Carpe Diem! If Not Now Then When?

6 weeks out from surgery. Brooke and I traveled to MD Anderson last week for my surgical follow up. Thankfully it went well. The surgeon was pleased and I am on track and recovering quickly. The one bit of concern was the persistent headaches and dizziness I have been wrestling with, a small cause for concern.

Brooke and I watched the surgeon’s face when I mentioned the headaches and dizziness, a flicker of concern, and he ordered a brain MRI to make sure I was clear. The MRI threw us for a loop. It was poignant reminder of how fragile we are, and that even with a good prognosis nothing is for certain when dealing with cancer. We had another 48 hours of “what if”, waiting for the results, holding our breath, and breathing through the uncertainty.

Thankfully the news from the MRI was positive, no issues. Most likely the headaches and dizziness are from a lingering sinus infection. Makes sense, my body has had other issues to worry about! So I started a round of antibiotics and the headaches and dizziness, although not entirely gone, seem to be receding.

Holding uncertainty is our new norm. Now, like so many other survivors, we play the cancer game. I am in remission and that is excellent, we stay vigilant for 5-years, get regular scans, and live as healthy a life as possible. Good diet, low stress, plenty of exercise, gratitude, and appreciation for everyday. Brooke and I can now let go of the constant fear and ease back into a “normal” life. Yet for me I feel as if I have walked through a looking glass. My life changed August 1st and it will never be the same.

As it turns out my cancer was farther along than previously thought. My first pathology report in Boulder said it was in situ, so early that a quick surgical procedure and I would be cured, a 100% survival rate in five years. My post surgical pathology revealed a bit more advanced nemesis, Stage 1B. The five-year survival rate for people with this stage, who have had my exact procedure and outcome, is 60%-80%. My surgeon said I should be on the “higher end” of that scale, I am relatively young, fit, and the tumor had not invaded the pleura or lymph’s. Good news. 

And yet, if you deal with %’s each day, as I have been trained to do, that still leaves risk on the table. 1-5 people, standing exactly where I am standing today, will be dead in 5 years. I don’t say that to be dramatic, it is just a fact. And while I am more than confident that I am solidly in the majority, I would be foolish not to be cognizant of this reality.

Like so many elements of this journey this too is a gift. I fully intend to live my life with the knowledge of another 40+ years ahead of me. At the same time if in 3 years I learn that I have stage 3 or 4 metastasized brain cancer I don’t want to have 1 minute of regret. Not 1 minute! I am not sure I can make that claim about the last 3, 5, or 7 years. I wonder how many people can?

I know that along the way I have made what I thought were meaningful sacrifices, trading X now for Y in the future. No more. I don’t want to have any “I wish I had…” spent time with my family or friends, time in nature, exercising, or investing in service to others. I do not want to waste another minute, personally or professionally, in areas that I am not completely passionate about.  Life is too short. The gift of this cancer is that standing facing my own mortality, I can no longer pretend otherwise. That genie will never go back in the bottle.

Isn’t that really the case for all of us? I wonder what the actual statistical percentage is for each of us once we pass 40 years of age? Life happens, illness, accidents, whatever…Maybe we all have an x% chance of survival in 5 years? Perhaps the only difference is that I have been given the gift of awareness to remain vigilant, to not slip back into the daily trance, the constant societal and cultural allure of “planning for the future at the expense of the present”.

As all the great spiritual and wisdom traditions teach us, death can come at any time for each of us, “this body too shall be a corpse”. The trick is to never forget the timeless wisdom, to live everyday as if this were our last. Carpe Diem!

 

 

 

 

Fear…

Fear: an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat.

I have had many people ask me recently if I am afraid. My surgery is in 4 days, and no doubt about it, it is a big deal. Thoracic surgery, incisions in my chest, the removal of parts of my lung and some lymph nodes. And from what we have learned from others who have been down this path, it is a big recovery. On top of that there is the usual surgical risks. Anesthesia, human error, and infection, the practice of medicine. Hospitals unfortunately are not the healthiest of places. In many respects at this very moment I face greater risks from the surgery than I do from the cancer. Of course this is a false argument, the cancer is the real threat, and is getting stronger every day. The surgery is the path to health and healing, yet requires some pain and discomfort to get there.

Based on the dictionary definition of fear it seems like a logical question to ask. I certainly have had some “unpleasant emotions caused by the belief that something is dangerous and likely to cause pain”. Guaranteed to cause pain is more like it! Yet given all of that I don’t feel that fear is the right description for what I have been feeling over the last few weeks, and especially over the last few days. Instead I am feeling more uncertainty than fear.

Uncertain: not able to be relied on; not known or definite.

I still struggle to wrap my head around the reality that I have cancer. Perhaps because I don’t have any symptoms? Perhaps I am in denial? Maybe it is just a matter of time? 4 weeks is just the beginning of adjusting to a new reality, a reality that in a single instant has changed the trajectory of my life. The dawning of a new perspective on what it means to live, and what it means to palpably feel the vulnerability and fragility of life up close and personal. I am resigned to the surgery as a necessary step in the process. After all what choice do I have? Let the cancer grow, pretend it will go away? And I have been down the surgical path before. This will be the 6th time in my life that I have been put under anesthesia. I am a relative veteran compared to some. Brooke has never undergone surgery, and in fact never spent the night in a hospital! I have the benefit of context and like any endeavor you have done before it is always “easier” the next time through.

Yet the uncertainty remains. Has the cancer spread (they will do a flash biopsy of some lung lymph while I am on the operating table)? Will there be post operative complications? How much of my lung will they remove? Will I be able to regain my full aerobic functioning? And God forbid could something go catastrophically wrong? The answer is probably a resounding NO to all of the above. And yet the uncertainty gnaws at the edges of my resolve and confidence. I am reminded of my past and the mountaineering instructors who would encourage me that if I was not a bit nervous and afraid then I wasn’t paying attention. Climbing has inherent risks, and many rewards as well. We rely on the equipment, we become proficient in the technique, and we trust our partners. The subjectivity of the environment and the mountain can never be fully mitigated. Much the same with my surgery. We have done everything we can, have an amazing team in place at one of the top hospitals in the world, etc. The rest is in God’s hands.

So am I afraid? Yes I would have to acknowledge that I am. Not every minute, in fact far less than I had expected. Yet it is there on the margin, a thin ribbon of concern.  Certainly there is anxiety to be stepping into the void, yet because of the paths I have already walked in my life, I know I have the mental, physical, and spiritual strength to walk across this pit of fire. Instead there is a different type of fear, focused more on a perceived threat. And this “threat” nips subtly at my consciousness. A concern that I will come through this, heal, and quickly forget the lessons that have unfolded for me in the last 4 weeks. The benefits of cancer; the intimacy and connection with myself, family, and friends. That when I am cancer free and healed I will once more step into the fog of being unaware. Succumb to the fiction of a perceived future. The enticing lure of ambition and external achievement above all else. The trap of gauging self worth based on external validation. The fantasy that time, health, and “tomorrows plans” are limitless.

I want to remember everyday from here forward what I so acutely feel today – that everyday is truly a gift. A gift to be cherished, shared, and not wasted. And I want to live my life in gratitude to all of those whose love supports me, and to whom I can support with my love. I want to stay awake.

Love yourself and be awake –

Today, tomorrow, always.

First establish yourself in the way,

Then teach others,

And so defeat sorrow.

To straighten the crooked

You must first do a harder thing –

Straighten yourself.

You are your only master.

Who else?

Subdue yourself,

And discover your master.

– Dhammapada