My Man Mozart

 [Note: In a previous post on Fear, I mention a poem written after my second cancer experience.] 

“I love Paris in the summer.

“I love Paris in the fall.”

The song on the downward elevator sings in my ears until they ache

With the sound of music other than Mozart.

 

Thank God for Mozart.

At least there is Mozart.

 

Not all the time.

Not at the worst times—

the times as I remember the hospital

cancer radiation treatment waiting room

with sexy magazines and death.

No Mozart in the air.

 

Oh Mozart. I want Mozart

as the stomach aches.

I cannot eat.

I do not eat.

 

I vomit

I cannot control the diarrhea.

Then blood and pain in the rectum and anus–

bad pain.

 

Where is Mozart when I need him?

Mozart in the air.

++++

Mozart with his French horns,

French horn music he stopped writing

because he fell in love with another woman

whose father did not play the French horn for a living

unlike his father’s friend the grocer who yearned to play professionally

whom Mozart treated so poorly I try to forget that mean Mozart so unlike his music.

Mozart did not really did not like the French horn anyway nor the flute not that it showed

to those of us for whom it was relief.

 

Sometimes (rarely) there is enough Mozart.

Most times there is not.

 

In the tough times,

the really hard times,

give me Mozart.

He’s my man.

–Joel Solkoff, March 20, 1990, Washington, D.C.

[Written about a year after the radiation stopped—radiation that cured me of Hodgkin’s disease again, a year during which the sickness spread through my body in a wave  that came to a blissful end to be followed without warning five years later by the radiation burning (as my oncologist explained later like a small fire that finally succeed in burning) through my spinal cord making me a paraplegic.]

Copyright © 2013 by Joel Solkoff. All rights reserved.

This poem is a subset of the ongoing story of my third cancer–kidney cancer, a story that follows this outline (which is expanding):

https://joelsolkoff.com/who-i-used-to-be/

https://joelsolkoff.com/my-personal-experience-with-cancer-cancer-iii-ii-i/

https://joelsolkoff.com/my-fear-of-the-future/

My fear of the future

I am sitting by a Zen-like creek in New Jersey (a delightful commuter trip away from Manhattan) watching an egret swimming along the water bobbing for a snack.

egret

I am at peace, but it is a strange peace.

For one thing, minor ailments begin to crowd out major ones:

  • The allergies of spring assault my nose.
  • My left eye tears.
  • Whatever illusions I have of dignity disappear as I search my pockets for a dry tissue.

The larger issue of CANCER does not appear as real to me.

I have none of the symptoms of renal cancer (yet?)—just the radiologist’s report and the CAT-scan itself. (While preparing to go to New York, PH [to help me out] picked up the disc duplicating the scan from Mt. Nittany Medical Center which I carried with me to Memorial Sloan Kettering Cancer Center; the disc now sits at the bottom of my book bag.)

Any time I like, I can insert the CAT-scan disc into a computer and view the tumor surrounding my right kidney—a view I have seen once and feel no desire to view again—dramatic as it might be to take a screen shot and show you. Ah technology!

Ever since I posted the news that I have renal cancer, I have received an outpouring of emotional support so intense it surprises.

I am loved; I am.

++++

Reluctantly, I leave the egrets, take the ferry to New York and go to the Morgan Library to view a Mozart manuscript—a manuscript Wolfgang Amadeus wrote himself.

Last time I was treated for cancer, I surrounded myself with Mozart—with the piano sonatas and with trios and quartets—nothing involving more than five instruments played regally. I wrote a poem on one reality I have learned in this life: You cannot get enough Mozart. He was a talented guy.

Taking Megabus back home to State College, I search intensely for the reporter’s notebook in which I have written EVERYTHING. The message arrives on my iPhone. The notebook is safe. It was left behind in New York. [Freud is clear on this subject.] The notebook will be in tomorrow’s mail.

++++

The relief that won’t be in tomorrow’s mail
.

The relief that won’t be in tomorrow’s mail is the banishment of fear.

I can define the fear with olfactory precision—the way one knows the smell of a pine but cannot use language to describe. The fear is an odor of decay—a mold-like substance that infects the battery of my power operated vehicle so I cannot move and have neither the cash nor the energy to call T & B Medical on Atherton Street for repair or replacement.

