Tag Archives: American Cancer Society

December motto plus optional isolation

CanceroustumorsurroundingrightkidneyDr. Jeniffer Simon, a caring and experienced urologist, Geissinger Medical Center, State College PA showed me on her computer this image–a cancerous tumor surrounding my right kidney, referring me to Memorial Sloan Kettering Cancer Center in New York City. “Unless you have surgery quickly, you will be dead in 10 years.” The date: April 5, 2013, 4 P.M. We hugged; I cried.

The order of this posting (typically presented in a hodgepodge of disorder):

  1. Motto
  2. Paraplegia and the recollection of previous cancers
  3. The last part of cancer therapy
  4. Optional isolation
  5. Joanna’s wedding
  6. This I believe

Motto

Make haste slowly is the motto.

Gold coin Emperor Augustus (63 BC to 14 AD) minted to display the symbol for his motto: "Make haste slowly."
Gold coin Emperor Augustus (63 BC to 14 AD) minted to display the symbol for his motto: “Make haste slowly.”

I first came across this seemingly contradictory expression when trying to learn Latin: Festina lente.

Unless one is in a situation such as mine, Make haste slowly appears to make no sense.

Speed and slow are opposites.

The last part of cancer therapy

My situation comes at the end of a difficult time.

The time began in April when I was diagnosed with kidney cancer and reached medical optimism after I left my home in State College, PA where the expertise to save my life did not exist.

This is my first "step" in getting to New York.
My first “step” in getting to New York.

I was referred to Memorial Sloan Kettering Cancer Center in New York City—a five hour car ride away. On August 8th, Dr. Paul Russo removed the cancerous tumor, saved my right kidney, and essentially prevented me from dying of kidney cancer. It was a gift of 10 years.

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In The Canary Murder Case by S.S. Van Dine, Philo Vance—almost certainly the most obnoxious snob in the history of detective literature—is helping his friend the district attorney solve a difficult murder. The district attorney says, “’Well, well! So the case is settled! Now if you’ll but indicate which is the guilty one, I’ll arrest him at once, and return to my other duties.’”

“’You’re always in such haste,’ Vance lamented. “Why leap and run? The wisdom of the world’s philosophers is against it. Festina lente, says Caesar; or, as Rufus has it, Festinatio tarde est. And the Koran says quite frankly that haste is of the Devil. Shakespeare was constantly lamenting speed. ‘He tires that spurs too fast betimes.’”

Still from the 1929 film version of The Canary Murder Case
Still from the 1929 film version, The Canary Murder Case

Vance, whose name in 1927 became synonymous with private detective, goes on to quote Moliere, Chaucer and the Bible on the subject.

My energy level is sufficiently low and my acuity high enough I understand Vance’s point without citing the additional paragraph.

Paraplegia 

For the past 20 years, I have been a paraplegic unable even slowly “to leap and run.” Paradoxically, in high school I received a letter sweater for running 2 ½ miles regularly during cross-country competitions. My best record was clocked running two miles in less than 12 minutes, hardly the Olympics, but good enough for Cheltenham High School  in Wyncotte, PA.

Yes, I would like to leap and run. There are a lot of things I would like to do that I cannot.

What I want to do is live life to the full and in the process make a contribution along the path I have committed myself.

I certainly have done a lot of living in the past 20 years as a paraplegic. In one of my three trips across the United States from sea to shining sea, I took my battery-powered scooter and drove it around the rim of the Grand Canyon.

In California, I watched my elder daughter Joanna train a horse to jump a fence. As I watched, the horse did something amazing. After going over the fence for the first time, the horse did a double-take, shaking its head as if to say, “I do not believe I did that.” Joanna’s smile of accomplishment…

In Santa Cruz, one glorious day, Amelia my younger daughter and I boarded a ship and watched whales frolicking.

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Isadora Duncan
Isadora Duncan

For a while, I chose the Isadora Duncan School of Dance rather than rehabilitation–both dance and physical rehabilitation have become an essential part of my doxology.

The brilliant physical therapist Alicia J. Spence at State College's Phoenix Rehab begins; it is time for me to return to her.
The brilliant physical therapist Alicia J. Spence at State College’s Phoenix Rehab begins; it is time for me to return to her.

In the Silicon Valley, I wrote a technical manual for KLA-Tancor on inspecting silicon wafers for defects. Often, I scrubbed down, putting on a white gown and hat; wheeling into the clean room where my readers would be using the documentation.

