The Wages of Anticipation.
TIME FOR ANOTHER UPDATE. Yes, it's been awhile. I've spent the past fifteen minutes writing and re-writing a joke about cancer and the time-dilation component of Einstein's General-Relativity. It seems like only yesterday when I last wrote an update... Thanks, I'll be here all week and don't forget to tip your waiter.
In all seriousness, I've been realizing throughout My Cancer Journey (TM) is how time moves differently for me than for others whose life hums with day-to-day routines, contracts, and collisions. I imagine that, were I the sort of person who relied on externalities for my mental ambroisia, the sense of lost time wouldn't be nearly as pronounced. It is all too easy for days, even a week to elapse in the blink of an eye. This sense of time-dilation is exacerbated by my own habits; placing myself between the "scylla" of numerous interests, and the "Charybdis" of my rich inner life of the mind, which often seems more real to me than the world beyond my doorstep.
Much has been made, in the advertising world, of characterizing Cancer as a journey. Coming from that world myself and knowing the field's inherent penchant for grandiosity, I'm instinctively suspicious of such obvious branding. While my own private jury is still out regarding any such claims that cancer is "a journey," it does seem apt when taken in hand with the underlying theme of uncertainty as your traveling companion. What may be even more to the point is that cancer is personal, unique to everyone who has a close encounter with it. For me, Cancer is a master class in cautious optimism. For another, it's something completely different.
Horrified. Deflated. Concerned -- I was previously discussing some distressing possibilities involving planned major surgery. It was anticipated that significant parts of me were likely to be removed by the tender mercies of a cautious surgeon, but to make a determination further data was needed. Either the words of Sherlock Holmes, "Data! Data! Data! I cannot make bricks without clay!" or Kruschev: "Trust, but verify," would serve to sum up the imperative. Endoscopies, biopsies, and MRIs were quickly scheduled. All are now behind me, for the time being. As of this writing, I have the latest endoscopy and biopsy results in hand:
(1) "An area of induration at the (primary site) [edited for privacy]." Read: Scar tissue left over from nuking the tumor from orbit like Hadley's Hope in Aliens.
(2) “An Edema at the Ileocecal valve consistent with prior injury, Crohn's Disease.”
Otherwise, the Endoscopy came up normal. Not only encouraging news, but also it confirms my pre-diagnosis opinion that the symptoms I had been experiencing throughout the Spring and Summer of 2018 and thought to be Crohn's Disease was reasonable since I not only carry the gene, but the Ileocecal injury suggests the gene's expression. I'm to report back in one year for surveillance via another endoscopy. The question now: Will the surgeon want to go in for the ancillary purpose of repairing the Ileocecal valve in lieu of removing anything else? With cancer cells still in my system, will removing seemingly normal tissues--comprised of the same type of cells that became tumor-infested to begin with-- be a drastic ounce of prevention for a pound of cure?
Still up in the air are the MRI results. I reported to my oncologist’s office just this past Friday for my port flush--my first since completing my last 18 week round of Chemo--and she reported the MRI results had yet to be shared with her, but if there was any bad news she would have received a call by now. All the findings are due to be presented at next week's tumor board and I should have a better idea of how they want to proceed when I next meet with my surgeon on September 6th. Fingers crossed, I hope the MRI results show no cause for the radial Prostatectomy discussed the last time I met with the surgical team, but hope is not a strategy. Again, the balance between saving a life and preserving the quality of that life remains unsettled. This may yet be the hill on which I plant my flag, and defend to the death; my own personal Little Round Top. Next month I'll start my 37th trip around The Sun. News of an impending prostatectomy would make for a lousy birthday present.
"Symptoms and the sense of reality are built out of the reified metaphors of the body.”
So writes Daniel Benveniste. Resolutely, fastidiously, I spend each day receptive to a touch of apophenia, where one sees patterns in random data. I live free from expectation. The greatest obstacle to living is expectancy. Anticlimactic, no? With little else to report from the Medical front, there's still some to be shared from the experiential side of things.