The fear originates from:

  • Unwashed dishes in the sink
  • Dirty floors
  • Soiled clothes
  • An empty refrigerator
  • The refusal/inability to do anything else but rerun the same movie over and over on Netflix

I am afraid of losing my independence, of losing the ability to take care of myself, of being unable to think or write or contribute.

I am, at 65, afraid of being confined in a nursing home, having pills doled out on a regular schedule.

Compared to fear of this sort, Big Things do not matter. Either the cancer will kill me—which I do not believe—or it won’t. Death is a minor fear compared to sickness, infirmity and ennui.

++++

I am glad that soon the Megabus will return me to my apartment and to the work I honor.

—-Joel Solkoff

Copyright © 2013 by Joel Solkoff. All rights reserved.

This posting is the third part of the ongoing story of my third cancer–kidney cancer, a story that follows this expanding outline:

1. https://joelsolkoff.com/who-i-used-to-be/

2. https://joelsolkoff.com/my-personal-experience-with-cancer-cancer-iii-ii-i/

3. https://joelsolkoff.com/my-fear-of-the-future/ [You are here.]

4. https://joelsolkoff.com/my-man-mozart/

My personal experience with cancer—Cancer III, II, I

New York, New York, Saturday, April 13, 2013: My third cancer is new. It did not present itself as a suspicious sign the way the lump (tumor) did under my right arm leading to a diagnosis of Hodgkin’s disease followed by major surgery and two rounds of radiation treatment when I was 28 years old. I am now 65.

My first cancer

The radiation did not prevent me from fathering a daughter Joanna (who graduates from nursing school next month and marries in October).

My second cancer

Then, 13 years later, an unpleasant surprise. A lump (tumor) appeared in my groin. My orthodox Jewish oncologist said, “It is a sheylah [a Talmudic term meaning a question which does not have an answer] whether this is a new case of Hodgkin’s disease or the return of the old one.”

Out of hubris, I had published an article in The New York Times under the title Learning to Live Again boasting of my cure, a boast to be repeated on ABC’s Good Morning America after an impressive limousine ride to the studio followed by a book with the same title (available on this site https://joelsolkoff.com/book-store/books/learning-to-live-again-my-triumph-over-cancer/) with the subtitle, My Triumph Over Cancer.

Now, with the arrival of my third cancer, Joanna expresses a familiar refrain over the phone from North Carolina, “Everyone knows nothing can kill you, Dad.” Then, she says, “Learning to live again and again and again.”

Amelia (whom I fathered after my cancer at age 42), who is teaching English in rural Spain, continues the theme calling on Skype (revealing her hair is growing long): “And again and again.”

As directed, finding an expert on Cancer III

So, here I am in New York City, a week and a day after I was diagnosed with renal cancer. My urologist had opened her laptop with the CAT-scan showing a very large tumor surrounding my right kidney.

The vividness of the image is startling—large tumor, large large tumor.

Will it kill me?

Can I avoid death?

The answer appears with an insistence:

I am told that I must find a surgeon better than any surgeon in town [i.e. State College]—the kind of skilled surgeon available at Pittsburgh or Philadelphia, only Pennsylvania has a limited number of surgeons of that caliber and finding one able to operate in April is unlikely.

I must go out of state—have an operation in 30 days or else the cancer from the large tumor wilI spread and kill me.

Run don’t walk to the best surgeon who can operate.

That’s the advice I follow.

Diagnosis on Friday at 4 pm.

I am on the phone on Monday to Memorial Sloan Kettering Cancer Center.

Yesterday (yesterday) I consulted at my urologist’s suggestion (yesterday) with Paul Russo a surgeon specializing in kidneys and cancer at Memorial Sloan Kettering Cancer Center (MSKCC). As he puts it, “I am a kidney surgeon warlord.”

A digression on traveling to NY by bus

It is worth pointing out—before getting to what the Kidney Warlord said—that getting from State College, PA to New York City is not easy for me. I cannot walk. The cumulative radiation from Cancers I and II burned a hole in my spine making me a paraplegic.

I can stand but I have to hold onto something. I get around on a scooter—a power operated vehicle (POV) scooter invented by Al Thieme (CEO of Amigo Mobility) to help his wife who had multiple sclerosis.

