Graduation Day: Dying From Cancer To Clean Scans In One Easy Step

I had my checkup at UPMC Hillman Cancer Center recently.  In the days leading up to the appointment, I was, as always, irrationally paranoid about every bump and bruise and utterly convinced that I had only days left to live.  "What the hell is that??" I'd say in the shower, only to find that the offending lump was in fact some completely normal anatomical part that was supposed to be where it was and had been for the prior 28 years of my life.  One day I found something really large that turned out to be my bicep.  Is it supposed to feel like that??  Jesus.

I'm pretty convinced that I also manufactured a crisis by feeling up the nodes in my thigh so much that I bruised the area around my junk, causing me to worry about the "strange sensation" so much that I began to formulate my last goodbyes and figure out who I should give my surplus of Magic cards to (they aren't even legal to play anymore, but what did you expect from a young adult cancer survivor -- a current deck of Magic cards?  What, am I made of money?).  At the appointment, the PA noticed similar bruising in the nodes between my armpit and chest, which had previously been described to me as "bumpy."  It was at this point I wondered if I could actually give myself cancer from checking so hard for signs of cancer.  Or at the very least, a severe case of internal bleeding.  Then I thought of the scenes from every medical drama in history where the doctor comes out and says very sadly, "I'm sorry, we can't stop the bleeding."  And I think to myself, Wait, what?  Don't you have like science and bags of other people's blood and stuff like that?  I mean, wrap it in a t-shirt for God's sake.  And I think of how much I would really disapprove of being the subject of one of those scenes because I pressed too hard while checking my nodes.

"I've taken out half of your bones and hung them on this pole here, and from these scans it looks like all of your blood has come with it.  I've done everything I can."

I did my X-Ray, blood work, and obligatory waiting room meditation before they called me back and stripped me down.  I met a new PA student who checked me over and wanted to talk about what I was doing in life, and all the bizarrely existential things people say to one another with eerie lightness during an initial meeting, and all I could think about was how bumpy my nodes were.  I stumbled through the conversation until the regular PA came in, who I'm very comfortable with and who has made this whole close to death thing a little less crappy.  As it turns out, all my worrying was for nothing (isn't it always?  Worrying is, by its very nature, useless).  The X-Ray was clear, which meant my core was not filled with death, and the blood work confirmed that, yes, my blood was mostly made of blood, and not terrifying cancer Legos waiting to combine into a macabre pirate ship and sail right into my brain (though the castle Legos were my favorite [and I always made my mother buy them for Christmas and then put them together for me.  It was obvious at an early age that I wasn't going to be an engineer.).].

I also have one of those Immunotherapy Krakens in my blood, so I guess I shouldn't be too worried about it.

We talked for a while, because, even though we meet routinely at an appointed time to make certain I'm not actively dying, I like to think that she and I are friends.  Then, suddenly, she informed me that I had graduated to six months.  I was surprised, because I didn't think I'd be at six months for several years.  "Nope," she said.  "One year after diagnosis you go to four, and two years after you graduate to six."  I went into this appointment convinced that I'd have to replay the scenario after my diagnosis where I went around telling everyone I was going to die, and that I loved them.  And I came out of it not only with a clean bill of health, but with the added bonus of being considered healthy enough to last an extra two months on my own at a time.

As a young adult cancer survivor, I will never stop worrying about dying before I've lived long enough to leave my mark, to positively affect the world, and do whatever other things my mother would no doubt disapprove of.  Every time I make the trip to the doctor, all of the emotions surrounding my initial diagnosis come flooding back.  But in a strange, dissociated kind of way because the memories have faded, and all I really feel now is that I'm submerged underwater in a claustrophobic sea of negativity.  The sensation causes me to find things that aren't there, and to worry myself into a bad place.  I blame this partially on the come down from surviving cancer, the getting back to "normal."  I have a wealth of experience with life and death and priorities and trivialities, intense emotions spawning from serious existential crisis, and the lessons that facing a terminal illness can teach you.  But all of this fades when the tests start to come back clean, and distance begins to seep in between you and what almost prematurely ended you.  In the future, I'd like to be more conscious of the divide, and learn how to better reconcile the urgency I used to feel with the humdrum of daily life.  It's a lofty goal, though I'm sure it's possible.  I'm not the only cancer survivor, stumbling through life trying to make sense of it all.  I'm sure I'll get there.  After all, I have at least six months to do it.

Photo credits: Top -- A doctor looks at an x-ray, by Ron Mahon

I Can't Get Enough of this Water Stuff

On a night much like this, when I've once again succumbed to the numbing and emotionally murderous wrath of alcohol poisoning, I take a deep, raspy breath and think to myself...

I can't get enough of this water stuff.

Water -- it was my constant companion for over a year.  In various forms, including sports drinks and uber-hydrating liquid goodness.  Water.  Water.  Water, water, water.

I'd like to talk about this nourishing liquid as a biological necessity, and also as a symbol of the ordeal in which I found myself.  And I'd like to do so in the form of a personal letter, addressed specifically to the clear, satiating beverage.

Ahem.  Here I go.

