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

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

How Far Have You Come?

The Allegory of the Winding Road

Life moves in curves, and currents.  There are corners to be strolled or cut, and obstacles to be leaped or removed.  The path winds down through the years with unyielding certainty -- the certainty is that the bends in this road will never stop.  How far have you come, through the winding pathways of life?  

Personally, I've gotten to a place in my life I never thought I'd be again.  Not ever.  I stumbled through violent switchbacks in recent years, only to come out in a place where I figured the road only lead in one direction, and that I would just have to deal with it.  But I was wrong.  There I was, finding myself rummaging through memories of when things were different, holding dear to my heart a spark of something I imagined I'd never see again.  I thought I would never hold a job again, or have a savings account again, or live in the places I wanted to live.  Mundane things mostly, but when you take them all under consideration, you find out that what you really believe is that there's no chance for you to lead a normal life.  I thought I was banned from a normal life, resigned to standing outside the gates, fingers wrapped around the bars, peering in at others going about their business, taking it all for granted.  And looking in at all the scurrying bodies and blurred faces, continuing on down the road to their own likely destinations, I was reminded of the other things I wouldn't have -- the things that hurt the most.  I thought I'd never love again, or be loved.  I wasn't worthy of anyone's love, sometimes not even my own.  And that I'd never have a family, or live with someone, or buy a house, and have children.  For a long while I thought that was okay, and it was just the cards I'd been dealt.  I would live with my revelations and move on.  

But your circumstances, or the events in your life, or the setbacks you feel so deeply, do not define the course of your happiness.  At any point in time, you can walk around another bend, and suddenly find exactly what you've been looking for.  That doesn't mean you have to wait around for it, trotting silently into the dusk with no direction.  Although unfortunately, most tragedy brings to mind a sense of helplessness, and a feeling that it would be entirely impossible to so much as grasp at the things you once wanted most.  Even tragedy is not as strong as the continuing whims of a road that winds down through time, ready and ever willing to heal, to encourage, to mend hearts and minds, to entwine lives and further goals, and most of all, to plant love in all directions, waiting for you to stumble onto it.  

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.

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.

How To Survive Cancer

Hope

A True Underdog Story - My Cousin Bryan

Writing about cancer all the time is really awful.  It takes a huge toll on the writer.  Especially if that writer is no longer actively fighting cancer himself.  You have to dive back into the same mindset you had while you were patrolling the trenches of cancer, and constantly relive a lot of traumatic shit, on cue.  It sucks, every time.  But I'm not here to complain, I'm here to educate.  Which is why today, I bring you a true underdog story.

There are some who label cancer survivors "heroes," and if you read my last post, you already know how I feel about that.  I think the real heroes have qualities that are present whether cancer is or not.  And those people fight against inequality and injustice, regardless of their own lot in life.  And that brings me to today's topic:

My cousin Bryan, the underdog.

Bryan is, as we speak, embroiled in a vicious battle with his Home Owner's Association.  For the right to keep his recycle bin on the front porch.  You heard it here.  It's a struggle to survive in his own neighborhood.  This story has it all -- drama, action, romance (I don't know if any of those claims are true).  It's a coming of age tale of one recycle bin who refused to be relocated, and the owners who loved him.

You can read the full story, complete with the back and forth with Bryan's HOA, here:  http://thebryguy115.wordpress.com/

Bryan is spectacularly witty and tells wildly entertaining stories.  I know this, because I had to see him on Thanksgiving every year of my whole life.  And this one's no different.  He takes a dull, innocuous topic and turns it into a tongue-in-cheek adventure.

"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

I almost died once; Nice to meet you.

Let's talk about sex.  Well, in a minute.  Why don't we get to know each other first?  Let's talk about where we grew up, what clique we fell into in high school, and what sports we watch.  What kinds of things do you like?  I like turtles, and chocolate chip pancakes.  How about you?  Let's engage in the long-standing tradition of courtship, and marinate slowly in the developing bond of our sprouting romance.  It'll be fun.  Hmm... that kind of talk makes me hungry.  So maybe we can cook together too.  I like dinner dates -- the kind where you go out of your way to cook some exotic dish together.  Some assembly required.  Which is alright, because some assembly is required in budding relationships to begin with, right?  We'll do sunsets, carriage rides, stargazing, and Eskimo kisses.  As long as we have each other, and these butterflies, what could go wrong?

I bet you can almost see where this is going.  Almost.  You see, I didn't have a significant other going into my diagnosis.  Sometimes that was sad, but mostly I felt lucky.  I thought it was a fortunate turn of events that I didn't have a girlfriend, and therefore had one less person in my life to worry about me.  I was lucky not to have to drag someone extra down into the depths of my suffering.  I'm not the kind of person who would forge an extreme bond with someone in order to distract myself from a terrible situation.  I couldn't star in "A Walk to Remember."  If anything, I'd rather "Sweet November" the shit out of someone, but I doubt I'd ever be able to, in reality.  A) I don't think, realistically, that anyone is strong enough to do something that intense, and B) Keanu Reeves is not my type.  And so it's better off leaving well enough alone, and keeping my distance from any potential emotional bonds on the horizon.