The scooter I used for the trip is a lightweight travel scooter which means that it folds apart easily, has remarkable power—climbing easily Manhattan’s hills and steep (sometimes very steep with deep cracks in the payment) curb cuts– is relatively light weight and is narrow (the place at which I slept last night had narrow hallways).

My friend PH came by my State College apartment shortly before 9 AM Thursday to take me to the bus. Megabus runs a double-decker (reminiscent of the buses I used to ride as a child down Fifth Avenue).  One problem with being disabled and riding Megabus is that to secure officially sanctioned accommodations one has to call the special disability number which in my experience takes as long as an hour for a simple bus ride plus the information does not reach the bus driver and on and on.

This time I decided to follow the rules that if I am willing to store my wheelchair (or other vehicle) in the luggage compartment of the bus, then I do not have to call the Disability Office.

I brief PH on what to tell the driver (who fortunately does not freak out as others have done). He removes the lift from the closet next to the bathroom, hooks it on the bus floor (so it does not slip when a scooter or wheelchair goes up or down).

I drive up the lift, move from scooter to chair, and PH, who knows how to take the scooter apart does so after leaving me on the bus chair and going down the lift to the luggage area. PH explains how Frank will have to put the scooter together when we arrive in New York.

This detail should make it clear (repetition is bad writing but good pedagogy) that traveling is not easy for me. The desire to save my life (as I saw it) overcame obstacles including the reality that I could not walk to the bus’ bathroom and had to tax my bladder to the limit. Enough said.

Background on Kidney Warlord consultation

So, there we are at Memorial Sloan Kettering Cancer Center (MSKCC) having arrived through a cold rain early for a 10 AM appointment. Since its founding in 1884 as a New York hospital devoted to treating cancer patients, MSKCC has established itself as a world-famous research and treatment center benefiting from the funding cycle created by President Richard Nixon and Congress. Nixon (of whom I cannot resist making disparaging remarks)–in what the White House press office described as “a Christmas gift to the nation”– began the War on Cancer by signing the National Cancer Act in December of 1971.  [Expect a return to this subject.]

I keep mentioning Sloan Kettering (as if it were a mantra) because it is regarded as one of the most distinguished cancer centers in the world (which also means it has its critics [and I have the opportunity to repeat myself again]). The surgeon I was scheduled to see is a hot-shot by any standards and (sadly) I have experience with cancer hot shots (remind me to tell you about the time
).

Paul Russo is on the staff of Cornell’s College of Medicine as well as Sloan Kettering and is widely published—see PubMed [an online index of biomedical articles maintained by the U.S. National Library of Medicine and the National Institutes of Health] for a full listing of his journal articles. One article is entitled, “The Role of Surgery in the Management of Early-Stage Renal Cancer.”

The first sentence reads: “There were an estimated 58,240 new cases and 13,040 deaths from kidney cancer in the United States in 2010.”

Here is how Dr. Russo describes his work: “I am a urologic oncological surgeon known for my academic work in kidney tumor surgery. My expertise includes partial nephrectomy, removing only the tumor using small ‘miniflank’ incisions while preserving maximal kidney function, and cytoreductive radical nephrectomy for patients with advanced kidney cancers. I also lead a kidney tumor surgical research team at Memorial Sloan-Kettering that has created nomograms predicting survival and renal functional outcomes.”

If you want to see a YouTube on cancer surgery for kidneys, go to Dr. Russo’s link: http://www.mskcc.org/cancer-care/doctor/paul-russo

The Consultation

Dr. Russo’s office suggested that I invite someone to the appointment which is an excellent idea because there were moments when I did not really hear what the doctor said. My friend Kathy graciously agreed to attend and Dr. Russo spent a surprising amount of time talking to her, which made sense because I was annoyed by how the appointment began.

“Are you irritated at me?” he eventually asked. “Yes,” I answered.

This is what I want: I want you to operate on me immediately, confirm that losing a kidney does not matter, that recovery from the operation (as I have been led to believe) is minor, and a swift operation will cure me of renal cancer by eliminating the tumor before the cancer has a chance to spread.

Dr. Russo said that I may not be suitable candidate for surgery—especially since the surgery he would perform is MAJOR surgery. I may not be suitable because I had a heart attack and have a pacemaker and am a diabetic.