Dear Water,

You have been my constant companion for over a year.  And, if you want to get technical, I guess forever, too.  Because I hear the majority of me is made of you.  Moreover, I think that if someone were to squeeze me very hard, and diligently, a large amount of you would squirt out of me in various directions until I was the shape and consistency of a deflated inflatable tubeman.  Crazy.

Anyway, thank you.  Thank you for being the life-saving goodness you were evolutionarily designed to be to my corporeal body.  I think that's actually repetitive, but you get the picture.  Simply put, you are awesome.  I drank at least sixty-four ounces of you per day for an entire year.  It's odd to think about, because the average human person creature is supposed to hydrate with upwards of sixty-four ounces per day, but I don't think I have ever actually met that goal at any other point in my life.  And that's because it's ridiculously hard to do.  I had to force-feed (force-drink?) myself large amounts of you at a time until I thought I was going to explode, and my parents would have to mop up the bits of me that stuck to the walls and clung to those hard-to-reach corners of the house.  I remember the intense subconscious paranoia of those days, and that at one point how I thought I'd actually killed myself by means of water intoxication.  Did you know that if you drink too much of you, a person can actually die?  I didn't, but Google made sure that I knew about it.  Thanks Google, for feeding into my crazy when I needed it the least.

My year of Interferon treatments and drinking of you into my very soul was extremely rough.  I can't hide that, or not admit to it anymore.  I hated a lot of it.  I hated you, Water.  It amazes me how quickly my perception of you turned around, to be honest.  How quickly I was able to say, "Well, I had enough of you times ten, but I still kind of need you to live... Well okay, you aren't so bad... Oh lordy, you taste fine... Give me some of your goodness... That's it, get in my veins."

After the Interferon treatments ended, I was sent to the hospital with intense pain, only to find out I had a kidney stone.  Do you remember that?  It was probably caused by the interferon, due in part to dehydration (figure that out, you liquid nightmare).  And then, just when I thought you were out of my life forever (or at least until I was thirsty again), there you were -- and in large, ungodly portions once more.  I stocked up on you like I was anticipating the end times.  All available counter space was filled with bottles of you.  Bottles and bottles and bottles and bottles.  I could have kept several families alive for centuries with the amount of you I had to drink.  "This will flush out your kidney stone," they said.  "Just drink a lot of water," they said. "Hey," they said, "Are you drinking a lot of water?"  I laughed.  "Fella," I told them, all morphined up and feeling pleasantly disassociated with my circumstances, "If you knew how much water I'd been drinking, you would dig canals in me and found a city called New Venice."  Needless to say, Water, my dear, you did not work very well in this particular instance.  Or the original instance, now that I think about it.  Otherwise, this second instance would not have been compounded upon the first.  Hmm... Yeah... Water... What it is a good for?

And yet, after all of our complicated history, here you are in my hand (and mouth, and [insert part of the throat that swallows because Wikipedia is unclear about this], and stomach, and bladder) again.  I can't quit you, it's just too hard.  In my more vulnerable moments, I must admit that... I need you.  There, I said it.  Shit.  Can we move on now?  Can we have a normal relationship at this point?  In truth, I need to know that you'll be there for me when I need you, but also that you won't smother me by means of water intoxication.  Maybe what I'm saying is... I love you... but I'm not "in love" with you.  Not anymore.  You were there for me when I needed it, but now I need someone else.  It's true -- and I'm sorry. What can I say?  I'm a complex man, with a lot of layers.  You really only penetrated down into one, or two, or whatever, I'm not a scientist.  There's a girl now, you know, and that's going well.  So I think maybe we should call it quits.  Let's just have what we have, if that makes sense, and go our separate ways.  It seems like your separate way involves the majority of surface area on the earth, so I doubt I'll be able to successfully avoid you for long.  But, ya know, I'm glad we've been able to calm things down a bit, and I'd like to continue that trend.

Thanks Water.

Yours always (and by that I mean only when I absolutely need you),

Kevin

Who Am I?

I came out of St. Marks Market today, with a bagel in one hand and coffee in the other.  I crossed to the south sidewalk and passed a group of punkish-looking fellows.  One of them wore a black hood with the eyes cut out, and was eyeing my approach eagerly.  I was fully aware that I was about to have an interesting story to tell.

Sure enough, the man began walking backwards, gesturing wildly.  "I am famous for chopping off people's heads in the 1800's," he yelled, excitedly.  "What is my name!?"  I felt like it was a riddle straight out of a video game.  If I got the right answer, I thought, maybe he'd give me a special sword because it's dangerous to go alone.  My first inkling was actually to stop in my tracks and respond to the inaccuracies of his riddle.  "Well, actually buddy, you're a few centuries off," I would start, proceeding to launch into a chronological analysis of the tradition of western capital punishment.  It took a lot of willpower, but I simply mumbled "executioner," and went on with my day.  

This could be a fun story about how I view life in the city, and the availability of bizarre and thought-provoking material at every turn.  In a way, I think it is.  For me though, I operate upon the connections I forge during daily life, and this called upon an idea I'd had for some time.  It made me think right away about death, of course.  And how everyone is basically very cool with the idea, in the abstract.  When it has a face, and is a symbol, and categorized.  Here's a man with a hood, inaccurately riddling people in the streets to get his jollies.  He represents an idea, and as long as it remains within certain social confines, most people will probably not think twice about it.  Maybe one or two people he solicits will be uncomfortable and leave with a bad taste in their mouths, but for the most part, I imagine a lot of folks will be thoroughly entertained by the man's shenanigans.  