The recollection of previous cancers

After radiation treatment for cancer, I fathered my two children, published three books, and loved and was loved in return.

The experience of having cancer twice, first at age 28 then at 42—treatment which burned my spine and made me unable to walk certainly slowed me down. It did not stop me. Nor has the experience of having cancer for the third time at age 65 stopped me.

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“The Roman historian Suetonius… tells that Augustus… thought nothing less becoming in a well-trained leader than haste and rashness, and, accordingly, favorite sayings of his were: ‘More haste, less speed’; ‘Better a safe commander than a bold’; and ‘That is done quickly enough which is done well enough.'”

Wikipedia continues, “Gold coins were minted for Augustus which bore the image of a crab and a butterfly, which was considered to be emblematic of the adage. Other pairings used to illustrate the adage include a hare in a snail shell; a chameleon with a fish; a diamond ring entwined with foliage; and, especially, a dolphin entwined around an anchor. Cosimo I de’ Medici, Grand Duke of Tuscany had festina lente as his motto and illustrated it with a tortoise with a sail upon its back.”

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Frequently, I suspect I have not learned from experience.

The same mistakes seem to repeat themselves in predictable order. This is most often the case with loss of energy. So often have I felt my body filled with power and enthusiasm that when the power disappears and getting out of bed becomes a chore, a dark cloud seems to hang over me.

The cloud is not there now.

Recovery from surgery has surprised me by its slow pace.

When I returned from New York in August, the combination of weakness and pain made me grateful to be alone.

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One consequence of my receiving a cancer diagnosis in April of this year is that the telling provoked waves of  affection and attention not merely from those close to home.

A woman whom I had loved intensely in 1972 ( not seen or heard from since) read here on this site an optimistic account of my situation and responded with an e-mail followed by phone calls. We talked about the children we did not have together, the life we did not share, and the strangely odd and encouraging fact that affection untended continues despite the reality that it had its origins so long ago.

Friends appeared with whom I had lost contact for decades. My expectations of how good people could be to me were vastly exceeded by reality. I have emerged from surgery with the feeling of being cherished. Nothing I can say or do can ever repay my gratitude. You know who you are and yet you do not truly appreciate how much you have graced my heart.

Often I feel words used to describe me are wrong, just wrong. I do not think of myself as “brave” or “courageous” or a “fighter.” When I think of myself, which I do often, I try to stop—meditate and in my own fashion pray that the ego will dissolve and I will just continue, pursue the path.

Optional isolation

Late in August, back at my apartment, alone, feeling that strange happiness that comes when intense pain disappears, whoever I am is comfortable to me. By nature I am impatient. By nature, I am persistent. Then, the phrase make haste slowly serves as a comfort. I will do what I need to do when the time comes. I will be grateful for energy and understanding when I cannot do what needs to be done. If the sky falls and I do not have the strength to stop it, the sky falls. Such is life.

Joanna’s wedding

Before I scooted Joanna down the aisle, she drove me to New York for the surgery. My friend  Ben Carlsen drove from State College to New York to bring me back home.
Three months before I scooted Joanna down the aisle, she drove me to New York for the surgery. My friend Ben Carlsen drove from State College to New York to bring me back home.

Going to Joanna’s wedding in October appears now on the second day of December a miraculous event. Weeks before I boarded the plane, I did not believe the energy would return. I persisted. Giving away my elder daughter on a farm in Mebane, North Carolina produced euphoria that brought me through and carried me home on Delta Airlines.

Amelia was my caregiver at  the American Cancer Society's Hope Lodge in NYC where we roomed together before, during, and after my surgery.
Amelia (right) was my caregiver at the American Cancer Society’s Hope Lodge in NYC where we roomed together before, during, and after my surgery.

At the wedding it was a delight seeing Amelia again in North Carolina a seeming aeon away from New York , saying goodbye before she returned to Spain for her third extended trip.

I loved:

  • Watching my sister Sarah Leah Schmerler dance without inhibition after the intensity of being together at the hospital in New York

sarahatwedding

  • Revisiting my 12 year-old only nephew Asher Simonson with his unexpected moments of humor
  • Seeing his father Robert Simonson who had lugged my mobility devices around the Island of Manhattan
  • My son-in-law Jade Phillips and his firefighting colleagues who, when the festivities were over and the bonfire burned out, literally picked up my exhausted body and flung me into the passenger side of a truck

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Then fatigue. Delight in being alone. Concern I would not finish the work I must finish. Optional isolation. Appearing outside my apartment only occasionally. Seeing as few people as possible. Avoiding crowds, large gatherings, and familiar places where I have been surrounded by affection.