Dr. Russo said that there is increased evidence that individuals such as myself who have multiple health problems do not follow the preconceived view that one kidney is enough. Losing a kidney might cause me significant problems.

Dr. Russo said that he orders his patients to walk a mile on the first day of surgery and two miles on the second. Since I am a paraplegic, I cannot walk at all. Not being able to walk could lead to significant complications.

Dr. Russo said that there is no rush. The tumor surrounding my right kidney is very large and could have been growing for 20 years. It is a good sign that the tumor was found by chance rather than as a consequence of symptoms. Perhaps, the tumor will continue to grow slowly and without causing cancerous damage. The thing to do is proceed slowly, and cautiously.

On Monday morning [remember, today is Saturday], Dr. Russo scheduled me for cardiac tests. In a month I return to New York to see him.

My reaction

I have been staring off in the distance looking at nothing thinking no thoughts. This was true a week ago when I was diagnosed with renal cancer and urged to rush to cut it out and it is true today after being told to proceed slowly and perhaps not have the operation at all.

The advice to rush and cut out the cancer immediately was comforting in its way. Once again I would be doing something to save my life. Doing something is better, in my book, than doing nothing—than waiting and seeing.

As it turns out, I believe Dr. Russo. He has performed more kidney operations than are performed by most countries. He is rewarded by the hospital when he performs an operation—discouraging operations is not good for business or reputation (at least, in the conventional sense).

Dr. Russo has convinced me to rewrite my figurative book and acknowledge that doing nothing may be better than doing something. As I type this, I have difficulty believing what I am writing in large part because I really do not see myself as a 65 year-old man with health problems. I see myself on many days as 16 and on most good days as capable of doing anything. Anything.

I am not 28 anymore as when I was treated for Cancer I. The decisions I make for the future ought to be made carefully because a well-lived life (the kind of life I want to live) causes joy and adds to the productivity of the gross domestic product. [This ongoing story will continue.]

–30–

Copyright © 2013 by Joel Solkoff. All rights reserved.

This posting is the second part of the ongoing story of my third cancer–kidney cancer, a story that follows this expanding outline:

1. https://joelsolkoff.com/who-i-used-to-be/

2. https://joelsolkoff.com/my-personal-experience-with-cancer-cancer-iii-ii-i/  [You are here.]

3. https://joelsolkoff.com/my-fear-of-the-future/

4. https://joelsolkoff.com/my-man-mozart/

 

Who I used to be

The provinces of his body revolted,/ The squares of his mind were empty, / Silence invaded the suburbs, / The current of his feeling failed: he became his admirers. -W.H. Auden

April, 2013

“Who did you used to be?”  a technician asked me while drawing my blood at the Mount Nittany Medical Center, State College, PA.

Before calling 911, I had been practicing before my home mirror trying not to be the usual pain in the ass I repeatedly became whenever I was admitted to a hospital. I had resolved to be gracious no matter what and yet my answer to the technician’s question was swift and angry’ “I am not dead yet.” As it turns out yet is the operative word.

Since Wednesday, I have been looking out the window of my hospital room at the 100,000 seat Beaver Stadium where Penn State plays football at home–musing cosmic thoughts between tests.

Beaver stadium from the air

By Friday afternoon (yesterday), I had racked up one echocardiogram, two CT scans, a chemical stress test, swallowed a camera while under sedation, and drank a lot of barium. Whatever I was expecting, it was not the arrival of Jeniffer Simon, M.D., urologist at 4. PM with the news that I have renal cancer and unless I take timely action, I will be dead in 10 years.

So, how should I begin?

What do you need to know before you know what I am thinking now, what I am preparing to do next and what frightens me the most?–

The organic route to telling this story follows the following malleable outline:

I. My personal experience with cancer

II. My fear of the future

III. Checking into the hospital for symptoms unrelated to renal cancer

IV. Not all I must learn. but enough for starters

V. Optimism

VI. Pessimism

VII. “Thou shall teach it diligently to your children.”

VIII. Orson Welles, an adult and new-to-me definition of “rosebud” (by way of PBS) and the thin tangential relationship to the subject at hand

(More to come with photos.)

— Joel Solkoff who dislikes being asked what I used to be since the question implies I am dead when I am a heartwarming  story in the making

Copyright 2013 by Joel Solkoff, all rights reserved.