What is it about death that makes it so easy to deal with as a clear symbol, something brutally and often inaccurately portrayed in mainstream culture?  And what is it about death that makes it so easy to symbolize, so easy to make into a caricature and focal point of such intense negativity?  Death is a man in a black hood. That's good -- this man is a symbol and an automatic enemy.  Death can be a disease.  Even better -- you can fight a disease, engage in a battle, and come out triumphant.  It's often easier to fight a disease as a concept than a man in a black hood as a concept.  Because an executioner is state-sanctioned, and he's still a person, and we can identify with aspects of his nature.  We absolutely cannot identify with a disease, a ruthless and unflinching organism or state of malfunction within our own bodies, that has no personification, and simply doesn't care, because it doesn't think or reason, and it has no sympathy, and is not state-sanctioned, or sanctioned by any force that human beings can readily comprehend.  As a symbol, it can be broken down into polarizing and unrealistic interpretations and handled more clearly.  

Because it's easier to make a symbolic fight out of something than to face the full extent of its terror.  Cancer is very much a symbolic battle these days, much to the chagrin of anyone diagnosed with the disease.  We are not fighting a symbolic enemy, but attempting to survive with a condition that doesn't have motives.  That's a paralyzingly scary thought.  Death is a scary concept to most of us, and I firmly believe in Irvin Yalom's existential psychology -- I believe the man is 100% accurate in his conclusion that the highest motivating factor in anyone's life is the conscious or unconscious anxiety spawning from the fact that someday life will end.  I don't know that it isn't okay to create symbols that serve as focal points for certain emotions and fears, but it does seem a bit juvenile after my own experience with the real facts of death and dying.  

It's possible that there's a way to bridge the gap.  I believe the bridge will be built firmly from education and genuine awareness.  Self-analysis is of huge importance in matters relating to such extreme finality.  It's very difficult to be comfortable with thoughts that you believe by extension will threaten your very existence.  But if these thoughts allow you to improve your circumstances and that of others going forward, then it might be time to deal with your fears, because not doing so would be selfish.  It's okay to be afraid.  It's not okay to create limitations revolving around your fears that prevent you from dealing with reality, and force others to go along with that.  Soon there will have to be a real conversation about the ethics of death and dying.  I feel fortunate that I was raised by a family that was abnormally comfortable with the subject, due to the fact that my mother is a hospice social worker.  I've been addressing the idea in one way or another my whole life, mostly in an analytic and observational way, and then suddenly in a very practical way.  I feel that it's important to assemble the collective powers on this one, and find the sense of duty possessed by those of us who have faced the issue in a practical way.  We hold certain keys that can succeed in opening doors that are sealed with the utmost apprehension.  There's so much wisdom and hope that comes arm-in-arm with facing these issues in a practical way, and that needs to be expanded upon and shared.  It's a top priority of mine to find a way to do this that will succeed, and will benefit the baseline happiness and self-awareness of the human condition for generations to come.  

The Wilderness Within

Sometimes you need the wilderness, other times you need to emerge from it.

I have been wandering around with such an awful resolve and sense of purpose for so long, that embracing new realities is something I'm very exited about, but it's also something scary.  Until recently, I have been braced against horrible things, and that's been my normal mode of operation.  Since 2011, there was a constant struggle in my heart and mind to return to the way things used to be; I struggled for a sense of normalcy, that slice of contentment we dream of obtaining and take for granted when we find it.  Recently, I picked up my trembling hands and I shook the sky, the covering that held in my self-limiting reality, and I took back my sense of ownership over my life.  From that sprung several things for which I can be thankful, and potentially much more.  Part of it was luck, and part of it was my decision to stop living like I had been, constantly subjugated and controlled by my developed fears and weaknesses, paralyzed by my dwindling hopes for the future and anything I'd once considered a possible outcome in my life.

I'm not sure what my message is this time.  Because I'm not sure what I'm taking from this just yet.  I think I'm starting to understand the miraculous people in the world who live through terrible things and yet still remain fully equipped to lead a fulfilling life, filled with joy and love.  Although I fundamentally needed the time I took to commit to pursuits related to my diagnosis and treatment, and solidify my plans for the foreseeable future, and I'm extremely proud of what I accomplished during that time, all of it served a particular purpose during a particular period.  The hardest part of that is letting it fuse naturally into the fibers of my heart, so that it mingles with my soul and so that I will always remember.  And then being able to let it go.  So that I retain control of myself and my direction, as opposed to following a prescribed direction based on my circumstances.  I am writing my own prescriptions now.  Certain people help, and certain events, too, but the signature at the bottom is my own.  I could fail, or be forcefully torn from my direction once again, but I refuse to let negativity define how I forge on.

I hope that everyone is as lucky as I am.  And that you all experience the revelation that you're the only qualified guide to the wilderness within you.