Periodically, I receive calls, visits, e-mails and reports of those who ask with affection and concern “Where’s Joel?”

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Life continues.

A dear friend becomes sick. Miles and often even a few blocks I do not have the energy to travel keep me from being where I would otherwise like to be.

I sit in my apartment and wait. A rush of energy and I find myself writing, as I am writing now, without stop, expressing while leaving dishes unwashed, my bed unmade, not yet able to complete rigorous academic writing—not quite able to pull together a large project.

Instead, I follow whim. I have been making You Tube videos—going off to a computer in the patient company of an expert in iMovie editing software, collapsing, returning, making slow steady progress as bills pile up, consistently refusing to think about the money I do not have and the energy I do not have to obtain it.

I have been reading Robert Alter’s The Book of Psalms, his introduction tracing the psalms’ origins back to the Bronze Age over 3,000 years ago, reciting his clear translation, going to the Hebrew, recalling my mother never left the house without a small Hebrew copy of Psalms in her pocketbook, dipping into David Halberstam writing about Elvis Presley, reading a paragraph here and there about architecture, engineering, virtual reality—not doing much for long, but doing and then in fatigue watching by choice vapid Netflix videos for hours.

The last part of cancer therapy

I hope to encourage others like me who are recovering to recognize our temporary limitations and persevere.

Most do not recognize the difficulties involved in recovering from cancer after the disease is gone but the energy has not returned.

[To be inserted here observations about suicide attempts by survivors. This issue I discuss in my book Learning to Live Again, My Triumph over Cancer available on this site http://www.joelsolkoff.com/book-store/books/learning-to-live-again-my-triumph-over-cancer/].

While researching, I came across a footnote in a medical journal article. A young man with the most dangerous stage of Hodgkin’s disease had killed himself after being cured. The autopsy revealed no cancer was present in his body.

Surviving while still recovering can be a hard time unless one is willing to believe in the future. Henry David Thoreau should be an encouragement to those us living in situations such as the one I am now in. Thoreau wrote, “There is one consolation in being sick; and that is the possibility that you may recover to a better state than you were ever in before.”

My life seems to have been lived on the principle that best way to get from here to there is NOT to go in a straight line.

I have been watching You Tubes of Edward R. Murrow, my hero. This one caught my fancy yesterday at 2 in the morning.

This I believe

I believe:

  1. I am alive for a purpose.
  2. The attempt to achieve the purpose, which I choose to call my path in homage to Laozi, serves not only its own end but to unite all that is sacred to me; namely, my children (of course) who are adults and have lives of their own; my sister Sarah and my family, my friends who are family; my love for women (a woman were the right woman in my bed); the need to care for myself, be independent in body and mind, be a good citizen who embraces not only my country but my mother Earth, and the need to be the human being I strive to be who believes in the spirit that gives us life.
Clearly a fictitious image of Laozi. No one knows what he looked like. The story is Laozi appeared at a border crossing. The guard asked him to write a book of wisdom. Laozi wrote The Way, gave it to the guard who allowed him to cross. Laozi disappeared. This story and The Way are the only evidence of his existence.
Clearly a fictitious image of Laozi. No one knows what he looked like. The story is Laozi appeared at a border crossing. The guard asked him to write a book of wisdom. Laozi wrote The Way (The Path), gave it to the guard who allowed him to cross. Laozi disappeared. This story and The Way are the only evidence of his existence.

3. My chosen path is to help the elderly and disabled achieve their potential.

4. Along that path is the virtue of technology which makes it possible for me to go seamlessly from my bed to my kitchen out the door and into the world on scooters like the kind that my dear friend Al Thieme of Amigo Mobility invented which he refers to as Power Operated Vehicle scooters or POV scooters to distinguish them from toys. The technology mobility path includes power chairs and equipment being developed at an astonishingly rapid pace. The consequence of this technology is I do not think of myself as one whose disability prevents me from living life to the full. For individuals with hearing and visual disabilities technology has developed to the point where, for example, an individual blind from birth can drive an automobile specially equipped with laser scanning of the road;  the automobile provides the driver computer-voice simulated operated instructions.

