Happy Birthday! Tales Of An Aging Cancer Survivor

My birthday is coming up.  It'll be the first birthday I've had since treatment ended.  My birthday, my birthday, my birthday.  I suddenly can't stop saying the words.  Soon, I'll be officially one year older.  Bring on the years, I say.  The looming shadow of untimely death may still follow doggedly at my heels, but it's less and less relevant.  Like an aging pop star, grasping for attention in the tabloids by snorting things and banging things and hanging other things out windows.  Such is the state of my conscious thoughts on the subject of the decay of my physical viscera.

All thugs and chumps must inevitably grow up.  But not all thugs and chumps must like it.  This one does.

Birthdays attract bears.

To be honest, I haven't thought much about it until I was reminded of the approaching date.  And then, I didn't care enough to really process the information until I sat down to write this post.  Now I can't stop myself from feeling elated at the prospect of the number of years I've been on this Earth getting, well, more numerous.  So it is with complete and utter childlike eagerness that I say, more numerous numbers please!  May they grow and grow, until a harvest of numbers shall be laid out in a banquet of the wealth of my years, garnished with the love of those I hold dear.

If Dad tries to eat all of my cake again this year...

Sorry about that last part.  I get all sentimental when I think about not dying and instead spending the time I could have spent dead with the people in my life that I like the best.  It's a simple thing, really.  But often overlooked among the day-to-day.  Most people dread this birthday stuff -- I used to.  I never wanted to make a big deal of it, and I didn't want to remind myself that I was chipping away at my youth, just by standing back and watching the sands filter through.  Age is something we can't control, and getting older is mostly terrifying.  It seems almost like a punishment.  Dealt to us for no apparent reason, and without just cause.  What have we done to deserve these advancing years?  These days, I ask the same question, but with a very different twist.  What have I done to deserve another birthday?

Image credits: Top -- HAPPY BIRTHDAY, by ritchielee via flickr; Middle -- Cleveland Zoo's birthday party, by Yvonne via flickr; Bottom -- murder on birthday 3, by Murat Suyur via deviantART

How Would You Want To Die?

Today I tripped over my total gym while moving to a new exercise and caught myself awkwardly before face planting and spilling my brains on the floor.  Then, after the workout, I slipped in the shower, bouncing on one foot to keep myself from falling (which is something I always do when I slip in the shower that makes next to no sense, because if you slip with the other foot, you have nothing left to save you and will surely die).  I sprayed my new leather shoes this morning, reading on the back of the label that the chemicals "can cause flash fires," and I day dreamed about being swallowed in a cloud of fiery death.

I got to thinking very quickly, in this maze of macabre disaster I call a home, about how I'd actually like to go out.  Having survived cancer already, I have conflicting opinions on the subject.  After surviving a life-threatening tragedy, you don't particularly want to go out in just any lame, regular sort of way.  You want some even more intense option, like drowning after saving everyone you love from a sinking battleship, or fighting off an alien invasion.

Other people are also aware of this fact.  I was crossing the street the other day with my friend Darrell, and when we got into the bus lane he held out his hand and said, "Watch out for buses.  You don't want to be run over by a bus after you lived through cancer."  And I'd say that's pretty accurate.

On the other hand, after surviving a horrible, traumatizing disease, it's easy to want to pick the most mundane way to die possible.  Sometimes I think I want to go out in my sleep, with no pomp or circumstances whatsoever.

"You planning to get up soon?  Nope?  Okay then."

It might be best to do that, and avoid all the messier ways, like sword fights with giants and skydiving snafus.  That way, everyone will have a semblance of closure.  Instead of, "If only he would have spent more time in the gym practicing his melee skills (because everyone knows giants have a resistance to elemental spells)," it would be more like:

"How did he die?"
"Why, in his sleep."
"Oh.  Well that's not very dramatic."
"Why no, not at all."

Something like this might be pretty ideal: *Read, read, read, read, read, read, read, read, DEAD*

So which is it?  After surviving cancer, I kind of get the notion that I won't be able to pick.  The natural progression (or random assertion of unconscious power) of the Universal DJ really doesn't leave any room for requests.  As much as I go back and forth between two extremes, I doubt that anything that has any control over how I go out cares in the least.  It's going to happen the way it does.  It almost did already, in a completely senseless and eye-opening kind of way.

"I'm coming for ya.  You know, eventually."

Whatever it is, I hope that the way I choose to live inspires someone.  Anyone.  And that the manner in which I leave this place is entirely washed away in the memory of what I added to it.

Image credits: Top -- Monster Shower Sign, by derekdavalos via deviantart; Middle -- Horse Sleep, by Ian Webb via flickr; Mid Bottom -- Studying and Sleeping, by mrehan via flickr; Bottom -- Death Rides a Pale Trike, by Marcus Ranum via deviantart

I Wrote My Will at 26

"And my collection of geographically accurate boogers goes to..."

I wrote my will at the age of 26.  It's infused with comedic zingers, and is in no way legal -- but hey, it's a will, nonetheless.

During the period leading up to my second surgery, after I was diagnosed with cancer at 25, I wrote what would become a symbolic offering of what little I had in those days.  I wanted to have something in writing that would tie up all the loose ends in my young life.  Turns out, having lived only a quarter of a century, there weren't very many loose ends to worry about.  Though I'd heard that it's better to have something in writing than to check out without making any kind of arrangements.  Turns out that isn't entirely accurate, but I didn't know that at the time.  So I drafted this letter.  No one knows that I did this, not even my family.