A Free Life

"I was supposed to die, and I just didn't.  And it kinda felt like I had a free life, an extra life."
        - Bukowski

I watched a documentary about Charles Bukowski recently.  I've always been interested in the man's words.  Although tortured and hard-earned, his views and expressions are primal, unrelenting, and pure.  He exhibits a fascinating reality, one that is unfamiliar to me in most regards, which probably accounts for my fascination.  However, I did not expect to hear him say those words, and it opened up an entirely new perspective on his life.

Because this is how I feel.  So I understand more fully where he came from now.  Obviously, this is one chunk of the man's personality, and while I identify with certain aspects of his character, I don't claim to understand the rest.  I, too, should have died, and I didn't.

There is no cure for what I have.

Typing those words is one of the hardest things I've ever done.  I literally had to take a minute to brace myself.  What else could possibly be worth worrying about?  Well, turns out, a lot of things.  Because we are not as isolated as we would like to think.  Those pesky people, all of the rest of them that live here with us -- they always get in the way of our plans.  No matter how hard we try, with our five-year plans and our ten-year plans, there are always things that derail us.  Organic, living, loving things.

For a long time I thought I was alone.  A very, very long time.  I had resigned myself to several things, none of which I'm ready to publicly admit.  But there is a strange power in hardening your resolve, and preparing yourself for a certain future that you have planned for, absurdly, without any thought as to how easily you might be swayed from it.  The reason this power is strange, is because it isn't real.  Because you don't have any power over your future.  It will happen 100% without you, if it has to.  Ride with it, or deny yourself the experience.  But there is no in-between.

My point was that worst of these concerns, the ones that cause us the most grief, are for the first life.  The free life is for remembering how absurd it is to obsess over these things, and to let yourself be caught up in the winds of fate, and taken wherever you will yourself to go, and some places that you don't.  Some people never have cause to own their free life.  Others go back and forth between the two.  For my own life, I hope there's a balance to be found between the two; between caring about the day-to-day, and remembering how superfluous most things are.  There is no question that I must remember the wisdom I etched into my heart the day I was diagnosed.  But as much as I'd like to have my effervescent transformation solidify and hold for the rest of my days, I'm only human, and the wisdom of the free life fades.

I'd like to delve deeper into the free life and what it means to me at another time.  For now, though, I believe 2 a.m. is threatening to swallow me whole and resurrect me into another day.

And Stone by Stone, We Craft the Temples of our Hearts

My first unadulterated thought when I was diagnosed with cancer -- "My God, I've wasted so much time."  There are many facets or interpretations of this thought, but it's no mystery to say that this is my greatest sin: Time management.  In fact, the Grand Architect has seen fit to bestow upon me many talents.  Some of them practical, some of them a burden.  By the time I was in High School, I was involved in dozens of things.  And I was naturally better than everyone else at all of them.  I had a disastrous case of big-fish-in-a-little-pond syndrome in those days.  All of it was easy for me back then.  All of it except for basketball, which I hopelessly sucked at.  I wanted to play basketball in the worst kind of way when I was younger.  And I was awful.  I did it because I couldn't do it, and I persisted in joining the team every year because I thought it's what my father wanted.  Of course, that turned out to be false.  It didn't matter anyway because I quit the team sometime in middle school.  I quit because I was written off, for the first time in my life.  And it hurt.  Pain like that was foreign to me until then.  I was so naturally talented at anything else I picked up, and I had received so much praise in my life, that I couldn't deal with the fact that I might actually have to try hard to succeed at something.

I made a habit of quitting when things became overwhelming, or when I finally had to try.  I could easily have gone to school on a scholarship for multiple things (in fact, I did get a full ride for theater that I turned down, and I would have for music if I'd decided to audition).  Maybe it was out of fear that I didn't pursue any of them.  I didn't want my activities to get to the point where they'd be work, because then I'd have to be tested, and I'd have to work hard.  So I scrapped them all, and I just winged it.  Maybe I'd find something else, I thought.  Something at which I'd be even more talented, and something I'd never have to work at as long as I lived.  I would get by on my talents, and the world would recognize me for my intrinsic value.

I won't take the blame for all of it, though.  I was conditioned to avoid working hard for various reasons.  And I wanted everything I did to be fun.  I was a kid.  And kids should always have fun.  Regardless, I had never set limits for myself.  I allowed my wants and desires free reign over my life.  And I deliberately shied away from anything that would cause me any grief.  The real world was different, however.  And even though I grumbled about it, I never missed a day of work or even called in sick.  Ever.  I spent my last day of one manually labor job with an upper respiratory infection.  Even though I didn't like it, I acted very responsibly whenever I was employed in a "grown up" money job.  And that made my revelation even harder to stomach.

What had I been doing?  Working a "real" job these days is little less than indentured servitude.  There was a point, after I'd entered the workforce, where I let my "responsibilities" define my actions.  I worked 24/7 on a certain job, before my diagnosis.  In the morning, I woke up to multiple voicemails, and at night I'd fall asleep after solving the last crisis of the day.  I missed out, ruined relationships, lost touch with family, and halted progress on finding my real place in the world, all out of a misplaced sense of duty.  When I was diagnosed with cancer, I realized that it was never my duty to put my life on hold for the sake of an intangible ideal that had never been mine.  What I believe my duties are now is debatable, but right then I knew my sole responsibility was to do what I wanted without excuse.  And that's exactly what I set out to do.