Thank you Wired Magazine: http://www.wired.com/autopia/2009/07/blind-driver-challenge/
Thank you Wired Magazine

Totally blind drivers have passed tests on intentionally difficult driving courses. I believe in my lifetime the Commonwealth of Pennsylvania will issue drivers licenses to individuals who are totally blind but who have proven their ability to drive sophisticated vehicles such as the ones already produced by the Virginia Tech’s Robotics and Mechanisms Laboratory.

Amigo manufactures this narrow travel scooter shown here in a tight space in a tiny motel room as I traveled nearly 1,000 miles to my daughter Amelia's college graduation.
Amigo Mobility manufactures this narrow travel scooter shown here in a tight space in a tiny motel room as I traveled nearly 1,000 miles to my daughter Amelia’s college graduation.

5. My path is focused on what the architectural, engineering, and construction community refer to as the built environment. See, for example, my biographical information and published work for e-architect: http://www.e-architect.co.uk/editors/joel-solkoff

6. To rebuild the environment, the promise of virtual reality is real. Virtual reality is a promise my 30 year-old mentor Sonali Kumar introduced to me as I worked with her as a research assistant at Penn State’s Architectural Engineering Department to complete her doctoral dissertation entitled: Experience-based design review of healthcare facilities using interactive virtual prototypes. 

VirtualRollinshower

Sonali apologized when she used me as the model for this avatar. “I am sorry I put so much gray in your hair. You do have a lot of gray in your hair.”

Fashion aside, one of my contributions to Sonali’s animated three-dimensional model of an independent-living-aging-in-place home was the suggestion she replace the original bathtub with a roll in shower. As a paraplegic for whom being clean is vital, I have all too often been trapped in a bathtub–on one occasion it took me 45 minutes to figure out how to get out of the tub finally using my arms to push me out, pulling my legs after me as I landed onto a dirty bathroom floor.

7. Experienced-based design is essential. Experienced-based design is one of a number of academic terms meaning the best way to design an environment is to ask the person who will use it. The example that comes most readily to mind is an article I read about a new hospital in the Philadelphia area. The article complemented the hospital administration for asking patients at the previous facility what changes they would suggest making to the design of the new building to make the hospital more patient-friendly. The patients suggested making it easier to get from bed to bathroom by making the bathroom closer to the bed. The article praised the administration for the reduction in falls as a consequence. [I know. My instant reaction to that was Daaaaaaaaaaaahh.] Asking does matter. Ask experts like me, for example, or my neighbors at Addison Court (an independent living apartment building for the elderly and disabled) whom I arranged to view Sonali’s model wearing 3-D glasses at Dr. John Messner’s Immersive Construction Lab for Construction industry. The consequence is we have the experience to instruct the design of the environment around us so that it is more efficient. The result is not merely an exercise in odd-sounding academic words such as case studies, scenarios, and activities of daily living (ADL); it is also a good idea.

SloanBath

8. Self reliance should be encouraged. Shown here

[Note: Think of I believe in points 8, 9, and beyond as Coming Attractions.]

9. Knowing when to ask for help.

Color coded socks at Mount Nittany Medical Center, State College, PA. These socks indicate patient is at risk of falling.
Color coded socks at Mount Nittany Medical Center, State College, PA. These socks indicate patient is at risk of falling.

To be continued.

Meanwhile, here is Edward R. Murrow  interviewing then former President of the United States Harry S Truman on what Truman believes. http://thisibelieve.org/essay/17058/

President Truman is followed by a bad video of an Alan Jackson song. I like the theme. I like the song.

–Joel Solkoff

Copyright 2013 by Joel Solkoff. All rights reserved.

 

My first cancer survival at age 28

I have been describing my third cancer experience at age 65 when I was diagnosed in April in State College PA and had a successful operation in August in New York City at Memorial Sloan Kettering Cancer Center.

  • How did I survive cancer three times?
  • How was I able to father two daughters after massive radiation treatment?
  • Why was cancer treatment responsible for my becoming a paraplegic?
  • What was my emotional state during these three experiences which otherwise might have forced me to concentrate on death rather than enjoying life?

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Answers may be difficult to provide, but what follows is my first attempt to use language for the ineffable.

Five years after my experience with Hodgkin’s disease, my publication on the subject in The New York Times, my appearance on ABC’s Good Morning America, I received a book contract and proceeded to interview formally (receiving signed releases) and on tape the accounts of my:

  • Oncologist
  • Lover
  • Surgeon
  • Mother
  • Father
  • Friends
  • Therapists
  • Members of the therapy group who first learned I had cancer

Writing the book was difficult especially revisiting the radiation treatment room at George Washington University Medical Center where the chief radiologist had died from exposure to his own machines.

