure

Bittersweet

Bittersweet

Finally, I spoke to my urologist yesterday. Here’s the scoop. At the time of surgery the cancer had invaded 35% of my prostate and a small percentage had nearly reached the margins of the gland. The Gleason Score for the tumor was an overall 4+4 (or in simpler terms an 8) meaning that this was an aggressive tumor. The biopsy of the lymph nodes was clear of any indications of disease. It seems that surgery was the right choice…hooray! Sadly, however, my urologist, a man who has cared for my prostate and other urological problems for years, is leaving his current position to accept a huge promotion around 200 miles from Chicago. Good news for him and I’m sure I’ll get over the shock of a new urologist.

So once again, life throws a curveball. One reason I never advanced as a baseball player is the simple fact that I couldn’t hit a curveball no matter how hard I tried. Catching up to a fastball, no problem but that damned curveball would never hold still long enough or be in the expected place when I took a swing at the pitch. Once I gave up playing kids games, however, I learned that life’s curveballs, difficult as they might be, are always subject to a period of adjustment. It is almost like Kübler-Ross’s stages of grief with acceptance being the ultimate goal. I found that coming to acceptance is a matter of deciding what the worst possible outcome is, accept that outcome and work hard to see that that outcome is avoided if at all humanly possible. Acceptance is, in this sense, an active step; one that requires a positive approach to any difficult situation.

Look, I know that grieving over the loss of one’s urologist is maybe a bit crazy, but the end of any relationship is always difficult, especially one that is long-standing. It is, however, just one more example of how I can use the ethical tools I am developing to remain on an even keel during times of hardship, great or small. In this case, I turn outward and, rather than feeling sorry for my loss, I feel a sense of joy for this extraordinary physician and care-giver. I wish him well and I am absolutely certain that he will hook me up with one of his partners who will afford me the best of care, albeit, most likely without the smiling bedside manner that separates him from the crowd.

From the Hospital

Calm Waters Photo credit: Roger Passman

Calm Waters

Surgery was performed yesterday, early in the morning. By the time I was introduced to my room, it was right around 6:00 PM. It seems I couldn’t be released from recovery until they had a room cleaned for me to occupy. This added about a 3 hour extension in recovery, a wait I didn’t mind for two reasons. First, I don’t recall to much of my stay in recovery because I slept most of the time. More importantly, my urologist found me in a moment of lucidity in recovery and told me that surgery went well and that it appears that he got everything. That news caused my blood pressure to drop into a normal range. It is amazing how stress effects one’s life.

While the news is quite good, I am not yet out of the woods. For the next two years I will be asked to submit to CAT scans four times a year, the next two years I will be asked to submit to CAT scans twice a year and thereafter one per year. Somewhere in the back of my mind, prostate cancer will always be with me.

I will be spending a second night in the hospital mainly because I am experiencing extraordinary pains deep in my shoulders from the carbon dioxide gas they push into the abdomen to allow the robot to see what is going on. It only effects me when I am walking in the corridor and it takes quite some time to go away. But even this pain cannot take away from the news that I am currently cancer free.

I need some time to process all this, deal with the post-operative side-effects and add the outcome to my gratitude list. I couldn’t have asked for a better result.

On Suffering

All that is past and that is future draws near to the present. Time shrinks, the line between the eternities disappears, only the moment lives and the moment is eternity.
Martin Buber,  Hasidim and Modern Man

Mask by Carl Milles (Photo credit: Wikipedia)

Suffering Mask by Carl Milles (Photo credit: Wikipedia)

Existentialists find life itself absurd, that suffering, that feeling of dread and woe, is the hook upon which absurdity hangs. Through suffering one comes to the very profound conclusion that even in an absurd life one must still live a life of responsibility; to behave in an ethical and moral manner toward one’s fellow man. Briefly, assuming responsibility for one’s actions toward the other.

I would like to take a different approach to the very notion of suffering, one that centers around choice and action. Let me start with the very idea that suffering is nothing more that an overload of external (or internal) datum experienced as a turning inward to the exclusion of the rest of the world. An escape from the real into the depths of despair  In this sense, when faced with such an overload of phenomenological sensations one is, in reality, faced with a choice; turn inward, thereby derailing one’s ethical compass or embracing the sensations yet projecting those sensations outwardly as an empathy for the suffering of the other. Self pity or empathy are the choices when facing potential suffering in one’s life. Nothing lies in between.

Suffering is born of projection into the future emboldened by fear that is coupled with a profound regret of the past. When one complains of pain, real or imagined, or hurt, or loss, or any other thing one is truly embracing the experience of self-pity and seeking attention from others. “Oh woe is me,” is really a cry for sympathy, a cry for understanding of those fears and for the guilt of the past, whether deserved or not.

So, with this in mind, I could ask about my cancer, “Why me?” But I am savvy enough to understand that whenever one asks a “why” question the only reasonable response is. “Because!” As I understand the universe we live in , the only place we have direct knowledge of, pretty much everything is based on probabilities. Once born, for example, the only outcome of life is not life or death. When not life occurs, however, is a matter of probabilities (if this were not the case all life insurance companies would necessarily go broke because of the inability to create reasonable actuarial tables). I like, then, to think of the universe as a random number generator complying with the mathematical laws of probability. The simple fact is, that I got cancer because the probability meter pointed toward me. It is as simple as that. I cannot dwell in the past trying to think about why or what I could or should have done differently to prevent this disease. If I did, I would be suffering needlessly; needless suffering is self-defeating because it only turns one more deeply inward leaving little room for escape. I also cannot project into the future a myriad of possibilities that hinge on fear and lack of knowledge for that is also self-defeating. I must, therefore, choose to live in this very moment.

Learning to live in this very moment is a difficult journey. For me two things are required. First, I make time for sitting quietly every day to clear my mind of wandering thoughts and just sit comfortably listening to the silence of the universe. Sometimes I chant a repetitive OM sound over and over until my brain hears nothing but my own breathing, while other times, just sitting quietly will do. Secondly, learning to let go of those things I cannot control, to not think about those things where I have no dog in the fight, where I have no interest whatsoever in reasons for or outcomes of, to accept the absolute worst outcome of those things that absolutely effect me, of things for which I have some level of control and then work for a better outcome; one might call that acceptance; I prefer to think of it as living in this very moment.

I cannot control the absolute fact that I have prostate cancer nor can I control whether or not it is metastatic at this very moment. I can, however, control what I will do about it when presented with choices for treatment. As readers know, I have opted for surgical removal of the prostate two days from now. Surgery and, then, pathologists will then determine what the next options will be. I have no reason to project beyond the surgical procedure and all I can do about that is anticipate the operation itself. The closer I stay to living in this very moment, the less I think about the procedure.

At the same time, I have accepted the worst possible outcome of the consequences of this disease; death. By acceptance I mean to eschew denial, recognizing that this is only a possibility among an finite number of possibilities but I refuse to deny that it is a very real possibility. In terms of probability I currently have a 15% possibility of dying in the next ten years from this disease (a bit more than a 5 to 1 chance of death). Should the biopsy of my lymph nodes prove positive the probability will increase to around 2 to 1, a near coin flip.

Yet, what do I have to complain about? Absolutely nothing! I am grateful for all those little things that make life worth living to its fullest up to and including this disease. Why, in other words, should I spend my time in unproductive suffering? I think the answer to those questions is that I should not. Rather than suffer, I choose to continue to live, to live for rather than to live with this disease, to live for rather than live with others. In short, I choose to be present in the world at the very moment of eternity contained within the immeasurably brief time represented by this very moment rather than to sink into the unproductive world of suffering. It just isn’t worth it!

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.

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