And that was my attitude, for a year and a half.  In some ways, it still is.  Because it's very hard to allow yourself to connect with someone when you think you might die.  Or, at the very least, when you've been bumped up a few spots on the list.  Connecting with people I find interesting has never been my strong suit, anyway.  I've always had an easy time winning over people I don't care about.  I could do that all day.  I could just turn on the charm as easy as if I were flipping on a light switch, and people would fall for me.  It was a tough realization when I figured out that isn't how you generally begin a relationship that's wired for success -- by seducing people you couldn't care less about, in order to make yourself feel better.  It sucks, I know.  But there comes a time when you have to learn to be okay with yourself long enough to find someone who might also be okay with you.  The real you.  Not the one you put on, like a mask, to serve your own narcissism.

Most of the relationships I've had, and the people I've met, in the last few years are a mystery to me.  Aside from the friends I've had growing up, the ones I can trace all the way to the backyard days of my youth, I really don't know how I've made any friends at all.  But it seems to me that I know a lot of people, and a great deal of them like me.  I've been told I'm "likable," and that may be true.  I like to appreciate and dissect the issues and concerns of others before those of myself, and I unconsciously focus on other people in conversation or action.  I also try to be funny.  At one time I was very funny, but I'm no longer as outspoken or extroverted as I once was.

When you go through something like this, something life-threatening, all of your quirks and character traits become multiplied by a thousand.  You become almost a caricature of yourself.  You double down on your principles and your deepest wants and needs.  Since my deepest feelings are for those closest to me in life, I stopped talking to anyone who I viewed as extraneous.  And I developed greater bonds with my family and close friends.  The people I included were genuinely needed at the time, and still are today.  However, the problem lies in the nature of my rejuvenated loyalties.  It seems I've forgotten how to connect with people in general, and I don't have the easiest time convincing myself that it's even necessary to do so.

Sometimes, the greatest depths of solitude are found in the eyes of the person across the table, whom you have no interest in saying another word to.  Since my diagnosis, I've had different opportunities to meet and talk with various people.  And every time, I walked away disappointed.  Mostly with myself, because I legitimately can't find the energy to connect with someone on a superficial level.  It's devastatingly hard to make small talk -- poking and prodding at the psyche of the other person in order to gain insight into what makes them tick.  Figuring out body language, and nonverbal messages.  That's something I used to love doing: character analysis, behavioral analysis.  It was always easy for me, and always enabled me to say exactly the right things at exactly the right time.  It gave me great satisfaction to be able to do that, in many more ways than one.  Maybe I'll get back to that someday, I don't know at this point.  Or more likely, there's a balance to be struck somewhere.  I'm realizing that possibly, just possibly, it matters a great deal more that you represent yourself in the most genuine way possible, rather than worry exclusively about how to make the person across the table swoon for you.

Honest communication, with women or otherwise, isn't a new idea to me.  I'm an adult, and I've had adult relationships.  But the concept, like all of my psychological anchors, is now multiplied by an infinite magnitude.  The pressure to be honest and the bold-faced luck it takes to find someone who actually appreciates what you're offering is probably terrifying enough for anyone.  Add to that a year and a half of post-terminal-illness neuroses, and you have yourself a cornucopia of obstacles.  Although everyone has issues, and many relationships are defined by who decides they can put up with each other, there are certainly other factors.  Perhaps most importantly, one has to be a voluntary participant.  And that includes several things.  One of which is, like I said before, being okay enough to find someone who is okay with you too.  And that shit takes guts.  It also takes time, energy, and other intangible resources that involve a stable psychological bearing.  When someone pursues a relationship but doesn't have these things, that relationship will fail.  People like this generally hop from one relationship to the next, never pausing for a diagnostic check or to evaluate their own self-worth.  Or they date superficially, turning on the charm like a switch, always making sure to say the right things in order to distract from the fact that they aren't actually letting anyone in, much like a magician uses slight of hand to hide his true actions.  You wouldn't hide your true self from someone unless you either didn't think yourself valuable, or you didn't think that person valuable.

I hide myself in public all the time now.  Because my true self is wounded.  And I have no desire to spill those wounds out onto the ground.  I'll hold my severed guts in with my own two hands for now, thanks.  But someday I plan to figure this out.  It's easy to assume I've permanently altered my ability to connect with people, because that implies no work needs to be done to correct my current attitude.  And I think that's the wrong way to go.  Because other people have had problems, and other people have found a way to love and friendship.  And I'm still very young, and I have a lot left to do.  I have many more people to meet.  I might as well do it on my own, principled terms, which include appreciating them for who they are, for what their minds and souls reflect, and not for how they can make me feel, or what I can get out of it.  Other people are enriching enough on their own, without having to make a game out of your relationships.  That's a conditioned response I'll have to work on.  I have pursued relationships with women and with friends for many reasons: because I was in love, in lust, I was bored, because once it was the greatest game.  It remains to be seen how I will do so in the future.

But hopefully I've uncovered something valuable to anyone who reads this.  Hopefully I've given a reason to reevaluate any relationship, even ours, and polish off some piece of it we can keep in our hearts, untainted, until the end of time.

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.