At the time, I was doing a lot of sitting around and feeling sorry for myself.  I laid on the couch at my parents' townhouse, watching TV, curled up under a snuggie, slowly losing the ability to cope with my evolving circumstances.  Mostly though, I was feeling sorry that I had to leave my family, and that I had nothing to offer that would soften the blow.  The thought of dying so early, loved ones gathered around to bury me, their faces twisted in mourning, was too much to bear.  It spawned thoughts of my parents splitting up, my sister's new marriage falling apart, and all three of them slipping further into the depths of grief, never to return.  And all that would be my fault.  I would be the cause of so much suffering for the people I cared about most.

My parents were getting older, and money was getting tighter and tighter.  My sister had gotten married during the summer, two months before I was diagnosed with cancer.  Mom and Dad paid for the majority of the wedding.  Shortly after, they'd sold my childhood home and bought a townhouse an hour up the road in State College, PA.  In doing so, they signed on to another mortgage, late in life, against their better judgment.  None of this would've been a problem, had I not shattered the illusion of youthful permanence and gotten myself all genetically mutated.

"There's a pen growing out of your brain, just like this."
Source: National Cancer Institute

The day of my first surgery was the day my parents closed on the new townhouse.  I sat in the office with them, that morning, listening to small talk thrown out by the lawyer and the real estate agent, all the while doing my best to remember that life hadn't stopped for them as it had for me, and they didn't have any idea that directly following this appointment I was hopping in the car with my family and traveling three hours to Pittsburgh to go under the knife for the first time in my life.

I also knew that this was cancer, and that it could very well be terminal.  That thought never left my mind.  I wanted to reach over to the console and hit the reset button like I'd done so many times as a child, sitting cross-legged in front of the TV in the basement, controller and princess-saving aspirations in hand.  But there was no reset button in my case.  I would be forced to deal with whatever came next, no matter how horrible.

Now that I think of it, Kirby kinda looks like a tumor...
Source: Andrew Evans

The possibility that I wouldn't make it loomed over the car on our drive to Pittsburgh like a dark cloud, hovering like a silent threat.  For a long while, I was able to stare right back into its core, challenging its authority over me.  Clouds like that cut through to your soul, and wear down your courage over time, until you begin to see the world, and the possible end of yours, in a more practical light.  "Well," you eventually say, stealing a glance at the blackening sky, "Maybe now it's time to prepare for the worst."

I wanted to provide for my family, but at the age of 26, I had nothing to provide.  And I realized how sad it was that I had to write a will with no real "willing" involved at all.  The only thing of real value I could give away were the emotions I felt for the people who would read it after I was gone, and I spread them liberally throughout.  I needed to make sure they all knew how I felt.  And if I couldn't give them anything of material value, I would leave my family and friends with a message of undying love.  I didn't want to leave my family without giving them something in return.  They had given me so much already.  Thoughts of Indiana Jones and the Temple of Doom ran through my mind, and the introductory scene where Harrison Ford is stealing a jewel and replacing it with a bag of sand to avoid setting off the trap.  My family had handed me a great jewel -- a lifetime of opportunities, love, and support, and I had only this crummy bag of sand to offer in return.  It didn't work in the movie, I thought, and it won't work now.

My 26th birthday was spent hobbling over to my sister's house for dinner, ice cream cake, and presents.  I was still healing from that first surgery, which was actually a two-fer that included separate procedures.  It was a combo situation like you find at family restaurants.

Me: "I'll have surgical combo A, please."
Waitress: "Would you like that with or without post-surgical bruising?"
Me: "Oh, I don't know.  What do you recommend?"
Waitress: "I recommend the bruising.  You won't be able to sit down practically anywhere, and you'll break the towel rack in your sister's house the first time you have to poop."
Me: "Interesting.  I guess I'll give it a go."
Waitress: "Excellent choice.  And how about a side of surgical drains?"
Me: "Hmm... I might pass on those this time."
Waitress: "Sounds good.  You make sure to try them next time."
Me: "Thanks, I'll keep the drains in mind."
Waitress: "I'll be right back with your IV and a pre-op syringe.  You'll be seeing pelicans and singing obnoxiously in the key of F in no time."
Me: "Can't wait."

"I'd like to avoid the anal leakage, if possible."
Source: Alan Light

I was uber sensitive to the situation in which I found myself.  I had just gotten through my first set of procedures to remove lethal cancer from my body.  I was just 26.  Though I'd dated a lot, I'd only had a few real adult relationships, I'd only had one real job of any import, I'd never made a splash, and at this point it was possible that I never would.  I had nothing to leave behind; I had no legacy.  My whole life, I'd wanted to be a writer.  I hadn't done much to pursue that goal, but I began to write a memoir about my experience with cancer.  And then I wrote a will.  I decided that I could write at least that much.  It was possible that I'd be dead, and the memoir would never be finished.  This will, or letter, would be my legacy.

And so I wrote the letter that would become my will, in the hopes that someone would take pity on me and see that my family survived the worst case scenario.  Because, at the age of 26, without any real prospects, pity was all I had.  Which lead me to thinking, "What should I have had at this point?"

I'll be answering that question in a series of posts that I hope will help shed some light on how easy it is to be prepared for life's worst case scenarios.  In Part 2, we'll talk about the legal issues associated with end-of-life situations, as well as what the average, healthy person should have in place.

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.