My advice is clear -- find your greatest flaws, and fix them.  Discover what it is that you would admit to yourself if you were going to die.  You know what it is.  I did.  It whispered to me in the dark recesses of my subconscious long before I gave it a name.  Even when you find it, there is no easy fix.  Self-analysis is not a spectator sport.  My flaws took me unto the verge of death, and it was only through a terminal crisis that I willfully decided to deal with myself.  Maybe it's impossible to deal with ourselves otherwise.  Maybe it isn't.  My advice is to live as best you can.  That involves all of the intricacies of your soul that you call your own.  Find them, fix them, craft the temple of your heart, and carve out a place for the ones you'd like to bring along for the ride.

How To Survive Cancer: Part 2

There is, of course, a lot more to it than that.  Yet, even with all of our 21st century medical knowledge behind us, there's still only so much we can do.  And if you think that cancer is a "battle" that you can win, please see the following: http://zenofmetastasis.blogspot.com/2013/03/honk-if-youre-hero-ps-you-are.html

But there are a few practical things you can do after a cancer diagnosis that will give you the best chances right from the start, and I'd like to go over them here.

1.)  Seek out the best doctors you can find that specialize in your type of cancer.  This probably ties as one of the most important things you can do.  Do it quickly; don't waste time.  The minute I got my diagnosis, I was on the phone scheduling appointments.  However, I wasn't in my right mind, and I didn't even think about finding the best possible doctors available to me.  When my mother got wind of things, she immediately researched the melanoma gurus on the East coast and called to get me appointments.  I had to cancel all the plans I'd made, much to the chagrin of the administrative assistant who'd helped me schedule them.  So, do yourself a favor, find the best doctors right away, or run the risk of having your mother do it for you.

2.)  Find your support network.  This is the other step that ties for most important.  You cannot suffer through the terrors of cancer without a support network.  Period.

3.)  Do your homework.  Don't blindly follow along with any treatment plan you're given without reading into it extensively.  I had a bit of insurance trouble throughout, but living a middle class American life, I was entering into a veritable wonderland of technological and medicinal options to treat my cancer.  However, many of these options are touted by the people who fund them, and they may represent particular agendas that don't include your best interests as a patient.  Be aware that we live in a complex and morally ambiguous world.  Do your own research and be your own advocate.

4.)  Make lifestyle changes if necessary.  I had been smoking when I got my diagnosis (a few cigs a day) and I'd been working a highly stressful job in the deep and terrible trenches of corporate NYC.  Most nights you'd find me partying my heart out, drinking away the stresses accrued during the day.  If you asked me now though, I'd tell you that it's easy to see how a "work hard, play hard" lifestyle falls directly into the realm of things with adverse health affects.  I'm not saying you shouldn't have fun.  In fact, I'm a big believer in the importance of fun and adventure, just be careful that you aren't seeking out your fun as a means to distract from all the bad parts of your life.  Of course, lifestyle alone is not going to kill you, for the most part.  There are certainly behaviors that are more dangerous than others, like smoking, or chowing down on discarded, depleted uranium cores.  However, there are those miraculous individuals who do everything wrong and still live to be a hundred.  These people are few and far between though, and no one knows what makes them so resilient (if they insist that they do, they're trying to sell you something).  In reality, until we know exactly what we should and shouldn't do on a genetic level, it's a good idea to lower your own risk factors as best you can.  It's very possible that the primary cause of most cancers is a genetic disposition (this is certainly true in certain cancers, if not all of them), combined with an individual's risk profile.  A genetic disposition doesn't guarantee that you'll get cancer, or that cancer will return.  But a genetic disposition aggravated by a life full of excessive risk factors just might.

Read more about stress and the immune system, here:  http://www.cancer.gov/cancertopics/factsheet/Risk/stress

There are other, optional things to keep in mind also.  These are things you can do in addition to the list above, and may or may not jive with your current goals.

5.)  Move home.  Be wherever your family is.  These people are important to you, or they should be.  Maybe you're estranged from them.  Well, fix it.  Having been diagnosed with cancer, you now realize that life is much too short.  I was fortunate enough to have a very supportive family throughout my life who were there for me during my surgeries and treatment.  I tried very hard to stay in NYC and go through this without them, but I quickly realized that I couldn't, nor did I have any right to deny them precious time with me in case I might be dying.

6.)  Find your friends.  My friends are everywhere.  I hated leaving the ones in NYC.  They had become a second family to me.  When I moved home to Pennsylvania though, I quickly fell back in with the close-knit group I'd grown up with.  And I had new people connect with me to show their support, too.  Some I'd never talked to before, and some I hoped to talk to much more.  One of the best things about cancer is that you'll quickly find out who in your life really belongs there.  Some people will disappear.  And others will be more supportive than you could have imagined.  These people, the ones who stick with you, are the ones you need to survive, and not just through cancer.  Carve their initials deeply into your heart, and make sure they know how much they mean to you.