After my port flush on Friday, I ventured into my old neck of the woods. There it was: The holy-mess of overgrown gardens, the detritus of homeless urban camping, the slapdash street vendors and art projects. Apart from my various procedures and scans, I hadn't ventured into Portland much since leaving back in April. I could taste a certain disquiet, the way you taste sourness in the back of your throat over a case of stage fright. What unsettled me wasn't so much the echoes of history--my favourite movie theatre, the old watering hole, distantly familiar streets down which I shared endless dog walks, neon signs aglow on many a rainy evening, the Powells storefront or the milling about of so many people, every one of them trying to have it all. It was something else. My reaction to the ataxia of the streets a grim reminder of death. What is death but the dissolution of cellular structures, the entropy of complex proteins, the deconstruction of order into simple raw forms. A return to a state of primordial chaos. Forgetting how I had adjusted to the mobocracy of front gardens invading sidewalks, my genetic need for order and tidiness actually, horrifyingly gelling with... Suburbia.
The biological processes return like the first buds of spring after a long winter. The salt and pepper of my beard coming in. The back of my hands moulted like scorched earth; Buzz Aldrin's Magnificent desolation made flesh. Chemo attacks new cell growth, prevents wounds from healing. Nearly two months after my last chemo cycle, I am finally beginning to grow new skin in parallel to other more internal renewals. Still other processes will continue to take time, my motor skills for instance still leave a lot to be desired. I have become adept at tripping both up and down flights of stairs, and am the scourge of potted plants everywhere, having face-planted into a few. It's called CIPN, Chemotherapy Induced Peripheral Neuropathy. Numbness in the extremities like the tingling you get when your foot falls asleep, decreased balance, and short tentative steps alien to the long gait I used to have. I'm told it's fairly routine with chemo, and to wait another two months before my nervous system regulates. More than once I find myself at the bottom of a spill, laughing at the absurdity of it all. I see each and every fall as an exhortation to keep moving. 7,500-9,000 steps a day for dog walks along the nearby trails at least.
Lastly, after eight months I'm pleased to report that I am medically cleared to drive again and have been doing so, with gusto, for about two weeks. Being behind the wheel of my car, buying groceries, driving my dogs to the dog park, driving to my own medical appointments A man on the road, a sense of masculine completion regained, having a return of such a integral part of my independence does wonders for my outlook. Thanks to you guys, I’ve been able to keep it insured, filled, and running. I may have to refrain from driving for a while if they go ahead with the surgeries, but that will be temporary. For now I get to feel some normalcy again. It also means I’ll be able to see many of you face-to-face.
Always present is the issue of survivorship, what happens after treatment. I’ve been working diligently to suss out my options and a plan is taking shape. For perhaps the first time in months I have a clear sense of purpose and a vision of what I’d like things to look like while I move through the next two years to what will hopefully be a cancer-free life. I’ll share this once I have a clearer picture of what the next phase of my treatment will entail, but here’s a hint. Thinking more in a literary sense than a cinematographic one, I haven't touched a camera in six months. There is more one can evoke with words on a page than with any lens—we'll see if I can prove that to myself. Being a fan of the Proustian odyssey through the banal, I'm writing letters to five of my favourite authors, kicking things off with Karl Ove Knausgaard and Henry Rollins. To Knausgaard I describe having cancer via something that came to me one chemo-Friday. Something one of my old professors refers to as "Mind-screens" when the film cuts beyond the linear temporality of the narrative, to the internal reflections of a character: I'm standing on the street, under a full moon, watching my house burn down. The fire brigade turns up and one of the firemen sidles up next to me. He pushes a wheezy wolf-whistle through Gary Busey lighthouse teeth, and watching the blaze, hands me a bag of marshmallows. Sometimes all you can do is embrace the absurd.
That's all for now.