Making the difficult an easy read was also difficult and slow.

What follows is Chapter One of Learning to Live Again, My Triumph Over Cancer.

[Readers desirous of obtaining the entire book, praised by the prestigious Library Journal, may download it here and now. http://www.joelsolkoff.com/book-store/books/learning-to-live-again-my-triumph-over-cancer/

What follows is the entire chapter one of Learning to Live Again: My Triumph Over Cancer, published by Holt, Rinehart, and Winston, then a subsidiary of CBS.

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Chapter 1

I DO NOT HAVE CANCER ANYMORE. The disease was treated by conventional radiation therapy, and my physicians say that it has been eradicated. I believe that I have been cured, despite a recurring nightmare that a doctor is examining my body, checking for lumps.

Today, I had lunch with Laura in the oak-paneled dining room of the Hay-Adams Hotel. We each had two drinks and needed more. Our love affair became a casualty of the cancer cure. Too much intensity was confined to too short a period of time, time that always seemed to be running out. Although we tried afterward, we were unable to salvage our relationship. Today, I told Laura that I am engaged to marry another woman—Diana, whom I met after the cancer experience was over. Laura and I toasted to the future—a future that we will not share.

It is spring here in Washington. The cherry blossoms are out early.

Spring this year feels the same as it did five years ago. I continue to live in the same city and in the same apartment. At thirty-three, I am too young to write my memoirs. Yet that is what I am doing, reliving the period five years ago when I was diagnosed as having cancer and feared death. The diagnosis and its treatment—over a period of six months—was the worst experience of my life. Remembering how poorly I behaved is worse than remembering the physical pain and the fear.

Now, five years later, my statistical category has changed. Today I conform to the American Cancer Society’s definition of cured: five years without a recurrence of symptoms. A generation ago my type of cancer, Hodgkin’s disease, was described as “invariably fatal.” A generation ago I could not have survived five years. I would not have lived to interview family, friends, and physicians, nor to revisit the hospital in which I was operated upon and treated. The difficulties of remembering and surviving would have been denied me.

ON FRIDAY AFTERNOON, April 23, 1976, I am sitting in a doctor’s office worrying. Worrying is something that I do a lot and am good at. At the time I do not realize that I have much more reason for concern than when I normally worry about (a) money, (b) getting the article in on time, (c) my relationship with Laura, (d) finishing the book, (e) cleaning the apartment, and so on. Specifically, I am in the waiting room of Aaron Falk’s * office because there is a small lump—about the size of a golf ball—under my right arm. The lump does not hurt, and it is noticeable to no one but me. However, it has been there for a number of weeks, and several times a day I find myself feeling under my armpit to check whether it has gone away. The lump has joined my mental list of things to worry about.

Given how regularly I worry about my health—running to a doctor’s office at the first sign of a cold, a sore throat, or a backache—I do not anticipate that my first appointment with Dr. Falk will be noticeably different from previous appointments with other doctors. My experience as a mild hypochondriac is that doctors find my ailments boring. I leave their offices feeling embarrassed for bothering them and stupid for paying so much money to find out that there’s nothing wrong with me.

Indeed, I have made the appointment because I want to be reassured that nothing is wrong with me. This time I am sufficiently concerned about the lump that I am willing to risk the likely embarrassment and expense. However, the longer I sit in the waiting room, the more convinced I become that the lump is inconsequential and that it will probably disappear if I wait long enough. I am convinced that Dr. Falk, whom I have yet to meet, will be polite, but in a tone that will imply that doctors go to medical school to cure really sick people and why does he have to waste his time seeing obviously healthy people like me.

As I read the plastic sign welcoming patients to talk about physician fees with the physician, I decide that now that I am in the doctor’s office, I can stop worrying about the lump and start worrying about money. My concern about money at this time has a rational aspect to it. As a free-lance writer my income is precarious. I have difficulty obtaining insurance. My previous policy, with Stan, a friend of a friend who agreed to let me join his group plan, was terminated because Stan pocketed the payments rather than sending them to Blue Cross. That experience has made me feel insecure about my current plan, with the newly formed Washington Independent Writers. The paperwork is already fouled up. Despite the organization’s reassurance that my membership card has been processed and is in the mail, I worry that I may not be covered by insurance at all. So as I appraise the doctor’s office, which is in an expensive neighborhood, provides free parking for its patients, has its own laboratory on the premises, and offers a spacious waiting room (where a large potted plant has cedar chips covering the soil), I am concerned that the tests and doctor’s fee will be more than I can afford—and all for a complaint that will probably turn out to be nothing.