7.)  Find your religion.  I don't care what it is, and I'm not going to tell you about mine.  Most people wouldn't appreciate it if I did.  And that's fine, because it's for me, like spiritual beliefs should be.  They're personal beliefs unique to each individual, and we use them to find our place in the universe.  And don't push your individual religion on someone else once you've found it; that doesn't make you "pious."  But do use your beliefs in whatever way you need to help you overcome your fears and live a more fulfilled life in the face of your diagnosis.

8.)  Quit your job and do what you love.  This one's simple.  There are many who don't have this option available to them, but sometimes it's easier to focus on dealing with the side effects of treatment rather than on your career.  If you can afford to, do it.  And, if you hate your job, do it with a smile on your face.  Afterward, go after that thing you've really wanted all your life, and make no excuses until you get it.

9.)  Reevaluate your priorities.  That is, if you haven't already done so.  I did so immediately, within nanoseconds of being told I had cancer.  I cataloged my greatest sins, and set out to atone for them.  Usually, our greatest sins are straightforward and easy to identify.  Mine was.  And if you have the energy, don't just identify your failings, set out to fix them.  Then, seek out the most important people in your life and tell them about it.  Spend as much time with them as you can.  Find the other things in life you know to make you happy, and don't ever lose sight of them.

I set out to write a guide about surviving cancer, but I realize that a lot of these things aren't cancer-specific, and you should probably be doing them anyway, regardless of what diseases you have or don't have.  Or, if you hate all of my suggestions, that's okay too.  Because this was my guide, and it consists of all the things that were important to me throughout my experience with cancer, and still are.  But please, if you take nothing else from this, use it as inspiration to find your own guide.  Because there are important things in your life that you can't live without -- I know there are.  And if you haven't figured out what they are yet, take it from me -- If you wait until you might be dying to find them, you'll end up having a lot of apologizing to do, and mostly to yourself.

Upcoming Story Collection

Hello all,

It's nice to see you again.  I wanted to provide a general update on my goings-on and keep everyone in the loop.  Very soon, I'll be publishing a science fiction short story collection that will be available on Amazon in print and ebook form, called Astral Imperium And Other Stories.  Right now, it's in the beta reader phase, and after a bit of polishing it should be ready to go.  My good friend Bobby Gore is doing the cover art, and I hear it looks fantastic.  Stories include homicidal robots, interstellar mysteries, unhinged space monks, conspiracy, temptation, revenge, and friends with awful intentions.  I personally recommend it, though others will do that too so you won't have to take my word for it, I promise.

The cancer memoir is in the pipeline as well, though I'll be saving that for a rainy day.  For now, I'm going to focus on science fiction.  Oh, and feeding myself (I've been told that's important).  Or, in other words, creating a viable living from wordsmithing.  But not to worry! -- I've written three books already, and I'm in peak form, weaving words together into coherent and entertaining thoughts daily and at a respectable rate.  In fact, I've been working very hard.  And I don't say that to sound impressive or brag.  I say it because I'm genuinely proud of myself, and happy that I've finally taken to something that doesn't make me want to leap from a skyscraper every day I leave the office.

Cancer has been very freeing in that regard.  I've been offered a fresh start from the universe.  And I haven't wasted any time grabbing it up (at least I don't think I have, you might have to ask my family and friends for the truth of it).  I've always been writing, only now the stakes are much higher.  There's this whole insurance thing I need to pay for in case of more cancer, or in case I decide to jump ten minivans on my tricked out scooter (I don't have a tricked out scooter, sadly).  I hope that my attitude toward pursuing my goals inspires you to do the same.  Because everyone should feel that way about their vocation.  It shouldn't ever be something that "pays the bills."  It should be do or die -- you do this because you can't imagine living without it.  There must be a sense of urgency.  Nothing else would cut it in the same way that writing does for me.  And it's not a chore to develop a work ethic around something you love.  It's easy for me to feel this way, because I was dying once.  And you tend to discover exactly what's important to you when you find out you might be dying.  Every day during my first month of immunotherapy in the hospital, I sat down and wrote around 1,500 words, even though I could barely stop shaking from the chills and a number of other horrible things.  And after a health crisis you respond to life very differently.  I deal with my most egregious sin, for instance, in a much better way than ever before.  I plan to talk about that in a later post (Sorry for the tease!).  And I've already discussed conquering fear and realizing your potential in a previous post.  If you haven't read that you can find it here: http://zenofmetastasis.blogspot.com/2013/02/a-domain-of-evil-it-is-in-you-must-go.html

Thanks for reading!  I'm very glad to have a fantastic support network to turn to when I need it.  This blog, and the readers who encourage me to continue to write it, are a large part of that.  I only hope I can offer in return what I've gotten from all of you.

"A domain of evil it is. In you must go."

Fear and dissatisfaction are the enemy.  If you're afraid, face it.  If you're dissatisfied, change it.

