Monday, August 12, 2013

Seriously?


I’ve had the great good fortune to be attended by world-class doctors. My attending physician and the fellows during my stay at the VA Hospital in Salt Lake City were affiliated with the Huntsman Cancer Institute and I’m finding out the doctors here in Seattle are similarly affiliated with another very well respected cancer hospital, the Fred Hutchinson Cancer Research Center, or “the Hutch,” as I hear people call it. It turns out that the stem cell transplant procedure was pioneered there and my attending physician is a veritable rock star in the hem/onc world, often away on speaking tours. To say I’m humbled to have this caliber of people in my court would obviously be an understatement!
In larger-than-life people like this, you might expect to come across a doctor with the stereotypical “god complex,” but I honestly haven’t seen that. I only had one encounter with one who was a bit on the insensitive side, but we sorted out our differences and as far as I could tell, all was well with the world afterward. What I haven’t quite gotten used to, though, is the matter of fact way some pretty ugly facts can be communicated. Some involving the side effects of the treatment are really hard to process, others leave me shaking my head thinking, “Seriously?” Yeah, I know they all mean well and it’s all in a day’s work, but feelings sometimes get ignored when the greater issue is saving the life. In the grand scheme of things, that makes sense, but the flip side of that coin is that feelings really have to be taken into consideration, precisely when you’re talking about saving a life…it’s the life which is at stake.
That may sound obvious, but the heavy conversations with doctors can make me feel like I'm missing the forest for the trees, so to speak. It’s so easy to focus on a detail and zone out while the rest of the paragraph the doctor is speaking just flies over my head. That’s the best reason I can think of to have at least one other person with you as you are working through one of those difficult conversations. It made a world of difference when I got my diagnosis as I just wasn’t able to process the whole picture, let alone formulate questions.  
It has been interesting and challenging as doctors have attempted to communicate next steps and side effects to me. The more sensitive issues I’ve tried to bandy about with some humor to make the message a little less difficult or awkward, sometimes to the dismay of the one trying to impart said message, but…I am, without a doubt, the eternal class clown underneath my staid exterior. Recently, a friend of mine welcomed me home from the hospital after a round of chemo and told me in the same breath that he was now a member of the cancer survivor club. He can be a cut-up like me, but his doctors were far less amused by his repartée than my doctors have been with mine…he just needs more practice, clearly. While my doctors learn quickly that while I do pay close attention to everything they say, I will be quick with a pun, a double entendre, or a word play to keep things a little less dour. After all, you gotta keep it just a little on the light side when you’re talking about dark topics. Even checking in, I'm quoting Monty Python lines … I'm getting better. I think I'll go for a walk. I feel happy!
And then there are topics that you just have to learn to take in stride because it’s all part of the game that is cancer, like all the really interesting changes that happen to your body. One of my first hem/onc doctors very sweetly put her hand on my shoulder and said, “You know, you will lose your hair.” True to form, I retorted, “I know, I saw the movie.” About three months later as I saw my hair returning, I saw her in the hallway and told her with great delight about this discovery. She got me back from the first time. “Well, you know,” she said, “you’ll lose it again.”
Touché, madame doctor! Well played.
During a conversation with one of the docs last week, he casually said to me, “You know, it’s a good thing that when you get to be your age; body image is far less an issue than with younger guys.”
Seriously?
My age? Doesn’t he realize I’m the youngest guy in the ward? I know, I know, that means diddly! I’m 50 freakin’ years old. That is my age. Now, this doc probably isn’t too much older than I am, but surely, he must have had some of the emotional struggles as the gray starts encroaching in on previously uncharted territory and the skin is a little less taught, not to mention all the other lovely physical changes that are part and parcel to aging. But let’s not forget that recently recovered hairline is about to recede all the way off again and we can probably add a little puffiness from the steroids to stave off the GVH...oh and damn, thanks to the chemo weakening so many things all over my aging bod, I broke yet another nail! Sorry, doc…body image is a big deal.  I can only imagine how women going through this feel. When I lost my hair during the first round of chemo, some nice people said I looked rather academic and my brother even shaved his head as a gesture of solidarity, but… *sigh* there’s no getting around the body image issue. It’s just as hard for us middle-aged folk as it is for the young guys.

And making this even more fun, I got a call from the MTU pharmacy at the VA Hospital here in Seattle this afternoon as I was on my way out, asking me what color the lumens of my PICC line were. That was an entertaining discussion of course, but it was outdone by the next call from one of the nurses at the MTU at the VA Hospital asking the same question. Then, of course, I got the fun news that I would be admitted tomorrow night for pre-meds instead of Wednesday morning. Oh, let the fun begin a bit early, shall we?

Seriously, I go to bed tonight with a lot of trepidation. I know it's gonna suck and there's no turning back. I can kid around and make a lot of jokes about it, but in the end, it's a scary proposition. I've received a lot of rather long, well thought-out and heartfelt e-mails and well wishes in the past 48 hours which tells me that there are a lot of people sending their prayers, best thoughts, and love my way. Over the next few weeks, I'll need all the available "close air support" you can muster.

Be well, stay very strong for me, and mucho màs love to you all.

Music for the day from Incubus - Drive


Sometimes, I feel the fear of uncertainty stinging clear
And I can't help but ask myself how much I let the fear
Take the wheel and steer
It's driven me before
And it seems to have a vague, haunting mass appeal
But lately I'm beginning to find that I
Should be the one behind the wheel

Whatever tomorrow brings, I'll be there
With open arms and open eyes yeah

Whatever tomorrow brings, I'll be there
I'll be there

So if I decide to waiver my chance to be one of the hive
Will I choose water over wine and hold my own and drive?
It's driven me before
And it seems to be the way that everyone else gets around
But lately I'm beginning to find that
When I drive myself my light is found

Whatever tomorrow brings, I'll be there
With open arms and open eyes yeah

Whatever tomorrow brings, I'll be there
I'll be there

Would you choose water over wine
Hold the wheel and drive

Whatever tomorrow brings, I'll be there
With open arms and open eyes yeah

Whatever tomorrow brings, I'll be there
I'll be there