Aaron Falk begins, as doctors do, by asking why I have come to see him. I tell him about the lump under my arm, that it has been there for several weeks, that it doesn’t hurt, and that it hasn’t gone away. I ask, “Is it serious?”

He says, “I don’t know yet. First let’s get the usual questions out of the way. Then we’ll go next door where you’ll take your clothes off and I’ll examine you. We’ll take some routine blood tests and a chest X ray. When we’re done with that we’ll come back here and I’ll tell you what I think, assuming I think anything. Okay? Now, how old are you?”

“Twenty-eight.”

“Profession?”

“I’m a writer, specializing in agricultural policy.” We talk about that for a while.

We get along instantly. Our ability to communicate seems uncanny. There are not the usual barriers that separate doctor from patient. Dr. Falk is only seven years older than I, so we relate as peers. He is not condescending toward me, as are physicians who make themselves inaccessible because of their specialized knowledge.

BY THE END Of the day, I was calling him by his first name, because it seemed artificial for him to call me Joel while I was calling him Dr. Falk. In retrospect, I must have decided to trust Aaron as soon as we met, when I entered his private office and sat down on the wood-and-wicker chair.

At the time of this first visit, I knew nothing about his educational background. Dr. Falk graduated from Harvard College and went to the University of Pennsylvania Medical School. I also did not find out, until much later, that Dr. Falk and I shared a similar religious upbringing: he attended the Hebrew Academy of Washington; I went to the Hebrew Academy of Miami Beach. While I soon rejected the ritual and ever-present discipline of orthodox Judaism, Dr. Falk continued to observe it. Indeed given the additional distance I was then putting between myself and Judaism, if I had known about our shared religious background, it would have put distance between us.

AARON is the same height as I am-5 feet 10 inches. He is thin and although prematurely gray, he looks younger than he is. Our preliminary small talk clearly makes him impatient, an impatience he has difficulty curbing. He recognizes the necessity of getting acquainted, but fidgets as he sits, uncertain about what to do with his large hands and arms, patently restraining the impulse to dash down the corridor and “do something.” This impatient, almost distracted manner extends to his dress. He is wearing a regulation jacket and tie, but it is that and no more, he looks neither dapper nor even coordinated, his clothes the expression of a man who has more important concerns. He talks in spurts, the way professors do who are more comfortable with scholarship than students. Sentences are strung together rapid-fire, followed by long pauses while he weighs each word. He suspects that he’s transparent and that everyone knows what he’s thinking when he’s thinking it. So Aaron smiles a lot during his embarrassed pauses or when I am talking too long, as if to say, Dealing with people comes awkwardly, but I want you to like me. The smiles work. His eyes light up, expressing interest, even tenderness.

“Marital status?” Aaron asks.

I must be more frightened than I realize. Rather than say, “Single and divorced,” which is how I usually automatically answer the question, I launch into an exposition on the intricacies of New York State’s divorce laws, which five years previous made it more convenient to get an annulment than a divorce. When I respond to a simple question with a long, irrelevant answer, it means that I don’t want to deal with whatever’s going on.

On the way to the examination room he asks how I’ve been referred to him. I say, “I see Dr. Bernstein” (an ear-nose-and-throat specialist whom I visit for colds and allergy attacks). “I asked the secretary what kind of doctor specializes in lumps. She said an internist and gave me your name.”

“You certainly are lucky,” Aaron says. “Not only am I an internist, but this office’s specialty is hematology.” (He does not mention that the office’s other specialty is oncology—the treatment of cancer.)

We are now inside the examination room and he says, “Take off your clothes and I’ll be right back.”

“What’s hematology?”

He stops moving and answers. “It deals with disorders of the blood. It means, you might say, that lumps are our bag.”

What he says frightens me. Instead of asking the obvious—”Do I have a disorder of the blood?”—I revert to worrying about money. Telling him of my concern I say, “Tests are expensive and I’m short of funds right now. Can you go easy on the tests?”

Abruptly, he places his right arm against the door, as if to stop himself from exiting. Turning toward me, he seems suddenly angry as he says, “Nobody’s going to tell me how to practice medicine. If I order tests, it’s because I think they’re necessary. I’m a doctor and my concern is your health. I don’t give a damn about the money. If you can’t afford it, then you can’t afford it. We’ll work something out. You’ll pay me if you can, and if you can’t then you can’t. Money is the last thing we need to worry about now. I’m not going to let you tie my hands by telling me not to order the tests I need to practice quality medicine.”