It's really that simple.  I did it just now, and I do it every day.  More often these days than in the past, but that's alright.  With more exposure to the world at large we generally expect to find more things to be afraid of, and to be dissatisfied with.  It's a numbers game.  I would never have thought to be afraid of dying before my thirtieth birthday before my cancer diagnosis, for instance.  I also never worried about being hit by a subway train before I moved to NYC.  I was never concerned about paying for sub-par deli meat and bagels before finding out there's life after Boar's Head.  And I most definitely never imagined how nervous I'd be that someone would find me out while masquerading as a marketing account manager for a beer company at a VIP signing party.  But hey, these things happen.  Also, a quick thank you to my bro Velasquez for smuggling me into that party.

This may be an obvious conclusion, but it's easy to remain unafraid of that which you have no knowledge.  It's easy to remain unconcerned with questions you've never asked and doubts you've never entertained.  Sometime, though, you will ask questions and have doubts.  And it's okay to have doubts and fears, because everyone does, and it's an unavoidable aspect of the human condition.

What isn't simple is preparing for these preexisting or sometimes unforeseen fears.  The difficult part is rising to the level of self-control it takes to be able to adjust your attitude and emotional state with relative ease.  It requires a great deal of personal development and self-knowledge.  Here is my step-by-step guide for $19.95!  No, I'm kidding.  Everyone acquires personal development from different sources, and self-knowledge is as subjective as there are "selves."  And there's no handbook to any of this.  People will tell you there is, but what they're really doing is trying to sell you their own handbook.  As a general rule, I'd advise not to trust anyone who won't allow you to find your own way.  As Basho reminds us, "Do not seek to follow in the footsteps of the men of old; seek what they sought."  No one can hand you inner peace, everyone must find their own.

My way is easy.  I consciously analyze my fears.  It's bizarrely effective to understand the roots and facets of your fears or dissatisfaction.  Maybe this is also fairly obvious.  But that doesn't mean it's accomplished very often.  For the most part, these things take the form of subconscious emotions.  They hide deep in the shadows of your mind, where they can't be fought.  They put up barriers that redirect and confuse your ability to confront them.  The minute you are able bring them to light, however, you can figure out how to deal with them.

I'll tell you a story.  After my year of immunotherapy treatment ended, I was very excited about things getting back to normal.  And I'd tell myself this every minute of every day; "Man, I'm so excited that this is over, and that now I can go to grad school and write another book and get a job and date."  I told myself this constantly, repeated it in my head like a mantra.  And if I had the courage at that point to take an honest look at what I was doing, I would have realized right away that I was in severe denial.  Justification mode was fully engaged, and I was making excuses for my behavior, which did not at all reflect the mantra I wanted so much to believe.  I wasn't ready for "normalcy," I was neurotic and terrified of everything.  The moment I realized this however, I was free of it.

One of my favorite quotes of all time, regarding the subject of confronting fear, comes from Michael Crichton's memoirs, Travels.  It describes a trip to the African Savannah where he comes to find out there's a giant elephant outside of his tent in the middle of the night.  It deals very nicely with the subject of true conscious awareness of fear as a way to quell it.  I'll post it here:

"We can all work ourselves into a hysterical panic over possibilities that we won't look at.  What if I have cancer?  What if my job is at risk?  What if my kids are on drugs?  What if I'm getting bald?  What if an elephant is outside my tent?  What if I'm faced with some terrible thing I don't know how to deal with?  And that hysteria always goes away the instant we are willing to hear the answer.  Even if the answer is what we feared all along.  Yes, you have cancer.  Yes, your kids are on drugs.  Yes, there is an elephant outside your tent.  Now the question becomes, what are you going to do about it?  Subsequent emotions may not be pleasant, but the hysteria stops... the minute we look, we cease being afraid."

I try very hard to challenge myself into examining my true fears, as well as my true desires.  The minute we admit to having them, we immediately find suitable avenues to pursue or deal with them.  Most people have fears with easily-identifiable sources.  Some people hate their jobs, but are afraid to quit.  Others are no longer in love but are afraid of breaking up.  And we can sit around complaining about our dead-end relationships, soul-sucking jobs, or whatever the case may be, or we can stop being afraid that the world will end if we deal with these things and actually get what we've wanted all along.  Maybe you want a better job or a better significant other.  You have to respect yourself enough to know that your time on the Earth is valuable and irreplaceable, and it simply doesn't pay to spend it not doing what you want.

These days, I have very clear goals.  It's been a long journey for me, but I've pinpointed my fears, and my desires.  I'm going after what I want.  I hope you will, too.

"The cave you fear to enter holds the treasure you seek."  - Joseph Campbell

Metastatic Memories

I've put this off for a long, long time. In fact, I've put it off for a year and a half. I mostly discouraged myself from even considering the attempt, from the very beginning. I saw other people doing it, and I thought that although in some cases they were very successful in their undertakings, it simply didn't appeal to me. Something about it makes me squirm. It inspires me to fight to uncover any excuse in the book in order to justify my inaction.

What am I talking about? What is this terrible and ugly thing that I'm resisting with every fiber of my being? Because there are many things in life that I choose to resist. Things I refuse to take responsibility for out of fear or an inability to face the emotional and psychological consequences. As with us all, I too abandon certain nagging thoughts to the dark recesses of my mind. As with us all, I accumulate pain and guilt through a series of encounters with forces either beyond my control or not. And as with us all, I have many pervasive and lingering fears. In this case, however, I'm talking about the decision to write publicly about my experience with cancer.