After I take off my clothes, he feels the lump under my right arm, asking whether it hurts as he touches it. It doesn’t hurt. Kneading my skin with his fingertips, he feels for lumps under my left arm, under my ears and behind my neck, across my abdomen, and at my groin. There aren’t any other lumps.

He asks, “Do you have sudden chills or wake up sweating in the middle of the night?

“Have you been running a fever?

“Do you have sudden outbreaks of itching?

“Have you recently experienced sudden and unexplained weight loss?

“Do you suffer from loss of appetite?”

I answer no to all the questions, and when they stop, I say, “Why are you asking me this? What’s wrong with me?”

He says, “I don’t know that anything’s wrong with you. Go to the lab around the corner—he points the way—”and they’ll take some blood. The nurse there will direct you to the X-ray room. After you’re done with the chest X ray, get dressed and return to my office. Then, we’ll talk.”

If there were more room in the office, he’d probably pace, trying to figure out some way of saying what he wants to say without frightening me. Instead, he leans awkwardly against a bookshelf and, in a rush to get it over with, blurts out, “Look, I don’t know what the lump is. It’s probably nothing, but I don’t know. I think it’s a good idea for you to see a surgeon so he can remove the lump from your arm and we can examine it and find out what it is.” He is trying hard to convey as much information as possible, so I can understand his perspective and make a rational decision. He smiles abruptly, as if to apologize for what he’s just told me, and asks, “Are you willing to see a surgeon?”

“I guess so.”

“Can you do it right now?”

“Yes.”

He gets on the phone and calls a surgeon named Cory Simpson and inquires whether he can see me right away. He can. Aaron says about me, “Yes, he’s perfectly capable of walking over. In fact, I’ll tell him to run over. He’ll be there in a few minutes.”

Aaron gives me Simpson’s address, which is about five blocks away. He says, “Look, it’s Friday afternoon and you’re lucky that Dr. Simpson can see you right now. I want him to have a look at your arm. Then come back here so we can talk.”

As I leave his office, he calls after me. “Hey, there’s nothing to worry about. I don’t want you to be alarmed. It’s best to do these things quickly, just to be on the safe side.”

As I am crossing L Street and New Hampshire Avenue, it does not occur to me to question why I am listening to this doctor’s urgent instructions or why I trust him. I am puzzled because never before has a physician taken my physical ailments quite this seriously. Fear is creeping up on me, fear because the doctor has asked me specific questions and because it seems that I have a specific disease; fear because he says he specializes in disorders of the blood and by implication that’s what I may have; fear because I am en route to a surgeon. I have never had an operation, and I’m a coward when it comes to pain. Fear because a doctor thinks that an operation is necessary at all. But I don’t actually feel frightened yet. I can tell that the fear is coming, but am able to put it off, not wanting to be afraid, too busy concentrating on getting to Simpson’s office and on obtaining as quickly as possible a new range of information that I’ll need to deal with this situation. I know that I’ll be frightened later, but for the moment my curiosity is stronger than the fear. I consciously decide—like Spock in “Star Trek”—to banish my emotions and concentrate on being logical.

I arrive at Dr. Simpson’s office and am filling out the insurance form when the doctor comes out. “Are you Mr. Solkoff?” Pointing to the insurance form, he says, “You can do that later. Why don’t you come into my office?”

Simpson is also not much older than I. He is tall, thin, and wears a tapered three-piece designer suit. Among George Washington University medical students, who are notoriously hard on their instructors, he has a reputation for being a very fast and very good surgeon.

Right away, I find him to be unpretentious and easy to understand. He feels the lump under my arm and says that he doesn’t think there will be any problem removing it. He reassures me that the operation won’t be painful (which I don’t believe), that I’ll be awake while he does it, and that I can return to work right away.

I say, “What’s the rush? Why did Dr. Falk tell me to run over here?”

“Aaron has a tendency to be enthusiastic. He probably thinks it’s a good idea to find out quickly what that ‘lump,’ as you call it, really is.”

“What do you think it is?”

“I don’t know. You’ll have to ask Aaron.”

SIMPSON’S ATTITUDE toward me, from the beginning, was matter-of-fact. Later, he told me, “In reality, as a surgeon I was actually put in the position of being just a technician. I was not making major decisions regarding your care. The major decisions were really made by Dr. Falk—and you, of course.” He explained that surgeons, like anyone else, would prefer to be creative and in a position of authority.

Instead, as often happens, he was asked to do a routine task which he had done hundreds of times before. He was perfectly willing to explain the procedure to me and consistently answered every question asked about surgery and possible complications. However, regarding speculations on my diagnosis and life chances he continually referred me back to Aaron, whom he regarded as my primary physician. Whenever I asked whether he thought a procedure Aaron recommended was necessary, he said yes, telling me that Aaron was a respected physician who specialized in conditions like mine and whose judgment was trustworthy.

Eventually Simpson told me, “You and I are relatively close in age, and since I could avoid thinking about your dying, I did.”

Simpson and I never became friends, as opposed to my relationship with Aaron. I still don’t know Simpson well, and I doubt that many people do. Yet I respected him. He was easy to be with during painful and stressful situations. Like Aaron, he has an off-beat sense of humor, which we shared and enjoyed, and while there was nothing memorable about our jokes and bantering, it made future events easier that we all “horsed around” (as Aaron put it), often in a self-deprecating way. Given the closeness in our ages, none of us took offense or felt threatened when I complained about Simpson’s sutures or Aaron’s plans for treatment or when they complained about my behavior. Had they been much older, or had I been much older, my relationship with my doctors would have been more decorous—making the whole experience grimmer.

BACK AT AARON’S OFFICE, I ask what he thinks the lump is. He says, “It may be nothing at all, just some fatty tissue.” “But you think it’s something else?”

“I don’t think it’s something else. I don’t know what it is. That’s why I want to find out.”

“What else might it be?”

“It’s probably a benign tumor.”

I am frightened by the word tumor. Having assumed that I’d never have to deal with a tumor, each time the word appears in conversation I tune it out. “If it’s benign, why is it swollen?” I ask Aaron.

“All tumors are enlargements, abnormal growths. Most just happen, for reasons which are complicated and about which we’re not entirely sure.

Most tumors are benign, which means they’re not serious, and when we remove them, there’s nothing to worry about. The chances are that yours is benign and that when Dr. Simpson removes it, you and I will be done and you can go about your business.”

“And if it’s a serious tumor?” I don’t want to say the word cancer.

“I don’t think it’s serious, but if it is, then we’ll cross that bridge when we come to it.”

We talk about scheduling for the operation. He wants the tumor out of me as quickly as possible. I realize that walking around worrying that I have “something serious” when I probably don’t is stupid, and the sooner I know the better. But I don’t want someone else or something else controlling my life. I have an article to complete on Cesar Chavez, which Marty Peretz, the owner of The New Republic, commissioned and is expecting. Already, I am beginning the process of negotiating, trying to fit the problem of my tumor into my schedule. Aaron says firmly, “Don’t wait too long. This is something that should be taken care of right away.” I promise to call Simpson’s office and schedule an appointment.


 * While all characters in this book are real, several names have been changed.

This material is copyrighted © 2013 by Joel Solkoff. All rights reserved.

[Reminder, to read the rest of the book, please click this link: http://www.joelsolkoff.com/book-store/books/learning-to-live-again-my-triumph-over-cancer/]

learning-to-live-again-triumph1

 

++++

Here is Tim McGraw singing on just this very subject.

He said 
I was in my early forties 
With a lot of life before me 
And a moment came that stopped me on a dime 
I spent most of the next days 
Looking at the x-rays 
Talkin’ ’bout the options 
And talkin’ ’bout sweet time” 

I asked him
“When it sank in
That this might really be the real end
How’s it hit you
When you get that kind of news?
Man, what’d you do?”

He said
“I went skydiving
I went Rocky Mountain climbing
I went 2.7 seconds on a bull named Fu Manchu
And I loved deeper
And I spoke sweeter
And I gave forgiveness I’d been denying”
And he said
“Someday I hope you get the chance
To live like you were dying”

He said
“I was finally the husband
That most of the time I wasn’t
And I became a friend a friend would like to have
And all of a sudden going fishin’
Wasn’t such an imposition
And I went three times that year I lost my dad
I finally read the Good Book, and I
Took a good, long, hard look
At what I’d do if I could do it all again…

And he said

“Someday I hope you get the chance

To live like you were dying

Like tomorrow was a gift

And you’ve got eternity
To think about
What you’d do with it
What could you do with it
What did I do with it?
What would I do with it?