Perhaps publicly isn't the right descriptor. Because, in fact, I've actually written a book about it that's currently being shopped around for publication. And there's hardly anything more public than that. I suppose what I mean, specifically, is the actual act of blogging. Blogging is a more accessible form of media. It's a series of intimate details about the blogger's own life. A projectile vomiting of unfiltered ideas that can be interpreted and analyzed with little effort. Constant postings that explain the character defects and neuroses of the author. Blogging constitutes a window into the blogger's very soul. It's a very public enterprise. I've always wanted my accessible thoughts, my public thoughts, to reflect a particular attitude or brand. I never wanted to be the cancer kid. Yet that's what I am. I wanted to be the carefree, mildly eccentric, live-life-on-his-own-terms, rock star personality that I so admire. I want to make people laugh. The last thing I want to do is make them uncomfortable. In fact, I don't even want to make myself uncomfortable (who does?), even though I've been in a constant state of discomfort, albeit unconsciously at times, since my diagnosis.

My decision to finally offer up a public record of my cancer fiasco is in fact an act of great personal courage. But I'm not asking for your admiration. Others may not find writing about their cancer to be very difficult. But they might struggle with something I find easy. That's the nature of being human. We all have our wars to wage.

And so my reluctance to blog about this has been covered by layers and layers of justification, buried deep with no hope of discovering why the resistance is present in the first place. Any time the topic is broached, I find myself saying, "Blogging? Well, shit, I wrote a book, for God's sake -- isn't that enough?" And I don't know the answer to that. Maybe it is enough. Or maybe, as a cancer survivor, I have a unique obligation to increase awareness and fight for those who can't fight for themselves. Possibly, and I plan to post more on this later.

But why the resistance to blogging? I did write a book. I wrote it while undergoing immunotherapy for stage 3 metastatic melanoma. A good bit of it, probably a third, was completed during my first month in the hospital, where I received the lion's share of treatment intravenously every weekday for four weeks. Days when I cried myself to sleep most nights, and struggled desperately to keep my sanity intact. But those images and feelings, those metastatic memories, are distant. My diagnosis, my surgeries, my treatment, all passed in a blur. And likewise, most of the actual writing did as well.

It's the paralyzing fear of revisiting these memories that keeps me from blogging. Now that I'm thinking clearly, and enough time has passed, I've gained the capacity for perspective. When something traumatic happens to you, it's very common to shut down emotionally in order to avoid the most terrifying aspects of your ordeal. And that's what I did. I functioned entirely on autopilot for a year and a half. Ostensibly, that isn't even a bad thing. In fact, I did very well. When you've severed all emotional connections to your circumstances, you can be anything you want. I was very courageous, and I'm told I was the glue that kept my family together after my diagnosis. I spouted contrived wisdom and used romantic ideals to comfort those closest to me, hardly realizing what I was doing. Some of the things I said or did are offensive to me now, due to the absurd oversimplifications I entertained or encouraged. Cancer is not romantic, and the smell of death circling above your head can never be effectively aerosol-ed. The mere suggestion that it can is offensive. And I was at one time the worst offender.

And so, after "waking up" from a year and a half of autopilot, a year and a half of embedded trauma, and a year and a half of drug-induced cognitive suppression, it's almost unbearable to look back over the events of the last year and a half without overwhelming terror. I've woken up to find myself alive, in working order, and surrounded by love and support. It's my responsibility to carve out a path from there. That in itself is terrifying -- what is life supposed to be like after cancer? How fulfilled can it really be? Do you stop taking shit from anyone, or anywhere? Do you adopt a no-shit policy? Is it okay to finally be selfish? Is it alright to ignore certain responsibilities, because you finally have your priorities straight? These questions and more are certainly worthy of extensive examination.

Personally, I suppose blogging will be an outlet. It'll allow me to finally free myself of some pervasive negativity, and maybe even relieve enough of my recently adopted neurotic behavior to once again function in the world at large. It will certainly serve to garner awareness for cancer, and that's a primary goal in my life these days. Because, as much as my experience has pained me and set me back in my own life, the thought of anyone else undergoing the same level of suffering is very hard for me to think about. I find myself tearing up every time I begin to read the account of another cancer survivor. Awareness is important, because suffering is only alleviated when there is enough manpower present to alleviate it. It isn't magic -- it's math. And all the publicity in the world won't help unless enough of us decide to act. Action manifests itself in several ways, and that's part of the reason I've finally decided to blog about this.

My account is detailed in my book, "Cancer Kid." But that isn't enough. I have certain goals I've sworn to meet, without excuse, and I plan to meet them. Blogging was not originally one of those goals, but it's going to help in several ways. It will hopefully help the public at large be more informed about the goings-on of cancer survivors. It will help me create a platform for myself and publicize my work, which will in turn increase awareness and further the fight. It will allow me the resources to fund the foundation I'd like to build. And, perhaps most importantly of all, it will free me from the fear I've buried so deep in my subconscious, and allow me to remember the important things in life.